GI pathology

Question 1

what layer of the GI tract changes throughout?

Answer 1

Mucosa

Question 2

what type of mucosa is in the oesophagus?

Answer 2

Stratified squamous

Question 3

what colour is oesophageal mucosa normally to the naked eye?

Answer 3

white

Question 4

what mucosa is the stomach got?

Answer 4

thick glandular mucosa

Question 5

what mucosa does the small intestine have?

Answer 5

Glandular with villi mucosa

Question 6

what is the structural difference between the small and large intestine?

Answer 6

Small: more villi
Large: more crypts

Question 7

what are causes of gastritis?

Answer 7

H pylori

NSAIDS

Question 8

what causes a stress ulcer?

Answer 8

When the body is under stress the large amounts of steroids released cause damage

Question 9

what are GORD risk factors?

Answer 9

Smoking, drinking, obesity, hiatus hernia, pregnancy

Question 10

what is the change in Barretts?

Answer 10

Squamous epithelium to columnar

Question 11

what blood tests are used for coeliacs?

Answer 11

Anti TTG

anti-endomysial

Question 12

what is coeliac associated with?

Answer 12

Small bowel lymphoma
Dermatitis herpetiformis (blistering rash_

Question 13

what symptoms make up charcots triad?

Answer 13

• jaundice
• fever
• SEVERE RUQ pain

Question 14

what is a fistula?

Answer 14

A communication between two epithelial surfaces

Question 15

what are the concentric layers of the GI tract?

Answer 15

• mucosa
• submucosa
• muscularis propria
• subserosa
• serosa

Question 16

what are complications of GORD?

Answer 16

• stricture causing dysphagia
• bleeding via peptic ulcer
• barretts oesophagus.

Question 17

what group is oesophageal cancer most common in?

Answer 17

males between 50-70

Question 18

what are the key investigations for oesophageal cancer?

Answer 18

Endoscopy

Biopsy

Question 19

what is the most common type of oesophageal cancer?

Answer 19

Adenocarcinoma

Question 20

what are risk factors for gastric cancer?

Answer 20

• H pylori infection
• cigarette smoking
• alcohol
• diet
• autoimmune gastritis

Question 21

how can gastric cancer present?

Answer 21

• new onset dyspepsia
• unintended weight loss
• progressive dysphagia
• vomiting
• virchows node in the left supraclavicular fossa

Question 22

what are the two main types of gastric adenocarcinomas?

Answer 22

1. intestinal type

2. diffuse type

Question 23

what type of gastric adenocarcinomas tends to present in the younger age group?

Answer 23

Diffuse type Adenocarcinoma

Question 24

what type of gastric adenocarcinoma shows gland formation lined by mucus secreting cells?

Answer 24

Intestinal type

Question 25

what type fo gastric adenocarcinoma shows signet ring cells?

Answer 25

diffuse type adenocarcinomas

Question 26

what type of gastric adenocarcinoma has a better prognosis?

Answer 26

intestinal type

Question 27

what are types of gallstones and their appearance?

Answer 27

1. cholesterol stone. Large and yellow 2. bilirubinate stone; small and pigmented 3. mixed stones

Question 28

what are the main risks for developing cholesterol stones?

Answer 28

Female, obesity, middle age, family history

Question 29

why does crohns disease lead to a higher likelihood of gall stones?

Answer 29

leads to malabsorption of bile salts from the terminal ileum

Question 30

what will be seen if the gallstone impacts the common bile duct?

Answer 30

obstructive jaundice | development of ascending cholangitis

Question 31

what is the most common cause of acute pancreatitis?

Answer 31

gallstones

Question 32

what is courvoisiers law?

Answer 32

A jaundiced patient with a palpable gallbladder means the jaundice is unlikely to be due to gallstones impacting the biliary system

Question 33

what is the most common type of pancreatic cancer?

Answer 33

Adenocarcinoma

Question 34

what is the presentation of tumour of the head of the pancreas?

Answer 34

obstructive jaundice weight loss mid epigastric pain

Question 35

what is removed in whipples procedure?

Answer 35

``` distal stomach gallbladder common bile duct head of the pancreas duodenum proximal jejunum regional lymph nodes ```

Question 36

what is the pathogenesis of coeliacs?

Answer 36

gliadin in gluten triggers inappropriate activation of T cells damaging intestinal epithelium cells

Question 37

what haplotypes are present in coeliacs?

Answer 37

HLA DQ2 | HLA DQ8

Question 38

what is gold standard diagnosis for coeliacs?

Answer 38

endoscopy and duodenal biopsy

Question 39

why are coeliac disease patients at higher risk of osteopenia and osteoporosis?

Answer 39

Due to less calcium

Question 40

what is osteopenia?

Answer 40

reduced bone density