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pathology Flashcards

1
Q

what is oesophageal reflux?

A

reflex of gastric acid into oesophageas

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2
Q

hiatus hernia?

A

part of stomach moves into thorax

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3
Q

why does oesophageal ulcer form from reflux?

A

acid tears away tissue lining and this ulcer can form and bleed!

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4
Q

stricture of the oesophagus leads to?

A

obstruction due to scar tissue

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5
Q

barrets oesophagus?

A

precancerous changes to oesophagus lining where it becomes more intestinal like

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6
Q

explain change of epithelium in barret’s oesophagus?

A

squamous epithelium to glandular epithelia

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7
Q

metaplasia?

A

transformation from one cell type to another

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8
Q

barrel’s oesophagus increases chances of what?

A

oesophageal cancer ADENOCARCINOMA

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9
Q

DYSPLASIA ?

A

abnormal development of cells lead to various conditions e.g. - cancer

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10
Q

ulceration if left unchecked leads to?

A

perforation - loss of continuity of wall - hole

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11
Q

3 types of gastritis?

A

autoimmune, bacterial, chemical

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12
Q

bacterial gastritis caused by?

A

helicobacter pylori

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13
Q

h.pylori in stomach lead to what?

A

peptic ulcers, gastritis, stomach cancer

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14
Q

bacterial gastritis and autoimmune gastritis does what to acid secretion

A 
bacterial = increases acid secreted 
autoimmune= decreases acid secreted
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15
Q

chemical gastritis due to ?

A

NSAIDS
ALCOHOL
bile reflux from small I

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16
Q

PEPTIC ULCERS?

A

open sores on inner lining of stomach, duodenum, lower oesophagus - anywhere gastric acid can come in contact

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17
Q

adenocarcinoma?

A

in mucus glandular cells

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18
Q

transcoelomic spread?

A

spread of cancer within peritoneal cavity

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19
Q

hepatomegaly? suggests?

A

enlarged liver - suggest metastases

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20
Q

ascites?

A

accumulation of fluid in peritoneal cavity

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21
Q

liver failure is what?

A

inability of liver to perform function

complication of acute and chronic liver injury = final stage of many liver diseases

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22
Q

alcohol affect on liver explain and describe

A

fatty change - accumulation
hepatitis inflammation
liver cell death
liver failure and cirrhosis

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23
Q

viral hepatitis types

A

A, B,C,E

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24
Q

cirrohosis?

A

late stage scarring fibrosis of liver

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25
Q

what is jaundice?

A

increased circulating bilirubin

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26
Q

cholestasis ?

A

decrease in bile flow so accumulation of bile

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27
Q

portal hypertension?

A

increased pressure inside portal vein in liver due to lack of flow(blockage)

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28
Q

primary sclerosis cholangitis associated with what condition?

A

IBD

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29
Q

complication of cirrhosis of liver? 3

A

altered liver function
hepatoceullar carcinoma
portal hypertension

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30
Q

portal hypertension leads to?

A

splenomegaly and oesophageal varies that can bleed

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31
Q

what is cholangiocarcinoma?

A

bile duct cancer

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32
Q

cholelithiasis?

A

gallstones

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33
Q

what are gallstones?

A

small stones made up of cholesterol that form in GB

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34
Q

CHOLECYSTITIS?

A

inflammation of gall bladder

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35
Q

causes of common bile duct obstruction?4

A

gallstones
bile duct tumour
stricture (fibrosis)
external compression

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36
Q

common Bile duct obstruction lead to what?

A

jaundice

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37
Q

IBD includes?

A

ulcerative colitis and chrons disease

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38
Q

what gene mutation in association with CD?

A

NOD2

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39
Q

what is pathology of IBD?

A

exaggerated immune response

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40
Q

what is ulcerative colitis?

A

colon inflamed and has ulcers in the tract which can bleed and produce pus

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41
Q

pseudopolyps?

A

projecting masses of scar tissue that develop from tissue during healing phase in repeated cycle of ulceration

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42
Q

pancolitis?

A

UC over entire large intestine

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43
Q

fistula?

A

abnormal connection between areas

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44
Q

ischaemic enteritis?

A

arterial blood flow to small I is restricted which leads to infarction

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45
Q

what is radiation colitis?

