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GIHEP > 16. Upper GI > Flashcards

16. Upper GI Flashcards

1
Q

What kind of epithelium is found in the oesophagus?

A

Squamous

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2
Q

What are the layers of the oesophagus?

A

Mucosa
Submucosa
Circular and longitudal muscle
Adventitia

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3
Q

Name a developmental disorder of the oesophagus

A

Atresia

Fistula between trachea and oesophagus

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4
Q

What is the difference between a true and false diverticula?

A

True involves all 4 layers

False only involves the mucosa and submucosa

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5
Q

What are webs and rings?

A

Webs are mucosal folds

Rings are made of mucosa and submucosa, fibrosis over time

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6
Q

What are the 2 types of hiatus hernias?

A

Sliding and paraoesophageal

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7
Q

What are the features of achalasia?

A

No peristalsis

LOS doesn’t relax when swallowing

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8
Q

What are the secondary causes of achalasia?

A

Trypanosoma, polio

Tumour, amyloidosis, sarcoidosis

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9
Q

How can the oesophagus be perforated?

A

Severe vomiting

Instruments

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10
Q

What is a longitudinal tear in the oesophagus known as?

A

Mallory-Weiss

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11
Q

What complication is associated with perforated oesophagus?

A

Mediastinitis

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12
Q

What are the infective causes of oesophagitis?

A

Candida, herpes, CMV

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13
Q

What are the physical causes of oesophagitis?

A

Irradiation
Hot liquids
Reflux

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14
Q

What are the signs of reflux on histology?

A

Basal cell hyperplasia
Eosinophils
Long lamina propia papillae

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15
Q

What is barret’s oesophagus?

A

Metaplasia of the lower oesophagus from squamous to glandular epithelium
Always in lower 1/3

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16
Q

What type of tumour does barret’s increase the risk of?

A

Adenocarcinoma

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17
Q

What benign tumours can be found in the oesophagus?

A

Leiomyomas
Lipoma
Fibroma

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18
Q

How is a tumour diagnosed in the oesophagus?

A

Barium swallow
Endoscopy
Biopsy

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19
Q

What are the causes of reflux?

A

Increased abdominal pressure
Hiatus hernia
Smoking and alcohol

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20
Q

What part of the oesophagus are squamous cell carcinomas found in?

A

Mid 1/3

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21
Q

What are the risk factors for squamous cell carcinoma in the oesophagus?

A

Alcohol, smoking, vitamin deficiencies, high nitrites in diet
Achalasia, long standing oesophagitis, coeliac disease
Plummer-Vinson syndrome

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22
Q

What is Plummer Vinson syndrome?

A

Iron deficiency, webs and glossitis

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23
Q

What are the causes of acute gastritis?

A

Alcohol and smoking
NSAIDs and steroids
Shock
Irradiation

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24
Q

What are important features in the history of a patient with acute gastritis?

A

Haematemesis

Malaena

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25
Q

What cell is found on histology in acute gastritis?

A

Neutrophils

26
Q

What are the features of chronic gastritis on histology?

A

Mucosal atrophy
Epithelial metaplasia
Infiltration by lymphocytes and plasma cells

27
Q

What are the causes of chronic gastritis?

A

H.pylori
Autoimmune
Chemical

28
Q

What parts of the stomach can h.pylori be found?

A

Antrum and corpus of stomach

29
Q

What stain is used to show h.pylori?

30
Q

What is autoimmune chronic gastritis?

A

Autoantibodies produced against parietal cells and intrinsic factor, resulting in pernicious anaemia

31
Q

What other diseases is autoimmune gastritis associated with?

A

Thyroiditis

Addison’s

32
Q

What is the pattern of autoimmune gastritis on histology?

A

Gland destruction and mucosal atrophy of fundic region, less in the antrum

33
Q

What is chemical gastritis?

A

Reflux of duodenal fluid and bile into the stomach

Seen in previous gastric surgery

34
Q

What are the features of chemical gastritis on histology?

A 
Foveolar hyperplasia (overgrowth of mucous cells)
Fibrosis in lamina propia
35
Q

What are the features of a peptic ulcer?

A

Sharp ‘punched out’ lesions
Smooth base
Surrounding inflammation

36
Q

What are the symptoms of stomach ulcers?

A

Epigastric pain,
nausea, bloating
Pain worse at night and 1-3 hours after eating

37
Q

What are the symptoms of duodenal ulcers?

A

May be relieved by eating and alkalis
Pain referred to back, chest, LUQ
Iron deficiency anaemia, haematemesis, malaena

38
Q

How can acute stress ulcers be differentiated from chronic ulcers?

A

Acute ulcers don’t have scarring or thickening of blood vessels

39
Q

What syndrome are hamartomas in the stomach associated with?

A

Peutz-Jeghers syndrome

40
Q

What are the types of malignant stomach cancers?

A 
Carcinoma
MALTomas
Carcinoid
GIST
Leiomyosarcoma
41
Q

What organs does stomach cancer spread to locally?

A

Duodenum
Pancreas
Retroperitoneum

42
Q

Give an example of transcoelomic spread of stomach cancer

A

Krukenberg tumour of ovaries

43
Q

What is Virchow’s node?

A

Supraclavicular node seen in gastric cancer

44
Q

What is a GIST?

A

Tumour of interstitial cells of Cajal

45
Q

What mutation is seen in GISTs?

A

CD117 mutation/ c-kit tyrosine kinase

Can be treated with imatinib

46
Q

What is the most common benign tumour in the mouth?

A

Papillomas caused by HPV 6 and 11

47
Q

What is the most common malignant tumour in the mouth?

48
Q

What disease are apthous ulcers associated with?

A

Crohn’s disease

49
Q

What are the causes of xerostomia?

A

Autoimmune
Drugs
Radiation

50
Q

What are the causes of glossitis?

A

Low B12 and iron

Plummer Vinson syndrome

51
Q

What is erythroplakia a sign of?

A

Oral cancer

52
Q

What name is given to salivary gland inflammation?

A

Sialadenitis

53
Q

What are the causes of inflammation in the parotid gland?

A

Mumps
Staph aureus
Sjogrens

54
Q

What is the most common benign salivary gland tumour?

A

Pleomorphic adenoma

55
Q

What name is given to a pleomorphic adenoma when it becomes malignant?

A

Carcinoma ex pleomorphic adenoma

56
Q

What is the other kind of benign salivary gland tumour?

A

Warthin’s tumour

57
Q

How does warthin’s tumour appear on histology?

A

Double layer of epithelial cells and dense lymphoid stroma

58
Q

What are the types of malignant salivary gland tumours?

A

Mucoepidermoid
Adenoid cystic carcinoma
Acinic cell carcinoma

59
Q

What kind of spread is favoured by adenoid cystic carcinomas?

A

Perineural

60
Q

What benign polyp can be found in the setting of chronic gastritis?

A

Hyperplastic

GIHEP (30 decks)

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