Gastro Flashcards
Approx length of oesophagus?
25cm
Upper sphincter of Oesophagus =?
cricopharyngeal
Where are the distal 1-2cm of oesophagus located?
below diaphragm
Lining of most distal oesophagus = ?
Glandular (columnar) mucosa
Where is squamo columnar junction usually located?
40cm from incisors
Most common form of oesophagitis?
Reflux oesophagitis
Risks for reflux?
Defective sphincter
Hiatus hernia
Increased abdo pressure
increase gastric fluid (outflow stenosis)
Strangulation is associated with which hiatus hernia?
Paraoesophageal
Type of hiatus hernia causing heartburn?
Sliding hiatus
Histological features of reflux?
basal cell hyperplasia, increased desquamation. infiltration of inflammatory cells
Cause of barretts oesophagus?
Longstanding reflux
Risk factors for barrets?
As normal reflux (male, overweight and caucasian)
Histology of barrets?
Glandular metaplasia (squamous replaced by columnar)
Is barretts pre-malignant?
Yes! surveillance useful
Barrets eventually may lead to what?
Adenocarcinoma
Two types of oesophageal cancer…?
Adeno and squamous
Uk has lower incidnce of what type of oesopho cancer than the other/other countries?
Squamous 30%
Male or femal more likely to get adenocarcinoma of oesophagus?
Male 7:1
Risk for squamous carcinoma of oesophagus?
Black, male, hpv, hot drinks!
Squamous higher or lower than adenocarcinoma in oesophagus?
Usually higher up
TNM staging uses what?
pT depth of primary invasion
pT stages?
1= lamina, submucos 2= muscularis 3= adventitia 4= adjacent structures
Node staging in oesophageal cancer?
1= 1 or 2 2= 3-6 3= 7+
Metastasis grading in oesophagus?
M0 is none M1 = some!
Causes of chronic gastritis?
H.pylori
chemical
Nsaid
Bile reflux and alcohol
Pylori, talk to me gram etc?
Gram neg, flagellae, lives on epithelium
Where is h.pylori more common in stomach?
Antrum
Major sites for peptic ulcers?
Duodenum first part, antral body, distal oesophagus
Histology of gastric ulcer?
full thickness coagulative, ulcer and granulation
H.pylori more associated with gastric or duodenal?
Duodenal
Duodenal or gastric ulcers are more likely?
Duodenal 3:1
Duodenal or gastric ulcer in younger?
Duodenal
Most frequent gastric cancer type?
Adeno
Aetiology of gastric cancer?
Diet(smoked food pickled)
H.pylori
bile reflux
Low pH
Carcinoma of GOJ increase or decrease recent and associated with?
Increase and in white males. no diet assoc or h.pylori, is assoc with reflux
Body and antrum of stomach cancer associations?
Diet assocaited, h.pylori but no reflux assoc
Mutation in what = HDGC hereditary gastric cancer ?
Cadherin
What causes the issue in gluten intolerant people?
Gliadin, cells express IL15
IL15 induces activation of what?
CD8= cells kill enterocytes
Mechanism of coeliac disease?
Not CD8 but IL15 expression from gliadin
Coleiac assocaited with what? (10%)
Dematitis herpeformis
Test for coeliac?
TTG Transglutaminase
What is diagnostic for coeliac?
Only a biopsy
Where are diverticulum most common?
Sigmoid colon
Diverticular in colon or mostly acquired or congenital?
Acquired
Where are the diverticular in the sigmoid?
Between mesenteric and antimesenteric taeni coli
Diet protection in divertucla disease?
High fibre