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Bio 3 End Semester > Gastro 2 > Flashcards

Gastro 2 Flashcards

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1
Q

The two main types of Oesophageal cancer are……

A

Squamous cell carcinoma

Adenocarcinoma

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2
Q

Describe squamous cell carcinoma…

A

Cancer of the epithelial cells, upper oesophagus.

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3
Q

What is Adenocarcinoma?

A

Cancer of epithelial cells of the glands, lower oesophagus.

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4
Q

Oesophageal cancer has a high mortality rate compared to incidence, and can metastasise rapidly.
True or False?
Why?

A

True.

Because there is no serosa around the oesophagus, so the cancer invades local lymph tissue easily.

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5
Q

GORD can result in cell type change which can lead to Adenocarcinoma.
True or False?

A

True

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6
Q

What factors increase the risk of squamous cell carcinoma of the oesophagus?

A

Age
Alcohol
Smoking
Possibly even drinks that are too hot.

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7
Q

Adenocarcinoma is associated with a condition called ………… , Where chronic irritation of the oesophageal mucosal lining occurs.

A

GORD. Gastro-oesophageal reflux disease.

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8
Q

What occurs in ‘Barrett’s Oesophagus’?

A

Normal squamous cell lining is replaced with columnar cells (like in stomach), which is a pre-malignant mucosal change, Adenocarcinoma becomes higher risk.

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9
Q

The change from squamous cells to columnar cells in the oesophagus is also known as…….

A

Metaplasia

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10
Q

When cells change from squamous to columnar in patients with GORD, it IS possible for the cells to revert back to normal.
True or False?

A

True

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11
Q

Clinical features of oesophageal cancer include…….

A

Dysphagia
Heart burn
Weight loss
Bleeding

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12
Q

Treatment for oesophageal cancer includes…..

A

Oesophagectomy is most common
Radiation
Chemo

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13
Q

Microvilli is otherwise known as……

What happens here?

A

Brush border.

Enzymes break down carbs, proteins and fats.

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14
Q

Digestion requires……….

A

Pancreatic enzymes
Bile from liver
Enzymes within epithelial cells of mucosa.

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15
Q

Malabsorption syndromes describes the inability to…….

A

Absorb nutrients from the small intestine.

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16
Q

Malabsorption syndromes occur due to impaired digestion. List reasons why impaired digestion may occur.

A

Lack of enzymes, eg. Lactose intolerance.
Pancreatic cancer
Cystic fibrosis
Surgical resection following small intestine cancer.
Lack of bile salts, eg. Liver cirrhosis, gall stones.

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17
Q

Malabsorption syndromes can occur through impaired mucosal function. Why might this happen?

A

Damage to small intestine due to coeliac disease or chemotherapy

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18
Q

How does coeliac disease relate to malabsorption?

A

Gluten flattens the villi; loss of villi means loss of surface area to absorb nutrients.

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19
Q

Why does cystic fibrosis cause malabsorption?

A

Because thick mucus blocks the ducts of the glands, enzymes get ‘stuck’ in the ducts and are not released for digestion

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20
Q

Clinical features of malabsorption syndromes include…..

A

Diarrhoea
Steatorrhoea
Abdominal distension (bloating, farts!)
Weight loss

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21
Q

What is steatorrhoea?

A

Fat in the stool due to poor fat absorption

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22
Q

Reduced absorption of Iron, B12 and folate, and calcium can lead to………

A

Anaemia

Osteoporosis

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23
Q

What is the main role of the large intestine?

A

To reabsorb water

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24
Q

Chronic inflammatory bowel disease describes ………. And ……….

A

Crohn’s disease, And

Ulcerative colitis

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25
Q

Chronic abnormal immune and inflammatory responses result in inflammation and ulceration of the wall of the intestine….. What is this describing?

A

Chronic inflammatory bowel disease.

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26
Q

What complications can occur from chronic inflammatory bowel disease?

A

Damage to intestinal mucosa and reduced absorption of nutrients can occur.
Leading to malnutrition, vitamin and nutrient deficiencies and steatorrhoea.

27
Q

Crohn’s disease involves the small AND large intestine and involves all 4 layers of intestinal wall.
True or false?

A

True

28
Q

Ulcerative colitis involves only the mucosal layer of the intestine.
True or false?

A

True

29
Q

Which parts of the large intestine are mainly affected by ulcerative colitis?

A

Sigmoid colon

Rectum

30
Q

Does malabsorption occur in ulcerative colitis?

A

No. Very rare.

31
Q

Does malabsorption occur in Crohn’s disease?

A

Yes.

32
Q

Skip lesions occur in Crohn’s disease but not in ulcerative colitis.
True or false?

