GI Flashcards
Summary of GI pathology?
Upper GI: Oesophageal/Stomach/SI pathology
Lower GI: Diverticular/IBD, Polyps, Adenoma, CRC,
Infective GE
Intra-abdominal infections
Nutritional support in trauma
What is the most common cause of oesophagitis?
Gastro-oesophageal reflux
infection if immunocomp/ corrosives
State 5 risk factors for reflex oesophagitis.
Male Caucasion Overweight Defective LES Hiatus heria Increased intra-abdo pressure
Ulceration/Haemorrhage/Perforation/Strictures are possible complications of long-standing reflux oesophagitis.
What is another one which is a pre-malignant condition?
BARRETT’S OESOPHAGUS
What are the risk factors for Barrett’s oesophagus?
Same as reflex oesophagitis
State the histiological changes in Barrett’s oesophagus.
Glandular metaplasia
sq –> columnar
Those wth Barrett’s oesophagus require regular endoscopic surviellance. For what?
ADENOCARCINOMA
What are the 2 types of Oesophageal cancer?
Adenocarcinoma - from Barrett’s
Squamous Carcinoma - from native cells (middle/lower 1/3)
Which Oesophageal cancer has the same risk factors as Barrett’s/reflex oesophagitis?
Adenocarcinoma
Risk factors for Squamous carcinoma?
Smoking Alcohol Thermal injury HPV Male Black
The 2 oesophageal cancers have the same macroscopic appearence. Describe these.
Strictures
Ulcerated
Fungating
Polypoidal
Causes of Chronic gastritis?
ABC: Autoimmune, Bacterial (H.pylori), Chemical injury
NSAIDs
Bile reflux
H.pylori is associated with which 2 cancers?
Gastric cancer
MALT Lymphoma
What effects does H.pylori have on the stomach?
Chronic inflammation (mucosa)
Glandular atrophy (fibrosis, intestinal metaplasia)
What is defined as a localised defect extending to the submucosa +
Peptic ulcer
Name 5 causes of peptic ulcers
H.PYLORI Smoking NSAIDs Hyperacidity Duodenl-gastro reflux
Is duodenal or gastric ulcer more common?
What is it always almost caused by?
Duodenal
H.PYLORI
Complications of peptic ulcers?
Haemorrhage
Perforation
Penetrate adjacent organs
Stricturing (hour-glass deforming –> reflux)
The most common type of gastric cancer is MALT lymphoma. T/F?
F
ADENOCARCINOMA
Adenocarcinoma of the GOJ has the same risk factors as Reflux oesophagitis.
What are the risk factors for Adenocarcinoma of body/antrum?
H.Pylori
Diet
Hypochlrohydria
Bile reflux
Gastric cancer in
HDGC
Hereditary diffuse-type
(scattered growth)
Other uncommon forms of gastric cancer?
Endocrine tumours
GIST
MALT lymphoma
Coeliac D is autoimmune and gliadin induces IL-15 expression –> CD8 IEL activation –> villi atrophy.
T/F?
T
Give 4 symptoms of Coeliac D.
Anaemia
Chronic diarrhoea
Bloating (bacteria)
Chronic fatigue (malabsorption)
How would you investigate for Coeliac D?
Antibodies
Biopsy
If got symptoms despite gluten-free diet, what would this suggest?
Cancer
Are diverticula are inward or outward protrusion of mucosa and submucosa?
OUTWARD
Diverticula are associated with…?
West
Urban
Elderly
Low fibre
Most diverticula present as…?
Other presentations?
Asymptomatic (90%)
Abdo pain
Alternating diarrhoea/constipation
Diverticulosis, Perforation, Haemorrhage are examples of what?
Acute complications of diverticula
Intestinal obstruction, Fistula, Colitis, Polypoid prolapsing mucosa folds are examples of what?
Chronic complications of diverticulosis