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Alimentary system > Alimentary pathology > Flashcards

Alimentary pathology Flashcards

1
Q

What is dyspepsia?

A

A group of symptoms describing pain or discomfort in the upper abdomen

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2
Q

What are the symptoms of dyspepsia?

A 
Upper abdominal pain or discomfort 
Retrosternal pain 
Anorexia
Nausea
Vomiting 
Early satiety
Bloating 
Heartburn
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3
Q

What is anorexia?

A

Loss of appetite or loss of interest in food

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4
Q

What are the two main types of dyspepsia?

A

Organic dyspepsia

Functional dyspepsia

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5
Q

What is organic dyspepsia?

A

Dyspepsia caused by a clearly defined underlying pathological process adversely affecting the structure and function of cells in the alimentary canal

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6
Q

What is functional dyspepsia?

A

Dyspepsia occurring despite no abnormalities being present in the cells of the alimentary canal

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7
Q

Causes of organic dyspepsia in the upper GI tract?

A

GORD
Peptic ulcer disease
Gastric cancer
Gastritis

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8
Q

Causes of organic dyspepsia in the colon?

A

IBD

Colonic cancer

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9
Q

Causes of organic dyspepsia in small intestine?

A

Duodenal ulcer

Coeliac disease

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10
Q

What are red flag symptoms of dyspepsia?

A 
Anorexia 
Weight loss
Iron deficiency anaemia 
Recent onset in a patient over 55y/o
Persistence despite treatment 
GI bleeding 
Mass
Dysphagia
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11
Q

Appropriate response to red flag symptom in patient with dyspepsia?

A

Referral for endoscopy

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12
Q

What are the functions of an upper GI endoscopy?

A

Diagnosis

Therapeutic function

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13
Q

What is the risk of perforation in an upper GI endoscopy?

A

1 in 2000

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14
Q

Appropriate response to a patient presenting with dyspepsia who has no red flag symptoms and is younger than 55 y/o?

A

Test for Helicobacter pylori

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15
Q

What type of bacteria is Helicobacter pylori?

A

Spiral (comma) shaped
Flagellated
Gram negative

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16
Q

Where in the alimentary canal does Helicobacter pylori colonise?

A

Gastric type mucosa

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17
Q

How does Helicobacter pylori survive the harsh conditions of the stomach?

A

Uses flagellum to hide in gastric mucus

Uses urease to create protective alkaline halo

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18
Q

Helicobacter pylori infection raises the risk of what serious GI pathology?

A

Gastric cancer

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19
Q

What are the potential outcomes of infection with Helicobacter Pylori?

A 
Asymptomatic 
Chronic gastritis 
Intestinal metaplasia 
Gastric cancer 
MALT lymphoma
Chronic atrophic gastritis 
Peptic ulcer
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20
Q

What is the potential outcome of chronic Helicobacter pylori infection in the antrum of the stomach?

A

Duodenal ulcer

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21
Q

What is the potential outcome of chronic Helicobacter pylori infection in the body of the stomach?

A

Gastric cancer

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22
Q

What is liver failure a complication of?

A

Acute liver injury

Chronic liver injury

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23
Q

What are the potential causes of acute liver injury?

A

Drugs
Alcohol
Viruses
Bile duct obstruction

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24
Q

Which two causes of viral hepatitis are closely related?

A

Hepatitis B and D

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25
Q

Which causes of viral hepatitis lead to chronic hepatitis and cirrhosis?

A

Hepatitis B and C

26
Q

What cells are damaged by hepatitis?

A

Hepatocytes

27
Q

What are the potential outcomes of viral hepatitis?

A

Resolution and return to normal function
Chronic hepatitis leading to cirrhosis
Liver failure

28
Q

Reason for excess alcohol consumption causing a fatty liver?

A

Alcohol affects fat metabolism

29
Q

What is jaundice?

A

Excess circulating bilirubin

30
Q

Three components of bilirubin metabolism pathway?

A

Pre-hepatic
Hepatic
Post-hepatic

31
Q

What processes occur in the pre-hepatic stage of bilirubin metabolism pathway?

