Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1st Year - Gastroenterology > Oesophagus and Stomach 3 and 4 - Pathology of oesophagus and stomach, dyspepsia and peptic ulcer disease > Flashcards

Oesophagus and Stomach 3 and 4 - Pathology of oesophagus and stomach, dyspepsia and peptic ulcer disease 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 glandsDue 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. asthmaYoungMales 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 papilllomaRareHPV

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

LeiomyomasLipomasFibrovascular polypsGranular cell tumoursVERY 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 deficiencyTannic acid/ strong teaSmoking, alcoholOesophagitisGenetic

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 palateDorsum 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

TobaccoAlcoholBetel quidViral? (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
Q

What is another name for dyspepsia?

A

Indigestion

26
Q

What is dyspepsia?

A

pain or discomfort in the upper abdomen after eating and sometimes accompanied by nausea, vomiting or a feeling of unease or fullness

27
Q

What is the name given to epigastric pain or burning?

A

Epigastric pain syndrome

28
Q

What is the name given to postprandial fullness?

A

Postprandial distress syndrome

29
Q

What is the name given to early satiety?

A

Postprandial distress syndrome

30
Q

What are the 2 different categories of causes of dyspepsia?

A

Organic (25%)Functional (75%)

31
Q

What are 3 organic causes of dyspepsia?

A

Peptic ulcer diseaseDrugs (esp NSAIDS, COX2 inhibitors)Gastric cancer

32
Q

What is functional dyspepsia?

A

Same symptoms of dyspepsia but no evidence of culprit disease(associated with other functional gut disorders e.g. IBS)

33
Q

Difference between dyspepsia/ indigestion and heartburn/ reflux?

A

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
Q

What are ALARM Symptoms related to dyspepsia?

A

AnaemiaLoss of weightAnorexiaRecent onset/ progressive symptomsMelaena/ haematemesisSwallowing difficulty

35
Q

Action required if patient has dyspepsia with alarm symptoms?

A

Refer to hospital

36
Q

Action if patient has dyspepsia with no alarm symptoms?

A

Check H pylori statusEradicate if infected (cures ulcer disease, removes risk of gastric cancer)If HP -ve, treat with acid inhibition as required

37
Q

What is the Rome III diagnostic criteria for Functional dyspepsia?

A

Presence of at least one of the following:Bothersome postprandial fullnessEarly satiationEpigastric painEpigastric burningAndNo 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
Q

What happens to patients with peptic ulcer diseases pain when they eat?

A

It is either aggravated or relieved

39
Q

What type of course does peptic ulcer disease lead?

A

A relapsing and remitting chronic illness

40
Q

Is peptic ulcer disease genetic?

A

Family history is common

41
Q

What are 2 major causes of peptic ulcer disease?

A

H pyloriNSAIDspossibly also gastric dysmotility and outflow obstruction

42
Q

What % of DU and GU does H pylori cause?

A

90% of DU60% of GU(NSAIDs cause most of the rest)

43
Q

What is a peptic ulcer?

A

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
Q

When is H pylori usually acquired?

A

Infancy

45
Q

What is the appearance of H pylori?

A

Gram negative microaerophilic flagellated bacillus

46
Q

How is H. pylori spread?

A

Oral-oral/ faecal-oral route

47
Q

What are the consequences of being infected by H pylori?

A

Usually no pathology20-40% = peptic ulcer disease1% = gastric cancer

48
Q

What do G cells in the stomach do?

A

Produce gastrin in response to a higher pH (this is a hormone that stimulates the parietal cells to increase secretion of HCl)

49
Q

How does H pylori affect gastrin production?

A

It increases the production of gastrin and therefore increases acid production and leads to an ulcer

50
Q

How does intense infection with H pylori affect the stomach?

A

It causes gastric atrophyThis 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
Q

What mucosal appearance does chronic gastritis tend to have?

A

A cobble stone appearance

52
Q

Diagnosis of H pylori infection? (4)

A

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
Q

Treatment of peptic ulcer disease?

A

All PPIAll tested for H pyloriIf +ve eradicate and confirmWithdraw NSAIDsChange lifestyle e.g. dietSurgery is sometimes performed

54
Q

Do PPIs and H2RAs heal ulcers?

A

yes - PPIs do it better

55
Q

Eradication therapy for H pylori?

A

Tripel therapy for 1 week = commenest2 week regimens = higher eradication rates but poorer compliance (dual therapy is not recommend)

56
Q

Triple therapy for H pylori?

A

PPI bd + amoxicillin 1g bd + clarithromycin 500mg bdPPI bd + metronidazole 400mg bd + clarithromycin 250mg bdUsually for 1 week but there are 2 week regimens

57
Q

Complications of peptic ulcer disease?

A

Anaemia, bleeding, perforation (doesn’t happen often), gastric outlet/ duodenal obstruction - fibrotic scar

58
Q

Post-therapy follow up for DU?

A

Uncomplicated DU requires no f/u unless ongoing symptoms

59
Q

Post-therapy follow up for GU?

A

F/u endoscopy at 6-8 weeksEnsure healing and no malignancy

60
Q

does achlorhydria increase risk of gastric cancer?

A

Yes e.g. pernicious anaemia, previous gastric surgery

61
Q

What is Correa’s hypothesis of gastric cancer?

A

A combination of H pylori, smoking and salt causes the following changes:Normal - chronic gastritis - atrophy - intestinal metaplasia - dysplasia - neoplasia

62
Q

What type of patients with H pylori are prohibited from developing gastric cancer?

A

Those with H/ pylori who have had a previous peptic ulcer

1st Year - Gastroenterology (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions