Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Study Notes - Gastroenterology > *Oesophageal and Stomach Disorders (lectures 3 and 4) > Flashcards

*Oesophageal and Stomach Disorders (lectures 3 and 4) Flashcards

1
Q

What mucosa lines the normal oesophagus?

A

Stratified squamous epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What tends to cause acute oesophagitis?

A

Rare but usually caused by corrosion following chemical ingestion or infection in immunocompromised patients e.g. candidiasis, herpes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What tends to cause chronic oesophagitis?

A

Reflux disease - “reflux oesophagitis)

Rarely, caused by crohns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is reflux oesophagitis?

A

Inflammation of oesophagus due to refluxed low pH gastric content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Microscopic appearance of reflux oesophagitis?

A

Basal zone epithelial expansion (hyperplasia)

Intraepithelial neutrophils, lymphocytes and eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Barrett’s oesophagus?

A

Replacement of stratified squamous epithelium by columnar epithelium with intestinal metaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does the metaplasia occur in Barrett’s oesophagus?

A

Due to expansion of columnar epithelium from gastric glands or from submucosal glands
Due to differentiation from oesophageal stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is allergic oesophagitis?

Other name

A

An inflammatory condition in which the walls of the oesophagus become filled with eosinophils
“eosinophillic” oesophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of patients does allergic oesophagitis tend to occur in?

A

Those with a personal/ family history of allergy e.g. asthma
Young
Males more than females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pH probe of allergic oesophagitis?

A

Negative for reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Blood test in a patient with allergic oesophagitis?

A

Increased eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Appearance of an allergic oesophagitis?

A

Corrugated or “spotty” oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for allergic oesophagitis?

A

Steroids/ chromoglycate/ montelukast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What benign tumours are most commonly found in the oesophagus?
What are they associated with

A

Squamous papillloma
Rare
HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other benign tumours of the oesophagus apart from squamous papilloma?

A 
Leiomyomas
Lipomas
Fibrovascular polyps
Granular cell tumours
VERY rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the commonest type of oesophageal cancer in males?

A

Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of squamous cell carcinoma?

A 
Vitamin A, zinc deficiency
Tannic acid/ strong tea
Smoking, alcohol
Oesophagitis
Genetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is commonest type of oesophageal cancer in caucasians?

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Steps to developing adenocarcinoma of oesophagus?

A

genetics, reflux, etc. - chronic reflux oesophagitis - barretts oesophagus - low grade dysplasia - high grade dysplasia - adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of cancers are the majority of oral cancers?

A

Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What parts of the mouth is it rare to develop cancer on?

A

Hard palate

Dorsum of tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Causes of squamous cell carcinoma of the oral cavity?

A 
Tobacco
Alcohol
Betel quid
Viral? (HPV)
Chronic infections?
Nutritional deficiencies
?genetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Staging system for oral cancer?

A

TNM system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment of oral cancer?

