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Year 2 Pathology > UPPER GI Tract > Flashcards

UPPER GI Tract Flashcards

1
Q

What consists of the UPPER GI tract?

A
  • Esophagus
  • Stomach
  • Intestines
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2
Q

What’s chronic gastritis?

A
  • It’s ongoing inflammation of the stomach mucosa
  • Compared to acute Gastritis, symptoms less severe but more persistent
  • Provides environment where dysplasia and carcinoma can arise.
  • Causing many symptoms: upper abdo pain, indigestion/ bloating, belching, nausia, loss of apetite.
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3
Q

What’s DYSPLASIA?

A

It’s the enlargement of an organ or tissue by rapid increase of abnormal cells .
Can be a development disorder or early stage cancer.

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4
Q

What disorder are these factors describing:

  • Ongoing inflammation of stomach mucosa
  • Compared to the acute variety, symptoms are less severe but more persistent
  • Provides an environment in which dysplasia and carcinoma can arise.
A

This is describing CHRONIC GASTRITIS

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5
Q

What are the symptoms of chronic gastritis

A
  • Upper abdo pain
  • Indigestion/ bloating
  • Nausea + vomiting
  • Belching
  • Loss of appetite or weight loss
  • CAN BE ASYMPTOMATIC
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6
Q

What disorder do these symptoms represent?

  • can be asymptomatic
  • belching
  • indigestion/ bloating
  • upper abdo pain
  • nausea / vomiting
  • loss of appetite/ weight loss
A

These symptoms are describing CHRONIC GASTRITIS

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7
Q

What can cause chronic gastritis?

A

A - autoimmune
B - bacterial (H.Pylori)
C - chemical (alcohol, tobacco, caffeine)

and psychological stress

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8
Q

What disease do these things cause:
A- Autoimmune
B- Bacteria (H.Pylori)
C- Chemical (tobacco, alcohol, caffeine)

Psychological stress

A

These things all may cause CHRONIC GASTRITIS

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9
Q

What does H.Pylori stand for

A

It stands for the bacteria:
Helicobacter pylori

(Gram -ve found in stomach particularly the antrum. Infects half the world pop by age 5. Faecal-oral route)

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10
Q

What is the bacterial H.Pylori linked to?

A

It’s been linked to:

  • Chronic gastritis
  • Development of duodenal ulcers
  • Development of stomach cancer.
  • Associated with gastric ulcer
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11
Q

Some clinical presentations of H.Pylori?

A
  • 80% asymptomatics!
  • 5-10% peptic ulcer disease
  • 10% non-ulcer dyspepsia
  • 1-3% gastric adenocarcinoma
  • 0.5% gastric MALToma
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12
Q

What are common causes of peptic ulcer disease?

A
  • H.Pylori infection

- NSAIDS

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13
Q

True or false:

Most ulcers come in groups?

A

FALSE

Most ulcers are solitary

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14
Q

Name some symptoms of peptic ulcer disease?

A
  • Pain (gnawing, burning, aching)
  • Worse at night
  • Worse after meals
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15
Q

What condition can these complications arise from?

  • Bleeding leading to iron deficiency anaemia
  • haematemesis (vomiting blood)
  • perforation leading to peritonitis
A

These complications are from peptic ulcer disease.

Can also cause long term cancer at the edge of the ulcer.

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16
Q

Name some complications of peptic ulcer disease…

A
  • Bleeding leading to iron deficiency (anemia)
  • Haematemesis (vomiting blood)
  • perforation leading to peritoneum inflammation (peritonitis)
  • Long term cancer at the edge of ulcer
17
Q

What’s Barrett’s Oesphagus?

A

It’s a condition where the normal (stratified squamous) epithelium of the oesophagus is replaced by columnar epithelium with goblet cells (usually in lower GI tract). Thought to be an adaptation to chronic acid reflux.

18
Q

What is the name of the condition where the cells of the oesophagus are changed from stratified squamous -> colunmar epithelium with goblet cells.

A

Barrett’s Oesophagus

Thought to be linked with chronic acid reflux.

