Session 1 - Clinical Flashcards

1
Q

What is the normal epithelium of the oesophagus?

A

Non-keratinized stratified squamous epithelium

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2
Q

Approximately how long is the oesophagus?

A

25cm

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3
Q

What is the distance from the incisor teeth to the oesophago gastric junction? Why is this clinically important?

A

38-40cm

Useful for diagnosis and endoscopy (nasogastric tubes)

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4
Q

What is Barret’s oesophagus?

A

Metaplasia of non-keratinized stratified squamous epithelium of oesophagus to simple columnar gastric epithelium
Caused by repeated exposure to gastric acid

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5
Q

Is Barret’s oesophagus a direct indication of cancer?

A

No, but can be considered pre-cancerous

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6
Q

Name two possible types of cancer that can arise in the oesophagus

A

Adenocell carcinoma

Squamous cell carcinoma

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7
Q

Deifne dysphagia

A

Difficulty swallowing

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8
Q

Name three things that may cause dysphagia

A

Tumours
Problems with musculature
Neural problems (achalasia)

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9
Q

What are oesophageal varicies?

A

Swollen and ruptured veins in the oesophagus, which can cause potentially fatal haemorrhage

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10
Q

What are oesophageal varicies caused by?

A

Portal hypertension (drains into oesophageal veins)

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11
Q

Name three mechanisms that help to prevent stomach contents refluxing into oesophagus

A

Pinch valve - angle of entry of oesophagus into stomach

Mucosal folds at the oesophagogastric junction

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12
Q

You’re going on a journey through the stomach. Outline the 6 landmarks you will see

A
Cardia
Fundus
Body
Antrum
Pyloris
Pyloric sphincter
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13
Q

Define peptic ulceration

A

Muscular erosions of greater the 5cm in stomach and duodenum

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14
Q

Why is the first part of the duodenum prone to ulceration?

A

Acidity of chyme and leakage of stomach acid, due to lack of protection - no bicarbonate or bile

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15
Q

What is delivered through the duodenal papilla?

A

Water

Bile, hepatic and pancreatic secretions

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16
Q

Where does the 14liters of fluid in the gut come from?

A

1.5l saliva
2.5l of gastric secretions
9l water + alkali

17
Q

Which part of the GI system absorbs the majority of fluid?

A

The small intestine (12.5l)

18
Q

If a person had their entire SI removed, what changes would be present in their faeces?

A

Watery

Steatorrhea

19
Q

Name two conditions affection the SI which potentially result in malabsorption

A

Chrohn’s disease

Coeliac disease

20
Q

What is Meckel’s diverticulum?

A

A congenital disorder where part of the SI bulges out and is a vestigal remnant of omphalo-mesenteric duct

21
Q

Outline the cool rule surround Meckel’s diverticulum

A

2% (of the population). 2 feet (proximal to the ileocecal valve). 2 inches (in length). 2 types of common ectopic tissue (gastric and pancreatic). 2 years is the most common age at clinical presentation. 2:1 Male:Female ratio

22
Q

What condition can Meckel’s diveritculum be mistaken for?

A

Acute appendicitis, presents with similar symptoms if inflamed

23
Q

How will someone present clinically if they have a blocked small intestine?

A

Nausea
Constipation
Vomit
Loss of appetite

24
Q

Give two common causes of appendicitis

A

Faecolith

Intestinal worms

25
Where is pain initially felt in appendicitis?
Umbilical pain
26
Where is McBurney's point, and what is it significant for?
1/3 up from illiac fossa, 2/3 water to umbilicus | Appendix location
27
What are diverticula and how do they develop?
Formation of pouches which extend outwards from large hollow organs Embryonic remmenant Develop in sigmoid colon, as it experiences highest pressure
28
What is a result of the variable mobility of different parts of the large bowel?
Twists | Blood blockage
29
Where is the dentate line?
1/3 up anus | Saw toothed pattern
30
What cancers occur above dentate line?
Adenocarcinoma
31
What cancers occur below dentate line?
Squamous cell carcinoma
32
What are haemorrhoids?
Dilated vascular structures which help with stool control | Vascular cushion which surround rectum
33
What are the symptoms of piles? (bad haemorrhoids)
Rectal bleeding | Pain