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Case 8: GIT diarrhoea > Anat Path: Oesophageal & Stomach Pathology > Flashcards

Anat Path: Oesophageal & Stomach Pathology Flashcards

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1
Q

What is the two congenital abnormalities

A
  1. Oesophageal atresia
  2. Tracheosophageal fistula
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2
Q

What is oesophageal atresia

A

It is abnormal narrowing at the upper end & forming a blind pouch (opening)
Can also form a fistula

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3
Q

What is tracheosophageal fistula & clinical presentation

A

Lower oesophagus communicate w/ trachea
Clinical presentation:
Failure to thrive & aspiration pneumonia

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4
Q

What is the two causes of hiatus hernia

A
  1. Sliding hernia
  2. Rolling hernia
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5
Q

What is a sliding hernia

A

The distal oesophagus & proximal stomach slide upwards

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6
Q

What is a rolling hernia

A

Loop of the stomach rolls up through diaphragm at the oesophagogastric junction

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7
Q

What is the 2 causes of hiatus hernia

A

Ageing
Increase intra-abdominal pressure due to tumour, fat or fluid

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8
Q

What is the 2 complications of hiatus hernia

A

Reflux oesophagitis
Ulceration

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9
Q

What is the three main types of oesophageal inflammation

A

Infective agents
Associated w/ reflux oesophagitis
Corrosive injury

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10
Q

What is the microorganism that causes infective type oesophagitis

A

Candida
HSV
CMV
TB

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11
Q

What is the causes of corrosive injury oesophagitis

A

Ingestion of strong alkali or acid

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12
Q

What is the phases of corrosive injury oesophagitis

A

Acute: mucosal sloughing & bacterial infection
Chronic: fibrous stricture & motility disturbance

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13
Q

What is reflux oesophagitis/GERD

A

Upward reflux of gastric content through lower oesophageal sphincter that digest oesophageal mucosa

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14
Q

What is the symptoms of GERD

A

Central chest pain

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15
Q

What is the risk factors of GERD

A

Hiatus hernia
Increased abdominal pressure
Incompetent lower oesophageal sphincter
Abnormal peristalsis

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16
Q

What is the complications of GERD

A

Peptic ulceration
Chronic haemorrhage
Fibrous stricture
Intestinal metaplasia/Barret oesophagus

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17
Q

What is Barret’s oesophagus

A

Long standing GERD causes metaplasia of squamous tissue to intestinal tissue w/ goblet cells

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18
Q

What is oesophageal varices

A

It is dilation of oesophageal submucosal venous plexus due to cirrhosis that lead to portal hypertension as a result of increased portal pressure & blood bypasses portal veins & shunting blood to systemic collaterals

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19
Q

What is the two types of oesophageal carcinoma

A

Squamous cell carcinoma
Adenocarcinoma

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20
Q

Where does oesophageal squamous cell carcinoma form

A

Middle third of oesophagus

21
Q

What is the risk factors of oesophageal squamous cell carcinoma

A

Smoking
Alcohol
Nitrosamines
Fungal contamination of maize
HOV 16 & 18

22
Q

What is the 3 macroscopic appearance of oesophageal squamous cell carcinoma

A

Stricture
Ulcer
Fungating mass

23
Q

What is the 3 types of oesophageal squamous cell carcinoma spread

A
  1. Local via continuity or contiguity
  2. Lymphatic
  3. Haematogenous spread
24
Q

What is the complications of oesophageal squamous cell carcinoma

A

Obstruction causing dysphasia or aspiration pneumonia
Infection
Cachexia
Haemorrhage
Oesophageal rupture/fistula

25
Q

What is the cause of oesophageal adenocarcinoma

A

GERD due to intestinal metaplasia that leads to dysplasia

26
Q

What does adenocarcinoma mean

A

Carcinoma involving glands

27
Q

What is hypertrophic pyloric stenosis

A

Gastric outlet obstruction caused by hypertrophy of pyloric muscle causing food not being able to pass due to an occluded gastroduodenal junction

28
Q

What is the clinical presentation of hypertrophic pyloric stenosis

A

Projectile vomiting in neonates- males

29
Q

What is the causes of acute gastritis

A

Alcohol & NSAIDS = local factors
Shock & raised intracranial pressure = general factors

30
Q

What is the pathogenesis of acute erosive gastritis

A

Injury to mucosal barrier that cause hydrogen ions to diffuse back into epithelium stimulating mast cells to release histamine & cause inflammation
Poor circulation that decrease cell production & loos of epithelial integrity

31
Q

What is the macro pathology of acute erosive gastritis

A

Oedematous mucosa
Haemorrhage
Erosion
Stress ulcers

32
Q

What is the 3 main causes of chronic gastritis

A
  1. H pylori
  2. Autoimmune
  3. Reactive
33
Q

What is H. Pylori associated gastritis

A

Active chronic gastritis of antral mucosa
Active due to neutrophils w/i gastic glands/ulcerations
Chronic due to plasma cells & lymphoid aggregates

34
Q

What is reactive gastritis

A

Reflux bile containing duodenal fluid into lower stomach form pyloric incompetence

35
Q

What is the causes of reactive gastritis

A

Prolonged NSAIDS use

36
Q

What is autoimmune gastritis

A

Circulating antibodies destruction of gastric parietal cells

37
Q

How is the gastric bodies affected in autoimmune gastritis

A

Chronic strophic gastritis that affects gastric bodies & leads to hypochlorhydria & hypergastrinaemia

38
Q

What is a clinical presentation of autoimmune gastritis

A

Megaloblastic anaemia due to malabsorption of B12 due to antibodies to intrinsic factor

39
Q

What is a peptic ulcer

A

Imbalance between acid/pepsin attack & mucosal resistance to digestion

40
Q

What is the 2 main sites of peptic ulcers & reasons of occurring

A

Gastric ulcers: due to decreased mucosal resistance
Duodenal ulcers: due to increased acid secretion

41
Q

What is the 2 causes of duodenal ulcers

A
  1. H pylori
  2. Gastric producing endocrine tumour
42
Q

What is the 4 causes of gastric ulcers

A
  1. H pylori
  2. NSAIDS
  3. Smoking
  4. Alcohol
43
Q

What is the appearance of a benign gastric ulcer

A

Punched out in the antrum (lesser curvature)
Smaller
Small soft lymph nodes
Vessels in smooth base
Radial mucosal folds

44
Q

What is the appearance of a malignant gastric ulcer

A

Irregular, raised edges
Greater curvature
Larger
Large firm lymph nodes

45
Q

What is the complications of gastric ulcers

A

Penetration
Perforation
Haemorrhage
Fibrosis/obstruction

46
Q

What is the 5 risk factors for gastric carcinoma

A

H. Pylori
Nitrosamines
Adenomatous polyps
Autoimmune gastritis
Gastric cancer families

47
Q

What is the 5 complications of gastric carcinoma

A

Haemorrhage
Obstruction
Penetration
Rupture
Cachexia

48
Q

What is the 4 manner in which gastric carcinoma’s spread

A

Local
Transcoelomic
Lymphatic
Blood

49
Q

What is the 4 macroscopic appearances of gastric carcinoma

A

Polyploid/fungating
Ulcerating (raised & rolled edges)
Annular constricting
Diffusely infiltrating (leather appearance)

Case 8: GIT diarrhoea (11 decks)

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