Pathology of the upper GI tract

Question 1

what effects does oesophageal reflux have on the oesophagus?

Answer 1

thickening of squamous epithelium

ulceration of epithelium if its severe

Question 2

what are the complications of oesophageal reflux?

Answer 2

healing by fibrosis which can restrict oesophageal motility and cause obstruction
Barrett’s oesophagus - metaplasia of squamous epithelium to glandular epithelium (pre malignant change)

Question 3

what are the histological types of oesophageal cancer?

Answer 3

squamous carcinoma

adenocarcinoma

Question 4

which type of oesophageal cancer develops from barretts oesophagus?

Answer 4

adenocarcinoma

Question 5

what are the risk factors for oesophageal cancer?

Answer 5

squamous:
smoking
alcohol
dietary carcinogens

adenocarcinoma:
obesity
barretts oesophagus

Question 6

what are the local effects of oesophageal cancer and what can this cause?

Answer 6

obstruction = dysphagia
ulceration = bleeding = haematemesis 
perforation = perforation into the thoracic cavity

Question 7

where can oesophageal cancer spread?

Answer 7

directly to surrounding structures
lymphatic spread through regional lymph nodes
blood spread to the liver

Question 8

what are the 3 types of gastritis?

Answer 8

autoimmune (A)
bacterial (B)
chemical injury (C)

Question 9

what bacteria causes type B gastritis? and what type of bacteria is this?

Answer 9

helicobacter pylori

gram negative

Question 10

what occurs in type A gastritis?

Answer 10

loss of specialised acid secreting gastric epithelium (parietal cells)
atrophy of acid secreting gastric epithelium cells (parietal cells)
results in decreased acid production
also loss of intrinsic factor = pericicious anaemia du to lack of vitamin b 12

Question 11

what type of gastritis is caused by increased acid production?

Answer 11

bacterial

produces an acute and chronic inflammatory response

Question 12

what drugs can cause gastritis?

Answer 12

NSAID’s

Question 13

what is peptic ulceration caused by?

Answer 13

imbalance between acid secretion and mucous barrier

Question 14

what is peptic ulceration usually associated with and how does this cause ulceration?

Answer 14

helicobacter pylori

the bacteria causes an increase in acid secretion

Question 15

what are the complications of a peptic ulcer?

Answer 15

bleeding - acute = haemorrhage or chronic = anaemia
perforation = peritonitis
healing by fibrosis = obstruction

Question 16

what is the histological type in stomach cancer?

Answer 16

adenocarcinoma

glandular epithelium

Question 17

what i stomach cancer associated with?

Answer 17

previous helicobacter pylorus infection

Question 18

how does stomach cancer spread?

Answer 18

direct
blood - to the liver
lymphatic
transcoelomic (direct) - spread through the peritoneal cavity

Question 19

gastritis caused by autoimmune disease - what cells are targeted in the stomach and what effect does this have?

Answer 19

they cause atrophy of parietal cells
results in loss of gastric acid production and intrinsic factors production
loss of intrinsic factor results in less vitamin B12 absorption = pernicious anaemia.