Upper Gastrointestinal Disease

Question 1

What organs make up the upper GI tract?

Answer 1

Oesophagus, stomach, intestines

Question 2

What is Chronic Gastritis?

Answer 2

Ongoing inflammation of the stomach mucosa

Question 3

What are the symptoms compared to acute gastritis?

Answer 3

Less sever but more persistent

Question 4

What environment can Chronic Gastritis provide?

Answer 4

Dysplasia and carcinoma to arise

Question 5

What are the symptoms of Chronic Gastritis?

Answer 5

Upper abdo pain, indigestion or bloating, N/V, belching, loss of appetite or weight

Question 6

Can Chronic Gastritis be asymptomatic?

Answer 6

Yes

Question 7

What are the causes for Chronic Gastritis?

Answer 7

A - Autoimmune
B - Bacteria (H.Pylori)
C- Chemical
Psychological stress

Question 8

What is H.Pylori?

Answer 8

Gram neg bacteria found in stomach, antrum

Question 9

Where is H.Pylori acquired from?

Answer 9

Faecal-oral route

Question 10

What conditions is H.Pylori associated with?

Answer 10

Gastric ulcers, duodenal ulcers and cancer

Question 11

What is Peptic Ulcer Disease and where does it occur?

Answer 11

Occurs in D1 and antrum, ulcer in stomach

Question 12

What is the reasoning for Peptic Ulcers?

Answer 12

H.Pylori and NSAIDs

Question 13

What are the symptoms of Peptic Ulcers?

Answer 13

Pain, worse at night and after meals

Question 14

What are the complications of Peptic Ulcers?

Answer 14

Bleeding resulting in anaemia, massive haematemesis, peritonitis, cancer

Question 15

What is the normal lining of the oesophagus?

Answer 15

Stratified squamous epithelium

Question 16

What happens to the lining of the oesophagus in Barrett’s Oesophagus?

Answer 16

SSE replaced by columnar epithelium with goblet cells

Question 17

What is Barrett’s Oesophagus thought to be adapted from?

Answer 17

Chronic acid exposure from reflux

Question 18

What process is involved with Barrett’s Oesophagus?

Answer 18

Process of dysplasia

Question 19

What is the strong malignant association with Barrett’s Oesophagus?

Answer 19

Oesophageal adenocarcinoma

Question 20

What type of cancer is associated with the Oesophagus?

Answer 20

Squamous carcinoma, Adenocarcinoma (Barretts)

Question 21

What type of cancer is associated with the Stomach?

Answer 21

Adenocarcinoma, GI stromal tumours

Question 22

What type of cancer is associated with the Small Bowel?

Answer 22

Lymphoma, GI stromal tumours, Neuroendocrine

Question 23

What are the risk factors with Oesophageal Squamous Carcinoma?

Answer 23

Alcohol, tobacco, injury, achalasia

Question 24

What are the symptoms of Oesophageal Squamous Carcinoma?

Answer 24

Dysphagia, weight loss, haemorrhage, sepsis

Question 25

What are the symptoms for Oesophageal Adenocarcinoma?

Answer 25

Dysphagia, weight loss, haematemesis, chest pain, vomitting

Question 26

How can Oesophageal carcinoma spread?

Answer 26

Direct - surrounding Lymphatic - e.g cervical Haematogenous - e.g liver and lung

Question 27

What is the cause for 90% of gastric malignancies?

Answer 27

Adenocarcinoma

Question 28

What are the precursor lesions with Stomach Adenocarcinoma?

Answer 28

Anaemia, mets, polyps, helicobacter associated gastritis

Question 29

What are the symptoms of Stomach Adenocarcinoma ?

Answer 29

Weight loss, anorexia, anaemia, heamorrage, fungating growth

Question 30

Where can Stomach Adenocarcinoma directly infiltrate to?

Answer 30

Duodenum, pancreas, colon, liver, spleen

Question 31

Where can Stomach Adenocarcinoma lymphatically spread?

Answer 31

Local and regional areas, virchows node

Question 32

What cancer is relatively rare compared to other GI malignancy?

Answer 32

Small bowel neoplasia

Question 33

What are the risk factors for Small Bowel Neoplasia?

Answer 33

Crohn's, Coeliac, Radition, Hereditary

Question 34

What is Coeliac disease?

Answer 34

Extensive mucosal disease related to sensitivity to gluten

Question 35

How can Coeliac be diagnosed?

Answer 35

Blood test (TTG) and biopsy

Question 36

What are the symptoms for Coelic disease?

Answer 36

Pain, constipation/diarrhoea, fail to thrive, anaemia, fatigue

Question 37

What can Coelic disease lead to an increased risk of?

Answer 37

Adenocarcinoma and lymphoma of the small bowel