Medicine /USMLE - GI Flashcards Part 8
Celiac Sprue Histology Ab findings? Screening Associated with Increased risk for
Blunting of villi. Crypt hyperplasia. Lymphocytes in LP Anti-endomysial, anti-tissue transglutaminase, and anti-gliadin Abs Serum levels of tissue transglutaminase Abs used for screening Associated with dermatitis herpetiformis Moderately increased risk for malignancy (T cell lymphoma)
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Key Terms
Term
Definition
Celiac Sprue Histology Ab findings? Screening Associated with Increased risk for
Blunting of villi. Crypt hyperplasia. Lymphocytes in LP Anti-endomysial, anti-tissue transglutaminase, and anti-gliadin Abs Serum levels of tissue tra...
Acute Gastritis MoA What can cause it? Especially common among
Disruption of mucosal barrier --> inflammation "U want a SNAC?" Caused by stress, NSAIDs (↓ PGE --> ↓ gasric mucosa protection), Alcohol, Uremia, Burn...
Curling's Ulcer
↓ plasma volume --> sloughing of gastric mucosa
Cushing's ulcer
↑ vagal stimulation --> ↑ ACh --> ↑ H production
Acute vs Chronic Gastritis
Erosive vs Non-Erosive
Type A Chronic Gastritis What part of stomach? Pathology Produces what? Associated with what?
Fundus and Body AutoAbs to parietal cells Produces pernicious Anemia and Achlorhydria Associated with other immune disorders
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Term | Definition |
---|---|
Celiac Sprue Histology Ab findings? Screening Associated with Increased risk for | Blunting of villi. Crypt hyperplasia. Lymphocytes in LP Anti-endomysial, anti-tissue transglutaminase, and anti-gliadin Abs Serum levels of tissue transglutaminase Abs used for screening Associated with dermatitis herpetiformis Moderately increased risk for malignancy (T cell lymphoma) |
Acute Gastritis MoA What can cause it? Especially common among | Disruption of mucosal barrier --> inflammation "U want a SNAC?" Caused by stress, NSAIDs (↓ PGE --> ↓ gasric mucosa protection), Alcohol, Uremia, Burns (Curling's ulcer), Brain Injury (Cushing's ulcer) Especially common among alcoholics and NSAID users (RA pts) |
Curling's Ulcer | ↓ plasma volume --> sloughing of gastric mucosa |
Cushing's ulcer | ↑ vagal stimulation --> ↑ ACh --> ↑ H production |
Acute vs Chronic Gastritis | Erosive vs Non-Erosive |
Type A Chronic Gastritis What part of stomach? Pathology Produces what? Associated with what? | Fundus and Body AutoAbs to parietal cells Produces pernicious Anemia and Achlorhydria Associated with other immune disorders |
Type B Chronic Gastritis What part of stomach? Frequency Pathology Increased risk of what? | Antrum Most common type of chronic gastritis Caused by H pylori infection Increased risk of MALT lymphoma |
Type A vs B Chronic Gastritis | "ABA, BAB" A is in Body and from Autoimmunity B is in Antrum and from Bacteria |
Menetrier's Disease What is it? Cancerous? Description | Gastric hypertrophy with protein loss, Parietal cell atrophy, ↑ mucous cells Precancerous Rugae of stomach are so hypertrophied that they look like brain gyri |
Stomach Cancer What kind of cancer? Does it spread? Often presents with | Almost always adenocarcinoma Early aggressive local spread and node/liver metastases Often presents with acanthosis nigricans |
Stomach Cancer: Diffuse Associated with? Histology Gross | Not associated with H pylori Signet ring cells Stomach wall grossly thickened and leathery (linitis plastica) |
Virchow's Node | Involvement of Left Supraclavicular Node by metastasis from stomach |
Krukenberg's Tumor Presents with Histology | Bilateral metastases from stomach to ovaries Presents with abundant mucus Signet ring cells |
Sister Mary Joseph's Nodule | Subcutaneous periumbilical metastasis |
Intestinal Stomach Cancer What causes it Associated with Common location Looks like | Caused by H pylori infection, dietary nitrosamines (smoked foods), achlorhydria, chronic gastritis, Associated with Type A blood Commonly on lesser curvature Looks like ulcer with raised margins |
Peptic Ulcer Disease | Gastric Ulcers | Duodenal Ulcers |
Gastric Ulcer Pain Weight H pylori Causes Risk Often occurs in what kind of pt? | Pain increases with meals Weight loss H pylori in 70% ↓ mucosal protection against gastric acid; NSAID use Risk of Carcinoma Often occurs in older patients |
Duodenal Ulcer Pain Weight H pylori Causes Risk Histological changes | Pain decreases with meals Weight gain H pylori in 100% ↓ mucosal protection or ↑ gastric acid secretion Generally benign Hypertrophy of Brunner's glands |
Ulcer Complications | Hemorrhage or Perforation |
Location of Hemorrhage from Ulcer | Gastric or Duodenal Ulcers | Posterior > Anterior |
Location of Perforation from Ulcer | Duodenal | Anterior > Posterior |
Ruptured gastric ulcer on the lesser curvature --> bleeding from | Left Gastric Artery |
Ulcer on posterior wall of the duodenum --> bleeding from | Gastroduodenal Artery |
Inflammatory Bowel Disease | Crohn's Disease or Ulcerative Colitis |
Crohn's Disease Etiology Distribution Location Gross XR | Disordered response to intestinal bacteria (Th1 mediated) Any portion of the GI tract; usually terminal ileum and colon; rectal sparing Skip Lesions Transmural inflammation; Cobblestone mucosa, creeping Fat, linear ulcers, fissures, fistulas Bowel wall thickening --> "string sign" on barrium swallow x ray |