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Gastrointestinal > Mouth & Oesophageal Diseases > Flashcards

Mouth & Oesophageal Diseases Flashcards

1
Q

is mouth cancer common in young people?

A

incidence is inc

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2
Q

what is the typical mouth cancer pt?

A

> 50 yo male

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3
Q

aetiology of mouth cancer?

A

smoking (tobacco, shisha, cigars),
alcohol,
diet,
Infection: HPV, candida, syphilis

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4
Q

presentation of mouth cancer?

A

asymptomatic, lesions, numbness, pain in mouth/neck, voice change, dysphagia

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5
Q

where do mouth lesions occur

A

soft sites i.e. tongue & floor of mouth

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6
Q

what is the malignant lesions of the mouth?

A

erythroplakia

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7
Q

how to diagnose mouth cancer?

A

history of lesion, screen soft tissue sites, contemplate risk factors

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8
Q

what is oesophagitis

A

inflammation of oesophagus due to reflux

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9
Q

types of oesophagitis

A

acute or chronic

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10
Q

what are the etiological differences between acute and chronic oseophagitis?

A 
acute= corrosive aetiology (chemical) or infection
chronic= reflux
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11
Q

expand on chronic (reflux) oesophagitis aetiology?

A

defective sphincter, abnormal oesophageal motility, inc intra-abdominal pressure

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12
Q

how to histologically identify reflux oesophagitis

A

basal zone expansion due to presence of neutrophils, eosinophils & lymphocytes

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13
Q

what are 2 common complications of reflux oesophagitis

A

ulcers and Barrett’s oesophagus

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14
Q

other than acute & chronic oesophagitis, what’s the 3rd type of oesophagitis?

A

Allergic oesophagitis

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15
Q

how to diagnose allergic oesophagitis?

A

pH probe, endo-corrugated oesophagus, inc eosinophilia

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16
Q

tx for allergic oesophagitis

A

steroids, chromoglycate (mast cell stabiliser), montelukast (leyukotrine receptor antagonist)

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17
Q

what is achalasia

A

intermittent dysphagia and impaired relaxation of lower oesophageal sphincter

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18
Q

symptoms of achalasia?

A

intermittent dysphagia, regurgitation (particularly at night), chest pain due to spasms

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19
Q

ix of achalasia?

A

CXR & barium swallow

20
Q

what would be seen on a CXR of an achalasia pt?

A

dilated oesophagus

21
Q

what would be seen by a barium swallow of an achalasia pt?

A

bird-beak appearance

22
Q

tx for achalasia?

A

palliative, nifedipine (Ca channel blocker), endoscopy

23
Q

what is Barrett’s oesophagus?

A

replacement of stratified squamous epithelium by columnar epi with intestinal metaplasia

24
Q

aetiology of barrett’s O?

A

persistant GORD, persistant oesophagitis

25
Q

what is the main risk barrett’s O poses?

A

inc risk of oesophageal carcinoma

26
Q

ix for Barrett’s O?

A

endoscopy & biopsy (exclude cancer)

27
Q

tx for Barrett’s?

A

PPIs, endoscopic mucosal resection, radio frequency ablation

28
Q

what is the benign oesophageal tumour?

A

squamous papilloma (HPV related)

29
Q

what are the 2 types of malignant oesophageal tumours?

A

squamous cell carcinoma and adenocarcinoma

30
Q

where does squamous cell carcinoma occur?

A

upper 2/3 of oesophagus

31
Q

true/false…

squamous cell carcinoma is most common type of oesophageal cancer/

A

true

32
Q

aetiology of SCC of oesophagus?

A

vitA def, smoking, HPV, oesophagitis, genetics

33
Q

pathogenesis of SCC?

A

normal > GORD > Severe dysplasia > SCC

34
Q

symptoms of SCC?

A

progressive dysphagia, hoarse voice, malignant symptoms e.g. wt loss

35
Q

signs of SCC?

A

ulcer/ lump in mouth

36
Q

ix of SCC?

A

endoscopy w biopsy*, CT for staging, USS, barium swallow

37
Q

staging of SCC?

A

TNM (diameter of tumour, nodal invasion, mets)

38
Q

what are the 3 mechanisms of invasion?

A

local invasion, lymphatic spread, haemtogenous spread

39
Q

tx for SCC?

A

surgery, palliation

40
Q

epidemiology of adenocarcinoma?

A

caucasian males

41
Q

where does oesophageal adenocarcinoma occur?

A

lower 1/3 of oesophagus

42
Q

pathogenesis of adenocarcinoma?

A

reflux > chronic reflux oesophagitis > barret’s O > dysplasia > adenocarcinoma

43
Q

main symptom of adenocarcinoma?

A

dysphagia

44
Q

tx of adenocarcinoma?

A

radio, surgery

45
Q

what are 2 oesophageal conditions not already mentioned?

A

mallory weis tear, oesophageal varices

Gastrointestinal (24 decks)

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