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Clinical Pathology > GI Diseases - Upper GI > Flashcards

GI Diseases - Upper GI Flashcards

1
Q

What cells line the oesophagus?

A

It is mostly lined by squamous epithilium.

Under the diaphragm it is lined by Glandular Columnar Mucosa

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2
Q

What is Oesophagitis?

A

Inflammation of the oesophagus.

It can be acute of chronic.

It can be caused by :
bacterial
viral (HSV1, CMV)
fungal (candida)
Chemial (acid reflux)
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3
Q

What is the commonest cause / form of oeophagitis?

A

Reflux Oesophagitis

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4
Q

What are the risk factors of Reflux Oesophagitis?

A
  • Defective Lower Oesophageal Sphincter
  • Hiatus Hernia
  • Increased Intra Abdo pressure
  • Increased gastric fuid volume caused by gastric outflow stenosis.
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5
Q

What are the consequences of Sliding hiatus hernia and Para-Oesophageal hernia?

A

Sliding hiatus hernia : Reflux Symptoms

Para-Oesophageal Hernia:
Strangulation

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6
Q

What are the complications of reflux oesophagitis?

A
  • Ulceration
  • Haemorrhage
  • Perforation
  • Barrett’s Oesophagus (dysplasia)
  • Benign narrowing
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7
Q

What is Barrett’s Oesophagus?

A

The squamo-columnar junction moves higher up the oesophagus due to long standing reflux.

Can progress to cancer

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8
Q

What are the 2 histological types of oesophageal carcinoma?

A

1) Squamous Cell Carcinoma

2) AdenoCarcinoma

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9
Q

Where is Oesophageal Adenocarcinoma usually found and how does it look?

A

-Found in lower oesophagus.

Looks :
-Plaque like, nodular, fungating, ulcerated, depressed.

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10
Q

What is the difference in indicence between Oesphageal adnocarcinoma vs. squamous carcinoma?

A

Adenocarcinoma:

  • industrual countries
  • more males affected
  • higher amongst caucasians

Squamous Carcinoma:
-wide variation in incidence

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11
Q

What are the 4 anatomical regions of the stomach?

A

1) Cardia
2) Fundus
3) Body
4) Antrum

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12
Q

What part of the oesophagus is more prone to squamous carcinoma?

A

Upper 2/3rds

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13
Q

What is gastritis?

A

Inflammation of lining of stomach

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14
Q

What are the causes of Chronic gastritis?

A

1) Autoimmune
2) Bacterial infection e.g. H. Pylori
3) Chemical Injury e.g. NSAIDs, Bile reflux

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15
Q

What is H.Pylori

A

-Gram Negative spiral shaped bacetrium

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16
Q

What does H.Pylori do?

A

H.Pylori damages the epithelium leading to chronic inflammation of the body,

It can lead to ulcers and cancer.

17
Q

What part of the stomach does H.Pylori more commonly affect?

A

Antrum

18
Q

What are the major sites of peptic ulcer disease?

A

1) First part of duodenum
2) Junction of antral and body mucosa
3) Distal Oesophagus

19
Q

What are the main causes of peptic ulcer disease?

A

1) Hyperacidity
2) H.Pylori Infection
3) Duodenal - gastric reflux
4) Drugs e.g. NSAIDs
5) Smoking

20
Q

What is the histological definition of an acute gastric ulcer?

A

It is a full thickness coagulative necrosis of mucosa.

21
Q

What are the features of a chronic gastric ulcer?

A
  • clear cut edges overhanging base of ulcer.
  • Extensive granualtion and scar tissue at floor,
  • Scarring
  • Bleeding
22
Q

What are the complications of peptic ulcers?

A

1) Haemorrhage (can lead to anaemia)
2) Perforation (cause peritionitis)
3) penetration into adjacent organ (e.g. liver)
4) Stricure

23
Q

What is the most frequent type of Gastric Cancer?

A

-adenocarcinoma

24
Q

What are the causes of gastric adenocarcinoma?

A
  • Diet
  • H.Pylori
  • Bile Reflux
  • Hypochlorhydia
25
Q

What is carcinoma of the gastric-oesophageal junction associated with?

A

1) Acid reflux
2) No association with H.pylori or diet
3) more common in white males.

26
Q

What carcinoma of the gastric body/antrum associated with?

A
  • H.Pylori
  • Diet (low fruit/veg)
  • NO link to acid reflux
27
Q

What is Coeliac Disease?

A

It is an immune mediated disease. Causing the intolerance of gluten.

28
Q

What is the pathogenesis of Coeliac disease?

A

GLIADIN is a component of gluten that causes epithelial cells to express IL-15.
This causes the activation of CD8+ve T cells. Which attack the cells which have absorbed the gluten.

29
Q

What are the symptoms of Coeliac?

A

Anaemia,
Diarrhoea
Bloating
Fatigue

Clinical Pathology (59 decks)

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