Pathology of the Upper GI Tract Flashcards

1
Q

What structures make up the upper GI tract?

A

Oesophagus, stomach and duodenum

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2
Q

What can happen to the oesophagus if it is experiencing constant acid reflux?

A
  1. Thickening of the epithelium (first response)
  2. Ulceration
  3. Barrett’s oesophagus
  4. Stricture due to healing by fibrosis
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3
Q

What is Barrett’s oesophagus?

A

Transformation of the epithelium in the oesophagus from stratified squamous to glandular
Pre-malignant condition

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4
Q

Which type of oesophageal cancer develops from Barrett’s oesophagus?

A

Adenocarcinoma

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5
Q

Local effects of oesophageal cancer?

A

Obstruction
Ulceration
Perforation

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6
Q

What is one way in which fatigue can be caused by oesophageal cancer?

A

If there has been an ulceration/perforation due to the cancer there may be bleeding - which can cause anaemia and therefore fatigue

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7
Q

What is the prognosis for oesophageal cancer like?

A

Very poor

5 year survival < 15%

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8
Q

3 Classes of gastritis causes?

A
Autoimmune (type A)
Bacterial (type B)
Chemical injury (type C)
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9
Q

What is gastritis?

A

Inflammation of the protective lining of the stomach, can be chronic or acute

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10
Q

Effect of autoimmune gastritis?

A

Immune cells attack specialized gastric acid secreting cells (parietal cells)
Loss of gastric epithelium - less acid secretion and loss of intrinsic factor (-pernicious anaemia)

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11
Q

Most common type of gastritis?

A

Bacterial gastritis

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12
Q

Which bacteria is commonly a cause of gastritis?

A

Helicobacter pylori

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13
Q

How does the stomach respond to bacterial gastritis infection?

A
Increases acid production 
Inflammatory response (can be a chronic or acute response)
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14
Q

Common causes of chemical gastritis?

A

Alcohol
Bile reflux from duodenum
NSAIDs

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15
Q

Common cause of peptic ulceration?

A

H. pylori infection

due to increased gastric acid

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16
Q

Why does peptic ulceration occur? Parts of body that can be affected?

A

Imbalance between acid secretion and mucosal barrier secretion (too much acid/too little mucous)

Lower oesophagus, body and antrum of stomach, first and second parts of duodenum)

17
Q

Complications of peptic ulceration?

A

Bleeding (acute haemorrhage/chronic - anaemia)

Perforation - peritonitis

Fibrosis - obstruction

18
Q

What can increase likelihood of gastric cancer?

A

Previous H. Pylori infection

19
Q

How can stomach cancer spread?

A

Direct (surrounding tissues)
Lymphatic
Blood
Transcoelomic (within peritoneal cavity)

20
Q

Prognosis of stomach cancer?

A

Poor

5 year survival <20%