GIT

Question 1

Features of oesophageal adenocarcinoma

Answer 1

Typically arises on background of Barrett’s oesophagus and long standing GERD

Commonly distal 1/3 and can invade adj gastric cardia

More common in men
More common in developed countries

Produce mucin and form glands

Tumours may form exophytic masses and infiltrate diffusely or ulcerate and invade deeply

Question 2

Clinical presentation of adenocarcinoma of oesophagus

Answer 2

Pain or difficulty swallowing
Weight loss
Chest pain
Vomiting.

^often mean cancer has spread to submucosal lymph nodes

Question 3

Features of squamous cell carcinoma of oesophagus

Answer 3

Common in males
Over 45yo
More in under developed countries and rural areas

Question 4

LFTSs - AST and ALT

Answer 4

ALT
More liver specific
Mainly in cytosol

AST
Also in other tissues like cardiac, skeletal, kidney and brain tissue
More in mitochondria

Ratio AST:ALT over 2 can indicate alcoholic liver disease

Question 5

ALP

Answer 5

Tissue specific isoenzymes can be requested (2) (cancer assoc, placental or intestinal)

Kidney bone and liver

Membrane bound forms with obstructive liver disease and bile-duct diseases

Question 6

GGP tend to be not increased

Answer 6

In bone problems

GGT=ALT can mean alcohol

Question 7

LDH

Answer 7

Lactate dehydrogenase
Catalyses reaction of pyryvate –> lactate
5 isoenzymes

Present in all cells cytoplasm
Highest conc in muscles liver and red cells

Question 8

GGT and ALP

Answer 8

Markers of obstruction

GGT more specific by affected by enzymes induction by alcohol and drugs etc

Question 9

Conj bilirubin is a marker of

Answer 9

Obstruction

Elevated highest with intrahepatic obstruction