12. c) H. pylori-induced gastritis i) antral-type - high H + production - risk of peptic ulcer ii) pangastritis - multifocal gastric atrophy - lower H + production - risk of adenocarcinoma d) IL-1 β (inflammatory cytokine) i) inhibits gastric acid ii) IL-1 β pangastritis iii) IL-1 β antral-type www.freelivedoctor.com
13. e) clinical: i) serologic test for Ab ii) fecal bacteria detection iii) urea breath test iv) gastric biopsy (culture) - histology visualization www.freelivedoctor.com
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16. f) dysplasia with long standing gastritis CA in-situ i) atrophic forms of chronic gastritis - H. pylori - pernicious anemia g) clinical: i) few symptoms - only with severe cases ii) peptic ulcer disease - H.pylori (gastric CA and lymphoma) www.freelivedoctor.com
23. iv) severe inflammation - IL-1, IL-6, IL-8,TNF - IL-8 recruits neutrophils v) produces proteases and phospholipases - break down protective actions of mucus vi) HCO 3 - in duodenum v) H + secretion in stomach vi) damage to mucosa and epithelial cells leakage of nutrients (sustain H. pylori) www.freelivedoctor.com
24. c) clinical: (table 17-3) i) epigastric pain, burning - worse at night and - 1-3 hours after meal - relieved with food or antacids ii) iron deficiency anemia iii) penetrating ulcers refer pain to back, left upper quadrant or chest (MI ?) iv) NO progression to CA (duodenal or gastric) www.freelivedoctor.com
29. d) gastric secretions i) excessive mucus ii) hypo- or achlohydria - due to glandular atrophy e) protein loss i) hypoalbuminemia and edema f) risk of gastric CA www.freelivedoctor.com
39. Gross : Linitis plastica carcinoma diffusely infiltrates the entire gastric wall without forming an intraluminal mass. The wall of the stomach is typically thickened to about 2-3 cm. and has a leathery, inelastic consistency. www.freelivedoctor.com
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