Upper GI tract pathology

Question 1

Name 5 upper GI tract pathologies

Answer 1

Oesophageal reflux/cancer
Gastritis
Peptic ulceration
gastic cancer

Question 2

What can cause oesophageal reflux

Answer 2

hiatal hernia

Question 3

What can oesophageal reflux do?

Answer 3

Thickening of squamous epithelim and ulceration of oesophagus if severe

Question 4

name some complications of oesophageal reflux

Answer 4

Baretts oesophagus
oesophageal obstruction
impaired oesophageal motility
stricture (narrowing) due to fibrosis

Question 5

what is Barrett’s oesophagus

Answer 5

a pre malignant condition in response to oesophageal reflux . It is a type of metaplasia from squamous epthelium to glandular epithelium

Question 6

Oesophageal Cancer is how common?

Answer 6

Third commonest cancer of alimentary tract

Question 7

What are the histological types of oesophageal cancer

Answer 7

squamous cell carcinoma and adenocarcinoma (deveops from barrett’s oesophagus)

Question 8

Risk factors for squamous carcinoma

Answer 8

smoking,alcohol, dietary carcinogens

Question 9

Risk factors for adenocarcinoma

Answer 9

Barrett’s metaplasia and obesity

Question 10

Local effects of oesophageal cancer?

Answer 10

ulceration,perforation, obstruction

Question 11

blood spread of oesophageal cancer goes to?

Answer 11

Liver

Question 12

What is the prognosis of oesophageal cancer

Answer 12

very poor.5 year survival rate less than 15%

Question 13

What is gastritis

Answer 13

inflammation of the stomach

Question 14

what are the types of gastritis

Answer 14

Autoimmune (Type A)
Bacterial (most common type B )
Chemical injury (type C)

Question 15

Autoantibodies of which cells are involved in autoimmune gastritis

Answer 15

Parietal cells and intrinsic factor

Question 16

What happens in gastritis

Answer 16

Atrophy of specialized acid secreting cells on gastric epithelium causing loss of specialised epithelial cells

Question 17

what does Loss of specialised gastric epithelial cells cause

Answer 17

decreased acid secretion and loss of intrinsic factor produced by stomach

Question 18

What is bacterial gastritis related to

Answer 18

helicobacter pylori

Question 19

What is H pylori

Answer 19

Gram negative bacteria that is found on the epithelial surface in mucus.

Question 20

What does H pylori do

Answer 20

Produces acute and chronic inflammatory response and increases acid production

Question 21

What is chemical gastritis due to

Answer 21

bile reflux
drugs (NSAIDS)
alcohol

Question 22

Why does peptic ulceration happen

Answer 22

due to an imbalance between acid secretion and mucosal barrier

Question 23

What does peptic ulceration affect

Answer 23

Oesophagus (lower), stomach (body and antrum) and duodenum (first and second part)

Question 24

What is peptic ulceration usually associated with

Answer 24

H pylori and increased gastric acid

Question 25

What are the complications of peptic ulceration and mechanisms

Answer 25

• Healing by fibrosis leading to obstruction
• Perforation leading to peritonitis
• Bleeding (acute = haemorrhage and chronic = Anaemia)

Question 26

How common is gastric cancer

Answer 26

2nd most common cancer of GI tract

Question 27

What is gastric cancer associated with

Answer 27

H pylori

Question 28

What kind of cancer

histology is gastric cancer

Answer 28

adenocarcinoma

Question 29

What is transcoelomic spread

Answer 29

spread within peritoneal cavity or pelvis via peritoneal spread

Question 30

Prognosis of stomach cancer?

Answer 30

Very poor as survival rate of 5 years is 20%