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Clinical Pathology (mine) > GI tract pathology > Flashcards

GI tract pathology Flashcards

1
Q

What is the main type of epithelium in the oesophagus?

A

squamous

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2
Q

What is the name of the sphincter at the top of the oesophagus?

A

cricopharyngeal

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3
Q

What epithelium lines the bottom 1.5-2cm of the oesophagus?

A

glandular columnar epithelium

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4
Q

How far from the incisor teeth is the squamo-columnar junction?

A

40cm

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5
Q

What is the common form of oesophagitis?

A

reflux oesophagitis

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6
Q

What are the 4 main risk factors for reflux oesophagitis?

A
  • defective lower oesophageal sphincter
  • hiatus hernia
  • increased intra-abdominal pressure
  • increased gastric fluid volume due to gastric outflow stenosis
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7
Q

What is a hiatus hernia?

A

abnormal bulging of a portion of the stomach through the diaphragm

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8
Q

In which type of hiatus hernia will you get reflux symptoms?

A

sliding hiatus hernia

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9
Q

How does the squamous epithelium of the oesophagus appear in reflux oesophagitis?

A

basal cell hyperplasia, elongation of papillae, increased desquamation

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10
Q

How does the lamina propria appear in the oesophagus in reflux oesophagitis?

A

inflammatory cell infiltration

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11
Q

What is the cause of Barrett’s oesophagus?

A

longstanding reflux

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12
Q

What histological changes occur in someone with Barrett’s oesophagus?

A

squamous mucosa replaced by columnar mucosa> ‘glandular metaplasia’

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13
Q

What are the 3 types of columnar mucosa that may be present in Barrett’s oesophagus?

A
  • gastric cardia type
  • gastric body type
  • intestinal type
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14
Q

What does Barrett’s increase risk of?

A

adenocarcinoma

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15
Q

What are the 2 histological types of oesophageal carcinoma?

A
  • squamous cell carcinoma

- adenocarcinoma

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16
Q

What is the macroscopic appearance of adenocarcinoma?

A

plaque-like, nodular, fungating, ulceratedm depressed, infiltrating

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17
Q

What are the main risk factors for squamous carcinoma?

A
  • tobacco/smoking
  • nutrition
  • thermal injury
  • HPV
  • male
  • ethnicity
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18
Q

Where would you expect to find squamous carcinoma?

A

middle and lower third of the oesophagus

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19
Q

What precedes squamous carcinoma?

A

squamous dysplasia

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20
Q

What does pT mean?

A

depth of invasion of primary tumour

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21
Q

What type of staging is used for squamous carcinoma?

A

TNM

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22
Q

What do T, N and M stand for in TNM staging?

A

T-depth of invasion
N-nodular involvement
M-metastasis

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23
Q

What are the 4 anatomical regions of the stomach?

A

cardia, fundus, body, antrum

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24
Q

Describe the pathogen H. pylori?

A

gram negative spiral shaped bacterium

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25
Q

Which anatomical region is H. pylori more common?

A

more common in antrum than in the body

26
Q

Define ulcer

A

localised defect extending at least into submucosa

27
Q

How would chronic gastric ulcer appear histiologically?

A
  • Clear-cut edges overhanging the base
  • Extensive granulation and scar tissue at ulcer floor
  • Scarring often throughout the entire gastric wall with breaching of the muscularis propria
  • Bleeding
28
Q

What complications are associated with peptic ulcers?

A
  • haemorrhage
  • perforation -> peritonitis
  • penetration into adjacent organ
  • stricturing
29
Q

What percentage of duodenal ulcers are caused by H.pylori?

A

95-100%

30
Q

Which is the most frequent gastric cancer?

A

adenocarcinoma

31
Q

Is carcinoma of GOJ associated with H.pylori?

A

NO

32
Q

Which microscopic subtype of gastric adenocarcinoma has a worse prognosis?

A

diffuse subtype

33
Q

What is coeliac disease?

A

immune mediated enteropathy

34
Q

What component in gluten causes the reaction in coeliac patients?>

A

gliadin

35
Q

In coeliacs disease, what does the IL15 production induce?

A

activation/proliferation of CD8+ IELS

36
Q

Which cancers may be associated with coeliac disease?

A
  • enteropathy-associated T-cell lymphoma

- small intestinal adenomcarcinoma

37
Q

What are the two types of diverticulum?

A

congenital or acquired

38
Q

What is diverticulosis of the colon?

A

protrusions of mucosa and submucosa through the bowel wall

39
Q

What is the main cause of diverticulosis?

A

irregular/uncoordinated peristalsis

40
Q

Which are the points of relative weakness in the bowel wall where diverticuli are most likely to occur?

A

penetration of nutrient arteries between mesenteric and anti-mesenteric taenia coli

41
Q

What is the earliest stage od diverticulosis?

A

thickening of muscularis propria (prediverticular disease)

42
Q

What percentage of people with diverticulosis are asymptomatic?

A

90-99%

43
Q

What clinical features may someone with diverticulosis present with?

A

cramping abdominal pain and alternating constipation and diarrhoea

44
Q

Whata re some possible acute complications of diverticulosis?

A
  • abcess
  • perforation
  • haemorrhage
45
Q

What are some possible chronic complications of diverticulosis?

A
  • intestinal obstruction
  • fistula
  • diverticular colitis
  • polypoid prolapsing mucosal folds
46
Q

Define colitis

A

inflammation of colon

47
Q

How does ulcerative colitis present?

A
  • diarrhoea
  • constipation
  • rectal bleeding
  • abdominal pain
  • anorexia
  • weight loss
  • anaemia
48
Q

what are the 3 main types of idiopathic inflammatory bowel disease?

A

ulcerative colitis, crohns disease, indeterminate colitis

49
Q

What complication may you get with ulcerative colitis?

A
  • toxic megacolon and perforation
  • haemorrhage
  • stricture
  • carcinoma
50
Q

What is the most common pattern of Croh’s disease?

A

ileocolic (30-55%)

51
Q

What complications may occur with Crohn’s disease?

A
  • toxic megacolon
  • perforation
  • fistula
  • stricture
  • haemorrhage
  • carcinoma
  • short bowel syndrome
52
Q

What hepatic extra-intestinal manifestations of IBD may occur?

A
  • fatty change
  • granulomas
  • PCS
  • bile duct carcinoma
53
Q

What skeletal manifestations of IBD may occur?

A
  • polyarthritis
  • sacro-ileitis
  • ankylosing spondylitis
54
Q

What are the possible renal manifestations of IBD?

A

kidney and bladder stones

55
Q

What are the possible haematological manifestations of IBD?

A
  • anaemia
  • leucocytosis
  • thrombocytosis
  • thrombo-embolic disease
56
Q

What are the possible systemic manifestations of IBD?

A

amyloid, vasculitis

57
Q

What are the possible ocular manifestations of IBD?

A
  • iritis
  • episcleritis
  • retinitis
58
Q

What are the possible muco-cutaneous manifestations of IBD?

A
  • oral-apthoid ulcers
  • pyoderma gangernosum
  • erythema nodosum
59
Q

Define polyp

A

a mucosal protrusion

60
Q

How does peutz-jeghers syndrome present?

A

in teens or 20s with abdominal pain, GI bleeding and anaemia

61
Q

What is an adenoma?

A

benign epithelial tumour

Clinical Pathology (mine) (28 decks)

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