A

Haemoglobin from erythrocytes is broken down within the spleen to create haem and globin
Haem is converted into bilirubin and released back into the bloodstream

32
Q

What is bilirubin synthesised from?

A

Haem

33
Q

What processes occur in the hepatic segment of the bilirubin metabolism pathway?

A

Bilirubin is conjugated in the hepatocytes to increase its solubility.
Bilirubin is secreted into the bile ducts

34
Q

What processes occur in the post-hepatic segment of the bilirubin metabolism pathway?

A

Bilirubin conjugate circulates in the small intestine and is broken down.
Bilirubin is reabsorbed into the blood via the enterohepatic circulation

35
Q

What are the classifications of the causes of jaundice?

A

Pre-hepatic
Hepatic
Post-hepatic

36
Q

What causes pre-hepatic jaundice?

A

Excess degradation of erythrocytes in the spleen

37
Q

What are the causes of hepatic jaundice?

A

Cholestasis

Intra hepatic bile duct obstruction

38
Q

What is cholestasis?

A

Accumulation of bile in the bile canaliculi and hepatocytes

39
Q

What are the causes of cholestasis

A 
Drugs
Hepatitis (viral or alcoholic)
Intra-hepatic bile duct obstruction 
Hormonal influences
Cirrhosis 
Liver failure
40
Q

What is predictable drug induced cholestasis?

A

Cholestasis caused by drugs which is related to dose.

41
Q

What is unpredictable drug induced cholestasis?

A

Cholestasis caused by drugs which is unrelated to dose

42
Q

Which type of drug induced cholestasis is more common?

A

Unpredictable cholestasis

43
Q

What are the two main types of drug induced cholestasis?

A

Predictable and unpredictable

44
Q

What are the causes of intra-hepatic bile duct obstruction?

A

Tumours of the liver
Primary biliary cholangitis
Primary sclerosis cholangitis

45
Q

What is the cause of primary biliary cholangitis?

A

Autoimmune dysfunction

46
Q

What protein is found to have a raised level in the blood of those with primary biliary cholangitis?

A

Alkaline phosphatase

47
Q

What is the difference in the inflammatory processes of primary biliary cholangitis and primary sclerosing cholangitis?

A

Primary biliary cholangitis presents as granulomatous inflammation while primary sclerosis cholangitis does not

48
Q

What condition massively raises the risk of developing cholangiocarcinoma?

A

Primary sclerosis cholangitis

49
Q

What is cirrhosis of the liver?

A

The response of the liver to chronic injury

50
Q

What are the causes of cirrhosis?

A 
Alcoholic liver disease
Infection with hepatitis B or C
Primary biliary cholangitis 
Auto-immune hepatitis 
Metabolic disorders
Excess iron or copper
Obesity 
Idiopathic cirrhosis
51
Q

What metals can cause liver cirrhosis when present in excess quantities?

A

Iron and copper

52
Q

What is the commonest cause of liver cirrhosis?

A

Idiopathic liver cirrhosis

53
Q

What is normal liver structure replaced with in liver cirrhosis?

A

Nodules of hepatocytes

Fibrotic scar tissue

54
Q

What is the most common source of liver tumours?

A

Metastasis from other sites in the body

55
Q

Main types of liver tumour?

A

Metastasis from other sites in the body
Hepatocellular carcinoma
Cholangiocarcinoma

56
Q

What type of liver tumour is caused mainly by liver cirrhosis?

A

Hepatocellular carcinoma

57
Q

What are the causes of extra-hepatic jaundice?

A

Gallstones
Obstruction of the extra-hepatic bile ducts
Gallbladder disease

58
Q

What are the main risk factors for gallstones?

A

Obesity

Diabetes mellitus

59
Q

What are the causes of a common bile duct obstruction?

A

Tumour of the cells of the bile duct
External compression of the bile duct
Gallstones
Benign stricture as a result of scarring

60
Q

What are the potential complications of a common bile duct obstruction?

A

Ascending cholangitis
Secondary jaundice
Secondary biliary cirrhosis

Alimentary system (4 decks)

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