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Pathology > Lecture 12 Upper GI disease > Flashcards

Lecture 12 Upper GI disease Flashcards

1
Q

Define chronic gastritis

A

Ongoing inflammation of the stomach mucosa. Symptoms less severe than acute gastritis.

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2
Q

What can arise from chronic gastritis?

A

Dysplasia and carcinoma

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3
Q

What are the symptoms of chronic gastritis?

A

Upper abdo pain. Indigestion/ bloating. N/V. Belching. Loss of appetite/weight loss.

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4
Q

Can chronic gastritis be asymptomatic?

A

yes

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5
Q

What can cause chronic gastritis?

A

ABC and other.

Autoimmune, bacterial, Chemical and other.

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6
Q

What can autoimmune problems (chronic gastritis) lead?

A

Pernicious anameia

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7
Q

What causes bacterial infection in stomach?

A

Helicobacter pylori infection

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8
Q

Notes on helicobacter pylori infection

A

Gram-neg bacteriain stomach, particularly antrum, infects over half the worlds population. Faecal-oral route. Untreated -> infection persists throughout life.

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9
Q

H.pylori is linked to what development?

A

Duodenal ulcers and stomach ulcers

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10
Q

What is the clinical presentation H.pylori.

A

80% asymptomatic. 5-15% peptic ulcer disease. 10% non-ulcer dyspepsia. 1-3% gastric adenocarcinoma.

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11
Q

What are the effects of h.pylori infections predominantly in body of stomach.

A

Gastric cancer
Hypochlorhydria
Gastric atrophy
Intestinal metaplasia

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12
Q

What are the effects of h.pylori infections predominantly in antrum.

A

Duodenal ulcers

Hyperchlorhydria

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13
Q

What chemicals can cause chronic gastritis?

A

Alcohol, tobacco and caffeine

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14
Q

What else (apart from ABC) can cause chronic gastritis?

A

Psychological stress

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15
Q

Where does peptic ulcer disease usually occur?

A

D1 or antrum (4:1)

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16
Q

What can cause peptic ulcer disease?

A

H. pylori (80-100% DU and 65% gastric). NSAIDs

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17
Q

When are peptic ulcers worse?

A

at night and after meals

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18
Q

What are the symptoms of peptic ulcer disease?

A

Pain (gnawing, burning and aching)

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19
Q

What are complications of peptic ulcer disease?

A

Bleeding -> iron deficiency anaemia. Massive haematemesis. Performation -> peritonitis. Long term cancer at edge of ulcer

20
Q

What is Barrett’s Oesophagus?

A

When lining of oesophagus changes from stratified squamous epithelium to columnar epithelium with goblet cells

21
Q

Where is columnar epithelium and goblet cells normally found?

A

low in GIT

22
Q

What is Barrett’s Oesophagus dysplasia process?

A

Low grade to high grade to invasive carcinoma.

23
Q

Where can oesophageal carcinoma be spread (haematogenous) to?

A

Liver or lung

24
Q

Who can suffer from oesophagus squamous cell carcinoma?

A

Adults over 45. M:F 4:1

25
Q

What are the survival rates for oesophagus squamous cell carcinoma?

A

5 year survival of 9%

26
Q

What are the risk factors for Oesophagus sqaumous cell carcinoma?

A

Alcohol, tobacco, caustic injury, achalasia

27
Q

Define achalasia?

A

when the lower part of the oesophagus fails to relax, preventing food passing to stomach

28
Q

What are the symptoms of Oesophageal carcinoma?

A

Dysphagia, weight loss, haemorrhage, sepsis, resp fistula, aspiration.

29
Q

What are the symptoms of Barrett’s Oesophagus?

A

Dysphagia, weight loss, haematemesis, chest pain, vomiting

30
Q

What are the gender statistics for Barrett’s Oesophagus?

A

M:F 7:1

31
Q

What is the survival rate for Barrett’s?

A

5 year survival

32
Q

What accounts for 90% of gastric malignances?

A

Adenocarcinoma

33
Q

What are the precursor lesions for stomach adrenocarcinoma?

A

Pernicious anaemia, intestinal metaplasia, neoplastic polyps, Helicobacter gastritis.

34
Q

What is the 2nd most common carcinoma world wide?

A

Stomach adrenocarcinoma

35
Q

What are the early symptoms of stomach adenocarcinoma?

A

Same as gastritis

36
Q

What are the advanced stomach adenocarcinoma symptoms?

A

Weight loss, anorexia, anaemia, haemorrhage, fungating exophytic growth.

37
Q

What is the survival rates for stomach adenocarcinoma?

A

5 year survival (early) after surgery 90%!!!

Overall 5 year survival 30%

38
Q

Where can stomach cancer directly spread to?

A

Duodenum, pancreas, colon, liver, spleen.

39
Q

Define virchow’s node?

A

Lymph node in left supraclavicular fossa. Takes blood supply from abdominal cavity

40
Q

Where can stomach cancers spread to through haematogenous?

A

Liver and lungs

41
Q

Small bowel neoplasia is

A

small chance. relatively rate compared to other GI mlignancies

42
Q

What are risk factors for small bowel adenocarcinoma?

A

Crohn’s disease and Coeliac disease, radiation, hereditary.

43
Q

Define Coeliac disease?

A

Extensive mucosal disease related to gluten sensitivity. Immune mediated villous atrophy and malabsorption

44
Q

How can Coeliac disease by diagnosed?

A

Serological blood test and biopsy

45
Q

What are the symptoms of coeliac disease?

A

Pain in digestive tract, chronic constipation and diarrhoea, failure to thrive (children), anaemia, fatigue.

46
Q

What can coeliac disease increase the risk of?

A

adenocarcinoma and lymphoma of small bowel

Pathology (25 decks)

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