GIT- microscopic anatomy

Question 1

Barrett’s oesophagus

• Pathogenesis
• Risk factors

Answer 1

Lower oesophagus is line with columnar epithelial cells from squamous epithelium (metaplasia)
- Caused by reflux of gastric content through cardiac sphincter

Risk factors:

• High BMI
• Alcohol
• Smoking tobacco
• Drugs that relax oesophageal sphincter
• Genetic

Question 2

Pathogenesis of Barett’s associated carcinoma

Answer 2

1. Squamous epithelium (normal)
2. Reflux oesophagitis
3. Columnar epithelium (gastric)
4. Intestinal metaplasia
5. Low then high grade dysplasia
6. Adenocarcinoma\

Question 3

Complications of coeliac disease [5]

Answer 3

Dermatitis herpetiformis

Osteoporosis

Adenocarcinoma of large or small bowel

T1 diabetes

Primary biliary cirrhosis

Question 4

Normal large bowel mucosa

Answer 4

Crypts arranged in test-tube like structure

- Separated by lamina propria from vessels and CT.

Question 5

Indications for colectomy in ulcerative colitis [5}

Answer 5

Non responding to treatment

Toxic megacolon

Severe bleeding

High grade dysplasia

Presence of cancer

Question 6

Diverticular disease

Answer 6

Outpouching due to mucosa and submucosa herniation.
- Common in low fibre diet

Mainly affects sigmoid colon

Complications:

• Perforation
• Diverticulitis
• Peritonitis

Question 7

Spurious diarrhea

Answer 7

‘False’ diarrhea

Very liquid stool that follows constipation.

Can be caused by large bowel obstruction

Question 8

Crohn’s complications

Answer 8

Intra-abdominal abscess

Sinus tract

Fistulas

Cancer

Strictures