Random Stuff to Memorize Flashcards
What is a oesophageal atresia/fistula?
abnormal connection between trachea and oesophagus
What is a true and a false oesophageal diverticula?
True = all 4 layers pushed out
False = only mucosa + submucosa pushed out
What is the difference between oesophageal webs and rings?
Webs = mucosa folds only
Rings = mucosa, submucosa + fibrous bands
List 2 types of haitus hernias - which is more common?
- Sliding (Axial) - more common
2. Paraoesophageal (Non-Axial)
Is achalasia a functional or mechanical obstruction?
Functional obstruction - failure of LES to relax completely
What is the most common cause of achalasia?
degenerative - degeneration of the inhibitory neurons
What is a Mallory-Weiss tear?
tearing of the lower oesophagus after severe vomiting
What are oesophageal varices?
dilated veins in submucosa of oesophagus
- may rupture + bleed
- mainly caused by portal hypertension
List the 3 main histological features of reflux oesophagitis
- Basal cell hyperplasia
- Increased eosinophils
- Elongated lamina propria papillae
What is long-segment and short-segment Barrett’s oesophagus?
Long-Segment = greater than 3 cm
Short Segment = less than 3 cm
Barrett’s oesophagus increases the risk of what type of cancer?
adenocarcinoma
What causes Barrett’s oesophagus?
reflux oesophagitis
- may occur in ppl with GERD
List 3 benign oesophageal tumours
- Leiomyoma
- Lipoma
- Fibroma
What are the 2 most common oesophageal cancers?
- Squamous Cell Carcinoma - most common
2. Adenocarcinoma
How can a oesophageal tumour be diagnosed?
Barium Swallow
Endoscopy
Biopy
Where do SCC of the oesophagus occur?
upper + mid part of oesophagus
List some risk factors for SCC of the oesophagus
alcohol tobacco long-standing oesophagitis achalasia Plummer Vinson Syndrome
What is Plummer Vinson Syndrome and what is it a/w? (hint: triad)
- Dysphagia
- Iron Deficiency Anaemia
- Eosophageal Web
Glossitis + Increased Risk of SCC
What are the possible treatment options of oesophageal cancer?
- chemotherapy
- resection
- stent
What is the outermost layer of the oesophagus?
Adventitia
What is the outermost layer of the stomach?
Serosa
List some of the causes of acute gastritis
- alcohol
- NSAIDs
- steroids
- smoking
- stress
List some of the clinical features/presentation of acute gastritis
- epigastric pain
- anaemia
- haematemesis/malaena
What is a histological finding of acute gastritis?
influx by neutrophils + oedema
What is a histological finding of chronic gastritis?
influx of lymphocytes + plasma cells
What are the 3 types of chronic gastritis?
- H. Pylori
- Autoimmune
- Reflux
H. pylori associated chronic gastritis will increase the risk of what 2 things?
PUD
gastric cancer
In autoimmune chronic gastritis there are antibodies to…
- parietal cells
- intrinsic factor
Autoimmune chronic gastritis is also seen with other autoimmune disorders like
Hashimoto’s thyroiditis
Addison’s disease
List the 3 microscopic findings of chronic reflux gastritis
- foveolar hyperplasia
- vascular ectasia
- fibromuscular lamina propria
What is Zollinger-Ellison syndrome and what can it cause?
caused by gastrinomas (neuroendocrine tumour) that produces too much gastrin and causes an increase in stomach acid
What is the most common benign tumour of the stomach?
hyperplastic polyps
List some of the benign tumours of the stomach
- hyperplastic polyps
- adenoma
- hamartoma
- fundic gland polyp
- lipoma
- schwannoma
What is the most common malignant tumour of the stomach?
Adenocarcinoma
List some of the malignant tumours of the stomach
- carcinoma (adenocarcinoma)
- lymphoma
- carcinoid
- mesenchymal tumours (GIST, leiomyosarcoma)
List some of the clinical features/presentation of gastric carcinoma
- often asymptomatic until late
- dyspepsia
- nausea
- weight loss; anorexia
- abdominal pain
- dysphagia
- anaemia
- haemetemesis/malaena
List the 2 types of gastric carcinoma
- Intestinal Type
2. Diffuse Type
What is Troisier’s Sign?
- supraclavicular node - Virchow’s node
- usually met to the lymph node from a gastric cancer
What mutation is present in GISTs?
C-Kit (mutation of CD117)
What is the treatment for GISTs?
Tyrosine Kinase Inhibitors (Gleevec)
What is the most common types of malignant cancer of the mouth?
SCC
note: most mouth cancers are primary
What is Xerostomia?
dry mouth
What is sialadentis?
inflammation of the salivary glands
can get sialorrhhoea or xerostomia
What is sialorrhoea?
hyper-salivation; drooling
Are benign or malignant cancers of the mouth more common?
benign
What are 2 benign tumours of the mouth?
- Pleomorphic Adenoma
2. Warthin’s Tumour
How is a pleomorphic adenoma of the mouth treated?
Wide Excision
List 4 malignant tumours of the mouth
- Mucoepidermoid
- Adenoid Cystic Carcinoma
- Acinic Cell Carcinoma
- Carcinoma Ex Pleomorphic Adenoma
Which malignant mouth tumours presents with cribiform glands and has perineural invasion on histology?
Adenoid Cystic Carcinoma
List 6 side effects of proton pump inhibitors (PPIs)
- hypomagnesaemia
- osteoporotic fracture
- C. difficile infection
- pneumonia
- vitamin B12 deficiency
List 2 genetic risk factors for the development of coeliac disease
HLA Class II - DQ2
HLA Class II - DQ8
In coeliac disease, there are 2 antibodies that may help with the diagnosis which are:
- Serum Endomysial Antibodies
2. Tranglutaminase Antibodies (TTG)*
What would be seen on histology of coeliac disease?
- villous atrophy
- crypt hyperplasia
- epithelial damage
- chronic inflammation
What are some extra-GI disorders a/w coeliac disease?
- Dermatitis Herpetiformis*
- Diabetes, Thyroid Dysfunction
Coeliac disease can increase the risk of what type of cancer?
Non Hodgkins - Enteropathy Associated T Cell Lymphoma (EATL)
What are 2 key characteristic histological findings of Whipple’s disease?
- lipid pools in the mucosa
2. PAS-stained distended macrophages in the lamina propria of the small intestine
Why does intussuception of the small intestine happen in children? Why does it occur in adults?
Children = no anatomic basis (usually lymphoid hyperplasia) Adults = an intraluminal mass or tumour
If a patient has non-obstructive appendicitis and there are Warthin-Finkeldey giant cells present, what is the cause?
Measles
The main predictor of aggressive behaviour in neuroendocrine tumours of the small intestine is GRADE.
What stain may be used to determine the grade in these neuroendocrine/carcinoid tumours?
Ki-67 mutation - determines proliferation index
Carcinoid tumours most commonly secrete serotonin. What are some of the effects of carcinoid syndrome?
facial flushing
intestinal hypermotility (diarrhea, cramps)
bronchoconstriction
right heart abnormalities
What is the most common tumour of the appendix?
neuroendocrine (carcinoid) tumour
If there are multiple duodenal lesions/ulcers present, what syndrome would this be suggestive of?
Zollinger-Ellison syndrome
