Pathology of the upper GI tract

Question 1

What is the definition of upper GI tract pathologies?

Answer 1

Diseases of the upper GI tract which cause upper abdominal or retrosternal discomfort or pain or “indigestion”

Question 2

What are the 3 structures located in the upper GI tract?

Answer 2

oesophagus, stomach and duodenum

Question 3

What causes oesophageal reflux?

Answer 3

gastric acid refux into the oesophagus

Question 4

What is a common cause of oesophageal reflux?

Answer 4

hiatus hernia

Question 5

What happens to the epithelium in oesophageal reflux?

Answer 5

the non keratinising stratified squamous epithelium is thickened

Question 6

How is the effects of oesophageal reflux repaired and what are the consequences of this?

Answer 6

fibrosis (scar tissue)

obstruct the oesophagus and can impair motility

Question 7

What is barrett’s oesophagus?

Answer 7

The changing of epithelium in the oesophagus to a premalignant simple columnar glandular epithelium
metaplasia

Question 8

What are the 2 types of oesophageal cancer and which is barrett’s oesophagus linked to?

Answer 8

squamous carcinoma

adenocarcinoma - BO

Question 9

What is oesophageal cancer linked to?

Answer 9

diet and environment and is on the rise

Question 10

What are the risk factors for oesophageal squamous carcinoma?

Answer 10

smoking, diet, alcohol

Question 11

What is adenocarcinoma of oesophagus risk factors?

Answer 11

barrett’s oesophagus and obesity

Question 12

Why is obesity a risk factor for oesophageal adenocarcinoma?

Answer 12

pro inflammatory environment

can cause hiatus hernia

Question 13

What is the prognosis for oesophageal cancer?

Answer 13

very poor

less than 15% 5YS

Question 14

What are the local effects of oesophageal cancer and also their effects?

Answer 14

obstruction - decreased nutrition as hard to eat
ulceration - blood loss as vessels exposed
perforation - causes abscess

Question 15

What are the 3 possible means of oesophageal cancer spread?

Answer 15

blood - liver
lymphatics
direct

Question 16

What is gastritis?

Answer 16

inflammation of the mucosa of the stomach

Question 17

What are the 3 types of gastritis?

Answer 17

autoimmune, bacterial, chemical injury

Question 18

What happens to gastric acid secretion in autoimmune gastritis?

Answer 18

decreased along with intrinsic factor as atrophy and loss of gastric epithelium cells
autoantibodies for parietal cells

Question 19

What bacteria is bacterial gastritis linked to?

Answer 19

H. Pylori

Question 20

What type of bacteria is H. Pylori, what is its effects and where is it found and treated?

Answer 20

gram negative found in the gastric mucus
increases acid production
antibiotics

Question 21

What kinds of things can cause chemical injury gastritis?

Answer 21

NSAIDS, alcohol, bile reflux

Question 22

What is the aetiology of peptic ulceration?

Answer 22

imbalance in the acid secretion and mucosal bacteria

Question 23

What parts of the GI tract does peptic ulceration effect?

Answer 23

lower part of oesophagus
body and antrum of stomach
1st and 2nd part of duodenum

Question 24

What is peptic ulceration associated with as a cause?

Answer 24

H. Pylori as increased acid production

Question 25

What are some complications of peptic ulceration?

Answer 25

bleeding, perforation and fibrosis

Question 26

What are acute and chronic bleeding called?

Answer 26

haemorrhage

anaemia

Question 27

What can perforation of a peptic ulcer cause?

Answer 27

peritonitis

Question 28

What is stomach cancer linked to a previous infection of?

Answer 28

H. Pylori

Question 29

What type of cancerous cells are found in gastric cancer?

Answer 29

adenocarcinoma as cancer of glandular cells

Question 30

What is an additional way of spread in stomach cancer compared to oesophageal cancer?

Answer 30

transcoelomic spread into the peritoneal cavity which travels to the pelvis

Question 31

What is the prognosis of stomach cancer?

Answer 31

very poor - less than 20% 5YS