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Pathology ICSM > Histopathology 10 - Upper GI disease > Flashcards

Histopathology 10 - Upper GI disease Flashcards

1
Q

What is the “Z line” in the GI tract?

A

Normal appearance of squamo-columnar junction

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2
Q

Where is the cardia portion of the stomach?

A

Junction between oesophagus and stomach

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3
Q

What are the 3 layers of the stomach wall?

A 
Gastric mucosa (columnar)
Lamina propria (containing glands) 
Muscularis mucosae

nb: difference between mucosa and mucosae

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4
Q

In a normal duodenum, what is the villous:crypt ratio?

A

2:1

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5
Q

Where are goblet cells usually found?

A

Intestine

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6
Q

What is the most common cause of acute oesophagitis?

A

GORD

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7
Q

If reflux oesophagitis causes a perforation of the oesophagus, what will be the result?

A

Mediastinitis

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8
Q

What are the most common complications to remember of most GI pathologies?

A

Ulceration
Haemorrhage
Perforation
Stricture

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9
Q

How is Barrett’s oesophagus different from metaplasia?

A

Reversible

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10
Q

What is gastric metaplasia?

A

Metaplastic change in oesophagus without goblet cells

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11
Q

What is intestinal type metaplasia?

A

Replacement of squamous epithelium with metaplastic columnar epithelium WITH goblet cells present

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12
Q

What is the most common sequence of pathological progression to cancer in the upper GIT?

A

Metaplasia –> dysplasia –> Cancer

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13
Q

What is the most common type of oesophageal carcinoma in developed coutries?

A

Adenocarcinoma

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14
Q

Where does adenocarcinoma of the oesophagus usually develop?

A

Lower oesophagus

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15
Q

Which type of oesophageal cancer is most strongly associated with GORD?

A

Adenocarcinoma

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16
Q

What is the most common type of oesophageal cancer in developing coutries?

A

Squamous cell carcinoma

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17
Q

Which type of oesophageal cancer is most associated with smoking and alcohol?

A

Squamous cell carcinoma

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18
Q

Where in the oesophagus does squamous cell carcinoma tend to present?

A

Mid/lower oesophagus

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19
Q

Why is prognosis for oesophageal cancer particularly poor?

A

Most patients are not suitable for resection surgery

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20
Q

What other condition are oesophageal varices particularly associated with?

A

Portal vein stenosis

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21
Q

What are the 3 main causes of acute gastritis?

A

Aspirin/NSAIDs
Alcohol
H pylori

22
Q

What are the 3 major causes of chronic gastritis?

A

ABC
Autoimmune (antiparietal cell Ig)
Bacterial (H pylori, affects antrum)
Chemical (NSAIDs, bile reflux, affects antrum)

23
Q

Which types of neoplasm is H pylori associated with?

A

Adenocarcinoma

Lymphoma (MALToma)

24
Q

How do H pylori inject toxin into the mucosa?

A

Via cag-A needle appendage

25
Q

Which strain of H pylori is associated with more aggressive chronic gastritis?

A

cag-A positive

26
Q

Why might you biopsy a gastric ulcer?

A

ALL gastric ulcers should be biopsied to exclude malignancy

27
Q

What will be the result of a perforated gastric ulcer?

A

Peritonitis

28
Q

What is gastric epithelial dysplasia?

A

Abnormal epithelial pattern of growth

29
Q

What is the key cytological feature of gastric epithelial dysplasia?

A

High nuclear cytoplasmic ratio

30
Q

What is the difference between gastic dysplasia and gastric Ca?

A

Invasion of basement membrane

31
Q

What type of carcinoma is the most common type of gastric cancer?

A

Adenocarcinoma

32
Q

Where is gastric cancer most common?

A

Japan, by far

33
Q

What are the morphological categories of gastric cancer?

A

Intestinal

Diffuse

34
Q

What is the intestinal pattern of gastric adenocarcinoma?

A

Well-differentiated

35
Q

What is the diffuse pattern of gastric adenocarcinoma?

A

Signet ring cells

Poorly differentiated

36
Q

What is linitis plastica?

A

No focal lesion in stomach, but whole thing is thickened and static - due to diffuse adenocarcinoma

37
Q

What is a gastrointestinal stromal tumour? (GIST)

A

Tumour of the interstitial cells of Cajal in the stomach - a SARCOMA

38
Q

What is the cause of gastric MALToma?

A

Chronic inflammation, usually due to H pylori

39
Q

What are gastric MALTomas composed of?

A

B cells

40
Q

What is the first-line treatment of gastric MALToma?

A

H pylori treatment

41
Q

Which type of gastrointestinal tract ulcers are always benign?

A

Duodenal

42
Q

What is cryptosporidiosis?

A

Protozoal GIT infection seen in immunosuppressed patients

43
Q

Where does giardia lamblia infection cause pathology?

A

Villi of GIT

44
Q

What is the route of transmission of giardia?

A

Faeco/oral route

45
Q

How are the villi damaged in coeliac disease?

A

Cytotoxic T cells

46
Q

In what condition are increased numbers of intraepithelial lymphocytes in the GIT seen?

A

Coeliac

47
Q

What are the 3 main histological features of coeliac?

A

Crypt hyperplasia
Villous atrophy
Increased numbers of intraepithelial lymphocytes

48
Q

Which two antibodies are required for diagnosis of coeliac disease?

A 
Endomysial
Tissue transglutaminase (TTG)
49
Q

Where is MALToma associated with coeliac likely to be located?

A

Duodenum

50
Q

What is the type of MALToma as a result of coeliac disease called?

A

Enteropathy associated T cell lymphoma

Pathology ICSM (85 decks)

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