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GI System > Pathology of upper GI > Flashcards

Pathology of upper GI Flashcards

1
Q

What is Barrett’s oesophagus?

A

Metaplasia of squamous epithelia to glandular epithelia

Pre-malignant condition

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2
Q

How does oesophageal reflux affect oesophageal epithelium?

A

Reflux of gastric acid into oesophagus
Thickening of squamous epithelium
Ulceration of oesophageal epithelium
Ulceration heals by fibrosis and leads to stricture and obstruction

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3
Q

What are the 2 main types of oesophageal cancer?

A

Squamous carcinoma

Adenocarcinoma

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4
Q

What are the main risk factors for oesophageal squamous carcinoma?

A

Smoking
Alcohol
Dietary carcinogens

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5
Q

What are the main risk factors for oesophageal adenocarcinoma?

A

Barrett’s metaplasia

Obesity

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6
Q

What are the local effects of oesophageal cancer?

A

Obstruction
Ulceration
Perforation

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7
Q

How may oesophageal cancer spread?

A

Directly
Lymph
Blood

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8
Q

What is the 5ys of oesophageal cancer?

A

<15%

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9
Q

What is the effect of autoimmune gastritis?

A

Autoantibodies attack parietal cells and intrinsic factor

May result in further autoimmune diseas, decreased acid secretion and loss of intrinsic factor

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10
Q

What is bacterial gastritis?

A

Helicobacter Pylori
Found in gastric mucus
Increases acid production

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11
Q

What is chemical gastritis?

A

Can be drug induced (NSAIDs)
Alcohol
Bile reflux from duodenum into stomach

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12
Q

How does peptic ulceration usually happen?

A

Imbalance between

Often H. Pylori associated

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13
Q

What is the most common kind of gastric cancer?

A

Adenocarcinoma

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14
Q

How does gastric cancer usually develop?

A

Metaplasia and hyperplasia

Associated with previous H. Pylori infection

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15
Q

What is the 5ys of gastric cancer?

A

20%

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16
Q

What is the classic triad for achalasia?

A

Loss of peristalsis
Increased LOS tone
Inadequate relaxation of LOS

17
Q

What may gastric ulcers lie over?

A

Gastric carcinoma

18
Q

What are some possible causes of oesophageal dysphagia?

A 
Benign stricture
Malignant stricture
Motility disorders
Eosinophilic oesophagitis
Extrinsic compression
19
Q

What are the main tests for dyphagia?

A

Endoscopy preferred

Barium swallow

20
Q

What does manometry assess?

A

Sphincter tonicity
Relaxation of sphincters
Oesophageal motility

21
Q

Give an example of hypermotility.

A

Diffuse oesophageal spasm

Corkscrew appearance on Ba swallow

22
Q

What is achalasia?

A

Functional loss of myenteric plexus ganglion cells in distal oesophagus and LOS

23
Q

What are the pharma options to treat motility disorders?

A

Nitrates

CCBs

24
Q

How does GORD happen without anatomical abnormalities?

A

Transient relaxation of LOS increases
Delayed gastric emptying
Delayed oesophageal emptying
Decreased oesophageal acid clearing

25
Q

What is the main anatomical cause of GORD?

A

Hiatus hernia distorts OG junction

26
Q

What bad does GORD actually do? (pathophysiology)

A

Mucosa exposed to acid
Increased cell loss and regenerative activity
Inflammation
Erosive oesophagitis

27
Q

What are some complications of GORD?

A

Ulceration
Stricture
Glandular metaplasia
Carcinoma

28
Q

What is Barrett’s oesophagus?

A

Intestinal metaplasia related to prolonged acid exposure in distal oesophagus

29
Q

How do cells change in Barrett’s oesophagus?

A

Squamous to mucin-secreting columnar epithelial cells in LO

30
Q

Can Barrett’s oesophagus lead to dysplasia or adenocarcinoma?

A

Yes

31
Q

How is Barrett’s oesophagus treated?

A

Endoscopic mucosal resection (EMR)

32
Q

How can GORD be treated apart form just lifestyle changes?

A

Alginates (Gaviscon)
Ranitidine
Proton pump inhibitors (Omeprazole)
Fundoplication (Anti-reflux surgery)

33
Q

What is the most common kind of oesophageal cancer?

A

Adenocarcinoma

34
Q

Where do squamous cell carcinomas usually occur in the oesophagus?

A

Proximal two thirds

35
Q

Where do adenocarcinomas usually occur in the oesophagus?

A

Distal third

36
Q

What are the main mets sites for oesophageal cancer?

A

Hepatic
Brain
Lung
Bone

37
Q

What are some good tests for staging oesophageal cancer?

A

CT
Endoscopic USS
PET scan
Bone scan

38
Q

How does eosinophilic oesophagitis present?

A

Dysphagia

Food bolus

GI System (20 decks)

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