Upper GI

Question 1

What are the 3 components of the anatomy of the upper GI tract?

Answer 1

Esophagus
Stomach
Intestines

Question 2

What is chronic gastritis?

Answer 2

Ongoing inflammation of stomach mucosa

Question 3

What can chronic gastritis be a possible environment for?

Answer 3

Dysplasia and carcinoma

Question 4

What are the symptoms of chronic gastritis?

Answer 4

Upper abdominal pain
Indigestion/bloating
Nausea/vomiting
Belching
Loss of appetite/weight loss

Question 5

What are the ‘ABC’ causes of chronic gastritis?

Answer 5

Autoimmune
Bacterial (helicobacter pylori)
Chemical (alcohol, tobacco, caffeine)

Question 6

What is helicobacter pylori?

Answer 6

Gram negative bacterium found in stomach (antrum)

Question 7

How is helicobacter pylori acquired?

Answer 7

Faecal-oral

Question 8

What is helicobacter pylori associated with?

Answer 8

Chronic gastritis
Duodenal ulcer
Gastric ulcer
Gastric carcinoma
Gastric MALT lymphoma

Question 9

Where do peptic ulcers occur?

Answer 9

D1 or antrum

Question 10

What are the causes of peptic ulcer?

Answer 10

Helicobacter pylori and NSAIDS

Question 11

What are the symptoms of peptic ulcers?

Answer 11

Pain (gnawing, burning, aching (worse at night & after meals))

Question 12

What are the complications of peptic ulcers?

Answer 12

Bleeding leading to anaemia
Haematemesis (vomiting blood)
Perforation leading to peritonitis
Long term cancer

Question 13

What is barrett’s oesophagus?

Answer 13

Oesophagus lined with columnar epithelium with goblet cells instal of stratified squamous epithelium

Question 14

What is the cause of barrettes oesophagus?

Answer 14

Adaptation to chronic acid exposure from reflux

Question 15

What are the 2 types of oesophageal cancer?

Answer 15

Squamous carcinoma

Adenocarcinoma

Question 16

What are the 2 types of stomach cancer?

Answer 16

Adenocarcinoma

GI stromal tumours

Question 17

What are the 3 types of small bowel cancer?

Answer 17

Lymphoma
GI stromal tumours
Neuroendocrine tumours

Question 18

What are the risk factors of oesophageal squamous cell carcinoma?

Answer 18

Alcohol, tobacco, caustic injury, achalasia

Question 19

What are the symptoms of oesophageal squamous cell carcinoma?

Answer 19

Dysphagia, weight loss, haemorrhage, sepsis, respiratory fistula with aspiration

Question 20

What does barrett’s oesophagus lead to?

Answer 20

Oesophageal carcinoma

Question 21

What are the symptoms of oesophageal adenocarcinoma?

Answer 21

Dysphagia, weight loss, haematemesis, chest pain, vomiting

Question 22

Where does oesophageal carcinoma spread directly?

Answer 22

Surrounding tissues

Question 23

Where does oesophageal carcinoma spread via the lymphatics?

Answer 23

Paraoesophageal, paratracheal, cervical node groups

Question 24

Where does oesophageal carcinoma spread haematogenously?

Answer 24

Liver and lung

Question 25

What are the precursor lesions of adenocarcinoma of the stomach?

Answer 25

Pernicious anaemia (atrophic gastritis) Intestinal metaplasia Neoplastic polyps Helicobacter associated gastritis

Question 26

What are the advanced symptoms of adenocarcinoma of the stomach?

Answer 26

Weight loss, anorexia, anaemia, haemorrhage

Question 27

Where does adenocarcinoma of the stomach spread via direct infiltration?

Answer 27

Duodenum, pancrea, colon, liver, spleen

Question 28

Where does adenocarcinoma of the stomach spread via the lymphatics?

Answer 28

Local and regional nodes | Virchow's node

Question 29

Where does adenocarcinoma of the stomach spread haematogenously?

Answer 29

Liver and lungs

Question 30

What other ways can adenocarcinoma of the stomach spread?

Answer 30

Transcoelomic Omentum Mesentery Ovary

Question 31

What are the 4 subtypes of small bowel neoplasia?

Answer 31

Adenocarcinoma GI stromal tumour Lymphoma Carcinoid (neruoendocrine) tumour

Question 32

What are the risk factors of small bowel neoplasia?

Answer 32

Crohn's Coeliac Radiation Genetic e.g. familial adenomatous polyposis

Question 33

What is coeliac disease?

Answer 33

Extensive mucosal disease related to sensitivity to gluten

Question 34

How is coeliac diagnosed?

Answer 34

Serological blood test (TTG) and biopsy

Question 35

What are the symptoms of coeliac disease?

Answer 35

``` Pain in digestive tract Chronic constipation and diarrhoea Failure to thrive (children) Anaemia Fatigue ```

Question 36

What 2 cancers does coeliac lead to an increased risk of?

Answer 36

Adenocarinoma and lymphoma of the small bowel