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ZA - GI Medicine > Pathology of the Upper GI Tract > Flashcards

Pathology of the Upper GI Tract Flashcards

1
Q

What are the 5 commonest upper Gi conditions?

A 
Oesophageal reflux
Oesophageal cancer
Gastritis
Peptic ulceration
Gastric cancer
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2
Q

What is oesophageal reflux? What is it caused by?

A

Reflux of gastric acid into oesophagus

Hiatus hernia

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3
Q

What is a hiatus hernia?

A

A hiatus hernia is when part of your stomach moves up into your chest via the oesophageal hiatus

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4
Q

What are the complitcations of oesophageal reflux?

A

Thickening of squamous epithelium
Ulceration of the oesophagus
Healing by fibrosis = Stricture formation
Barrett’s Oesophagus

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5
Q

What is barrett’s oesophagus?

A

metaplasia - squamous epithelium gets transformed to glandular epithelium

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6
Q

What is metaplasia

A

Abnormal change in the nature of a tissue

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7
Q

What is a major risk that comes with having barrett’s?

A

It is a pre-malignant condition

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8
Q

What is the 2 histological types of oesophageal cancer?

A

Squamous carcinoma

Adenocarcinoma - develops from barretts

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9
Q

Is oesophageal cancer linked with environmental factors?

A

yes

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10
Q

Risk factors for o. squamous carcinoma ?

A

Smoking
Alcohol
Dietary carcinogens

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11
Q

Risk factors for O. adenocarcinoma?

A

Barretts

Obesity

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12
Q

What is the local effects of o. cancer?

A

Obstruction
Ulceration
Perforation

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13
Q

What are the ways o.cancer can spread?

A

Direct to surrounding tissues
Lymphatic spread to regional lymph nodes
Blood spread to distant sites - liver

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14
Q

Prognosis for o. cancer?

A

Very poor - 5 yr survival rate less than 15%

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15
Q

What is the 3rd most common GI cancer?

A

oesophageal

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16
Q

What is gastritis?

A

Inflammation of the stomach mucosa

17
Q

Types of gastritis?

A

Types ABC

Autoimmune
Bacterial
Chemical Injury

18
Q

What happens in type A gastritis?

A

Autoantibodies attack parietal cells and intrinsic factor.

Causes atrophy of the specialised gastric epithelium and damages parietal cells
–> Decrease Acid Secretion & Loss of intrinsic factor

19
Q

Which type of gastritis is commonest?

A

Type B (bacterial)

20
Q

What bacteria is involved in type B gastritis?

A

Heliobactor Pylori (A gram -ve)

21
Q

Where is H. pylori found?

A

Gastric mucus on surface of gastric epithelium

22
Q

What does H.pylori do?

A

It releases ammonia
Stomach detects pH rise
Parietal cells release more acid
Increases acid = inflammation

23
Q

How is type B gastritis treated?

A

Antibiotics

24
Q

What causes Type C gastritis?

A

Drugs e.g. NSAIDS
Alcohol
Bile Reflux from Duodenum

25
Q

What is a peptic ulceration?

A

An imbalance of acid secretion and the mucosal barrier = an ulcer

26
Q

Where exactly do peptic ulcerations happen?

A

Lower oesophagus
Body + antrum of stomach
1st & 2nd parts of duodenum

27
Q

What causes a peptic ulcer?

A

Too much acid
Acid in a place it shouldn’t
It’s usually associated with H.pylori infection

28
Q

Complications of a peptic ulcer?

A

Bleeding
Perforation
Fibrosis

29
Q

Describe the bleeding that comes with peptic ulcers.

A

Can be acute or chronic

Chronic is more common due to capillary damage. it leads to anemia

30
Q

What happens due to perforations that come with peptic ulcers.

A

Gastric contents start to leak into the peritoneal cavity and cause peritonitis

31
Q

Why does fibrosis occur? Consequences of it?

A

Attempt to heal

Can lead to an obstruction of the GI tract

32
Q

How common is gastric cancer?

A

2nd commonest GI cancer

33
Q

How does gastric cancer develop?

A

Metaplasia and dysplasia of the stomach epithelium

34
Q

What is dysplasia?

A

the presence of cells of an abnormal type within a tissue

35
Q

What is gastric cancer associated with?

A

Previous H.pylori infections

36
Q

Histology of gastric cancer?

A

Adenocarcinomas

37
Q

What types of spread is there with stomach cancer?

A

Direct - surrounding tissues
Regional - lymphatic
Blood - Liver

Transcoelomic - spread within the peritoneal cavity

38
Q

Stomach cancer prognosis?

A

Very poor - 5 yr rate is less than 20%

ZA - GI Medicine (16 decks)

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