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alimentary system: pathology sa > Pathology of Upper GI Tract: > Flashcards

Pathology of Upper GI Tract: Flashcards

1
Q

What are examples pathological problems in the oesophagus

A

Oesophageal Reflux

Oesophageal Cancer

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2
Q

Define oesophageal reflux

A

Reflux of gastric acid into oesophagus

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3
Q

What is a posible cause of oesophageal reflux

A

Lower oesophageal spinchter doesn’t work

hiatus hernia

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4
Q

What happens to the lining of the oesophagus in oesophagus reflux

A

Thickening of squamous epithelium cells due to the healing process of fibrosis

(cant tolerate acid)

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5
Q

What are the complications of the healing process fibrosis in ooesophageal reflux

A

Impaired motility
Oesophageal obstruction
Stricture formation - abnormal narrowing

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6
Q

What are the further complications of oesophageal reflux

A

Ulceration (due to epithelium not being adapted to acid)

Barrets oesophagus

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7
Q

Define Barrets oesophagus

A

Type of metaplasia that has the transformation from squamous epithelium to glandular epithelium

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8
Q

What are the two histological types of oesophageal cancer

A

Squamous carcinoma
(develops near top)

Adenocarcinoma
(develops near bottom)

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9
Q

What is the risk factors of squamous oesophageal cancer

A

Smoking
Alcohol
Dietary carcinogens

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10
Q

What is the risk factors of adenocarcinoma oesophageal caner

A

Barrets oesophagus (premalignant)

Obesity

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11
Q

How is obesity a risk factor of oesophageal cancer

A

Abdominal obesity aplies pressure on the stomach pushing the stomach contents through oesophageal spinchter resulting in acid reflux

Obesity creates a pro-inflammatory environment

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12
Q

What is the three local effects causes by oesophageal cancer

A

Obstruction
Ulceration
perforation

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13
Q

What symptoms are causes by the local effect of obstruction in oesophageal cancer

A

Dysphagia - difficulty swallowing

Weightloss

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14
Q

How does the symptom of anaemia occur in oesophageal cancer

A

Due to the local effect of ulceration, resulting in large areas of cell death resulting in blood loss

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15
Q

What can occur due to the local effect of perforation in oesophageal cancer

A

Food passes down oesophagus and passes through perforation into the thorax

causing a potential abscess

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16
Q

What is the three ways oesophageal cancer can spread

A

Direct (to surrounding structures)

Lymphatic spread (to regional lymph nodes)

Blood spread
(Liver)

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17
Q

What is the prognosis of oesophageal cancer

A

Very poor

5 year survival rate less than 15%

18
Q

Overall what are the indirect symptoms of oesophageal cancer

A

Weight loss
Dysphagia
Anemia
Abscess

19
Q

What is the three pathologies Of Gastritis (inflammation of the stomach lining)

A

Autoimmune
Bacterial
Chemical injury

20
Q

Define autoimmune gastritis

A

Specific autoimmune disease targeting stomach due to autoantibodies to parietal cells and intrinsic factor
(further associated with other autoimmune diseases)

21
Q

What is the pathology of autoimmune gastritis

A

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

22
Q

What is the affect of autoimmune gastritis

A

Decreased acid secretion

Loss of intrinsic factor
Vitamin B12 deficiency =pernicious anaemia

23
Q

What is the most common type of gastritis

A

Bacterial

24
Q

What bacteria causes bacterial gastritis

A

Heliobacter pylori

Gram negative

25
Q

Where is Heliobacter Pylori found in Gastritis

A

Found in gastric mucus on the surface of the gastric epithelium

26
Q

How does H. Pylor result in gastritis

A

Produces acute and chronic inflammatory response

Increases acid production

27
Q

How does H. Pylori increase acid production

A

As antrum Inflammation increases gastrin production which therefore stimulates more acid production

28
Q

How does H.Pylori protect itself in the stomach

A

H.Pylori release the enzyme urease which breaks down urea to ammonia and bicarbonate creating an alkaline environment around it

Located in the gastric mucus for protection

29
Q

What are the causes of chemical gastritis

A

Drugs (NSAIDS)

Alcohol

Bile reflux

30
Q

How does peptic ulceration occur

A

Due to Imbalance between acid secretion and mucosal barrier

  • break down of mucosal barrier
  • Acid in the wrong place
31
Q

Where can peptic ulceration affect

A

Lower oesophagus
Body and antrum of stomach
First and second parts of duodenum

32
Q

What is the most common aetiology of peptic ulceration

A

H.pylori infection resulting in an increase in gastric acid

33
Q

What are the three ways complication can occur in Peptic ulceration

A

When bleeding occurs

Perforation

Healing by fibrosis

34
Q

What are the two affects of bleeding in a peptic ulcer

A

Acute - Haemorrhage

Chronic - Anaemia

35
Q

What is the potentially complication if perforation occurs in peptic ulcer

A

Release of gastric contents through perforation into the peritoneal cavity resulting in peritonitis

36
Q

What is the affect of fibrosis healing in a peptic ulcer

A

Narrowing of alimentary tract, which can result in an obstruction

37
Q

What is the associated aetiology of gastric cancer

A

Previous H.Pylori infection

38
Q

What is the histology of gastric cancer

A

Adenocarcinoma

- Malignant tumour forms in the glandular epithelium

39
Q

What are the symptoms of stomach cancer

A

Non specific

40
Q

What is the four methods of spreading stomach cancer

A

Direct
(Spread to surrounding structures)

Lymphatic
Spread
(to regional lymph nodes)

Blood spread
(Liver)

Transcoelomic spread
(Spread within peritoneal cavity)

41
Q

What is the prognosis of stomach cancer

A

Very poor

5 year survival rate less than 20%

42
Q

What is all the aetiologies of peptic ulceration

A

H. Pylori infection resulting in an increase in gastric acid

NSAIDS
Smoking

Rare

  • zollingers ellison syndrome
  • hyperparathyrodism
  • chrons disease

alimentary system: pathology sa (27 decks)

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