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Pathology > Hi - Upper GI > Flashcards

Hi - Upper GI Flashcards

1
Q

3 layers of SI

A

epithelium
Submucosa
Muscularis propria

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2
Q

what is the Z line of the oesophagus?

A

Squamocolumnar junction

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3
Q

3 layers of the normal stomach?
in layer 1, what shape are the cells?

A

1) Columnar epithelium
2) Lamina Propria
3) Muscularis mucosa

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4
Q

Which cell type should NOT be present in the normal stomach? (It’s presence is indicative of metaplastic change)

A

Goblet cells

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5
Q

normal ratio of villous architecture?

A

2:1 (villi:crypt)

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6
Q

5 complications of GORD?

A

1) Haemorrhage
2) Perforation
3) Stricture
4) Barret’s
5) Ulceration

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7
Q

Which particular complication may arise if GORD –> fibrotic change?

A

Stricture

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8
Q

Define Barrett’s oesophagus

A

metaplastic columnar epithelium in the oesophagus

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9
Q

Lymphoid follicles in the stomach. What is the cause?

A

H. Pylori infection

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10
Q

Which strain of H-pylori is most worrying?

A

Cag-A positive: has a needle like appendage which injects toxin into intracellular junctions

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11
Q

Complications of gastric ulcers

A

Haemorrhage
Anaemia
Perforation –> peritonitis

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12
Q

Steps to gastric cancer

A

H. pylori –> intestinal metaplasia –> dysplasia –> invasive cancer

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13
Q

Which type of gastric carcinoma is most common?

A

adenocarcinoma (95%)

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14
Q

which cell is high in gastric maltoma?

A

B cell (marginal zone) lymphocytes

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15
Q

How can H. Pylori affect the duodenum?

A

Increases gastric acid secretion in stomach, which spills in to duodenum –> Chronic inflammation –> gastric metaplasia –> H.Pylori colonise duodenum –> ulcers / duodenitis

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16
Q

common parasite in children which causes duodenitis?

A

Cryptosporidium

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17
Q

which cell type populates the duodenum in malabsorption?

A

Lymphocytes

18
Q

Coeliac disease increases the risk of which cancer? Which cells are important in this cancer?

A

Duodenal MALToma/lymphoma

T-cell mediated!!!

19
Q

2 types of oesophageal cancer - state their differences in:
- Aetiology?
- Location?

A

ADENOCARCINOMA
- Barrett’s oesophagus
- Lower 1/3 of oesophagus
vs

SqCC
- EtOH, smoking, nutritional deficiencies
- Middle 1/3 of oesophagus

20
Q

Which antibody is important in pernicious anaemia

A

Anti-Intrinsic factor

21
Q

Cancer associated with Coeliac disease

A

Duodenal MALToma aka
Enteropathy associated T cell Lymphoma

22
Q

Cancer associated with chronic immune stimulation by H. Pylori

A

Gastric MALToma

23
Q

What is the flat pathway?

A

Squamous epithelium –> metaplasia –> low grade dysplasia –> high grade dysplasia –> adenocarcinoma

24
Q

2 types of Baretts?

A

With or without goblet cells

25
Q

Apperance of acute oesophagitis

A

red, pain, hot, decreased function, swollen
increased neutrophils in epithelium

26
Q

2 features of adenocarcioma of oesophagus

A

makes glands, secretes mucin

27
Q

2 features of SCC of oesophagus

A

produces keratin
strong intracellular bridges

28
Q

where do oesophageal varices occur

A

anastomoses of artery and vein

29
Q

causes of acute gastritis

A

NSAIDs
alcohol
corrosives
H.Pylori / infection

30
Q

causes of chronic gastritis

A

ABC
Autoimmune - antiparietal ABs
bacterial - H.Pylori
chemical - NSAIDs

31
Q

complications of H.Pylori

A

CLO - IM - Dysplasia / adnenocarcinoma / MALT lymphoma
8x risk of gastric cancer

32
Q

ulcer vs erosion

A

ulcer goes through muscularis mucosae into submucosa but erosion more superficial

33
Q

% survival from gastric cancer

A

15%

34
Q

what are the other 5% of causes of gastric cancer

A

SCC
MALT lymphoma
GI stromal tumour (GIST)
neuroendocrine tumours

35
Q

2 types of gastric adenocarcinoma and features

A

Intestinal = well differentiated
Diffuse = poorly differentiated

36
Q

Histology of diffuse adenocarcinoma of stomach

A

Linitis plastica
Signet ring cells - mucin inside cell

37
Q

Most common cause of duodenal ulcers

A

H.Pylori
Giardia lamblia

38
Q

Histology of villous atrophy

A

Crypt hyperplasia
Villous atrophy
Raised intraepithelial lymphocytes

39
Q

Dx of coeliac?

A

Endomysial ABs and anti TTG (tissue transglutaminase)

40
Q

Biopsy results of coeliac?

A

If on diet WITH gluten –> vilous atrophy
If on diet WITHOUT gluten –> normal vili

41
Q

Name a disease which can present similarly to coealic

A

Tropical sprue

Pathology (87 decks)

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