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Second Year Systems > Upper GI tract pathology > Flashcards

Upper GI tract pathology Flashcards

1
Q

What does the upper GI tract consist of?

A

oesophagus, stomach and duodenum

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2
Q

What type of pain do upper GI tract diseases cause?

A

Upper abdominal or retrosternal discomfort or pain or ‘indigestion’

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3
Q

What are the diseases of the upper GI tract?

A
  • Oesophageal reflux
  • Oesophageal cancer
  • Gastritis
  • Peptic ulceration
  • Gastric cancer
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4
Q

What is one of the causes of oesophageal reflux?

A

Hiatus hernia - less sphincter action

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5
Q

What are the outcomes of Oesophageal reflux?

A
  • Thickening of squamous epithelium
  • Ulceration of oesophagus when severe reflux
  • Healing by fibrosis which results in stricture formation, reduced oesophageal motility and obstruction (scar tissue contracts - problem with passing food)
  • Barrett’s oesophagus - Metaplasia – transformation of one normal tissue to another tissue – transformation from squamous epithelium to glandular epithelium, precursor of oesophageal adenocarcinoma
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6
Q

What are the two types of oesophageal cancer?

A

–Squamous carcinoma

–Adenocarcinoma

•Develops from Barrett’s oesophagus

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7
Q

What are the Risk Factors for
Oesophageal Cancer?

A

•Squamous carcinoma

–Smoking

–Alcohol

–Dietary carcinogens

•Adenocarcinoma

–Barrett’s metaplasia

–Obesity

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8
Q

What are the local effects of oesophageal cancer?

A
  • Obstruction
  • Ulceration
  • Perforation
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9
Q

What is meant by ulcer?

A

An erosion of the skin or mucus membrane

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10
Q

Describe the spread of oesophageal cancer

A

•Direct

–To surrounding structures

•Lymphatic spread

–To regional lymph nodes

•Blood spread

–Liver

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11
Q

What is the prognosis of oesophageal cancer?

A

•Very poor

–5 year survival rate less than 15%

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12
Q

What are the different ways of getting gastritis?

A

ABC

A - Autoimmune

B - Bacterial

C - Chemical injury

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13
Q

What do autoantibodies attack in autoimmune gastritis?

A

Parietal cells and intrinsic factor

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14
Q

What is the result of autoimmune gastritis on the epithelium of the stomach?

A

Acid secreting epithelium and specialised gastric epithelial cells are lost

Results in a decrease in acid secretion and a loss in intrinsic factor (Vitamin B12 deficiency (pernicious anaemia))

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15
Q

What is the most common type of gastritis?

A

Bacterial

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16
Q

What bacteria is responsible for bacterial gastritis and how does it function?

A

Helicobacter pylori - gram negative, found in the gastric mucus

H. pylori also neutralizes the acid in its environment by producing large amounts of urease, which breaks down the urea present in the stomach to carbon dioxide and ammonia. These react with the strong acids in the environment to produce a neutralized area around H. pylori. This increases acid produciton by the stomach.

Causes an acute and a chronic inflammatory response

17
Q

What are the common causes of chemical gastritis?

A

•Drugs

–Non-steroidal anti-inflammatory drugs (NSAIDs)

  • Alcohol
  • Bile reflux (from duodenum into the stomach)
18
Q

What causes peptic ulceration?

A

•Imbalance between acid secretion and mucosal barrier

19
Q

What does peptic ulceration affect?

A

All parts of the upper GI

–Lower oesophagus

–Body and antrum of stomach

–First and second parts of duodenum

20
Q

What is peptic ulceration often secondary to?

A

H. Pylori associated

21
Q

What are the complications of peptic ulceration?

A

•Bleeding

–Acute = haemorrhage

–Chronic = anaemia

•Perforation

–Peritonitis

•Healing by fibrosis

–Obstruction (Obstruction in distal stomach, lower oesphagus or even duodenum)

22
Q

What is gastric cancer often secondary to?

A

H.Pylori

23
Q

What type of cancer is gastric cancer?

A

Adenocarcinoma

24
Q

Where is obstruction likely to occur as a result of gastric cancer?

A

In the antrum of the stomach as opposed to the stomach

25
Q

What is the spread of stomach cancer?

A

•Direct

–Spread to surrounding structures

•Lymphatic

–Spread to regional lymph nodes

•Blood spread

–Liver

•Transcoelomic spread

–Spread within peritoneal cavity

26
Q

What is the prognosis of stomach cancer?

A

•Very poor

–5 year survival rate less than 20%

27
Q
A

Second Year Systems (21 decks)

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