Upper GI Tract Pathology

Question 1

what are some upper GI tract diseases?

Answer 1

Oesophageal reflux
Oesophageal cancer
Gastritis
Peptic ulceration
Gastric cancer

Question 2

what is the pathology of oesophageal reflux?

Answer 2

Reflux of gastric acid into oesophagus
Hiatus hernia

Thickening of squamous epithelium

Ulceration of oesophageal epithelium when severe reflux

Question 3

what are the complications of oesophageal reflux?

Answer 3

healing by fibrosis
Stricture formation
Impaired oesophageal motility
Oesophageal obstruction

barretts oesophagus

Question 4

what is barretts oesophagus?

Answer 4

Type of metaplasia
Transformation from squamous epithelium to glandular epithelium

Response in some patients to oesophageal reflux

Pre-malignant condition

Question 5

what is the third commonest cancer of alimentary tract?

Answer 5

oesophageal cancer

Question 6

what are the two histological types of oesophageal cancer?

Answer 6

squamous carcinoma

adenocarcinoma

Question 7

what are the risk factors for squamous carcinoma oesophageal cancer?

Answer 7

smoking
alcohol
dietry requirements

Question 8

what are the risk factors for adenocarcinoma for oesophageal cancer?

Answer 8

barrett’s metaplasia

obesity

Question 9

what are the local effects of oesophageal cancer?

Answer 9

obstruction
ulceration
perforation

Question 10

what are the types of spread of oesophageal cancer?

Answer 10

direct- to surrounding tissues

lymphatic spread- to regional lymph nodes

blood spread- to liver

Question 11

what is the outcome of oesophageal cancer?

Answer 11

v poor- 5 year survival rate less than 15%

Question 12

what is the paathology of gastritis?

Answer 12

autoimmune type A
Bacterial type B
Chemical injury type C

Question 13

what is autoimmune gastritis?

Answer 13

Organ-specific autoimmune disease

Autoantibodies to parietal cells and intrinsic factor

Associated with other autoimmune diseases

Question 14

what is the pathology of autoimmune gastritis?

Answer 14

Atrophy of specialised acid secreting gastric epithelium

Loss of specialised gastric epithelial cells
Decreased acid secretion
Loss of intrinsic factor
Vitamin B12 deficiency (pernicious anaemia)

Question 15

what is the commonest type of gastritis?

Answer 15

bacterial gastritis

Question 16

what is helicobacter pylori?

Answer 16

Gram negative bacterium

Found in gastric mucus on surface of gastric epithelium

Produces acute and chronic inflammatory response

Increased acid production

Question 17

what is chemical gastritis?

Answer 17

Drugs
Non-steroidal anti-inflammatory drugs (NSAIDs)
Alcohol
Bile reflux

Question 18

what is peptic ulceration?

Answer 18

imbalance between acid secretion and mucosal barrier

Question 19

what does peptic ulceration effect?

Answer 19

oesophagus, stomach, duodenum

Lower oesophagus
Body and antrum of stomach
First and second parts of duodenum

Question 20

what are the complications of peptic ulceration?

Answer 20

Bleeding
Acute = haemorrhage
Chronic = anaemia

Perforation
Peritonitis

Healing by fibrosis
Obstruction

Question 21

what is the second commonest cancer of alimentary tract?

Answer 21

gastric cancer

Question 22

what is the spread of stomach cancer?

Answer 22

Direct
Spread to surrounding tissues

Lymphatic
Spread to regional lymph nodes

Blood spread
Liver

Transcoelomic spread
Spread within peritoneal cavity

Question 23

what is the prognosis of stomach cancer?

Answer 23

Very poor

5 year survival rate less than 20%

Question 24

what is the commonest cancer in the alimentary tract?

Answer 24

colorectal cancer

Question 25

what is the lack of vitamin b12 called?

Answer 25

pernicious anaemia