GIT Pathology Flashcards
what is required for absorption of nutrients?
large SA of SI.
pancreatic & brush border enzymes of SI. & bile for fats.
Risk factors for the development of gall stones
Five F’s: Female, Fat, 40’s, fair, fertile (not the only risk factors -> also rapid weightloss)
Possible consequences of gall stones
- one stone predisposes to more
- repeated acute becomes chronic
- if we get chronic inflammation of the gallbladder it increases risk of cancer.
- obstructiion of bile flow can cause cirrhosis if untreated -> malabsorption -> pancreatitis & if chronic -> pancreatic cancer
Is the gastrointestinal site considered to be a sterile site?
no, it is populated with a variety of organisms that are essential for the maintenance of health
What substances are produced by the exocrine pancreas?
digestive enzymes (protease, lipase, amylase, ribonuclease, gelatinase, elastase etc.) - bicabonate HCO3-
why is the liver a common site of secondary cancer?
rich arterial and VENOUS blood supply. rich lympathic supplu and it is a large viceral organ
Main risks for development of gastric ulcers & gastritis?
infection with H. pylori, alcohol, smoking, chronic use of NSAIDs (Non-steroidal anti-inflammatory drugs)
Possible complication associated with gastric ulcers?
- Cancer
- chronic blod loss -> anaemia
- acute massive blood loss
- scarring/obstruction
- perforation & pain
What is diverticulum?
bilnd-ended sack or out-pouch
What diverticulum are most people born with
appendix
Some people have an additional congenital diverticulum, what is it called
Meckel’s diverticulum
What is Diverticulosis
a diverticulum forming in weak spots in colon
How can a low fibre diet cause diverticulosis?
when stool lacks bulk, the mucle layers within the walls of the colon have to contract with more force to push out stool. in response the muscle layer hypertrophies and the overlying tissues can be pushed between the muscle fibres forming pouches.
Possible complications of chronic inflammatory bowel disease
- cancer
- scarring which leads to adhesions, fistula formation & obstruction
- chronic blood loss leading to anaemia
- malasorption
- pain
where is bile synthesised & stored?
synthesised in liver, stored in gallbladder & makes it moreconcentrated.
Main functions of Bile?
- helps remove substances from the body
- emulsifies fat increasing breakdown for adsorption of fat & fat-soluble vitamin
What is gallstones?
a small, hard crystalline mass formed abnormally in the gall bladder or bile ducts from bile pigments, cholesterol, and calcium salts
Where is arterial blood dervied from?
Hepatic aretery from teh celiac branch off the aorta
Where is the venous blood dervied from?
portal system from the spleen, pancreas, digestive system
where does blood travel after it leaves the liver lobule?
the central veins coalesce to form the hepatic vein which is a major signaory to the inferior vena cava
What is Cirrhosis?
Chronic inflammation of the liver resulting in complete distruption of the liver’s normal archutecture
Causes of Cirrhosis?
Chronic alcohol intake, NAFLD, hepatitis, autoimmune disease, iron-overload, heart failure, biliary disease
Impact of liver failure on rest of the body
??
Most pancreatic cancers are derived from cells of the exocrine pancreas and 70% of these occur at the head of the pancreas where they cause what signs and symptoms?
- Pain due to cell death & enzymatic fat necrosis/auto-digestion.
- Obstruction leading to malabsorption & weight loss, jaundice. - The combination of wasting & pain requiring opioid analgesics means that most people have a poor prognosis
Why do people with Cirrhosis & Liver failure develop ascites?
Cirrhosis causes congestion which increases hydrostatic pressure leading to oedema & ascites.
LF -> reduced sythesis of plasma protein -> reduced colloidal pressue worsening the oedema & ascites
ways we can die from having Cirrhosis apart from Liver Failure
- Cancer: hepatocellular carcinoma
- Haemorrhoid rupturing causing severe blood loss
- Encephalopthy -> disruption to CNS -> coma or death
Risk factors for Cancers of the tube & accessory organs
smoking, alcohol, chronic inflammation
Risk factors for Bowel cancer
chronic inflammatory bowel disease. usually starts off as benign (adenoma -> adenocarcinoma/squamous cell carcinoma)
Gastric Cancer Risk factors:
Chronic gastritis, chronic gastric ulcer
Liver Cancer Risk factors
cirrhosis of the liver
Pancreatic Cancer Risk factors
chronic pancreatitis,
lower osophagus risk factors
chronic gastric reflux, causes metaplasia, possible dysplasia which leads to cancer of the lower osophagus
