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My Gastrointestinal > Pathology > Flashcards

Pathology Flashcards

1
Q

What is the type of cell in a normal oesophagus?

A

stratified squamous epithelial cells

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2
Q

What is involved in acute oesophagitis?

A
  • rare
  • corrosion following chemical ingestion
  • infective causes in immunocompromised patients
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3
Q

What is involved in chronic oesophagitis?

A
  • reflux disease

- inflammation of the oesophagus due to stomach acid

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4
Q

What can cause reflux oesophagitis?

A
  • defective sphincter
  • abnormal oesophageal motility
  • increased intra-abdominal pressure
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5
Q

What is seen microscopically in reflux oesophagitis?

A
  • basal zone epithelial expansion
  • lengthening of the papillae
  • intraepithelial neutrophils, lymphocytes and eosinophils
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6
Q

What are the complications of reflux oesophagitis?

A
  • ulceration/ bleeding
  • stricture
  • Barrett’s oesophagus
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7
Q

What is Barrett’s oesophagus?

A
  • complication of reflux
  • replacement of columnar epithelium from gastric or submucosal glands
  • differentiation from oesophageal stem cells
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8
Q

The risk of what is increased in Barrett’s oesophagus?

A
  • developing dysplasia
  • carcinoma of the oesophagus
    requires surveillance
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9
Q

What is allergic oesophagitis?

A
  • eosinophilic
  • in a patient with a family history of allergy
  • most common in young males
  • no reflux but eosinophils in the blood
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10
Q

What is the treatment for allergic oesophagitis?

A
  • steroids
  • cromoglycate
  • montelukast
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11
Q

What is the most common benign oesophageal tumour?

A

squamous papilloma which is rare, symptomatic and papillary

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12
Q

What are the types of malignant oesophageal tumours?

A
  • Squamous cell carcinoma

- Adenocarcinoma

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13
Q

What are the features of a squamous cell carcinoma of the oesophagus?

A
  • more common in males
  • caused by vitamin deficiency, smoking and alcohol
  • can cause obstruction and dysphagia
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14
Q

What are the features of an adenocarcinoma of the oesophagus?

A
  • common in males or obese
  • can develop from Barrett’s oesophagus to low grade dysplasia to high grade to adenocarcinoma
  • main symptom is dysphagia and general symptoms of malignancy (anaemia and weight-loss)
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15
Q

What are the mechanisms of metastasis for oesophageal adenocarcinoma?

A
  • direct invasion eg trachea
  • lymphatic invasion
  • vascular invasion
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16
Q

What are the features of oral squamous cell carcinoma?

A
  • can present white and red, speckled or with an ulcer
  • causes are smoking and alcohol
  • all show invasion and destruction of local tissues
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17
Q

What is the prognosis of oral squamous cell carcinoma dependent on?

A 
depth
diameter
pattern
lymph node invasion
metastases
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18
Q

What is the treatment and prognosis for oral squamous cell carcinoma?

A

treat with surgery and survival rate is not good

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19
Q

What is acute gastritis caused by?

A
  • from an irritant chemical injury
  • severe burns
  • shock
  • trauma
  • head injury
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20
Q

What is chronic gastritis caused by?

A

autoimmune
bacterial
chemical
(ABC)

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21
Q

What is autoimmune gastritis?

A
  • rare
  • anti-parietal and anti-intrinsic factor antibodies
  • atrophy and intestinal metaplasia in the body of the stomach
  • loss of B12 and increased risk of malignancy
22
Q

What is bacterial gastritis?

A
  • associated with H.pylori
  • excites early acute inflammation response which leads to chronic active inflammation
  • lamina propria plasma cells produce antibodies with increase risk of ulcers, carcinoma and lymphoma
23
Q

What is chemical gastritis?

A
  • common
  • due to NSAIDs, alcohol or bile reflux
  • caused by direct injury to the mucus layer by fat solvents
  • marked epithelial regeneration, hyperplasia, congestion and inflammation
  • may produce erosions or ulcers
24
Q

What is peptic ulceration?

A

breach of GI mucosa as a result of acid and pepsin attack

25
Q

What is seen microscopically in a peptic ulcer?

