Upper GI Tract

Question 1

What is chronic gastritis?

Answer 1

Ongoing inflammation of the stomach mucosa. Can present an environment in which dysplasia and carcinoma can arise.

Question 2

What causes chronic gastritis?

Answer 2

H.pylori, alcohol, tobacco, stress, caffeine, autoimmune

Question 3

Symptoms of chronic gastritis?

Answer 3

upper abdo pain, indigestion and bloating, n+v, belching, loss of appetite or weight loss

Question 4

What causes peptic ulcers?

Answer 4

H.pylori, NSAIDs

Question 5

What are symptoms of peptic ulcers?

Answer 5

pain (gnawing, during, aching), worse at night and after meals

Question 6

Complications of peptic ulcers?

Answer 6

Bleeding leading to iron deficiency anaemia, massive haematemesis (vomiting of blood), perforation leading to peritonitis

Question 7

What is Barratt’s Oesophagus?

Answer 7

When the normal lining of the oesophagus (stratified squamous epithelium) is replaced by columnar epithelium with goblet cells (usually found in lower GI tract). Thought to be an adaptation of chronic acid exposure from oesophageal reflux. Strong association with oesophageal carcinoma

Question 8

What are the types of oesophageal malignancies?

Answer 8

Squamous carcinoma (90%) - Risk factors = alcohol, tobacco, caustic injury, achalasia.
Adenocarcinoma (Barratt's)

Question 9

What is the stomach malignancy?

Answer 9

Adenocarcinoma

Question 10

What are the types of small bowel malignancies?

Answer 10

Lymphoma, GI Stromal Tumours (GIST), Neuroendocrine Tumours

Question 11

What is coeliac disease?

Answer 11

Extensive mucosal disease related to insensitivity to gluten

Question 12

What causes coeliac disease?

Answer 12

Prevalence in white europeans
Immune mediated villous atrophy and malabsorption. Leads to increased risk of adenocarcinoma and lymphoma in the small bowel

Question 13

Symptoms of coeliac disease?

Answer 13

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