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Gastrointestinal Pathology > Upper GI Tract Pathology > Flashcards

Upper GI Tract Pathology Flashcards

1
Q

What is oesophageal reflux?

A

Reflux of gastric acid into the oesophagus

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2
Q

What is a hiatus hernia?

A

Protrusion of part of the stomach into the thorax

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3
Q

Pathology of oesophageal reflux

A

Reflux of gastric acid into the oesophagus
Thickening of squamous epithelium
Ulceration of oesophagus when severe
Sets up an inflammatory process

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4
Q

Complications of oesophageal reflux

A 
Healing by fibrosis
- stricture formation 
- impaired oesophageal motility
- oesophageal obstruction 
Barrett's oesophagus
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5
Q

Causes / types of gastritis (ABC)

A

Autoimmune
Bacterial
Chemical injury

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6
Q

What is the most common type of gastritis?

A

Bacterial

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7
Q

Pathology of autoimmune gastritis

A

Targets stomach
Autoantibodies to parietal cells and intrinsic factor
Atrophy of specialised acid secreting gastric epithelium
Also loss of specialised gastric epithelial cells leading to
- decreased acid secretion
- loss of intrinsic factor leading to vit B 12 deficiency - pernicious anaemia

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8
Q

What is bacterial gastritis related to?

A

Helicobacter pylori

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9
Q

Causes of chemical gastritis

A

Drugs (NSAIDs)
Alcohol
Bile reflux

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10
Q

Pathology of peptic ulceration

A

Stomach has well established mucosal barrier so that it does not destroy itself, however the oesophagus and duodenum do not have this same mucosal barrier.
Imbalance between acid secretion and mucosal barrier
When barrier breaks down, there will be damage to the epithelium due to the acid

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11
Q

What does H pylori increase?

A

Gastric acid

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12
Q

Complications of peptic ulceration

A

Bleeding - haemorrhage or anaemia
Perforation
- > peritonitis

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13
Q

What is gastric cancer?

A

Stomach cancer

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14
Q

Pathology of gastric cancer

A

Develops through phases of intestinal metasplasia and dysplasia

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15
Q

What is gastric cancer associated with?

A

Previous H pylori infection

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16
Q

Histology of gastric cancer

A

Adenocarcinoma

17
Q

How does gastric cancer spread?

A

Direct to surrounding areas
Lymphatic
Blood spread to liver
Transcolemic spread within peritoneal cavity

18
Q

Prognosis of gastric cancer

A

Very poor - 5 year survival rate less than 20%

19
Q

Pathology of Barrett’s Oesophagus

A

Metaplasia

- transformation from squamous epithelium to glandular epithelium

20
Q

What is metaplasia?

A

The transformation of one normal tissue to another normal tissue

21
Q

What does barretts oesophagus happen in response to?

A

Oesophageal reflux

22
Q

What is barrets oesophagus a pre malignant condition for?

A

Oesophageal cancer

23
Q

Two types of oesophageal cancer

A

Squamous cancer

Adenocarcinoma

24
Q

Which type of oesophageal cancer develops from barretts oesophagus?

A

Adenocarcinoma

25
Q

Risk factors for squamous carcinoma of the oesophagus

A

Smoking
Alcohol
Dietary carcinogens

26
Q

Risk factors for adenocarcinoma of the oesophagus

A

Barrett’s metaplasia

Obesity

27
Q

How can obesity increase the risk of developing an adenocarcinoma of the oesophagus?

A

Abdominal obesity pushes the stomach through the lower sphincter leading to herniation
This creates a proinflammatory environment which increases the chance of cancer

28
Q

Local effects of oesophageal cancer

A 
Obstruction 
- dysphagia 
- weight loss 
Ulceration 
- blood loss
- anaemia
Perforation 
- infection 
- inflammatory response
29
Q

How does oesophageal cancer spread?

A

Direct to surrounding structures
Lymphatic
Blood spread to lier

30
Q

Prognosis of oesophageal cancer

A

5 year survival rate < 15%

31
Q

What is helicobacter pylori?

A

Gram -ve bacterium

32
Q

Where is H pylori found?

A

Gastric mucus on the surface of gastric epithelium

33
Q

Effects of H pylori

A

Produces acute and chronic inflammatory response
Increases acid production
Produces urease which splits urea into ammonia and carbonate which increases the local pH
The stomach senses the rising pH and this stimulates acid production

34
Q

What is the most appropriate tool to screen for malnutrition?

A

MUST

35
Q

What is the waterloo score for?

A

The risk of a patient developing a pressure sore

Gastrointestinal Pathology (26 decks)

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