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3A week 1 - upper GI tract > gastroduodenal pathology > Flashcards

gastroduodenal pathology Flashcards

1
Q

what control is essential for peristalsis and where is this control derived from in the GI tract

A

nervous control - delivered by auerbach’s (myenteric) and Meissner’s (seubmucosal) plexuses

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2
Q

what are the layers of the oesophagus (in to out)

A
  1. mucosa
  2. sub mucosa
  3. muscularis
  4. adventitia/serosa
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3
Q

what kind of cell replaces the oesophageal epithelium in oesophageal cancer

A

squamous epithelium replaced by glandular epithelium

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4
Q

what does the gastric rugae aid with

A

the continuous movement of food

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5
Q

what is found in the mucosa/sub muscosa of the oesophagus (4)

A
  1. stratified squamous epithelia
  2. glands
  3. folds
  4. submucosal glands
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6
Q

what is found in the mucosa of the stomach (3)

A
  1. pits
  2. rugae
  3. glands
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7
Q

what is found in the mucosa/sub muscosa of the duodenum (4)

A
  1. villi
  2. microvilli
  3. lactea (sm)
  4. brunner’s gland (sm)
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8
Q

what is found in the mucosa/sub muscosa of the jejunum (2)

A
  1. intestinal gland/crypt
  2. blood/lymphatic vessels (sm)
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9
Q

what is found in the mucosa of the ileum

A

peyer’s patches

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10
Q

what is found in the mucosa of the colon (2)

A
  1. straight tubular glands
  2. goblet cells
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11
Q

what is congenital hypertrophic pyloric stenosis

A

a form of obstruction that presents between the third and sixth weeks of life

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12
Q

presentation of pyloric stenosis (4)

A
  1. regurgitation
  2. vomiting
  3. visible peristalsis
  4. palpable mass after feeding
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13
Q

what muscles are hypertrophied in pyloric stenosis

A

circular muscles of the muscularis

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14
Q

what types of musles make up the GI muscularis layer

A

circular and logitudinal

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15
Q

3 types pf chronic stomach inflammation

A
  1. H.pylori associated
  2. non-HP associated
  3. autoimmune
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16
Q

acute gastritis causes (5)

A
  1. irritants (smoking, alcohol)
  2. drugs (aspirin, NSAIDs, steroids)
  3. severe stress (burns, trauma, surgery etc.)
  4. radiation
  5. chemotherapy
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17
Q

complications of acute gastritis (2)

A
  1. erosions - small uclers where the depth is limited to Lamina propria and which bleed
  2. acute stress ulcers - penetrate the muscularis mucosa and particular associated w stress, alcohol, smoking etc, they can bleed
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18
Q

what are cushing’s ulcers

A

a gastro-duodenal ulcer produced by elevated intracranial pressure caused by an intracranial tumor, head injury or other space-occupying lesion

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19
Q

what are curling’s ulcers

A

Curling’s ulcers occur following burns involving greater than 30 percent total body surface area

20
Q

what other conditions is HP gastritis associated with (4)

A
  1. duodenal ulcers
  2. gastric ulcers
  3. gastric MALT lymphoma
  4. gastric carcinomas
21
Q

what is the mode of infection for H.pylori

A

person-to-person transmission via gastro-oral route (saliva, vomit, stool)

22
Q

how does H.pylori colonise the gastric mucosa

A

they release urase which buffers the acid stomach environment, and virulence factors which allow colonisation and adhesion to gastric mucosa where factors promoting tissue damage are released

23
Q

what are the 2 important components to H.pylori that allow for its colonisation

A
  1. urease
  2. virulence factors
24
Q

what is non-HP chronic gastritis usually due to

A

bile reflux

25
Q

autoimmune gastritis pathophys (4)

A
  1. autoimmune destruction of specialised glands of the body mucosa
  2. autoantibodies to IF and parietal cells
  3. loss of parietal cells leads to achlorhydria (absence of hydrochloric acid in the gastric secretions)
  4. loss of IF leads to B12 deficency and pernicious anaemia
26
Q

tumour ulcers vs peptic ulcers

A

tumour- have rolled, rounded edges due to collapse from the tumour
peptic - vertical edge, punched out appearance, margins level or slightly elevated

