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Pathology And Medicine > GI track diseases I > Flashcards

GI track diseases I Flashcards

1
Q

Disorders of the Oesophagus

A

obstruction

inflammation

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2
Q

What does obstruction of Oesophagus cause?

A

dysphagia

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3
Q

dysphagia

A

inability to swallow, feeling something is stuck

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4
Q

What is dysphagia caused by?

A

carcinoma - presents late, usually inoperable

benign structure (eg. scar tissue) - associated with reflux oesophagitis

stroke

neurological issues
- motor neurone disease

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5
Q

What does lower oesophageal sphincter protect against?

A

lower oesophageal sphincter (LES) protects against reflux of HCl

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6
Q

GORD/GERD - Gastro-oesopheal reflex disease

A

HCl moves into oesophagus

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7
Q

What is GORD/GERD caused by?

A

Central NS depressant, pregnancy, alcohol

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8
Q

Anatomical changes resulting from disorders of oesophagus

A
  1. infiltration of inflammatory cells in the squamous epithelial layer
  2. neutrophils are markers of severe injury
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9
Q

Treatment of inflammation of the oesophageal mucosa

A

removal of acid, sleeping upright, smaller meals (reduced stimulus for HCl)

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10
Q

What can we use to detect oesopahitis?

A

gastroscopy

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11
Q

Oesophageal Varices

A

secondary to liver disease

end up with portal hypertension
- blood can’t flow properly through hepatic portal vein

blood diverted to sub-musosal veins - gastric and oesophageal

small vessel abnormally dilated

very prone to bleeding - vomiting blood

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12
Q

Disorders of the stomach

A

gastritis

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13
Q

What is gastritis?

A

inflammation of the gastric mucosa to HCl

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14
Q

Acute gastritis

A

neutrophil infiltration

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15
Q

Chronic gastritis

A

long term changes in cell types, lymphocytes, intestinal metaplasia and atrophy

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16
Q

What does chronic gastritis lead to?

A

ulcer
- breach of 4-layer structure
- stomach contact leaks into peritoneum

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17
Q

Range of gastritis

A

loss of superficial mucosa

rupture of stomach

acute GI bleeding

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18
Q

What is gastritis associated with?

A

alcohol and tobacco

servere stress/chemo

bacterial and viral infections

NSAIDs eg. ibuprofen

19
Q

What do NSAIDs do to the stomach?

A

impacts mucus and bicarbonate production

20
Q

What does alcohol and tobacco do to stomach?

A

increases HCl production

damaging blood supply

21
Q

What are the three ways damage is caused to the stomach?

A

increased HCl

decreased HCO3 - reduced blood flow

disruption to mucus layer
- direct damage to epithelium

22
Q

Is gastritis self-limiting?

A

yes
- does not require more than simple OCT treatment

23
Q

How to diagnose chronic infection with H.Pylori

A

biopsy
- presence of bacteria or urease enzyme activity OR urea breath test OR stool sample

24
Q

Complications of disorders if the stomach

A

bleeding

perforation of stomach/duodemun

severe pain/rigid abdomen - will require surgery

25
Q

Treatment of disorders of the stomach

A

Al/Mg hydroxide eg. gaviscon

Histamine H2 receptor antagonist - reduces HCl production

Proton pump inhibitors - switch off HCl production

Antibiotics - against H.pylori

26
Q

Malabsorption Syndromes

A

Defective Intraluminal Digestion

Mucosal

Reduced SI surface area

27
Q

Defective Intraluminal Digestion

A

Pancreatic insufficiency
- no enzyme or bicarbonate
- pancreatitis
- CF

Biliary Insufficiency
- no bile, no emulsification which leads to fat malabsorption

Bacterial Overgrowth in Small Intestine (SIBO) - colonic bacteria enter sl

28
Q

Mucosal Malabsorption

A

Disaccharidase deficiency
- lactose intolerance

Abetolipoproteinaemia
- LCFA malabsorption

Primary bile acid malabsorption
- causes bile acid diarrhoea

29
Q

Reduced SI surface area

A

coeliac disease

crohn disease

30
Q

Fat malabsorption

A

greasy stool which do not flush

bile insufficiency

pancreatic lipase deficiency

mucosal defects

31
Q

How to confirm fat malabsorption

A

faecal fat test

32
Q

Coeliac disease

A

sensitivity to gluten from wheat and close related grains

t-cell mediated inflammatory reaction

anti-gliadin antibodies

33
Q

dermatitis herpetiformis

A

fluid filled blisters

skin manifestation of celiac disease in 15-25%

34
Q

SI biopsy to diagnose coeliac disease

A
  • atrophy and loss of villi
  • intra-epithelial lymphocytes - immune reaction
  • crypts elongated
  • overall mucosal thickness in unchanged
35
Q

What happens to coeliac disease in gluten free diet?

A

musosal histology reverts to near normal following period of gluten exclusion

36
Q

What are the 4 major causes of intestinal obstruction

A

herniation of segment

surgical adhesions

intussusceptions

volvulus

37
Q

herniation of segment

A

weakness in a wall of peritoneal cavity causes blockage and loop of bowel loses blood supply
- surgery

38
Q

Surgical adhesions

A

surgery or infection resulting in Peritonitis
(forming of scar tissue on outside)

as infection heals, fibrous bridges causing strangulations of intestinal segment, bowl blockage

39
Q

intussusceptions

A

segment of intestine becomes telescoped within a distal segment during peristalsis
- defect of peristalsis

40
Q

volvulus

A

complete twisting of loop of bowel, connective tissue to abnormal wall is lost

41
Q

Is volvulus rare?

A

rare

birth defect

malrotation lacks normal attachment to abdominal wall

42
Q

volvulus symptoms

A

vomiting

trapped gas

abdominal pain and distension

constipation

43
Q

Superior mensenteric artery syndrome

A
  • occurs in very learn people
  • flattering of duodenum by SMA
  • anorexia (very low visceral fat)
  • duodenum crushed between arteries

Pathology And Medicine (15 decks)

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