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The Alimentary Canal > Pathology of Upper GI Tract > Flashcards

Pathology of Upper GI Tract Flashcards

1
Q

What anatomy is included in the upper GI tract?

A

Oesophagus
Oesophageal sphincter
Stomach
Pyloric sphincter
Duodenum

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2
Q

Explain oesophageal reflux

A

Reflux of gastric acid into oesophagus
Acid degrades top keratin layer which provides strength and structure

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3
Q

What does oesophageal reflux cause?

A

Thickening of oesophageal epithelium
Ulceration of epithelium when severe

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4
Q

What are some complications of oesophageal reflux?

A

Healing by fibrosis causing stricture, impaired motility and obstruction
Barrett’s oesophagus

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5
Q

Explain Barrett’s Oesophagus

A

Type of metaplasia where transformation from squamous epithelium to glandular epithelium
Is a pre-malignant condition

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6
Q

Is oesophageal cancer common?

A

Third most common cancer of the alimentary tract

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7
Q

What are the histological types of oesophageal cancer?

A

Squamous carcinoma (from squamous)
Adenocarcinoma (from glandular)

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8
Q

What are the risk factors for squamous carcinoma?

A

Smoking
Alcohol
Dietary carcinogens

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9
Q

What are the risk factors of adenocarcinoma?

A

Barrett’s metaplasia
Obesity

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10
Q

What is the difference of location between squamous carcinoma and adenocarcinoma?

A

Squamous - upper GI tract
Adenocarcinoma - lower GI tract

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11
Q

What are some local effects of oesophageal cancer?

A

Obstruction
Ulceration
Perforation

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12
Q

Where can oesophageal cancer spread to?

A

Direct to surrounding tissues
Lymphatic spread to regional lymph nodes
Blood spread to liver

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13
Q

What is the outcome/ Prognosis of oesophageal cancer?

A

Very poor - only 5 year survival rate less than 15%
Need 6 cycles of neoadjuvant chemo then surgery

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14
Q

What are the 3 types of gastritis?

A

Autoimmune (A)
Bacterial (B)
Chemical injury (C)

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15
Q

Explain autoimmune gastritis

A

Organ specific autoimmune disease
Autoantibodies to parietal cells and intrinsic factor
Associated with other autoimmune diseases

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16
Q

What is gastritis?

A

Inflammation of the stomach

17
Q

Describe the pathology of autoimmune gastritis

A

Atrophy of specialised acid secreting gastric epithelium
Loss of specialised gastric epithelium cells

18
Q

What does loss of specialised gastric epithelial cells cause in autoimmune gastritis?

A

Decreased acid secretion
Loss of intrinsic factor so vitamin B12 deficiency

19
Q

What is vitamin B12 deficiency called?

A

Pernicious anaemia

20
Q

Describe the histology of autoimmune gastritis

A

Makes intestinal metaplasia
Loss of specialised glands and chronic inflammation
Glands disappear to be replaced by lymphocytes

21
Q

What is the most common type of gastritis?

A

Bacterial gastritis

22
Q

Explain bacterial gastritis

A

Helicobacter pylori related - gram negative
Found in gastric mucus on surface of gastric epithelium

23
Q

What does bacterial gastritis cause?

A

Produces acute and chronic inflammatory response
Increased acid production

24
Q

What could chemical gastritis be caused by?

A

Drugs - NSAIDs
Alcohol
Bile reflux

25
Q

Describe the features of chemical gastritis

A

No inflammation
No organisms
Corkscrewing - hyperplasia of cells
Dilated blood vessels at surface

26
Q

Explain peptic ulceration

A

Imbalance between acid secretion and mucosal barrier
Usually h. pylori associated - increased gastric acid

27
Q

Where does peptic ulceration affect?

A

Oesophagus - lower
Body and antrum of stomach
First and second parts of duodenum

28
Q

What are some complications of peptic ulceration?

A

Bleeding - acute haemorrhage or chronic causing anaemia
Perforation - peritonitis
Healing by fibrosis - obstruction

29
Q

Is gastric cancer common?

A

Second most common alimentary cancer

30
Q

What is gastric cancer associated with?

A

H.pylori

31
Q

Explain gastric cancer development

A

Develops through phases of intestinal metaplasia and dysplasia

32
Q

Describe the histology of gastric cancer

A

Adenocarcinoma

33
Q

Where can stomach cancer spread to?

A

Direct to surrounding tissues
Lymphatic to regional lymph nodes
Blood spread to liver
Trans-coelomic spread within peritoneal cavity

34
Q

What is the prognosis of stomach cancer?

A

Very poor - 5 year survival rate less than 20%

The Alimentary Canal (33 decks)

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