19
Q

What condition has a strong association with oesophageal adenocarcinoma (0.5% per patient per year)

A

Barrett’s oesophagus

Large need for surveillance if people have this condition to prevent cancer.

20
Q

What are the types of UPPER GI tract cancers?

A
  • Oesophagus (squamous carcinoma, adenocarcinoma (barrett’s)
  • Stomach (Adenocarcinoma, GI stromal tumours)
  • Small bowel (Lymphoma, GI stromal tumours, Neuroendocrine tumours)
21
Q

What’s another name for the cancer largely caused by Barrett’s oesophagus

A

Adenocarcinoma of the oesophagus

22
Q

What are some risk factors for developing Oesophageal squamous cell carcinoma?

A
  • Adults over 45
  • Male (4:1 female)
  • Alcohol
  • Tobacco
  • Caustic injury to oesophagus
  • Achalasia (condition where muscles at end of oesophagus don’t relax causing food to stay there)
23
Q

Name some symptoms of oesophageal squamous cell carcinoma.

A
  • Dysphagia (difficulty swallowing)
  • Weight loss
  • Haemorrhage
  • Sepsis
  • Respiratory Fistula (with aspiration)
  • Over five year survival 9%
24
Q

What are the types of Oesophageal cancers?

A
  • Oesophageal squamous cell carcinoma

- Oesophageal Adenocarcinoma (Barrett’s)

25
Q

How might an oesophageal carcinoma spread?

A
  • Directly (into surrounding tissue)
  • Lymphatic (to paraoesophageal, paratracheal and cervical node groups)
  • Haematogenous (to liver or lung)
26
Q

What precursor lesions may put someone at risk of getting stomach adenocarcinoma?

A
  • Pernicious anaemia (atrophic gastritis)
  • Intestinal Metaplasia
  • Neoplastic polyps
  • Helicobacter associated gastritis
27
Q

True or false:

Stomach adenocarcinoma is quite a rare carcinoma?

A

FALSE:

It’s 2nd most common carcinoma worldwide

28
Q

Symptoms of Stomach Adenocarcinoma?

A
  • Early symptoms resemble gastritis

- Advanced (Weight loss, anorexia, anaemia, heamorrhage)

29
Q

How might adenocarcinoma of the stomach spread?

A
  • Direct (duodenum, pancreas, colon, liver, spleen)
  • Lymphatic (local + regional, verchow’s node)
  • Haematogenous (liver lungs)
  • Transcoelomic
  • Omentum
  • Mesentery
  • Ovary (Krukenberg tumour)
30
Q

True or false:

Small bowel neoplasia is quite a common GI malignancy

A

FALSE

It’s quite a rare GI malignancy

31
Q

What are some of the risk factors for small intestinal cancer?

A
  • Crohn’s disease
  • Ceoliac disease
  • Radiation exposure
  • Hereditary GI cancer syndromes (familial adenomatous polyposis)
32
Q

What type of cancer does these problems predispose you to?

  • Crohn’s disease
  • Ceoliac disease
  • Radiation exposure
  • Hereditary GI cancer syndromes (familial adenomatous polyposis)
A

These conditions are all risk factors for developing small intestinal cancer.

33
Q

What causes extensive mucosal disease related to gluten sensitivity?

A

Coeliac’s disease

34
Q

What is coeliac’s disease?

A

Extensive mucosal disease related to sensitivity to gluten. It’s immune mediated.

35
Q

What do these symptoms characterise?

  • pain and discomfort in the digestive tract,
  • chronic constipation and diarrhoea,
  • failure to thrive (in children),
  • anaemia
  • fatigue
A

Coeliac’s disease

36
Q

Name some possible SE of Coeliac’s disease

A
  • pain and discomfort in the digestive tract,
  • chronic constipation and diarrhoea,
  • failure to thrive (in children),
  • anaemia
  • fatigue

All symptoms including intestinal damage begins to heal within weeks of gluten being removed.

37
Q

If you have coeliac’s disease, what are you more at risk of getting?

A

Having Coeliac disease can lead to increased risk of:

  • Adenocarcinoma
  • Lymphoma

of the small bowel!

Year 2 Pathology (19 decks)

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