A

injury inflammation to colon due to radiation -

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46
Q

dysplasia is either?

A

high or low grade

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47
Q

what is dysplasia?

A

abnormal development of cells in tissue/organs

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48
Q

an adenoma? presents as?

A

benign tumour of glandular cells in epithelium - as polyps

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49
Q

high grade dysplasia is ?

A

precursor to cancer

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50
Q

most common type of colorectal cancer?

A

adenocarcinoma

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51
Q

colorectal adenocarcinoma types/names?

A 
right-sided(ascending) = exophytic/polypoid 
left-sided(descending/tranverse) = annular
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52
Q

angle of his?

A

angle between stomach and oesophagus

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53
Q

pain when swallowing called?

A

odynophagia

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54
Q

dysphasia?

A

difficulty swallowing

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55
Q

achalasia?

A

condition where LOS doesn’t relax properly and muscles in oesophageal wall are weak - PARALYSED

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56
Q

pH metro into oesophagus meaning?

A

pH probe into oesophagus - measure acid levels in stomach - diary and record changes in pH over time

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57
Q

manometry into oesophagus does what?

A

describes pressure waves in oesophagus and give food to swallow and see pressure changes monitored

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58
Q

achalasia caused by?

A

nerves in oesophagus damaged - myenteric plexus damaged -

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59
Q

what happens with food in achalasia?

A

collects up in oesophagus bc LOS won’t open

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60
Q

fundoplication?

A

full/partial wrap of stomach around bottom of oesophagus

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61
Q

examples of 2 PPIs?

A

omeprazole and lansoprazole

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62
Q

what carcinoma is barrets more associated with?

A

adenocarcinoma

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63
Q

eosinophilic oesophagitis? caused by?

A

chronic allergen mediated inflammation of oesophagus caused by build up of WBC in lining of oesophagus.

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64
Q

dyspepsia?

A

bad digestion - group of symptoms

vomiting, nausea, upper abdomen pain, heartburn,

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65
Q

red flag symptoms for endoscopy ?

A 
anorexia
loss of weight 
anaemia 
recent onset >55 yrs 
melaena/haematemisis - gi bleeding 
swallowing difficulty 
ALARMS
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66
Q

what is helicobacter pylori?

A

gram negative bacteria, spiral shaped that form ulcers in stomach and inflammation

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67
Q

where does helicobacter pylori reside?

A

surface mucous layer DOES NOT PENETRATE LAYERS

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68
Q

outcomes of HP infection?

A

asymptomatic
gastritis
ulcer
cancer

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69
Q

outcomes of HP infection depend on?

A 
site
host factors (smoker, genes) 
characteristics of bacteria
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70
Q

what antibody present if HP infection?

A

IgG

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71
Q

tests to investigate for HP infection?

A 
UREA breath test 
stool antigen test 
CLO urease test 
biopsy 
endoscopy
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72
Q

NSAIDS such as?

A

ibuprofen, aspirin, steroids,

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73
Q

ranitidine?

A

H2 receptor antagonist - reduce acid in stomach

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74
Q

haematemesis?

A

vomit blood

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75
Q

treatment to eradicate HP?

A

triple therapy

clarithromycin
amoxicillin
PPI

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76
Q

gastric outlet obstruction?

due to?

A

inflamed, scarred stomach ulcer obstructs passage of food

obstruction due to-
inflammation
scar tissue

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77
Q

2 types of gallstones

each caused by what?

A

cholesterol stones - increase in cholestrol
pigment stones - increase in bile

or mixed

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78
Q

blockage of pancreatic duct leads to?

A

pancreatitis

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79
Q

obstructive jaundice painful due to?

A

gallstones in common BD

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80
Q

lithotripsy?

A

fragment gallstones

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81
Q

biliary atresia?

A

congenital -

infants where bile ducts outside and inside are scarred and blocked

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82
Q

choledochal cysts?

A

congenital - bile duct swells and bile backs up into liver

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83
Q

what tumours cause jaundice?

A

bile duct cancers
gallbladder cancer
pancreas head cancer

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84
Q

cholaniocarcinoma types?

A

bile duct cancer

mass forming - mass in duct
periductal - around duct
intraductal - within duct

85
Q

ERCP?

and what done with it?