A

True

33
Q

What is haematochezia?

A

Red blood in stool due to bleeding from the lower GI tract.

34
Q

Clinical features of chronic inflammatory bowel disease include…..

A

Abdominal pain, cramping.
Haematochezia
Diarrhoea
Weight loss

35
Q

Treatment for chronic inflammatory bowel disease includes…..

A

Modify diet
Reduce stress
Anti-inflammatory drugs

36
Q

Surgical resection of the large intestine is possible for ulcerative colitis, but not Crohn’s disease.
True or false

A

True

37
Q

Changes to the structure of the GIT can be seen in irritable bowel syndrome.
True or false?

A

False.

No apparent changes are present.

38
Q

Irritable bowel syndrome is related to what 3 contributing factors?

A

Psychological stressors
Diet
Abnormal gut motility

39
Q

Pain and discomfort, change in stool form and frequency, and discomfort that improves after defecation need to occur ….. days over …. months for irritable bowel syndrome to be diagnosed.

A

3

3

40
Q

Diarrhoea and/or constipation
Chronic abdominal pain
And bloating are clinical features of what condition?

A

Irritable bowel syndrome.

41
Q

There is a cure for irritable bowel syndrome.

True or false?

A

False.

Treatment must be individualised

42
Q

Colorectal cancer usually occurs from ……….. of the colon.

A

Adenocarcinoma

43
Q

How does colorectal cancer usually develop?

A

From benign polyps

44
Q

Adenomatous polyps are malignant.

True or false?

A

False

They are benign

45
Q

List risk factors for colorectal cancer.

A

Age over 50
Family history of polyps or colorectal cancer
Genetic syndrome
Inflammatory bowel disease

46
Q

Can lifestyle factors contribute towards colorectal cancer?

What might they be?

A 
Physical inactivity
Low fruit and veg intake
Low fibre and high salt diet
Obesity
Alcohol consumption
Smoking
47
Q

Do adenomatous polyps arise from all layers of the colon or just the mucosal layer?

A

Mucosal layer only. They can be removed by colonoscopy before they have the opportunity to grow and spread within the layers of the colon

48
Q

Once adenoma spreads to the ……….. layer, it becomes an …………… which is a ……… tumour.

A

Submucosal
Adenocarcinoma
Malignant

49
Q

What can occur when adenoma spreads to the submucosal layer of the colon?

A

Metastasis

Difficulty in treating

50
Q

Stage I colorectal cancer is limited to the ……… and …………..
What is the 5 year survival rate?

A

Mucosa and submucosa

90%

51
Q

Stage II colorectal cancer has spread to the …….. ……….
What is the 5 year survival rate?

A

Muscularis externa

87%

52
Q

Stage III colorectal cancer has spread to the …….. and ……. ……..
What is the 5 year survival rate?

A

Serosa and lymph nodes

57%

53
Q

Stage IIII colorectal cancer has spread to ……. ……. (……….)
What is the 5 year survival rate?

A 
Other organs (metastasised)
10%
54
Q

What does the 5 year survival rate actually mean?

A

The % of patients that are still alive after 5 years of treatment

55
Q

Clinical features of colorectal cancer become apparent very rapidly.
True or false?

A

False.

Few symptoms show until advanced stage

56
Q

Symptoms of colorectal cancer depend on location of cancer and can include……

A

Change in bowel habit
Abdominal pain, bloating
Occult blood
Unexplained tiredness

57
Q

What would explain increased tiredness in a patient with colorectal cancer?

A

Depletion of red blood cells due to the chronic slow bleed.

58
Q

What is occult blood?

A

Traces of blood in stool usually due to bleeding from the lower GI tract.

59
Q

Why has screening been introduced for colorectal cancer?

A

No early warning signs.
Remains confined for long period before invading bowel wall and other organs.
Treatment more successful if detected early.

60
Q

At what age should you commence the National bowel screening program?
How is this done?

A

50, then every 5 years thereafter.

Faecal occult blood test (FOBT)

61
Q

Early stage treatment of colorectal cancer is ……….. or ………….
If not reached muscularis externa, will cure ….. % of cases.

A

Polypectomy or surgery

90%

62
Q

If colorectal cancer penetrates wall and/or spreads to lymph nodes, how should it be treated?

A

Surgery and chemotherapy

63
Q

List some age-related changes that may lead to anorexia, impaired absorption, malnutrition and constipation in the elderly.

A 
Loss of teeth
Decline in taste bud numbers
Sense of smell lessens
Saliva secretion decreases
Dysphagia
Gastric secretions decrease
Decreased liver function 
Decreased GIT motility

Bio 3 End Semester (3 decks)

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