Histopath - upper GI

Question 1

3 layers of SI

Answer 1

epithelium
Submucosa
Muscularis propria

Question 2

wtf is the Z line of the oesophagus?

Answer 2

Squamocolumnar junction

Question 3

3 layers of the normal stomach?

in layer 1, what shape are the cells?

Answer 3

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

Question 4

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

Answer 4

Goblet cells

Question 5

normal ratio of villous architecture?

Answer 5

2:1 (villi:crypt)

Question 6

4 complications of GORD?

Answer 6

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

Question 7

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

Answer 7

Stricture

Question 8

Define Barrett’s oesophagus

Answer 8

metaplastic columnar epithelium in the oesophagus

Question 9

Lymphoid follicles in the stomach. What is the cause?

Answer 9

H. Pylori infection

Question 10

Which strain of H-pylori is most worrying?

Answer 10

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

Question 11

Complications of gastric ulcers

Answer 11

Haemorrhage
Anaemia
Perforation –> peritonitis

Question 12

Steps to gastric cancer

Answer 12

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

Question 13

Which type of gastric carcinoma is most common?

Answer 13

adenocarcinoma (90%)

Question 14

which cell is high in gastric maltoma?

Answer 14

B cell (marginal zone) lymphocytes

Question 15

How can H. Pylori affect the duodenum?

Answer 15

Gastric acid can spill into the duodenum –> chronic inflammation –> gastric metaplasia

Question 16

common parasite in children which causes duodenitis?

Answer 16

Cryptosporidium

Question 17

which cell type populates the duodenum in malabsorption?

Answer 17

Lymphocytes

Question 18

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

Answer 18

Duodenal MALToma/lymphoma

T-cell mediated!!!

Question 19

2 types of oesophageal cancer - state their differences in:

• Aetiology?
• Location?

Answer 19

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

SqCC

• EtOH, smoking, nutritional deficiencies
• Middle 1/3 of oesophagus

Question 20

Which antibody is important in pernicious anaemia

Answer 20

Anti-Intrinsic factor

Question 21

Cancer associated with Coeliac disease

Answer 21

Duodenal MALToma aka

Enteropathy associated T cell Lymphoma

Question 22

Cancer associated with chronic immune stimulation by H. Pylori

Answer 22

Gastric MALToma