Hi - Upper GI Flashcards
3 layers of SI
epithelium
Submucosa
Muscularis propria
what is the Z line of the oesophagus?
Squamocolumnar junction
3 layers of the normal stomach?
in layer 1, what shape are the cells?
1) Columnar epithelium
2) Lamina Propria
3) Muscularis mucosa
Which cell type should NOT be present in the normal stomach? (It’s presence is indicative of metaplastic change)
Goblet cells
normal ratio of villous architecture?
2:1 (villi:crypt)
5 complications of GORD?
1) Haemorrhage
2) Perforation
3) Stricture
4) Barret’s
5) Ulceration
Which particular complication may arise if GORD –> fibrotic change?
Stricture
Define Barrett’s oesophagus
metaplastic columnar epithelium in the oesophagus
Lymphoid follicles in the stomach. What is the cause?
H. Pylori infection
Which strain of H-pylori is most worrying?
Cag-A positive: has a needle like appendage which injects toxin into intracellular junctions
Complications of gastric ulcers
Haemorrhage
Anaemia
Perforation –> peritonitis
Steps to gastric cancer
H. pylori –> intestinal metaplasia –> dysplasia –> invasive cancer
Which type of gastric carcinoma is most common?
adenocarcinoma (95%)
which cell is high in gastric maltoma?
B cell (marginal zone) lymphocytes
How can H. Pylori affect the duodenum?
Increases gastric acid secretion in stomach, which spills in to duodenum –> Chronic inflammation –> gastric metaplasia –> H.Pylori colonise duodenum –> ulcers / duodenitis
common parasite in children which causes duodenitis?
Cryptosporidium
which cell type populates the duodenum in malabsorption?
Lymphocytes
Coeliac disease increases the risk of which cancer? Which cells are important in this cancer?
Duodenal MALToma/lymphoma
T-cell mediated!!!
2 types of oesophageal cancer - state their differences in:
- Aetiology?
- Location?
ADENOCARCINOMA
- Barrett’s oesophagus
- Lower 1/3 of oesophagus
vs
SqCC
- EtOH, smoking, nutritional deficiencies
- Middle 1/3 of oesophagus
Which antibody is important in pernicious anaemia
Anti-Intrinsic factor
Cancer associated with Coeliac disease
Duodenal MALToma aka
Enteropathy associated T cell Lymphoma
Cancer associated with chronic immune stimulation by H. Pylori
Gastric MALToma
What is the flat pathway?
Squamous epithelium –> metaplasia –> low grade dysplasia –> high grade dysplasia –> adenocarcinoma
2 types of Baretts?
With or without goblet cells
Apperance of acute oesophagitis
red, pain, hot, decreased function, swollen
increased neutrophils in epithelium
2 features of adenocarcioma of oesophagus
makes glands, secretes mucin
2 features of SCC of oesophagus
produces keratin
strong intracellular bridges
where do oesophageal varices occur
anastomoses of artery and vein
causes of acute gastritis
NSAIDs
alcohol
corrosives
H.Pylori / infection
causes of chronic gastritis
ABC
Autoimmune - antiparietal ABs
bacterial - H.Pylori
chemical - NSAIDs
complications of H.Pylori
CLO - IM - Dysplasia / adnenocarcinoma / MALT lymphoma
8x risk of gastric cancer
ulcer vs erosion
ulcer goes through muscularis mucosae into submucosa but erosion more superficial
% survival from gastric cancer
15%
what are the other 5% of causes of gastric cancer
SCC
MALT lymphoma
GI stromal tumour (GIST)
neuroendocrine tumours
2 types of gastric adenocarcinoma and features
Intestinal = well differentiated
Diffuse = poorly differentiated
Histology of diffuse adenocarcinoma of stomach
Linitis plastica
Signet ring cells - mucin inside cell
Most common cause of duodenal ulcers
H.Pylori
Giardia lamblia
Histology of villous atrophy
Crypt hyperplasia
Villous atrophy
Raised intraepithelial lymphocytes
Dx of coeliac?
Endomysial ABs and anti TTG (tissue transglutaminase)
Biopsy results of coeliac?
If on diet WITH gluten –> vilous atrophy
If on diet WITHOUT gluten –> normal vili
Name a disease which can present similarly to coealic
Tropical sprue
