Acute and Chronic Gastritis Quiz

Questions and Answers

What characterizes acute gastritis in terms of histological findings?

Absence of any inflammatory cells

Presence of histiocytes

Presence of neutrophils (correct)

Presence of eosinophils

Which of the following is a common irritant causing acute gastritis?

Beta-blockers

Insulin

Antibiotics

Alcohol (correct)

What is the primary difference between an erosion and an ulcer of the stomach?

Erosions are deeper than ulcers

Erosions are caused exclusively by infection

Ulcers penetrate through all layers of the stomach wall (correct)

Ulcers do not lead to bleeding, whereas erosions do

Which drug is known to inhibit prostaglandin synthesis and can lead to acute gastritis?

Aspirin Signup and view all the answers

What common factor contributes to the development of stress-related acute gastritis?

Impairment of defense mechanisms Signup and view all the answers

Which of the following is not a recognized cause of acute gastritis?

Viral infections Signup and view all the answers

How does Helicobacter pylori contribute to the development of gastritis?

By promoting urease formation Signup and view all the answers

What type of ulcer is associated with central nervous system disorders and is a complication of stress?

Cushing ulcers Signup and view all the answers

What is a characteristic feature of Helicobacter pylori in infected patients?

It is concentrated with superficial mucus on epithelial cells. Signup and view all the answers

Which type of inflammation is commonly associated with H.Pylori gastritis?

Neutrophilic inflammation with plasma cells Signup and view all the answers

What can chronic H.Pylori gastritis potentially transform into?

Mucosa-associated lymphoid tissue lymphoma Signup and view all the answers

Which type of ulcers are referred to as Curling ulcers?

Ulcers resulting from severe burns or trauma Signup and view all the answers

What pathological condition is stress-related gastric mucosal injury primarily linked to?

Local ischemia Signup and view all the answers

Which of the following features identifies the mucosa in H.Pylori infection?

Coarse or nodular mucosa Signup and view all the answers

What histological feature significantly indicates a chronic H.Pylori infection?

Lymphoid aggregates with germinal centers Signup and view all the answers

What is the common staining method used to visualize H.Pylori in gastric biopsies?

Methylene blue stain Signup and view all the answers

What defines a gastric ulcer compared to an erosion?

An ulcer involves loss of all epithelial cell layers. Signup and view all the answers

Which of the following statements is true regarding gastric erosions?

Erosions can occur in areas of preexisting epithelial hyperplasia. Signup and view all the answers

What is a common feature of gastric ulcers?

They form solitary, sharply punched out defects. Signup and view all the answers

Which characteristic is associated with the depth of gastric ulcers?

Deep extension may be influenced by surrounding tissues. Signup and view all the answers

What is often found at the base of a gastric ulcer?

A thin layer of fibrinoid debris. Signup and view all the answers

What typically describes the mucosal margin of a gastric ulcer?

It may overhang the base on the proximal side. Signup and view all the answers

Which condition can lead to the formation of gastric erosions?

Preexisting epithelial hyperplasia. Signup and view all the answers

Which of the following statements is false regarding the peritoneum in peptic ulcers?

It is often irritated. Signup and view all the answers

What is a characteristic feature of stress-related ulcers compared to peptic ulcers?

They are less than 1 cm in diameter and can be multiple. Signup and view all the answers

What is the role of endothelin-1 in stress-related gastric mucosal injury?

It contributes to ischemic damage by causing vasoconstriction. Signup and view all the answers

Which of the following best describes 'watermelon stomach'?

It is characterized by longitudinal stripes of edematous erythematous mucosa. Signup and view all the answers

What is a common cause of Dieulafoy lesion?

Non-steroidal anti-inflammatory drugs (NSAIDs). Signup and view all the answers

Which physiological change contributes to mucosal cell injury in stress-related conditions?

Decrease in blood flow to the mucosa. Signup and view all the answers

What histological feature is characteristic of stress-related gastric mucosal injuries?

Sharply demarcated ulcers with normal adjacent mucosa. Signup and view all the answers

What can lead to the requirement of blood transfusion in critically ill patients with gastric mucosal damage?

Severe perforation of the stomach. Signup and view all the answers

What is the primary mechanism by which systemic acidosis contributes to gastric mucosal injury?

