GI: Pathology Flashcards
What is paralytic ileus?
Loss of GI contractility
-Can occur following GI surgery
What is achalasia?
Failure of LOS to relax
What is Hirschsprung’s disease?
- Lack of myenteric and submucosal plexus
- Results in function obstruction
What are the effects of inflammatory bowel disease on crypts?
- Crypt alteration
- Cryptitis (inflammation of wall)
- Crypt abscess (neutrophils in lumen)
What is coeliac disease?
- Inability to tolerate gliadin found in gluten.
- Gluten is found in wheat, rye and barley
- Results in immune response which damages the mucosa leading to poor digestion and malabsorption
- Causs absence of intestinal villi and causes lengthening of intestinal crypts.
- Lymphocytes infiltrate epithelium
What is xerostomia?
-Dry mouth
Can lead to dental cavities, mouth ulcers, bad breath and oral thrush
What are causes of dysphagia?
Dysphagia is difficulty swallowing
Causes are
- Stroke that affect nerves controlling swallowing
- Oesophageal tumour (solid are a problem)
- Hardening of muscular layers
Which drugs could have an effect of the parasympathetic innervation of the salivary glands?
- Anti muscurinic
- Can cause xerostomia
What are the narrowings found in the oesophagus?
- Tightest narrowing is the junction between the pharynx and oesophagus
- Second narrowing is when the arch of aorta crosses the oesophagus
- Third narrowing is when the left main bronchus crosses the oesophagus
- Final narrowing is when oesophagus passes through diaphragm (T10)
Outline some of the clinical consequences of free gastro-oesophageal reflux.
-Barrett’s oesaphagus
What is the treatment for gastro-oesophageal reflux disease?
-Lifestyle modifications
Pharmacological
- Antacids
- H2 antagonists (block histamine)
- Proton Pump Inhibitors
Surgery(rare)
What is acute gastritis?
Acute mucosal inflammatory process. Caused by:
- Heavy use of NSAIDS
- Lots of alcohol
- Chemotherapy
- Bile reflux
What are the symptoms of acute gastritis?
Asymptomatic most of the time but can present with
- Pain
- Nausua
- Vomiting
- Occasionally bleeding
What are the common causes of chronic gastritis?
Bacterial
-H pylori infection
Autoimmune
- Antibodies to gastric parietal cells
- Can lead to pernicious anemia
Chemical/reactive (minimal inflammation)
- Chronic alcohol abuse
- NSAIDS
- Reflux of bile
What are symptoms of chronic gastritis caused by H.pylori?
Asymptomatic or similar to acute gastritis
-Symptoms may develop due to complications (peptic ulcers, adenocarcinoma, MALT lymphoma)
What are symptoms of chronic gastritis caused by an autoimmune disorder?
- Symptoms of anaemia
- Glossitis
- Anorexia
- Neurological symptoms
What is peptic ulcer disease?
Defects in gastric/duodenal mucosa that extend through the muscular mucosa
-Commonly in first part of duodenum and lesser curve of the stomach
What are the causes of peptic ulcer disease?
- Stomach acid
- H pylori
- NSAIDS
- Smoking
- Massive physiological stress
What are the symptoms of peptic ulcer disease?
Epigastric pain
- Burning/Gnawing
- Follows meal times
- Often at night
Serious symptoms
- Bleeding/anaemia
- Satiety (early)
- Weight loss
What is functional dyspepsia?
- Symptoms of ulcer disease
- No physical evidence
- Diagnosis of exclusion
What are the methods used to diagnose gastric pathology?
- Upper GI endoscopy (biopsies)
- Urease breath test
- Erect chest X-ray (perforation)
- Blood test (anaemia)
How do H2 blockers work?
-Stop histamine components which stimulate parietal cells
Describe the pathogenesis of helicobacter-pylori?
- Spread via faecal-oral route
- Helix shaped gram negative
- Produces urease which covers urea to ammonium to increase local pH
- Has flagellum for good motility. It lives in mucus layer/adheres to gastric epithelia
How does helicobacter pylori cause problems?
- Relase cytotoxins to cause direct epithelial injury
- Expresses urease which can form ammonia which is toxic to epithelium
- Possibly degrades mucus layer
- Promotes inflammatory response which can cause self injury
What is the pathological result of the location of H-pylori colonisation?
In antrum
-Duodenal ulceration
In antrum and body
-Asymptomatic
Predominantly in body
-Can lead to cancer
What are causes of stress ulceration?
- Severe burns
- Raised intracranial pressure
- Sepsis
- Severe trauma
- Multiple organ failure
What are the symptoms of coeliac disease?
- Diarhoea
- Flatulence
What investigations done for coeliac disease?
- Upper GI endoscopy and biopsies. Checks for mucosal pathology and whether villli are reduced or absent
- Bloods (Serology, Electrolyte imbalances and Anaemia)
- Treatment (diet)
