Gastritis
A patient with gastritis is prescribed several psychotropic medications.
Gastritis
- Acute gastritis involves inflammation without mucosal injury (e.g., NSAIDs, alcohol, stress); severe cases can lead to acute haemorrhagic erosive gastropathy . Chronic gastritis is characterized by mucosal inflammation, atrophy, and metapla
- H. pylori Gastritis: This is the most common chronic gastritis, predominantly affects the antrum , is associated with increased acid secretion, and can lead to PUD , MALT lymphoma , and adenocarcinoma .
- Autoimmune Gastritis: This affects the body and fundus , is associated with anti-parietal cell and anti-intrinsic factor antibodies , leading to achlorhydria (decreased acid) and hypergastrinemia . It is a major cause of pernicious anaemia
Read this in GASTROINTESTINAL PATHOLOGY (Part 1) — Notes
What our notes say
- A patient with gastritis is prescribed several psychotropic medications. (Psychiatry Year 4 CAT: June 2023, schizophrenia, dementia, eating disorders and )
- Family / genetic: History of hereditary macrocytosis, pernicious anemia, cobalamin transport defects — Autoimmune gastritis (pernicious anemia) is rare but possible; rare inherited disorders may be relevant. (Megaloblastic anaemia)
- Gastritis\nAcute gastritis: Most commonly results from alcohol, aspirin or (Davidson's Essentials of Medicine - 2nd)
- Anticonvulsants (folate), zidovudine, myelodysplasia and atrophic gastritis (B12) all cause it. (Internal Medicine End of Semester CAT (MBChB 4): haematology and renal, 30 MCQs )
- Differential diagnosis: acute alcoholic hepatitis, alcoholic gastritis, perforated or bleeding peptic ulcer, acute cholecystitis, acute appendicitis, mesenteric ischaemia, bowel obstruction, and inferior myocardial infarction. (Internal Medicine (MBIM 4100) main exam, Paper One: 3 July 2019)
- Causes: blood loss (menstruation, hookworm, peptic ulcer, haemorrhoids), increased need (pregnancy, growth), poor intake (diet), poor absorption (coeliac disease, atrophic gastritis). (Internal Medicine (MBIM 4100) main exam, Paper One: 3 July 2019)
Study material on Gastritis
- GASTRITIS
- Gastritis and Peptic Ulcer Disease
- GASTROINTESTINAL PATHOLOGY (Part 1) — Notes
- Davidson's Essentials of Medicine - 2nd
- 04 gastroenterology mcqs
- Gastrointestinal and liver
- Dyspepsia and peptic ulcer disease
- Gastrointestinal Neoplasms: High-Yield Exam Review — Revision Guide
- Ovarian & Colorectal Cancer: Risks, Pathogenesis, Staging — Notes
- Gastropathology Pathology — Notes
- GASTROINTESTINAL PATHOLOGY (Part 1) — Essay Questions
Practice questions on Gastritis
A 60-year-old man has had abdominal pain and early satiety for 8 months. He has a history of Helicobacter pylori gastritis. Endoscopy shows a gastric mucosal mass. Biopsy shows a low-grade B-cell lymphoma composed of small lymphocytes infiltrating the mucosa. Most likely diagnosis?
- Diffuse large B-cell lymphoma
- Marginal zone lymphoma (MALT lymphoma)
- Mantle cell lymphoma
- Burkitt lymphoma
Answer: B. H. pylori gastritis + low-grade B-cell mucosal lymphoma = gastric MALT lymphoma (marginal zone lymphoma). H. pylori antigen chronically stimulates mucosal B cells leading to clonal proliferation. Early cases may regress with H. pylori eradication.
A patient with chronic atrophic gastritis is at risk of which type of anaemia?
- Iron deficiency anaemia
- Sickle cell anaemia
- Pernicious anaemia
- Thalassaemia
Answer: C. Atrophic gastritis destroys parietal cells that produce intrinsic factor, impairing B12 absorption and causing pernicious anaemia.
A patient with chronic gastritis and peptic ulcer has a urease-positive curved rod. The organism is
- Proteus mirabilis
- Vibrio cholerae
- Helicobacter pylori
- Campylobacter jejuni
- It causes chronic gastritis, peptic ulcers, and is associated with gastric cancer.
Answer: E. H. pylori produces abundant urease enzyme creating an alkaline microenvironment that neutralizes gastric acid, allowing colonization of gastric mucosa. It causes chronic gastritis, peptic ulcers, and is associated with gastric cancer.
A patient with chronic H. pylori gastritis has increased cancer risk. Which factor MOST directly explains this association?
- The bacteria directly transform cells into cancer cells
- The infection causes immediate p53 inactivation
- H. pylori produces carcinogenic toxins that directly mutate DNA
- Persistent cell replication during tissue repair increases mutation risk
Answer: D. ** Chronic inflammation from H. pylori causes compensatory proliferation during tissue repair. This persistent cell replication, aided by growth factors and cytokines from immune cells, places cells at risk of acquiring mutations in genes involved in carcinogenesis. Reduced apoptosis further compounds this risk.