It lowers the intracellular pH of mucosal cells. Signup and view all the answers

What characterizes gastritis cystica?

Entrapment of epithelial lined cysts Signup and view all the answers

Which condition is associated with excessive growth factor release leading to epithelial hypertrophy?

Menetrier’s disease Signup and view all the answers

What is a common systemic effect of transforming growth factor in Menetrier’s disease?

Weight loss and peripheral edema Signup and view all the answers

What histological feature is most significant in the diagnosis of Menetrier’s disease?

Hyperplasia of foveolar mucus cells Signup and view all the answers

What is the primary reason gastritis cystica may be mistaken for adenocarcinoma?

Regenerative changes in entrapped epithelium Signup and view all the answers

Which condition is characterized by the potential risk of developing gastric adenomas, especially in adults?

Menetrier’s disease Signup and view all the answers

What is the defining morphology of hypertrophic gastritis?

Marked hypertrophy without inflammation Signup and view all the answers

In which layer of the gastric wall may cystic formations occur in gastritis cystica profounda?

Deeper layers of gastric wall Signup and view all the answers

Study Notes

Acute Gastritis

Inflammation of gastric mucosa characterized by the presence of neutrophils indicates acute gastritis; absence suggests gastropathy.
Common causes include NSAIDs, alcohol, and bile, all leading to gastric pain, nausea, and potential complications like hematemesis, hemorrhage, and melena.
Risk factors include:
- Diet: Alcohol increases aggressive forces, smoking impairs defense mechanisms, hot spicy foods impair defenses.
- Infections: Helicobacter pylori impairs bicarbonate secretion.
- Drugs: NSAIDs inhibit prostaglandin synthesis via COX-1.
- Chemical injury: Ingestion of strong acids/bases increases aggressive forces.
- Stress: Conditions causing shock, ischemia, or trauma can lead to stress ulcers.

Erosion vs. Ulcer

Erosion: Loss of superficial epithelial layers; generally occurs in areas of preexisting epithelial hyperplasia.
Ulcer: Loss of all epithelial cell layers extending to the submucosa; typically presents as solitary and sharply punched-out defects.
Inflammation common around erosions; ulcers may be lined with fibrinoid debris and exhibit inflammatory infiltrate.

Helicobacter Pylori Gastritis

H. pylori infection is characterized by dense colonization in gastric mucosa, particularly the antrum, and corrosive or nodular mucosa.
Inflammatory infiltrate includes plasma cells, lymphocytes, and neutrophils; increased risk of both gastric carcinoma and lymphoma due to MALT transformation.

Common in critically ill patients post-trauma, severe burns, and major surgeries.
Characterized by local ischemia caused by splanchnic vasoconstriction leading to gastric mucosal injury.
Ulcers in this context are multiple, sharp, and less than 1 cm in diameter, found throughout the stomach; healing occurs within days after treatment.

Clinical Features

Histological evidence of gastric mucosal damage in critically ill patients; risk of perforation present.
Dieulafoy lesion: abnormal submucosal arteriol, erosion leads to severe bleeding; typically associated with NSAIDs.
Gastric antral vascular ectasia: characterized by longitudinal stripes of erythematous mucosa, also known as "watermelon stomach."

Gastritis Cystica

An exuberant reactive epithelial proliferation often mistaken for adenocarcinoma.
Cysts can be found within submucosa (gastric cystic polyposis) or deeper layers (gastritis cystica profunda) and are associated with chronic gastritis.

Hypertrophic Gastritis

Characterized by substantial enlargement of gastric rugal folds due to epithelial hypertrophy without inflammation.
Examples include Ménétrier’s disease and Zollinger-Ellison syndrome.

Ménétrier’s Disease

Associated with excessive secretion of transforming growth factor (TGF) and hyperactivation of the epidermal growth factor receptor on gastric epithelial cells.
Symptoms include diffuse hypertrophy of foveolar epithelium and hypoproteinemia due to albumin loss.
Systemic effects observed include hyperplasia of various organs and increased risk of gastric adenoma.

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Description

This quiz covers acute and chronic gastritis, focusing on their aetiology, morphology, and differentiation between erosion and ulcer of the stomach. Additionally, the quiz delves into autoimmune and chemical gastritis, including the pathogenesis related to Helicobacter pylori. It's designed for BOT Batch 1 Semester 2.