A
  • layered with a floor of necrotic debris
  • base of inflamed granulation tissue
  • deepest layer is fibrotic scar tissue
26
Q

What are the sites for longstanding peptic ulcers?

A
  • duodenum
  • stomach
  • oesophago-gastric junction
  • stomal ulcers
27
Q

What are chronic ulcers caused by?

A
  • increased and prolonged secretion of acid –> H.pylori infection, inflammation, epithelial damage and ulceration
  • failure of mucosal defence mechanisms
28
Q

What is a complication of peptic ulcers?

A
  • perforation
  • penetration
  • haemorrhage
  • stenosis
  • intractable pain
29
Q

What are the types of malignant gastric tumours?

A
  • carcinomas
  • lymphomas
  • gastrointestinal stromal tumours (GISTs)
30
Q

What are the features of gastric adenocarcinomas?

A
  • varying incidence
  • having H. pylori increases risk of cancer by increasing chronic gastritis so intestinal metaplasia/ atrophy leading to dysplasia then carcinoma
31
Q

How are gastric adenocarcinomas classed?

A
  • intestinal
  • diffuse
    (some can be mixed types)
    intestinal has a better prognosis
32
Q

Where do malignant gastric adenocarcinomas spread to?

A
  • local invasion
  • haematogenous (liver)
  • transcoelomic (into peritoneal cavity)
33
Q

What is a gastric lymphoma?

A
  • derived from mucosa associated lymphoid tissue
  • associated with H. pylori
  • clonal B-cell proliferation that can develop into a high grade B-cell lymphoma
34
Q

What are the three histological zones of the liver?

A

peripheral
mid acinar
pericentral

35
Q

What is the chain of pathogenesis to the liver?

A

insult to hepatocytes –> inflammation –> fibrosis –> cirrhosis (end stage)

36
Q

What are the causes of acute liver failure?

A

viruses
alcohol
drugs eg paracetamol
bile duct obstruction

37
Q

What are the consequences of acute liver failure?

A

complete recovery
chronic liver disease
death from liver failure

38
Q

What are the categories of the causes of jaundice?

A

prehepatic
hepatic
posthepatic

39
Q

What are the causes of prehepatic jaundice?

A

haemolysis
haemolytic anaemia
unconjugated bilirubin

40
Q

What are the causes of hepatic jaundice?

A 
acute liver failure
alcoholic hepatitis
cirrhosis
bile duct loss
pregnancy
41
Q

What are the causes of post hepatic jaundice?

A

congenital biliary atresia
gallstones
stricture
tumours

42
Q

What is cirrhosis defined by pathologically?

A

bands of fibrosis separating regenerative nodules of hepatocytes

43
Q

What does cirrhosis result in?

A

alteration of hepatic microvasculature

loss of hepatic function

44
Q

What are the causes of cirrhosis?

A 
alcohol
Hep B and C
iron overload
gallstones
autoimmune disease
45
Q

What are the complications of cirrhosis?

A
  • portal hypertension (varices, caput medusa and haemorrhoids)
  • ascites
  • liver failure
46
Q

What is the pathology of alcoholic liver disease?

A
  • release of fatty acids
  • death of hepatocytes
  • fatty liver (steatosis) and hepatitis are reversible
47
Q

What are the pathological features of alcoholic hepatitis?

A
  • hepatocyte necrosis
  • neutrophils
  • mallory bodies
  • pericelllular fibrosis
  • getting worse is collagen laid down (permanent)
48
Q

What are the outcomes for alcoholic liver disease?

A

cirrhosis
portal hypertension
malnutrition
carcinoma

49
Q

Which Hep viruses cause chronic hepatitis and what is the pathology of this?

A

B and C

areas of portal inflammation link up with collagen to cause fibrosis

50
Q

What can chronic drug-induced hepatitis cause?

A 
hepatitis
granulomas
fibrosis
necrosis
failure
cholestasis
cirrhosis etc
51
Q

What are the three main storage diseases?

A
  • haemochromatosis
  • Wilson’s disease
  • alpha-1-antitrypsin deficiency
52
Q

What organs cause metastases to the liver?

A 
colon
pancreas
stomach
breast
lung 
others

My Gastrointestinal (18 decks)

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