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Year 2 - Clinical Pathology > UGIT path > Flashcards

UGIT path Flashcards

1
Q

how long is the oesophagus

A

25 cm

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2
Q

what is the lining of the oesophagus

A

squamous epithelium

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3
Q

what i the sphincter at the end vs start of the oesophagus called

A

cricopharygneal upper

gastro-oesophageal lower

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4
Q

what is the distal oesophagus lined with

A

glandular collumnar mucosa

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5
Q

where is the squamocolumnar junction

A

40cm from the incisor teeth

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6
Q

what is the normal structure of the oesophagus

A

mucosa
submucosa
musculares propria
adventitia around each layer

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7
Q

what is oesophgitis - and common causes

A

inflammation of the oesophagus
infectious - bacterial/viral/fungal eg HSV1 or candida
chemical is most common - ingestion or reflux of gastric contents

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8
Q

what is the commonest form of oesophagitis

A

reflux of gastric acid or bile

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9
Q

what are the two types of hiatus hernia

A

sliding - reflux symptoms

para-oesophageal hernia - strangulation and reflux = ischameia and infarction of the stomach

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10
Q

what are some risk factors of reflux oesophagitis

A

defective lower sphincter
hiatus hernia
increased abdominal pressure
increased gastric fluid volume

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11
Q

what is the histology of reflux oesophagitis

A

inflammatory cells causing loose distinction between basal and lamina propria - infiltration of WBC’s

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12
Q

what are 5 complications of reflux oesophagitis

A 
ulceration 
haemorrhage 
perforation
benign structure 
Barrett oesophagus
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13
Q

what is barretts oesophagus

A

long standing gastro oesophageal reflux - proximal extension of the squamo-columnar junction = glandular metaplasia

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14
Q

what is the disease progression of barretts oesophagus to carcinoma

A

barretts
low grade dysplasia
high grade dysplasia
adenocarcinoma

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15
Q

describe oesophageal carcinoma and the two main types

A

squamous cell carcinoma - endemic tissue

adenocarcinoma - most common

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16
Q

what is the most common cause of adenocarcinoma

A

mainly lower oesophagus
more males in whites
barretts oesohpasgus, tobacco, obesity

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17
Q

what is preceded by squamous dysplasia

A

squamous carcinoma

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18
Q

what are some risk factors of squamous carcinoma

A

hot beverages, HPV, male, black

19
Q

what is the staging system for oesophageal cancers

A

TNM
T - depth of invasion (grade of tumour)
N - regional lymph nodes
M - distant metastasis

20
Q

what is the normal anatomy of the stomach

A

cardia - area around in GO sphincter
fundus - located in upper part of stomach
body - main
antrum - near the pylorus

21
Q

what are the three stages of gastritis

A

normal - balance of aggressive and defensive forces
increased aggression - excessive alcohol, drugs ie aspirin, heavy smoking
impaired defences - ischameia, shock

22
Q

describe the causes of acute gastritis

A

usually due to chemical injury - drugs alcohol - to helibactor pylori infection

23
Q

describe the causes of chronic gastritis and risk

A

autoimmune - B12 deficiency
helibactor pylori
increased risk of gastric cancer and MALT lymphoma

24
Q

describe the structure and mode of infection of helibactor pylori

A

gram negative spiral shaped bacterium - live on surface epithelium and protected by the overlying mucus barrier

infection damages epithelium leading to chronic inflammation = decreased acid levels

25
Q

where is helibactor pylori infection most common

A

antrum of the stomach

26
Q

what is peptic ulcer disease and the major sites of effect

A

localised defect extending at least into submucosa - part of the lining is erosion - full lining is ulcer

first part of duodenum
junction of astral and body mucosa
distal oesophagus

27
Q

what are the main causes of peptic ulcer disease

A

anything increasing stomach acid secretion, H pylori infection
reflux, drugs, smoking, NSAIDS

28
Q

what is the specific histology of acute peptic ulcer

A

full thickness coagulative necrosis of mucosa or deeper layers

29
Q

what is the histology of chronic gastric ulcer

A

clear cut edges overhanging the base - extensive granulation and scar tissue

30
Q

what are the complications of peptic ulcer

A

haemorrhage
peritonitis
penetration into adjacent organs
strictring - hour glass deformity - narrowing at centre of stomach

31
Q

what are the differences between gastric and duodenal ulcer

A

gastric - low incidence, increases with ages, normal/low acid levels in blood group A

duodenal - higher incidence
increases up to 35 y/o - elevated gastric acid, mainly from h pylori gastritis
occurs in the bulbus in blood group O

32
Q

what is the most frequent gastric cancer

A

adenocarcinoma

33
Q

what are the differences in association between carcinoma of the GOJ and the gastric body/antrum

A

GOJ - associated with GO reflux not h Pylori/diet

gastric body/antrum - non association with GO reflex

34
Q

what are the macroscopic subtypes of gastric cancer

A

plastica - ulceration involves all the stomach
polypoidal - polyps
ulcerated

35
Q

what are the microscopic subtypes of gastric cancer

A

intestinal - well differentiated

diffuse type - poor differentiation cadherin gene mutation = linitis plastica

36
Q

what does a loss in GDH1 gene lead to

A

cadherin (adhesion molecule) - diffuse type of microscopic gastric cancer

37
Q

what is HDGC and the mutation

A

hereditary diffuse type gastric cancer

germline - CDH1 mutations - adhesion molecule

38
Q

what type of pathology is coeliac disease

A

small bowel

39
Q

what is coeliac disease and the pathogenesis

A

immune mediated enteropathy due to gluten
(gladin - causes epithelial cells to produce IL-15 = proliferation of CD8 intraepithelial lymphocytes - attacks tissue transglutaminase on bowel epithelium

40
Q

what non invasive procedures are there for coeliac and what i stew gold standard test

A

IgA antibodies to tissue transglutaminase
IgA/G to deaminated gliadin

tissue biopsy gold standard

41
Q

what are the clinical features and associations of coeliac disease

A

dermatitis herpeiformis

lymphocytic gastriis and lymphocytic colitis

42
Q

what cancers are associated with coeliac disease

A

enteropathy associated t cell lymphoma

small intestinal adenocarcinoma

43
Q

what is the treatment of coeliac and what risks does it reduce

A

gluten free diet - anaemia, female infertility, osteoporosis and cancer

44
Q

what is the morphology of coeliac disease

A

finger like projections of epithelial cells
increased intraepithelial lymphocytes
increased lamina proprietary inflammation

Year 2 - Clinical Pathology (67 decks)

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