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GI > Mouth & Oesophageal Pathology > Flashcards

Mouth & Oesophageal Pathology Flashcards

1
Q

What differentiates between the oesophageal and gastric mucosa?

A
  • Gastro-oesophageal junction (GOJ)

- Also known as the Z-Line

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2
Q

What can cause acute oesophagitis?

A
  • Corrosive following chemical ingestion
  • Infective in immunocompromised pts
    e. g. candidiasis, herpes, CMV

acute oesophagitis = RARE

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3
Q

What can cause chronic oesophagitis?

A
  • Reflux disease ( called: ‘reflux oesophagitis’)
    = COMMON
  • Rare causes include Crohn’s disease
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4
Q

What can potentially cause reflux oesophagitis?

A
  • Defective sphincter mechanism +/- Hiatus hernia
  • Abnormal oesophageal motility
  • Increased intra-abdominal pressure (pregnancy)
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5
Q

How does Reflux Oesophagitis appear microscopically?

A
  • Basal zone epithelial expansion (basal cell expansion)

- Intraepithelial neutrophils, lymphocytes and eosinophils

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6
Q

What are the main complications of reflux?

A
  • Ulceration (bleeding)
  • Stricture
  • Barrett’s Oesophagus
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7
Q

What happens in Barretts oesophagus?

A
  • persistent reflux of acid or bile
  • causes squamous to columnar metaplasia
    OR expansion of gastric/ submucosal glands up into oesophagus
  • protective response from the body
  • pre-malignant oesophageal cancer
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8
Q

Allergic oesophagitis is also known as what?

A

‘Eosinophillic’ oesophagitis

pH probe negative for reflux
Increased eosinophils in blood
Corrugated (feline) or ‘spotty’ oesophagus

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9
Q

Who is most at risk of allergic/ eosinophilic oesophagitis?

A
  • Personal/family history of allergy
  • Asthma
  • Young
  • Males > females
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10
Q

How is allergic oesophagitis diagnosed?

A
  • pH probe negative for reflux
  • Increased eosinophils in blood
  • Corrugated (feline) or ‘spotty’ oesophagus
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11
Q

What treatments can be used for allergic oesophagitis?

A
  • steroids
  • chromoglycate
  • montelukast
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12
Q

What oesophageal tumours are considered benign?

A
  • Leiomyomas (smooth muscle)
  • Lipomas
  • Fibrovascular polyps
  • Granular cell tumours
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13
Q

Squamous papilloma of the oesophagus is related to which virus?

A

HPV related

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14
Q

What malignant tumours can arise in the oesophagus?

A

Squamous cell carcinoma

Adenocarcinoma

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15
Q

What can cause Squamous cell carcinomas in the oesophagus?

A
  • Vitamin A, Zinc deficiency
  • Tannic acid/ Strong tea
  • Smoking, Alcohol
  • HPV
  • Oesophagitis
  • Genetic
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16
Q

What complications can malignancy of the oesophagus cause?

A

Obstruction
Stricture`
Dysphagia

17
Q

What groups are most at risk of oesophageal adenocarcinoma?

A
  • Commoner in caucasians
  • Males > females
  • obesity
18
Q

Where in the oesophagus does adenocarcinoma usually occur?

A

Commonest in lower 1/3 oesophagus

19
Q

What is the pre-malignant lesion to adenocarcinoma of the oesophagus?

A

Barrett’s Oesophagus

20
Q

How do carcinomas of the oesophagus present clinically?

A

Dysphagia
– due to tumour obstruction

OR General symptoms of malignancy
- Anaemia,
- Wt. Loss/ Lack of energy
(effects of metastases)

21
Q

What are oesophageal varices?

A

Swollen blood vessels (like varicose veins) in the lower oesophagus
- usually due to portal hypertension

22
Q

When would a patient be at risk of a Mallory-Weiss Tear?

A

Repetitive Vomiting

23
Q

> 90% of oral cancers are what type?

A

Squamous Cell Carcinoma

24
Q

How do oral cancers present?

A

white/red
speckled
ulcer
lump

25
Q

What site of the mouth are high risk for oral cancers?

A
  • floor of mouth
  • lateral border of tongue
  • Ventral tongue
  • soft palate
  • retromolar pad/ tonsillar pillars
26
Q

What sites of the mouth are rarely affected by oral cancers

A
  • hard palate

- dorsum of tongue

27
Q

What can increase the risk of patients developing oral cancer?

A
  • Tobacco
  • Alcohol
  • ??Viral ?HPV (p16)
  • Chronic infections
  • Nutritional deficiencies
  • Post Transplant
  • Hx of oral cancer (increases risk of another cancer)
28
Q

What histological features are analysed in oral cancers to determine their prognosis?

A
  • Tumour diameter
  • Depth of invasion
  • Pattern of invasion
  • Lymphovascular invasion
  • Neural invasion by tumour
29
Q

How is oral cancer treated?

A

Surgery

+/- adjuvant therapy

30
Q

Why is the 5 year survival of oral cancer only 40-50%?

A
  • Due to late detection

=> even though there have been advancements in treatment, people are still caught late

GI (33 decks)

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