A

ENDOscopic procedure to look at small tubes in body - bile ducts

endoscopic with a biopsy or removal of stones

86
Q

gall bladder cancer due to?

A

gallstones, polyps, diabetes, inflammation

87
Q

ampullary carcinoma?

A

cancer tumour found in small opening where pancreatic duct and bile duct connect

88
Q

type of ampullary carcinoma?

A

adenocarcinoma

89
Q

functions of liver?

A

synthetic function - processing nutrients
detoxification - detoxify drugs -
immune function - combats infection -
storage -

90
Q

liver function tests?

A 
ALT 
AST 
ALP 
bilirubin 
gamma GT 
albumin 
prothrombin time
91
Q

ALT and AST tests?

A

aminotrasnferases enzymes of liver

AST/ALT ratio - increased means damaged hepatocytes

92
Q

ALP test?

A

alkaline phosphatase enzyme found highly in liver -

elevated if obstruction

93
Q

gamma gt test?

A

liver enzyme that if elevated - sign of liver damage

94
Q

albumin test?

A

test for functioning of liver

95
Q

prothrombin time?

A

protein made by liver - clotting factor

tests liver function

96
Q

MRCP?

A

imaging of liver, GB, ducts - scanner

97
Q

cirrhosis of liver leads to what issue?

A

portal hypertension

98
Q

analyse ascitic fluid for what?

A

cell count
protein
albumin
SAAG

99
Q

SAAG for ascites is what?

A

ascites albumin gradient

tells us if ascites due to portal hypertension or not

more than 1.1 = portal hypertension present
less than 1.1 = non- portal hypertension causes (malignancy, infection)

100
Q

hepatorenal syndrome?

A

worsening of ascites

101
Q

oesophageal varices due to ? explain

A

enlarged/swollen veins that can bleed and lead to vomit blood

varies bleed due to increase portal hypertension that pushes blood elsewhere to areas that handle increase vol. (porto-systemic areas)

102
Q

TIPS procedure explain?

A

connect two veins in liver to decrease pressure and create shunt

103
Q

hepatic encephalopathy?

A

confusion due to increase in toxins in blood complication due to liver disease

104
Q

tumour marker for hepatocellular carcinoma?

A

AFP protein

105
Q

what chemical increases causing hepatic encephalopathy?

A

ammonia released into brain lead to confusion

106
Q

causes of hepatic encephalopathy? 3/4

A

infection
drugs
alcohol
GI BLEED

107
Q

Spontaneous bacterial peritonitis?

A

bacterial infection in peritoneum with no obvious source of infection - increase in ascitic fluid in abdomen

108
Q

what is KEY treatment in alcohol hepatitis patients?

A

thiamine NUTRITIONAL SUPPORT - AS MOST ARE MALNOURISHED

109
Q

What is non-alcoholic fatty liver? and causes?

A

build up of fat in liver due to
obesity
diabetes

110
Q

difference in labs results between non-alcoholic FD AND alcoholic FD? (AAT/ALT)

A

non-alcoholic FD = ALT more than AAT

alcoholic FD = AAT more than ALT

111
Q

viral hepatitis types either?

A 
A,E = self limiting 
B,C,D = chronic disease
112
Q

hepatitis D significant feature?

A

only affected with it if affected by hep B

113
Q

Fibroscan of liver says what?

A

how scarred is the liver??

no fibrosis or cirrhosis present

114
Q

contraindications of transplant? 6

A 
active malignancy - spread elsewhere 
psychosocial factors 
brain death
uncontrolled infection present 
vessels involved in tumour 
anatomical barriers
115
Q

what is chronic pancreatitis?

A

pancreas permanently damaged from inflammation - loss of function

116
Q

pseudocysts?

A

fluid filled growths that form in/out pancreas - can block ducts/vessels etc

117
Q

what can cysts develop to?

118
Q

EUS allows for?

A

images
biopsy
fluid aspiration if need be

119
Q

pancreatic cancer causes what?

A

painless obstructive jaundice

120
Q

serum amylase in pancreatitis?

A

elevated highly

121
Q

gallstones in pancreatic duct does what?

A

raises the pancreatic duct pressure

122
Q

celiac plexus block?

