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Clinical Pathology > 5. GI Pathology > Flashcards

5. GI Pathology Flashcards

1
Q

The oesophagus is mostly lined by what cell type?

How does this change as you go down the oesophagus?

A

Stratified squamous epithelium

Changes to Columnar epithelium at the squamo-columnar junction (usually 40cm from the incisor teeth, below the diaphragm)

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2
Q

What is the most common cause of oesophagitis?

A

Chemical causes:

  1. Ingestion of corrosive substance - accidental/intentional
  2. Reflux of gastric contents - reflux oesophagitis (heartburn)
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3
Q

What is the difference between a ‘Sliding hiatus hernia’ and a ‘Paraoesophageal hiatus hernia’?

A

Sliding = part of the stomach slides up into the chest with the oesophagus. Gives reflux symptoms.

Paraoesophageal = part of the stomach herniates through the diaphragm to sit along side the oesophagus. Strangulation of this hernia can occur. (less common, more serious)

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4
Q

What is Barrett’s oesophagus and what is the cause?

What are the risk factors for it?

A

Barrett’s oesophagus = change in mucosal lining from stratified squamous to columnar (same as intestines), this increases your risk of developing an oesophageal adenocarcinoma.

Cause = long standing gastro-oesophageal reflux

Risk factors = Male, Caucasian, Overweight

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5
Q

Barrett’s oesophagus can develop into what?

A

Oesophageal adenocarcinoma

Barrett’s > low grade dysplasia > high grade dysplasia > adenocarcinoma

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6
Q

Oesophageal carcinoma is the 8th most common cancer in the world.
What are the 2 main histological sub-types?

A
  1. Squamous cell carcinoma

2. Adenocarcinoma

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7
Q

The TNM system is a staging system used to classify the extent of spread of a tumour.
What does the T, N, M stand for?

A

pT = how far has the primary Tumour invaded

pN = number of regional lymph Nodes

pM = is there a distant Metastasis

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8
Q

What bacterial infection can cause acute gastritis which develops into chronic gastritis if left untreated?

Where in the stomach is it most commonly found?

A

Helicobacter pylori

Antrum

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9
Q

What is the cellular order in GI starting with mucosa?

A

Mucosa > lamina propria > sub mucosa > muscularis propria

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10
Q

Gastric adenocarcinoma is the 5th most common cancer in the world.
What are the 2 subtypes?

A
  1. Diffuse type - Linitis plastica
    (poorly differentiated, H pylori NOT important)
  2. Intestinal type
    (well/moderately differentiated, H pylori important)
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11
Q

Coeliac disease is caused by a reaction to …………. which induces IL-15 secretion by epithelial cells that cause CD8+ cells to proliferate and kill enterocytes.

A

Gliadin

alcohol soluble component of gluten

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12
Q

How is coeliac disease diagnosed?

A

Serology test followed by a biopsy (gold standard)

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13
Q

What are the histological features of coeliac disease?

A
  1. Villous atrophy
  2. Increased IELs (intraepithelial lymphocytes)
  3. Crypt elongation
  4. Increased lamina propria inflammation
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14
Q

Type of large bowel diverticula which outpouches through the mucosa and submucosa of the bowel wall.

A

Acquired (‘false/pseudo’) diverticulum

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15
Q

Type of bowel diverticula composed of ALL layers of the bowel wall e.g. Meckel’s diverticulum.

A

True (‘congenital’) diverticulum

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16
Q

Where is the most common site of diverticulosis?

A

Sigmoid colon

sigmoid colon is one of the most muscular parts of the colon so can generate a lot of pressure within the lumen

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17
Q

What is colitis?

A

Inflammation of colon

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18
Q

Inflammatory bowel disease affecting only the rectum and/or sigmoid colon

A

Ulcerative colitis

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19
Q

Inflammatory bowel disease presenting with patchy distribution and the formation of a granuloma.

A

Crohn’s disease

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20
Q

Where do most cases of ischemic colitis affect?

A

Left colon

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21
Q

Most common type of polyp in the colo-rectum, usually have no clinical significance.

A

Hyperplastic polyp

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22
Q

Most common type of polyp in children.

A

Juvenile polyp

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23
Q

What gene mutation causes Peutz-Jeghers syndrome?

A

STK11 gene (Chr 19)

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24
Q

Common type of neoplastic polyp arising from the epithelium.

A

Adenoma

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25
Q 
Lynch syndrome (HNPCC) is a form of hereditary colo-rectal cancer syndrome.
What is is caused by?
A

Mutation in the DNA mismatch repair genes.

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26
Q

Where is the most common distant metastasis site of colorectal cancer?

A

Liver

followed by lungs

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27
Q

Angular Cheilitis is acute/chronic inflammation of the skin at the corners of the mouth.
What bacterial infection causes this?

How is it treated?

