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Alimentary System > Upper GI Tract Pathology > Flashcards

Upper GI Tract Pathology Flashcards

1
Q

define oesophageal reflux

A

reflux of acid into oesophagus

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2
Q

how can oesophageal reflux arise?

A

if the lower oesophageal sphincter doesn’t work properly a hiatus hernia occurs where the stomach refluxes into the oesophagus.

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3
Q

what is the response of the oesophageal epithelium to gastric acid?

A

thickening of the squamous epithelium

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4
Q

what can occur in severe reflux?

A

ulceration of the epithelium creates inflammation

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5
Q

what complications can occur with an oesophageal reflux?

A

> fibrosis

> barrett’s oesophagus

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6
Q

describe the process of fibrotic healing of an oesophageal reflux

A

> stricture formation, scar tissue causes narrowing of tube
impaired oesophageal motility
= oesophageal obstruction

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7
Q

what is metaplasia?

A

one normal tissue transforms into another normal tissue

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8
Q

what metaplasia takes place in barretts oesophagus?

A

squamous epithelium transforms to glandular epithelium

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9
Q

what can barretts oesophagus predispose?

A

malignant conditions, cancer

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10
Q

what is the third commonest cancer of the alimentary tract?

A

oesophageal cancer

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11
Q

what are the two histological types of oesophageal cancer?

A

squamous carcinoma

adenocarcinoma

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12
Q

what type of oesophageal cancer arises from barretts oesophagus?

A

adenocarcinoma

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13
Q

what are the risk factors associated with squamous carcinoma oesophageal cancer?

A

smoking
alcohol
dietary carcinogens

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14
Q

how can obesity lead to (adenocarcinoma) oesophageal cancer?

A

the large abdomen puts pressure on the stomach, pushing it through the lower oesophageal sphincter creating a hernia

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15
Q

what are the local effects of oesophageal cancer?

A

> obstruction
ulceration
perforation

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16
Q

how may ulceration from an oesophageal tumour cause anaemia?

A

ulceration causes cell death so when the vessels on top of the ulcer erode there is blood loss = anaemia

17
Q

describe perforation of an oesophageal tumour

A

if cell death is sustained a hole through the tumour may occur. food may then enter the thorax and cause infection.

18
Q

how may oesophageal cancer spread?

A

> directly to surrounding structures
through the lymphatics to regional lymph nodes
through the blood to the liver

19
Q

what is the prognosis for oesophageal cancer?

A

very poor as the 5 year survival rate is less than 15%

20
Q

what are the three types of gastritis?

A

> autoimmune
bacterial
chemical injury

21
Q

what is the most common type of gastritis?

A

bacterial

22
Q

what do antibodies in autoimmune gastritis target?

A

parietal cells and intrinsic factor

23
Q

what is autoimmune gastritis associated with?

A

other autoimmune diseases

24
Q

what is the pathology of autoimmune gastritis?

A

> atrophy of specialised acid secreting gastric epithelium
loss of specialised gastric epithelial cells: decreased secretion factor and loss of intrinsic factor (pernicious anaemia)

25
Q

describe the bacteria that causes bacterial gastritis

A

> helicobacter pylori related
gram negative
found in gastric mucous of surface epithelium

26
Q

what is the effect of bacterial in bacterial gastritis?

A

> increase in acid production

> acute and chronic inflammatory response

27
Q

is bacterial gastritis treatable?

A

yes and reversible

28
Q

what can cause chemical gastritis?

A

> Drugs (NSAIDs)
alcohol
bile reflux

29
Q

an imbalance in what causes peptic ulceration?

A

between the acid secretion and mucosal barrier

30
Q

what parts of the alimentary system are effected by peptic ulceration?

A

> lower oesophagus
body and antrum of the stomach
first and second parts of the duodenum

31
Q

what is peptic ulceration often associated with?

A

H. pylori (increased gastric acid)

32
Q

what are the complications associated with peptic ulceration?

A

> bleeding (acute/chronic)
perforation (peritonitis)
Fibrosis (obstruction)

33
Q

what is the second commonest cancer of the alimentary tract?

A

gastric cancer

34
Q

what phase does gastric cancer develop?

A

through phases of intestinal metaplasia and dysplasia

35
Q

what infection gastric cancer often associated with?

A

previous h. pylori infection

36
Q

what is the histology of gastric cancer?

A

adenocarcinoma

37
Q

how does stomach cancer spread?

A

> directly
through lymphatics
through the blood
transcoelomic

38
Q

describe transcoelomic spread of stomach cancer

A

the tumour penetrates all layers of the stomach wall and tumour cells are released in the peritoneal cavity

39
Q

what is the prognosis of stomach cancer?

A

very poor, 5 year survival rate is less than 20%

Alimentary System (33 decks)

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