Gastro-Oesophageal Pathology

Question 1

Why does a hiatus hernia predispose one to GORD?

Answer 1

The location of the lower oesophageal sphincter in the diaphragm reinforces the sphincter’s strength

Question 2

What are some upper GI causes of haematemesis?

Answer 2

Gastric ulcer

Oesophageal varcies

Erosive gastritis

Mallory-Weiss tear

Upper GIT tumour

Duodena ulcer

Question 3

What are some complications of GORD?

Answer 3

Ulceration, Scarring, Bleeding, perforation of the oesophagus

Aspiration pneumonia and subsequent fibrosis

Question 4

What are some causes of achalasia?

Answer 4

DM

Scleroderma

Parasitic infections

Question 5

What is linitis gastrica?

Answer 5

Bottle space stomach due diffusely thickened stomach wall

Question 6

What are some predisposing factors for gastric adenocarcinoma?

Answer 6

Helicobacter pylori

Smoking

Question 7

What are the most important tumours of the stomach?

Answer 7

Adenocarcinoma

Gastrointestinal stroma tumour

Question 8

How are gastric carcinomas classified?

Answer 8

Diffuse

Intestinal type

Question 9

What causes Achalasia?

Answer 9

Damage to the enteric nervous system

Question 10

What is the pathophysiology of adenocarcinoma of the oesophagus?

Answer 10

GORD + bile reflux > chronic reflux oesophagitis > columnar cell (Barrett’s) metaplasia > dysplasia > adenocarcinoma in situ > invasive addenocarcinoma

Question 11

What type of tumours occur in the oesophagus?

Answer 11

Squamous cell carcinoma

Adenocarcinoma

Small cell carcinoma (rare)

Smoth muscle (rare)

Question 12

Where do H. pylori ulcer occur most?

Answer 12

Duodenum

Question 13

What is eosinophilic oesophagitis? Treatment?

Answer 13

Eosinophilic inflammation throughout the oesophagus in young with a history of allergies

Patient respond to steroids not PPIs or antacids

Question 14

How do you determine whether a GIST is benign or malignant?

Answer 14

Size

Mitotic activity

Question 15

What layers make up the mucosa?

Answer 15

Epithelium

Lamina propria

Muscularis mucosa

Question 16

What are GISTs?

Answer 16

Gastrointestinal stromal tumours

• The most important soft tissue tumours that arrise from the pacemaker cells “interstitial cells of Cajal”

Question 17

What is Boerhaave’s?

Answer 17

Mediastinal complication of Mallory-Weiss tear

Question 18

What allows GORD to occur?

Answer 18

Loss of lower oesophageal tone due to EtOH, caffeine, pregnancy, medication, hiatus hernia

Question 19

What is the pathophysiology of oesophageal SCC?

Answer 19

Chronic injury cause by risk factors like smoking, high alcohol intake, HPV, dietary carcinogens, chronic Fe deficiency

> Dysplasia > SCC in situ > Invasive SCC

Question 20

Are all causes of dysphagia from the GIT?

Answer 20

No, extramural causes like aneurysms can also cause it

Question 21

What type of lymphomas do you get in the stomach?

Answer 21

Low grade, indolent B cell lymphomas

Question 22

What are some complications of portal hypertension?

Answer 22

Varices

Hemorroids

Ascites

Splenomegaly - thrombocytopenia

Question 23

What type of epithelium is present in the oesophagus?

Answer 23

Stratified squamous

Question 24

How does oesophageal adenocarcinoma appear histologically?

Answer 24

Rolled edges