A

destroy nerves to relief pain in pancreatitis

123
Q

MD-IPMN?

A

MAIN DUCT CYST pancreas

124
Q

MCN?

A

MUCINOUS CYST in pancreas

125
Q

what to do if cyst in duct? and why?

A

monitor the cyst and look fro worrisome features like enlarged - cyst wall - nodules -

as risk of malignancy

126
Q

causes of upper GI bleeding?

A

ulcers and inflammation

127
Q

risk of anticoagulants?

A

bleeding excessively

128
Q

e.g. - anticoagulant?

129
Q

hepatitis c due to?

A

contact with blood and use of injecting and needles

130
Q

mallory-weirs tear?

A

tearing at oesophageal-gastric junction - cause upper GI BLEED

131
Q

angiodyplasia?

A

vascular malformation - leading to upper GI BLEED

132
Q

What usual cause of lower GI bleed FRESH red blood?

A

haemorrhoids - if fresh red blood

133
Q

what are haemorrhoids?

A

vascular cushion around anus

134
Q

diverticular disease? lead to?

A

pouches form on inner lining of lower tract - lead to lower GI bleed

135
Q

Meckel’s diverticulum?

A

bulge in lower small I - can get inflamed - lead to lower GI bleeding

136
Q

management of GI bleed FIRST THING?

137
Q

MANAGEMENT OF GI BLEED?

A
  1. resuscitation
  2. risk classification - see if need critical care
  3. investigations/treatment
138
Q

how to calculate risk in gi bleed?

A

measure blood urea, hb, HR, BP, PULSE,

age, drugs using, other conditions?

139
Q

what medications not good for gi bleeds?

A

antiplatlets/anti-coags

140
Q

liver cirrhosis leads to what?

A

portal hypertension

enlarged spleen and oesophageal. varices

141
Q

treatment for varices?

A

oeso. band ligation - band over varices to shrink it down endoscopically
ab
vasoconstrictors
TIPS - shunt

142
Q

peritonitis?

A

inflammation of peritoneum due to infection

143
Q

functions of small I?

A

digestion, absorption, motility

144
Q

what is constantly happening in the villi and crypt?

A

constant turnover

145
Q

bacterial population in small I?

A

LOW bacterial population

146
Q

capsule enterography?

A

capsule with lens/light and imager - swallowed to study inside of GI tract

147
Q

Steatorrhoea?

A

high fat content in stool - smelly

148
Q

coeliac disease?

A

autoimmune - when body attacks own healthy tissue - and damages gut in response - when eaten gluten

149
Q

affect of coeliac disease?

A

damages lining of small I - prevents intake of nutrients

150
Q

the mucosa of gut recognises what about bacteria?

A

detects and differenciates good bacteria from pathogens that require immune response

151
Q

cytokines/chemikines?

A

mediators of immune response -

that are secreted by immune cells

152
Q

peters patches? found where?

A

found ileum of gut -
masses of lymph tissue - nodules -
part of immune system

153
Q

macrophages?

A

are phagocytotic
kill foreign microbes
first line of defence in gut

154
Q

lamina propria function?

A

supports mucosal epithelium

provides immune defence

155
Q

dysbiosis of microbiota meaning?

A

imbalance in bacterial colonic levels - leading to disease etc

156
Q

crp in blood means?

A

inflammation marker in blood - from liver

157
Q

faecal calprotectin?

A

biomarker substance released by body when inflammation in intestines - high levels associated with IBD

158
Q

transmural inflammation in which IBD?

A

crowns disease not UC

159
Q

pouch surgery?

A

after removal of intestine - allows for waste in body to be removed properly by pouch

160
Q

surgical indications of crohns disease/IBD?

A

failure to manage with meds
relief of symptoms
management of fistulae
failure to thrive - weight loss/gain

161
Q

FIT test?

A

faecal test to test for bowel disease - it detects blood in poo -

162
Q

anal fissure?

A

tear in anus lining - pain and blood in poo

163
Q

IBS? explain symptoms?

A

irritable bowel syndrome

bloating 
cramps
constipation 
diarrhoea 
gas
mucus in poo
164
Q

classic feature of IBS?

A

relapses and remiits

symptoms comes and goes

165
Q

calprotectin checking for?

