Upper GI Tract Pathology

Question 1

Can the oesophagus cope with an acidic environment?

Answer 1

No

Question 2

Can the stomach cope with an acidic environment?

Answer 2

Yes

Question 3

What is a hiatus hernia?

Answer 3

Protrusion of part of the stomach into the thorax

Question 4

Through which level does the oesophageal hiatus occur?

Answer 4

T10

Question 5

What is barrett’s oesophagus?

Answer 5

Type of metaplasia

Caused by acid exposure to the oesophagus

Question 6

What is metaplasia?

Answer 6

The transformation of one type of tissue into another type of tissue

Question 7

What transformation os tissue occurs in barrett’s oesophagus?

Answer 7

From squamous epithelium to glandular epithelium

Question 8

What does barrett’s oesophagus increase the risk of?

Answer 8

Oesophageal cancer

Question 9

What are the risk factors for squamous carcinoma of the oesophagus?

Answer 9

Smoking
Alcohol
Dietary carcinogens

Question 10

What are the risk factors for glandular carcinoma of the oesophagus?

Answer 10

Barrett’ metaplasia

Obesity

Question 11

What are potential effects of oesophageal carcinoma?

Answer 11

Obstruction
Ulceration
Perforation

Question 12

What are the methods by which oesophageal cancer can spread?

Answer 12

Direct
Blood
Lymphatics

Question 13

Where is a common metastatic site for oesophageal cancer?

Answer 13

Liver

Question 14

What are the 3 types of gastritis?

Answer 14

Autoimmune
Bacterial
Chemical

Question 15

Which gender does autoimmune gastritis tend to affect?

Answer 15

F

Question 16

What is attacked in A gastritis?

Answer 16

Parietal cells and intrinsic factor

Question 17

What is the consequence of type A gastritis?

Answer 17

Loss of specialised epithelium
Less acid in stomach
Loss of intrinsic factors

Question 18

Due to the loss of intrinsic factor what condition may the patient present with in type A gastritis?

Answer 18

Anaemia

Question 19

Which is the commonest form of gastritis?

Answer 19

Bacterial

B

Question 20

Which organism is typically associated with B gastritis?

Answer 20

H.pylori

Question 21

What chemicals does H.pylori produce?

Answer 21

Enzyme that breaks urease to ammonia and carbonate

Question 22

Why is a rising pH associated with H.pylori infection?

Answer 22

Due to the creation of ammonia

Question 23

What can cause chemical gastritis?

Answer 23

Drugs (e.g NSAIDS)
Alcohol
Bile reflux from duodenum

Question 24

What pathology causes a peptic ulcer?

Answer 24

Imbalance between acid secretion and mucosal barrier

Question 25

Where can peptic ulcers appear?

Answer 25

Lower oesophagus
Body and antrum of the stomach
1st and 2nd part of duodenum

Question 26

What can perforation of a gastric ulcer cause?

Answer 26

The release of gastric contents into the peritonea cavity

Inflammation of the peritoneum - peritonitis

Question 27

What is peritonitis?

Answer 27

Inflammation of the peritoneal cavity

Question 28

Infection with which organism is associated with gastric cancer?

Answer 28

H.pylori

Question 29

What is the common histological type of gastric carcinoma?

Answer 29

Adenocarcinoma as the stomach is lined with glandular epithelium

Question 30

What is meant by transcoelomic spread?

Answer 30

Spread within peritoneal cavity

Due to the tumour penetrating all layers of the stomach

Question 31

What is meant by direct spread of tumour?

Answer 31

Spread to surrounding structures

Question 32

What is meant by lymphatic spread?

Answer 32

Spread to regional lymph nodes

Question 33

Where does gastric cancer often metastasis to by blood spread?

Answer 33

The liver

Question 34

What is the 5yr survival rate of gastric cancer?

Answer 34

<20%

Question 35

Why does gastric cancer have such a poor survival rate?

Answer 35

Due to asymptomatic nature causing most cases to present late