Path Blco 3 (GIa)

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Path Blco 3 (GIa)
2010-11-03 23:10:14
PaPath Blco GIa

Path Blco 3 (GIa)
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  1. What parts of the Stomach secretes:
    Has Mucus Cells?
    • - Fundus
    • - Fundus
    • -Antrum
    • -Antrum and Cardia
  2. What is the differenct in the Histplpgy of the stumach?
    The is an Extra 3rd Layer of Smooth Muscle

    • Mucosa
    • Submucosa
    • Muscularis
    • Serosa
  3. What is Pyloric stenosis?
    What is the Major Symptom?
    Sex & age?
    Pyloric Sphincter is not open enough. Smooth muscle is hypertrophied

    • - Projectile vomiting in the first months (2-8 weeks) of life.
    • - White Males
    • - Yes, this may be inherited
  4. What is Pancreatic Heteropia?
    What does it present as?
    • It is a congenital Defect.
    • Presents as a mass in the stomach area
    • Located commonly in the Submucosa of the Antral or pylorus
  5. What is this???
    Pancreatic Heterotopia in the Stomach. A congenital Defect.
  6. What is Acute Gastritus?
    Is it associated with Infection?
    What are the Thee types?
    It is acute inflammation in the stomach

    Rarely associated with infection

    • 1. Acute Hemorrhagic (erosive) Gastritis
    • 2. Stress Ulcers (Ulceration)-- (Burns, Shock)
    • 3. Reactive Gastropathy--- repair process due to repeated acute episodes
  7. What are some causes of Acute Hemorrhagic Erosive Gastritis.
    • NSAIDS
    • Heavy alcohol
    • Heavy Smoking
    • Stress
  8. This is Acute Gastritis

    • a) see alot of PMNs
    • b) See Punctate erosions
  9. What is Chronic Gastritis?
    What are the 2 Causes?
    Presence of Chronic Imflammation with atrophy and metaplasia.

    1. Chronic Gastritis (90%)--- usually due to H. pylori.

    2. Autoimmune atrophic gastritis (10%)---- may be premalignant
  10. What disease are associated with H. Pylori?
    • Chronic Gastritus
    • Peptic Ulcer disease
    • Gastric Carcinoma
    • Gastric MALT lymphoma
  11. What is this?
    • H. Pylori infection
  12. Chronic Gastritis

    • See replacement of Epithelium by intestinal Metaplasia.
    • See LYMPHOCYTES and Plasma cells
  13. What chages will you see associated with H. Pylori?


    Acute: See PMN's which is the hallmark of a continued infection.

    Chronic: See difuse lymphocytes and PLASMA cells. Lymphoid follicals = Severe ongoing infection
  14. Pathologic Changes Associated with H. Pylori Chronic Gastritis.
    • Metaplasia
    • Mucosal Atrophy
    • Peptic Ulcer Disease
    • Dysplasia--> adenocarcinoma sequence
  15. What is Peptic Ulcer disease?
    What is an ulcer
    Where is the Erosion
    Chronic, Solitary Lesions. Occur in ANY part of the GIT.

    • -Ulcers through the Muscularis Mucosae
    • -Erosion only on the mucosae
    • -Duodenal more common than gastric
    • - Males
    • - Most due to H. Pylori
  16. IN a peptic ulcer, you will see layers of ?
    Necrosis, Inflammation, granulation, and a scare.
  17. What is this?
    • Peptic Ulcer
    • sharply " Punched out " appearance.
    • margins are NOT elevated
  18. What is going on in Autoimmune Gastritis?

    -Associated with?
    - what might you see?
    -When it is sever it is associated with?
    - what test do we used to esses the B12 deficiency?
    Hypochlorhyria (less acid)--> atrophic change , may have G-Cell hyperplasia and hypergastrinemia.

    -increased risk of Gastric Cancer and carcinoid tumors. See in association with other autoimmune diseases

    • - see various autoantibodies (parietal cell, ATPase, Intrinsic Factor, gastrin receptor)
    • - Pernicious Anemia
    • - Schilling test
  19. What tests do you run for Autoimmue gastritis?
    • antibodies
    • look ofr other autoimmunities
    • Atrophic Glossitis
  20. What is two diseases are Hypertrophic Gastropathies?

    What can they mimic?
    What do they have?
    Menetrier disease and Zollinger-Ellison

    • minic Carcinoma or lymphoma
    • can have sever peptic ulcer disease
  21. What do they have?
    Hypertrophic Gastropathy

    Note: The Thickened Gastric Folds
  22. What do you see in Menetriers disease?

    Protein loosing Enteropathy (see skinny people)
  23. What do you see in Zollinger Ellison Syndrome
    • - Gastric Producing tumors
    • -5 times the Numer of Parietal cells
    • -HIGH< HIGH Gastrin levels
  24. What are the two main Benign Gastric Tumors?
    Hyperplastic Polyps

    Adenomatous Polyps
  25. Hyperplastic Polyps
    • Reactive
    • Benign
    • 90 % of Gastric polyps
  26. Adenomatous Polyps
    Have Poloiferative dysplastic Epithelium

    • start in Chronic Gastritis
    • make up 5% of gastric polyps
    • associated with carcinomas