Oral & Oesophageal Pathology

Question 1

Acute oesophagitis is more common than chronic oesophagitis. T/F?

Answer 1

False- chronic more common

Acute- infection- Candiadisis, herpes or chemical ingestion

Chronic- reflux disease, Crohns

Question 2

Reflux oesophagitis is caused by what? What chronic condition is it affected by?

Answer 2

Low pH gastric content

Can be due to defective sphincter mechanism, +/- hiatus hernia

Increased abdominal pressure- mainly due to Obesity

Question 3

Which layer of the gut wall os affected by reflux Oesophagitis?

Answer 3

Basal cells expand, the papillae extend

Question 4

What are the complications of Relfux? (3)

Answer 4

1. Ulceration (bleeding)
2. Stricture- narrowing
3. Barret’s oesophagus- Replacement of stratified squamous epithelium by columnar epithelium

Question 5

Barrett’s oesophagus arise due to persistent _ of acid or bile

Answer 5

Reflux

It is a protective response and generated rapidly, however it is even more susceptible to destruction by Oesophagitis.

Question 6

Barrett’s oesophagus is unstable making it more risky of getting _ of Oesophagus

Answer 6

Dysplasia/Carcinoma

Question 7

Allergic Oesophagitis is mediated by what immune cells?

Answer 7

Eosinophils.

Question 8

Allergic oesophagiti show a large number of intraepithelial eosinophils. T/F?

Answer 8

True

Question 9

Treatment for allergic oesophagitis?

Answer 9

Anti allergy- Steroid, cromoglycate, montelukast

Question 10

Squamous papilloma is a malignant cancer type. T/F?

Answer 10

False- Benign, V rare

Question 11

What are the two most common types of malignant oesophageal tumours?

Answer 11

1 Squamous cell carcinoma

2. Adenocarcinoma

Question 12

Squamous cell carcinoma is more common in males. T/F?

Answer 12

True

Question 13

Two biggest risk factors of squamous carcinoma?

Answer 13

1. Smoking
2. Alcohol

Question 14

Squamous carcinoma is associated most commonly with what symptom?

Answer 14

Dysphagia- difficulty swallowing

Question 15

Adenocarcinoma is closely associated with _ Oesophagus

Answer 15

Barrett’s

Question 16

Summarise the pathogenesis of developing adenocarcinoma. (6)

Answer 16

1. Genetic factors, reflux disease
2. Chronic reflux Oesophagitis
3. Barrett’s Oesophagus
4. Low grade Dysplasia
5. High grade Dysplasia
6. Adenocarcinoma

Question 17

What are the mechanisms of carcionma metastasis? (3)

Answer 17

• Direct invasion
• Lymphatic permeation
• Vascular invasion

Question 18

Oesophageal carcinomas commonly metastasise to which organs?

Answer 18

Liver

Question 19

Dysphagia is the most common symptom of Oesopheal carcinoma. What are the other common symptoms?

Answer 19

1. Anaemia
2. Weight loss
3. Malaise

Question 20

What is Mallory Weiss?

Answer 20

A tear in the mucous membrane where the oesophagus meets the stomach. Significant tears can cause bleeding

Question 21

More than 90% of oral cancers are of the _ cell type

Answer 21

Squamous

Question 22

Biggest risk factor for oral cancer?

Answer 22

Smoking