Upper GI Tract Pathology

Question 1

What do disease in the oesophagus, stomach and duodenum cause?

Answer 1

Upper abdominal or retrosternal discomfort or pain or “Indigestion”

Question 2

What causes reflux of gastric acid into the oesophagus?

Answer 2

Impairment to the LOS

Question 3

What does gastric acid in the oesophagus lead to?

Answer 3

Thickening of the squamous epithelium and thus ulceration may occur

Question 4

Oesophageal reflux complications?

Answer 4

Healing by fibrosis leads to a strictures oesophagus
Impaired motility
Possible obstruction

Question 5

What is Barrett’s Oesophagus?

Answer 5

Transformation of the squamous epithelium into glandular epithelium Pre-malignant condition

Question 6

What are the two types of oesophageal cancer?

Answer 6

Sqaumous Carcinoma & Adenocarcinoma

Adeno = Glands

Question 7

Sqaumous Carcinoma risk factors?

Answer 7

Smoking
Alcohol
Diet

Question 8

Adenocarcinoma risk factors?

Answer 8

Barrett’s Metaplasia

Obesity

Question 9

Local effects of oesophageal cancer?

Answer 9

Obstruction
Ulceration
Perforation

Question 10

Spread of oesophageal cancer?

Answer 10

Directly to surrounding structures
Lymphatic spread to lymph nodes
Blood spreads metatases to the liver

Question 11

Survival rate of oesophageal cancer?

Answer 11

5 year survival = 15%

Question 12

What are the three types of gastritis?

Answer 12

A - Autoimmune
B - Bacterial
C - Chemical Injury

Question 13

How does type A gastritis occur?

Answer 13

Organ specific with no symptoms directly relating to this
Atrophy of specialised gastric epithelial cells and the loss of these specialised gastric epithelial cells leading to decreased acid secretion and loss of intrinsic factor

Question 14

How does type B gastritis occur?

Answer 14

Most common form and is Helicobacter Pylori related
Produces acute and chronic inflammation with increased acid production
Stomach believes its pH is higher than it is so secretes more acid

Question 15

What is H. Pylori?

Answer 15

Gram negative bacteria that is found in the gastric mucus on the surfasce of gastric epithelium

Question 16

How does type C gastritis occur?

Answer 16

Drugs (NSAIDS), Alcohol & Bile refluz

Question 17

Hows does Peptic ulceration occur and where does it affect?

Answer 17

Imbalance between acid secretion and the mucosal barrier
Oesopahgus, Stomach (Body & Antrum) & Duodenum
Can occur anywhere in the upper GI Tract where lumenal contents come into contact with epithelium

Question 18

Peptic Ulceration complications?

Answer 18

Bleeding - Acute = Haemorrhage or Chronic = Anaemia
Perforation - Peritonitis
Healing by fibrosis - Obstruction

Question 19

What are the first two stages of gastric cancer?

Answer 19

Intestinal metaplasia

Dysplasia

Question 20

What is gastric cancer associated with?

Answer 20

Previous H. pylori infection

Question 21

What type of tumour is gastric cancer?

Answer 21

Adenocarcinoma

Question 22

Where does transcoelmic spread, spread to?

Answer 22

Within the peritoneal cavity

Question 23

Apart from transcoelmic spread what other types of spread are there?

Answer 23

The same of that of oesophageal cancer

Question 24

What is the 5 year survival rate for oesophageal cancer?