A

Candida albicans

(less so S. Aureus)

Treatment = topical antifungals/antibiotics

28
Q

Oral Hairy Leucoplakia are white patches on the lateral tongue with a ‘hairy’ appearance.
What virus causes this?

A

Epstein Barr virus

(also causes glandular fever)`

29
Q

Peritonsillar abscess = unilateral swelling of tonsils

What bacteria causes this?

A

Streptococcus pyogenes (group A streptococcus)

30
Q

Acute suppurative parotitis = infection of parotid glands

What bacteria almost always causes this?

A

Staphylococcus aureus

31
Q

An infection of the submandibular space.

A

Ludwig’s angina

32
Q

A condition involving inflammation of the GI tract that is usually induced by chemotherapy.

A

Mucositis = inflammation of mucous membranes lining the GI tract

33
Q

Oesophageal rupture is known as what syndrome?

A

Boerhaave syndrome

34
Q

The enzyme secreted by Helicobacter pylori to neutralise stomach acid and survive.

A

Bacterial urease

35
Q

Cholangitis = inflammation/blockage of the common bile duct

The classic presentation of this is Charcot’s triad, what is this?

A
  1. Fever
  2. Abdominal pain
  3. Jaundice
36
Q

Infection of the gall bladder itself.

A

Cholecystitis

37
Q

What bacteria causes Whipple’s disease and what are the 4 classical symptoms?

A

Tropheryma Whipplei

  1. Joint pain
  2. Chronic diarrhoea
  3. Malabsorption
  4. Weight loss
38
Q

Where is the most common GI site for Tuberculosis?

A

Ileocecal

39
Q

Meckel’s diverticulum is an out pouching of the small intestine.
What is it a remnant of?

A

Yolk sac

40
Q

What are the different types of gastroenteritis and give an example of a cause for each.

A

Foodborne gastroenteritis =

  1. Staphylococcus aureus
  2. Clostridium perfringens
  3. Escherichia coli
  4. Salmonella spp (gram -)
  5. Shigella spp (gram -)
  6. Campylobacter spp

Non-foodborne gastroenteritis =

  1. Salmonella spp (gram -)
  2. Campylobacter spp
  3. Escherichia coli

Viral gastroenteritis =

  1. Rotaviruses
  2. Noroviruses

Waterborne gastroenteritis =

  1. Giarda lamblia
  2. Vibrio cholerae

Antibiotic associated diarrhoea =
1. Clostridium difficile

41
Q

Microorganism commonly associated with chronic gastritis?

A

Helicobacter pylori

42
Q

Main risk factor for hepatocellular carcinoma?

A

Cirrhosis

43
Q

Condition in which there is increased susceptibility for developing colorectal cancer due to mutations in DNA mismatch repair genes?

A

Lynch syndrome

44
Q

Inherited disorder of copper metabolism that results in increased urine copper levels?

A

Wilson’s disease

45
Q

Condition in which there are IgA antibodies to tissue transglutaminase (TTG) with villous atrophy of duodenum?

A

Coeliac disease

46
Q

What type of epithelium lines the normal oesophagus?

A

Stratified squamous

47
Q

Liver tumour that arises in the bile ducts?

A

Cholangiocarcinoma

48
Q

Condition that presents with a sudden onset of severe abdominal pain radiating to the back and a raised serum amylase?

A

Acute pancreatitis

49
Q

Condition in which the squamous mucosa of the oesophagus is replaced by columnar mucosa?

A

Barrett’s oesophagus

50
Q

A glucose polysaccharide that serves as a form of energy storage?

A

Glycogen

51
Q

An enzyme that can be tested for in blood that helps the diagnosis of Wilson’s disease?

A

Caeruloplasmin

52
Q

The presence of fatty change associated with inflammation in the liver?

A

Steatohepatitis

53
Q

In which part of the large bowel are diverticulae most often seen?

A

Sigmoid

54
Q

The conversion of Glycogen to Glucose in the body is termed as …….?

A

Glycogenolysis

55
Q

Term for bilateral infection of the submandibular space?

A

Ludwig’s angina

56
Q

What is the most frequent site for colon cancer distant metastasis?

A

Liver

57
Q

What type of chronic inflammatory bowel disease commonly affects the anus?

A

Crohn’s disease

58
Q

Name the fungus responsible for oral thrush?

A

Candida

59
Q

Liver enzyme that is commonly elevated in cholestasis?

A

Alkaline phosphatase

60
Q

A common cause of diarrhoea in infants and young children?

A

Rotavirus

61
Q

A common pancreatic neuroendocrine tumour that can result in hypoglycaemia?

A

Insulinoma

62
Q

Most common benign epithelial polyp in the lower GI tract?

A

Adenoma

63
Q

Sign of chronic liver disease?

A

Spider naevi

64
Q

Cholecystitis occurs when there is an infection of which anatomical structure?

A

Gall bladder

65
Q

The clinical effect of hyperbilirubinaemia?

A

Jaundice

Clinical Pathology (11 decks)

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