Upper GI

Question 1

order of organs in upper GIT + functions

Answer 1

mouth (chewing, lube, enzymatic digestion)
eso - move via peristalsis
stomach = continue digestion
pancreas = enzyme + bicarbonate
gall bladder = store bile
small intestine = absorbs nutrients
large intestine = concentration and water absorbtion

Question 2

describe the duodensum

Answer 2

first part of small intestine
receives partially digested chyme from stomach, bile secretions, pnacreatic juice
functions to further breakdown food + secrete hormones

Question 3

describe stomach secretions

Answer 3

pepsinogen by chilef cells
HCl by parietal cells
intrinsic factors by parietal cells for absorption of vit b12 in intestine

Question 4

how does the stomach avoid damage from secretions

Answer 4

mucus production, bicarb propduction, prostaglandin production, tight junctions + rapid gastric epithelial regen

Question 5

what is peptic ulcer disease

Answer 5

breach in mucosa of stomach/duodenum by gastric secretions

distal stomach + proximal duodenum

Question 6

pathogenesis of peptic ulcer disease

Answer 6

imbalance gastroduodenal mucosal defence + damaging forces (eg acid + pepsin)

Question 7

what are the 4 layers of chronic peptic ulcer histopathology

Answer 7

necrotic slough, zone of inflammatory infiltrate, vascular + fibrovas tissue, fibrous scar

Question 8

what causes failure of stomach detence mechanisms

Answer 8

helicobacter pylori infection = small, gram -ve rods with flagella + corkscew motion

Question 9

describe the survival and action of H. pylori

Answer 9

bore into protective mucus layer, mostile, buffers gastric acid, adhere to epi cells+ weakens junctions between cells
promotoes infalm response = collateral damage

Question 10

what are the clinical features of chroninc peptic ulcers

Answer 10

epigatrict pain, burning, aching at night, anneamia vomiting, blood, burping, nausea, bloating, weight loss

Question 11

describe bleeding as an outcome of peptic ulcers

Answer 11

penetrate into blood vessels
small = iron deficiency anaeamia
large = life threatening haeamorrhage

Question 11

describe bleeding as an outcome of peptic ulcers

Answer 11

penetrate into blood vessels
small = iron deficiency anaeamia
large = life threatening haeamorrhage

Question 12

describe healing as an outcoe of chronic peptic ulcers

Answer 12

overcomes damaging stimulus
filld with fibrous scar + recovered mucosa
looks like rugal folds in collagenous scar (star)

Question 13

describe perforation as a result of chronic peptic ulcers

Answer 13

= gastric acid -> extensive damage ad ucle transmurally -> pancreatitis/peritonitis -> septicarmia

Question 14

describe obstruction as outcome o chronic peptic ulcres

Answer 14

during healing = scarrinf constricts esp in pylorus

Question 15

wat is gastroesophageal reflux disease (GORD)

Answer 15

failure lowers oesophageal sphincter = gastric contents in oesophagus
defence mechanisms overwhelmes = mucosal damage

Question 16

describe GORD patho

Answer 16

decreases salivation, impaired eso clearance, dec LES Resting tone, delayed gastri empyting
symptoms of oesophageal mucosal damage = reflux
or aused by hernia

Question 17

describe the grading of GORD

and what gord can cause

Answer 17

LA grade A = mucosal breaks shorter than 5mm not birding tops of folds
grade B = longer 5mm
grade c = briding + <75% circum
grade D = >75 % circum
damages mucosa - oesophagitis, chronic inflam = erosion

Question 18

what are the symptoms of GORD

Answer 18

heartburn, regurgitation

Question 19

waht are GORD complications

Answer 19

strictures aused by attemots at healing = abnormal narrowins/tightening of passage
barrett’s oesophagus = squamous -> columnar