GI disease Flashcards
GORD classification
Los Angeles Classification
GORD -other name
Reflux Oesophagitis
Barrett’s Oesophagus - cells invovled
Squamous mucosa to Columnar epithelium
Oesophageal Adenocarcinoma - who gets it?
Caucasians, M more then F
Oesophageal Adenocarcinoma - Where is it usually?
Distal 1/3 of oesophagus
Squamous cell oesophageal carcinoma - Associated with?
who gets it?
where on oesophagus is it most commonly found?
Alcohol and smoking
Afro-carribeans, M more then F
Usually found in middle 1/3
Squamous cell oesophageal carcinoma presentation
Progressive dysphagia (solids then fluids)
Odynophagia (pain)
Severe weight loss
What is Gastritis?
Inflammation of the lining of the stomach
Gastric Ulcer - better or worse with food?
Worse
What is the main cause of Gastric Lymphoma
H. Pylori
What relieves the pain of a duodenal ucler?
Food and Milk
Coeliac Disease - buzz words
T cell mediated
Irish women
serological tests - Anti-endomysial Ab
Gold standard = upper Gi endoscopy and duodenal biopsy
Diverticular disease - overview
In the west due to low fibre diet
High intraluminal pressure = outpouching in wall (seen on barium enema CT)
90% in left colon
Often asymp, can have PR bleed
Complications of Diverticular disease?
Diverticulitis - fever and peritonisms, gross perforation, fistula, obstruction
Crohns - Facts
20s, more women then men Smoking WORSENS symptoms Affects whole GIT Skip lesions = cobblestone appearance Can have deep Rosethorn ulcers
Ulcerative Colitis - facts
20-25yrs
Extends proximally from rectum, continuously
Small bowel rarely affected
Superficial broad ulcers and pseudopolyps
Bloody Diarrhoea and mucus
Extra-GI manifestations of Crohns and UC
Eyes - Uveitis
Skin - Erythema nodosum
Joints - asymmetrical polyarthropahty of large joints
Liver - Primary sclerosing cholangitis
Carcinoid syndrome - what is it?
Diverse group of tumours of enterochromaffin cell origin. Produce 5-HT (serotonin). Slow growing, often in bowel
Symptoms of Carcinoid syndrome?
Bronchoconstriction
Flushing
Diarrhoea
Symptoms of Carcinoid crisis?
Live threatening vasodilation Hypotension Tachycardia Bronchoconstrction Hyperglycaemia
Adenoma - What are they? random facts
Benign dysplastic lesions
Found in 50per cent of over 50s in the western world
Mostly asymptomatic so need regular surveillance
Villous adenomas are rare - they leak protein and K
Large size is most important risk factor for malignancy
Adenoma - ‘First Hit’ hypothesis
can have 2 hits on APC, progress with mutations of p53
Clinical features of Hamartomatous polyp
Found sporadically
Also seen in Peutz-jaghers syndrome = Multiple polyps, freckles around the mouth, palms and soles
Colorectal cancer - epidemiology
60-79yrs, if found under 50 think familial syndrome
98% are denocarcinoma, 45% in rectum
Clinical features of colorectal cancer
Right sided tumours - iron def anaemia, weight loss
Left sided tumours - change in bowel habit, crampy LLQ pain
Familial adenomatous polyposis (FAP) inheritance?
70per cent autosomal dominant mutation in APC gene
present 10-15years
hereditary non-polyposis colorectal cancer (HNPCC) - inheritance?
Autosomal dom mutations in DNA mismatch repair genes