27
Q

what is Ménétrier’s disease

A

a rare disorder characterized by giant mucosal folds in the proximal part of the stomach, diminished acid secretion, and a protein-losing state with hypoalbuminemia

28
Q

acute stress ulcer (5) vs chronic peptic ulcer (5)

A

acute stress:
1. does not penetrate muscularis propria
2. no scarring under ucler
3. no endartitis obliterans
4. heals by regeneration
5. anywhere and multiple

chronic peptic:
1. penetrates muscularis propria
2. scarring under ulcer
3. endarteritis obliterans (inflammation of inner artery which usually results in lumen obstruction)
4. heals by repair w fibrous scar
5. single and usually antral

29
Q

what are the 4 zones of prptic ulcers

A
  1. zone of cicatrisation (layer of fibrosis)
  2. superficial exudative zone (cellular layer rich in neutrophil polymorphs)
  3. granulation tissue zone
  4. necrotic zone (surface layer)
30
Q

complications of peptic ulcers (7)

A
  1. penetration into pancreas, liver, gastroduodenal artery etc.
  2. biliary peritonitis (GB penetraiton)
  3. gastro-colic fistula (tansverse colon penetration)
  4. perforation
  5. haemorrhage
  6. pyloric stenosis
  7. malignant change
31
Q

what is zollinger ellerson syndrome

A

increased gastrin secretion by a gastrin secreting tumour resulting in a thick gastric body mucosa with pronounce rugal folds, hyperplasia of gastric parietal cells and increased gastric acid secretion

32
Q

ZE syndrom presentation (3)

A
  1. pain
  2. multiple duodenal ulcers in atypical sites
  3. diarrhoea (due to increases gastric secretion)
33
Q

what condition are 1/3 of ZE syndrome gastrinomas associated with

A

MEN1/Werner’s sydnrome - rare disorder that causes tumors in the endocrine glands and parts of the small intestine and stomach, characterised by premature ageing

the rest are sporadic

34
Q

what gene mutation is associated with Werner’s syndrome

A

11q13

35
Q

what are gastric neoplasmsasms

A
  1. adenocarcinoma
  2. malignant gastrointestinal stromal
  3. lymphoma
36
Q

when might a lymphoma resolve

A

HP related MALT lymphomas may resolve with HP eradication

37
Q

what is a polyp

A

a lesion raised above the mucosa

38
Q

risk factors for gastric adenocarcinoma (5)

A
  1. genetic
  2. group A blood
  3. diet - carcinogens, polycyclic hydrocarbons in smoked foods, increased starch etc.
  4. premalignant condtions e.g. atrophic gastritis, adenomas
  5. pernicious anaemia
39
Q

4 types of gastric carcinoma (?)

A
  1. polypoid
  2. fungating
  3. ulcerated
  4. inflitrative
40
Q

what layer is early gastric cancer usually limited to

A

mucosa or submucosa

41
Q

what is virchow’s node

A

left-sided supraclavicular lymph node -> Troisier’s sign (hard, raised node) is indicative of gastric cancer as their lymphatic supply is from the abdominal cavity

42
Q

what is the main causative agent of stomach cancer

A

H.pylori

43
Q

4 conditions associated w H.Pylori

A
  1. acute and chronic gastritis
  2. peptic ulcer disease
  3. gastric adenocarcinoma
  4. non-Hodgkin lymphoma
44
Q

what is whipple’s disease

A

systemic disorder that not only involves malabsorption from the gastrointestinal tract but also affects other systems like the cardiovascular, central nervous system, joints, and vascular system - caused by a gram-positive bacteria, Tropheryma whippeli

45
Q

whipple’s disease presentation (6)

A
  1. steatorrhoea
  2. diahhorea
  3. malabsoption
  4. lymphadenopathy
  5. arthritis
  6. encephalopathy (occasionally)

3A week 1 - upper GI tract (7 decks)

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