Pathology Flashcards
pathology of GORD
occurs when a portion of your stomach herniates through the diaphragm and you loos function of the sphincter and get reflux of acid
what is Barretts oeseophagus
metaplasia- oesophageal epithelium changes from squamous to glandular
what investigations would we do for GORD
endoscopy
PH metry
manometry
treatment for GORD
lifestyle measures,
proton pump inhibitors
anti reflux surgery
what are classic red flag symptoms for GI disease
anorexia, weight loss anaemia recent onset >55 melaena or mass swallowing difficulties
risk factors for oesophageal carcinoma - squamous cell
smoking
alcohol
dietary carcinogens
where does squamous cell oesophageal carcinoma occur
proximal and middle third of oesophagus
where does oesophageal adenocarcinoma take place
distal third of oesophagus
risk factors for adenocarcinoma - oesophagus
barrets metaplasia
obesity
reflux
investigations for oesophageal cancer
endoscopy and biopsy
barium swallow
common mets of oesophageal cancer
liver, brain , pulmonary, bone
why does peptic ulceration occur
imbalance between acid secretion and the mucosal barrier
common causes of peptic ulceration
gastritis, H pylori, NSAIDS, smoking
what is the treatment for H pylori
eradication therapy
triple therapy for 7 days
2 antibiotics
1 PPI
symptoms of stomach cancer
Dyspepsia nausea and vomiting weight loss GI bleed Anaemia obstruction
symptoms for oesophageal cancer
Progressive dysphagia anorexia chest pain cough pneumonia haematesis
what types of hepatitis are more chronic
B and C
what is cholestasis
accumulation of bile within the hepatocytes
what is primary biliary cholangitis
organ specific autoimmune disease of the bile duct you get granulomatous inflammation which can progress to cirrhosis
what tests would we do for primary biliary cholangitis
anti-mitochondrial auto antibodies
raised serum alkaline
phosphatase
elevated IGM
how do we treat primary biliary cholangitis
USCA bile thinners
what is primary sclerosing cholangitis
chronic inflammation and fibrous obliteration fo the bile duct
can progress to cirrhosis with a risk of progressing to cancer
symptoms of primary scleroisng cholagnits
pain
jaundice
stones
dilation and narrowing at various points
what would investigations deter in primary sclerosing cholangitis
pANCA antibodies
MRCP should be done
how do we treat primary sclerosing cholangitis
biliary stents
what is cholethiasis
gall stones
symptoms of gall stones
pain when eating fatty foots asymptomatic feel bloated pain nausea biliary colic
what is cirrhosis
end stage chronic liver failure
loss of liver structure that is replaced by nodules of hepatocytes and fibrous tissue
causes of cirrhosis
hep b or c
metabolic disorders
alcohol
what score do we use to prioritise liver transplants
UKELD
what is cholangiocarcinoma
Tumour of the bile duct epitherlium
can be intrahepatic or extra hepatic
what is a common investigation to do for any biliary or pancreatic disease
ERCP
what histological changes occur in appendicitis
exudate
perforation and access
layers can get destroyed
risk factors for colorectal cancer
diet obesity smoking family history IBD age Male previous adenoma certain genes FAP HNPCC Puetz Jeghers
symptoms of colorectal cancer
rectal bleeding loose stools anaemia palpable mass obstruction systemic symptoms
is right sided colorectal cancer normally polypoid or annular
polypoid
what is an illeostomy
stoma found on the right side and has a spout
what is a colostomy
usually on the left side and is flushed with the skin
who has the FIT test
ages 50-74
every 2 years
what is achalasia
functional loss of the myenteric plexus
failure of the LOS leading to reflux
treatments for achalasia
endoscopic balloon
surgery- incision made in the sphincter
botox
investigations for achalasia
manometry
what kind of bacteria is H pylori
gram negative
symptoms of alcoholic hepatitis
jaundice, encephalopathy
decompensated hepatic function
infection
what investigations would you do in alcoholic hepatitis
bloods -
raised bilirubin
raised GGT, raise ALK p
AAT:ALT>2
what do we do to score and assess treatment for alcoholic hepatitis
use the Glasgow Alcoholic hepatitis score
scre above 9 we treat with steroids below 9- don’t use steroids
how do we treat alcoholic hepatitis
supportive
treat infection
protect against a GI bleed
what is the pathology of non alcoholic fatty liver disease
fatty liver disease- you get steatosis, steatohepatitis,
many will develop to cirrhosis
what is biliary atresia
children that are born with absence of the bile duct
symptoms of pancreatic cnacer
obstructive jaundice weight loss abdo pain and upper abdomen pain diabetes vomiting recurrent bouts of pancreatitis
what is acute pancreatitis
inflammation of the pancreas
main causes of pancreatitis
gall stones
alcohol
symptoms of acute pancreatitis
abdo pain nausea vomitign collapse pyrexia dehydration abdo tenderness circulatory failure
symptoms of chronic pancreatic
pain
often a late manifestation of exocrine insufficiency
jaundice
GI bleeds upper are uncommon
what are the diagnostic criteria for IBD
recurrent abode pain for more than 3 days in the past 3 months
pain improves with defecation
change in stool frequency and form
what type of gene issue is FAP
autosomal dominant
what type of gene issue is MAP
autosomal recessive
what are haemorrhoids
perforated blood vessels
treatment for haemorrhoids
rubber band litigation
what Is the treatment or fissures
GTN
surgical treatment- botox
sphincterectomy for males
symptom of a perianal abscess
excruciating pain and very tender
symptoms for rectal cancer
painless or painful rectal bleeding
how do we treat rectal cacner
prep MRI
neoadjuvant cancer to reduce the size
surgery
means me we can get clear margins
Examples of prehepatic jaundice
if too much haem is released from red blood cells then it can lead to an increase in bilirubin
what are examples of hepatic jaundice
due to cholestasis and intra-hepatic bile duct obstruction.
what are examples of post hepatic jaundice
cholelithiasis , extra hepatic obstruction
symptoms of hep A
fatigue, fever, nausea, appetite. loss, jaundice, dark urine, pale stools
how long is the incubation period for hep A
2-4 weeks
