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Year 2 Pathology > Upper GI Disease > Flashcards

Upper GI Disease Flashcards

1
Q

What 3 structures does the upper GI consist of?

A

Oesophagus, Stomach, Intestines

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2
Q

Define chronic gastritis

A

Ongoing inflammation of the stomach mucosa, it can provide an environment in which dysplasia and carcinoma can arise.

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3
Q

Whats the difference between chronic gastritis and acute gastritis?

A

Compared to acute gastritis, symptoms are less severe but more persistent.

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4
Q

What are the symptoms of chronic gastritis?

A

Upper abdo pain, indigestion or bloating, nausea & vomiting, belching, loss of appetite or weight loss.

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5
Q

What are the 3 main causes of chronic gastritis?

A

Autoimmune
Bacterial - H.pylori
Chemical - alcohol, tobacco, caffeine
Psychological stress

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6
Q

What is H.pylori?

A

Helicobacter pylori. Gram negative bacterium found in the stomach.

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7
Q

How is H.pylori infection acquired?

A

Probably through the faecal-oral route.

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8
Q

What can H.pylori infection cause?

A

Peptic ulcer disease, chronic gastritis, duodenal ulcer, gastric ulcers, gastric carcinoma and lymphoma.

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9
Q

What does peptic ulcer disease occur?

A

Usually occurs in D1 or antrum.

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10
Q

What are the common causes of PUD?

A

H.pylori infection and NSAIDs.

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11
Q

What are the symptoms of PUD?

A

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

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12
Q

What are the complications of PUD?

A

Bleeding leading to iron deficiency anaemia. Massive haematemesis. Perforation leading to peritonitis. Long term cancer at edge of ulcer.

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13
Q

What is Barrett’s oesophagus?

A

Normal lining of the oesophagus is stratified squamous epithelium - in Barrett’s these are replaced by columnar epithelium with goblet cells.

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14
Q

Why does Barrett’s oesophagus occur?

A

Thought to be an adaptation to chronic acid exposure from reflux oesophagitis.

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15
Q

What can Barrett’s oesophagus lead to?

A

Process of dysplasia, strong association with oesophageal adenocarcinoma

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16
Q

What are the 2 types of oesophageal cancer?

A

Squamous cell carcinoma (Oesophageal SCC) and Adenocarcinoma

17
Q

What are the risk factors for oesophageal SCC?

A

Adults over 45, more common in males, alcohol, tobacco, injury

18
Q

What are the symptoms of oesophageal SCC?

A

Dysphagia, weight loss, haemorrhage, sepsis, respiratory fistula

19
Q

What is oesophageal adenocarcinoma?

A

Largely from dysplastic change in Barrett’s oesophagus.

20
Q

What are the risk factors and symptoms of oesophageal adenocarcinoma?

A

7:1 M:F ratio, dysphagia, weight loss, haematemesis, chest pain, vomiting.

21
Q

How can oesophageal carcinoma spread?

A

Direct spread into surrounding tissues. Lymphatic to paraoesophageal and cervical node groups. Haematogenous to liver or lung.

22
Q

What is adenocarcinoma of the stomach?

A

Stomach cancer. 90% of gastric malignancies. Precursor lesions involve intestinal metaplasia, neoplastic polyps and H.pylori associated gastritis.

23
Q

What are the symptoms of adenocarcinoma stomach?

A

Early symptoms resemble gastritis. Advanced symptoms include: weight loss, anorexia, anaemia, haemorrhage.

24
Q

How can adenocarcinoma stomach spread?

A

Direct infiltration into duodenum, pancreas, colon, liver and spleen. Lymphatic spread into local and regional nodes. Haematogenous into liver and lungs. Omentum and mesentery and ovary.

25
Q

What is small bowel neoplasia?

A

Relatively rare bowel cancer compared to other GI malignancy. Different subtypes include: adenocarcinoma, GI stromal tumour, Lymphoma, Carcinoid tumour.

26
Q

What are the risk factors for small bowel neoplasia?

A

Chron’s disease, Coeliac disease, Radiation exposure, Hereditary GI cancer syndromes.

27
Q

What is Coeliac disease?

A

Extensive mucosal disease related to sensitive to gluten.

28
Q

What are the symptoms of Coeliac Disease?

A

Pain and discomfort in the digestive tract, chronic constipation and diarrhoea, failure to thrive in children, anaemia, fatigue.

29
Q

What can coeliac disease lead to?

A

Increased risk of both adenocarcinoma and lymphoma of the small bowel.

Year 2 Pathology (20 decks)

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