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Path - Histo > Upper GI > Flashcards

Upper GI Flashcards

1
Q

Describe the normal oesophageal epithelium

A

starts as squamous epithelium
Z line - transition
Becomes columnar epithelium

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2
Q

What is the Z line

A

the point at which the epithelium transitions from squamous to columnar

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3
Q

What does the esophageal epithelium contain

A

submucosal glands

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4
Q

what does the gastric columnar epithelium of the body and fundus of the stomach contain/produce?

A

SPECIALISED GLANDS

Produce acid + intrinsic factor

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5
Q

what is the function of intrinsic factor

A

accompanies B12 for absorption in the terminal ilieum

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6
Q

what happens without intrinsic factor?

A

in pernicious anaemia, antibody against intrinsic factor

means B12 cannot be absorbed > anaemia

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7
Q

What kind of epithelium lines the stomach?

A

gastric mucosa columnar epithelium

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8
Q

What does the epithelium in the pylorus and antrum produce?

A

gastrin

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9
Q

Describe the epithelium in the normal duodenum

A

Glandular epithelium

wtih goblet cells

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10
Q

What is the villous to crypt ratio in the duodenum

A

villous : crypt = 2:1

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11
Q

Why are villi important

A

for absorption

so if this ratio diminishes, it means malabsorption is occurring > find underlying disease

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12
Q

Are goblet cells normally seen in stomach?

A

NO > feature of metaplasia

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13
Q

What usually causes oesophagitis

A

GORD

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14
Q

what are unwanted consequences of GORD

A

Ulceration, fibrosis, haemorrhage, perforation, stricture,

BARRETS OESOPHAGUS

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15
Q

what is barret’s oesophagus

A

normal squamous epithelium of the lower oesophagus is replaced by METAPLASIC columnar epithelium

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16
Q

what are the three layers in the oesophagus

A

epithelium (squamous/columnar)
submucosa
Muscolaris

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17
Q

is Barrets reversible

A

YES

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18
Q

What occurs in intestinal metaplasia

A

GOblet cells become visible in the stomach

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19
Q

explain the transition from healthy oesophagus to cancer

A

acid rises up from stomach e.g. gord > metaplasia from squamous to columnar > persists > dysplasia

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20
Q

What is the most common type of oesophageal cancer in West

A

ADENOCARCINOMA

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21
Q

what are RF for adenocarcinoma

A

Barrett’s

GORD

22
Q

Where does adenocarcinoma occur

A

Lower 1/3 of oesophagus

23
Q

What is seen on histology of the adenocarcinoma

A

glandular (columnar) epithelium

24
Q

What part of the oesophagus is most affected in adenocarcinoma

A

lower 1/3

25
Q

WHere is SCC the most common tuype of oesophageal cancer

A

In developing countries

26
Q

what is oesophageal SCC associated with

A

smoking, alcohol

27
Q

what part of the oesophagus is most affected in SCC

A

lower 2/3

28
Q

what is seen on histology of SCC

A

keratrinised cells, IC bridges

29
Q

What is gastritis

A

inflammation of gastric mucosa

30
Q

what are causes of gastritis

A

ABC
Autoimmune
Bacteria: H pylori
Chemicals: alcohol, NSAIDS, corrosives

31
Q

What is an example of c hornic gastritis causing severe damage

A

chronic gastritis associated with H pylori induces lymphoid tissue in stomach > dev elipmeent of lympohoid follicles > increased risk of MALT lymphoma

32
Q

What is the MOA of H pylori

A

bind to epithelial cells

inject. toxins into theme

33
Q

summarise consequences of H pylori gastritis

A

dysplasia
adenocarcinoma
lymphoma (MALToma)

34
Q

what is the toxin secreted by H pylori

A

Cag A

35
Q

what is a gastric ulcer

A

depth of tissue loss beyond the mucosa, into the submucosa

36
Q

what is an erosion

A

loss of surface epithelium and lamina propria (NOT beyond the mucosa)

37
Q

what is the difference between an acute and chronic ulcer

A

a chronic ulcer presents with SCARRING and FIBROSIS

38
Q

what should you do for all patients presenting with an ulcer

A

BIOPSY it

TO EXCLUDE MALIGNANCY

39
Q

what is the most common type of malignant gastric cancer

A

ADENOCARCINOMA

40
Q

what are the two types of gastric adenocarcinoma

A

intestinal

diffuse

41
Q

describe an intestinal gastric adenocarcinomna

A

has all features of intestinal mucosa
well differentiated
presence of glands containing muciin

42
Q

describe an diffuse gastric adenocarcinomna

A

no identifiable features, poorly differentiated

composed of single cells, no attempt at gland fomrartion

43
Q

what are the two types of diffuse adenocarcinoma

A

Linitis plastica

Signet ring cell carcinoma

44
Q

what are histological features of coeliac

A

villous atrophy
crypt hyperplasia
increased intraepithelial lymphocytes

45
Q

why is it bad that villous atropby occurs

A

villi flatten > less area for absortpion > malabsorption

46
Q

What is lymhocytic duodenitis

A

PRECURSOR TO COELIAC

there are inflammatory changes (increased intraepithelial lymphocytes ) without architectural changes

47
Q

what antibodies are used to diagnose coeliac disease

A

Endomysial antibodies

Tissue transglutaminase antibodies (IgA)

48
Q

what must you also measure when measuring TTA

A

total serum IgA > because if they have selective IgA deficienncy they will not have TTAs

49
Q

What is the gold standard for coeliac dx

A

duodenal biopsy - on gluten rich diet

50
Q

what is tropical sprue

A

another cause of malabsorption
similar histology to coeliacs
but occurs in tropical countries, where there are different bacterial types

Path - Histo (19 decks)

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