A

inflammation in gut

166
Q

laxatives for?

A

loosen stool and increase bowel movements

167
Q

polyps in tract?

A

precancerous

but can be benign

168
Q

two types of staging for cancer?

169
Q

dukes staging

A

A - confined to submucosa
B - C = invasion through muscular
D= presence of distant met

170
Q

FAP condition?

A

Hereditary condition - which forms multiple polyps adenomas in intestine

171
Q

screening for crc includes?

A

FIT testing

172
Q

what symptoms of CRC?

A

IRON deficiency anaemia
altered bowel habits
bleeding
pain

173
Q

stapled anoplexy?

A

procedure for haemorrhoids in anus

174
Q

anus fissure bleeds how?

175
Q

treatments for anul fissures?

A

sphincterectomy

botox injection

176
Q

faecal incontinence?

A

inability to control bowel movements - causing unwanted leaks

177
Q

cobblestones on X-ray sign of?

A

crohns disease

178
Q

colicky pain means?

A

comes and goes

179
Q

rectal cancer what is done before surgery?

180
Q

colostomy? ileostomy?

A

divert one end of the colon through opening in tummy - STOMA - allow contents/stool to divert its flow

ileostomy - small bowel done instead

181
Q

large bowel obstruction benign causes?5

A 
stricture
volvulus - twisted
faecal impaction 
intussusception - in on itself 
recent surgery injury
182
Q

options/treatments for colorectal tumours ? 4

A

stoma (colostomy)
colectomy +anastomsis
stenting - keeps it open
palliation

183
Q

hartmanns procedure?

A

resection of sigmoid rectal colon and end with colostomy

184
Q

jaundice is when bilirubin is what level?

A

more than 3mg/dL

185
Q

haemolytic jaundice? affect on stools and urine?

A

increase level of unconjugated bilirubin

no change in urine or stool

186
Q

ALT and AST indicate what?

A

enzymes that indicate liver cell injury

187
Q

ALP and GGT indicate what?

A

markers enzymes of biliary obstruction

188
Q

affect of hepatocellular jaundice on stools and urine?

A

stools pale and urine is dark

189
Q

alp/ast and alt levels in haemolytic jaundice?

190
Q

mrcp investigation?

A

non-invasive assessment of biliary tree - detect stones, tumours, etc

191
Q

intussuspeption of bowel?

A

invagination of intestinal segment into a loop - obstruction the bowel

192
Q

volvulus of gut?

A

twisted - lead to obstruction

193
Q

adhesive small bowel obstruction means?

A

usually after operation - structures sticking together

194
Q

what gene is most commonly associated with IBD?

195
Q

toxic megacolon due to?

A

severe UC - causes dilation of t/right colon

196
Q

as stool frequency increases what it means for severity of UC?

A

WORSENING !

197
Q

PATTERNS OF CD?

A 
strictures 
scarring 
perforation 
fistulas 
abscesses 
ulcers
198
Q

crypt abscesses seen where in UC or CD?

199
Q

COELIC DISEASE ASSOCIATE WITH WHAT? 3

A

other autoimmune diseases

  • dermatitis heretiformis
  • PBC
  • insulin dependant diabetes mellitus
200
Q

complications of coeliac disease?

A

cancer of small intestine - lymphoma/adenocarcinoma

cancer of pharynx and oesophagus

201
Q

ceolic disease what is it?

A

chronic digestive disorder due to immune reaction to gluten protein

202
Q

coelic disease - physiology?

A

inflammation of inner lining of small intestine and can lead to malabsorption of nutrients

203
Q

skin rash formed from coeliac disease?

A

DH - dermatitis herpetiformis

204
Q

causes of coeliac disease?

A

immune disorder - eats gluten it triggers the immune attack

205
Q

functional GI DISORDERS? 4

A

disorders where no clear issue structurally or chemically

IBS
OESO. SPASM
non-ulcer dyspepsia
biliary dyskinesia

206
Q

biliary dyskinesia ?

A

pain in GB

207
Q

organic disease meaning?

A

there is an observable pathology

208
Q

what electrolyte conditions are there in refeeding syndrome? 3

A

hypokalaemia
hypomagnesia
hypophosphatemia

GI SYSTEM (4 decks)

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