A

Surgery +/- adjuvant therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is another name for dyspepsia?
Indigestion
26
What is dyspepsia?
pain or discomfort in the upper abdomen after eating and sometimes accompanied by nausea, vomiting or a feeling of unease or fullness
27
What is the name given to epigastric pain or burning?
Epigastric pain syndrome
28
What is the name given to postprandial fullness?
Postprandial distress syndrome
29
What is the name given to early satiety?
Postprandial distress syndrome
30
What are the 2 different categories of causes of dyspepsia?
Organic (25%) | Functional (75%)
31
What are 3 organic causes of dyspepsia?
Peptic ulcer disease Drugs (esp NSAIDS, COX2 inhibitors) Gastric cancer
32
What is functional dyspepsia?
Same symptoms of dyspepsia but no evidence of culprit disease (associated with other functional gut disorders e.g. IBS)
33
Difference between dyspepsia/ indigestion and heartburn/ reflux?
Heartburn is an unpleasant condition that occurs when acid from the stomach leaks into the oesophagus and rises upwards to cause pain and discomfort in the chest. Indigestion is a general term for pain or discomfort felt in the stomach and under the ribs.
34
What are ALARM Symptoms related to dyspepsia?
``` Anaemia Loss of weight Anorexia Recent onset/ progressive symptoms Melaena/ haematemesis Swallowing difficulty ```
35
Action required if patient has dyspepsia with alarm symptoms?
Refer to hospital
36
Action if patient has dyspepsia with no alarm symptoms?
Check H pylori status Eradicate if infected (cures ulcer disease, removes risk of gastric cancer) If HP -ve, treat with acid inhibition as required
37
What is the Rome III diagnostic criteria for Functional dyspepsia?
Presence of at least one of the following: Bothersome postprandial fullness Early satiation Epigastric pain Epigastric burning And No evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms Symptom onset 6 months ago with criteria fulfilled for past 3 months
38
What happens to patients with peptic ulcer diseases pain when they eat?
It is either aggravated or relieved
39
What type of course does peptic ulcer disease lead?
A relapsing and remitting chronic illness
40
Is peptic ulcer disease genetic?
Family history is common
41
What are 2 major causes of peptic ulcer disease?
H pylori NSAIDs possibly also gastric dysmotility and outflow obstruction
42
What % of DU and GU does H pylori cause?
90% of DU 60% of GU (NSAIDs cause most of the rest)
43
What is a peptic ulcer?
a lesion in the lining (mucosa) of the digestive tract, typically in the stomach or duodenum, caused by the digestive action of pepsin and stomach acid.
44
When is H pylori usually acquired?
Infancy
45
What is the appearance of H pylori?
Gram negative microaerophilic flagellated bacillus
46
How is H. pylori spread?
Oral-oral/ faecal-oral route
47
What are the consequences of being infected by H pylori?
Usually no pathology 20-40% = peptic ulcer disease 1% = gastric cancer
48
What do G cells in the stomach do?
Produce gastrin in response to a higher pH (this is a hormone that stimulates the parietal cells to increase secretion of HCl)
49
How does H pylori affect gastrin production?
It increases the production of gastrin and therefore increases acid production and leads to an ulcer
50
How does intense infection with H pylori affect the stomach?
It causes gastric atrophy This results in the distal part of the stomach producing lots of gastrin trying to drive the stomach to produce acid but they can't due to atrophy - this can lead to gastric carcinoma
51
What mucosal appearance does chronic gastritis tend to have?
A cobble stone appearance
52
Diagnosis of H pylori infection? (4)
Gastric biopsy (urease test, histology, culture/ sensitivity) Urease breath test (need to stop PPI) (helicobacter produces large amounts of urease) FAT (faecal antigen test) Serology (IgA) - not accurate with increasing patient age so doesn't tend to get done
53
Treatment of peptic ulcer disease?
``` All PPI All tested for H pylori If +ve eradicate and confirm Withdraw NSAIDs Change lifestyle e.g. diet Surgery is sometimes performed ```
54
Do PPIs and H2RAs heal ulcers?
yes - PPIs do it better
55
Eradication therapy for H pylori?
Tripel therapy for 1 week = commenest 2 week regimens = higher eradication rates but poorer compliance (dual therapy is not recommend)
56
Triple therapy for H pylori?
PPI bd + amoxicillin 1g bd + clarithromycin 500mg bd PPI bd + metronidazole 400mg bd + clarithromycin 250mg bd Usually for 1 week but there are 2 week regimens
57
Complications of peptic ulcer disease?
Anaemia, bleeding, perforation (doesn't happen often), gastric outlet/ duodenal obstruction - fibrotic scar
58
Post-therapy follow up for DU?
Uncomplicated DU requires no f/u unless ongoing symptoms
59
Post-therapy follow up for GU?
F/u endoscopy at 6-8 weeks | Ensure healing and no malignancy
60
does achlorhydria increase risk of gastric cancer?
Yes e.g. pernicious anaemia, previous gastric surgery
61
What is Correa's hypothesis of gastric cancer?
A combination of H pylori, smoking and salt causes the following changes: Normal - chronic gastritis - atrophy - intestinal metaplasia - dysplasia - neoplasia
62
What type of patients with H pylori are prohibited from developing gastric cancer?
Those with H/ pylori who have had a previous peptic ulcer

Study Notes - Gastroenterology (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions