Upper GI tract pathology Flashcards
What is oesophageal reflux?
Reflux of gastric acid into the oesophagus
What problems does oesophageal reflux cause?
Thickening of squamous epithelium
Severe reflux can cause Ulceration of the oesophageal epithelium
Oesophageal reflux is commonly caused by, and is thus an indicator of a specific anatomy-ish problem in le body…
What is this?
Hiatus hernia
When your stomach slips oot eh
What are the complications of oesophageal reflux?
1) Repeated insult to epithelium will lead to healing by fibrosis
2) Barrett’s oesophagus
What are the specific problems caused by fibrosis in the oesophagus?
Stricture formation
Impaired oesophageal motility
Oesophageal obstruction
What is Barrett’s oesophagus?
Pre malignant Condition in which the bottom end of the oesophagus’ lining becomes thin/weak
A Transformation from squamous epithelium to columnar epithelium in the lower oesophagus is seen
Oesophageal reflux can cause it to develop
What histological types of cancer are there of oesophageal cancer ?
Squamous carcinoma (proximal 2/3rds) & Adenocarcinoma (distal 1/3rd)
Adenocarcinoma develops from what oesophageal condition>
Barrett’s oesophagus
barrett’s metaplasia
What are the risk factors for squamous carcinoma in the oesophagus?
Smoking
Alcohol
Dietary carcinogens
What risk factors are there for the development of adenocarcinoma of the oesophagus
Barrett’s oesophagus / GORD
Being phat
What are the potential local effects of Oesophageal cancer?
Obstruction
Ulceration
Perforation
Like with many cancers, oesophageal cancer can spread directly, via the lymphatic system and through the blood
What organ is at risk of metastasis to through the blood?
Liver
bc distal oesophagus involved in portal circulation
Whats the prognosis for oesophageal cancer?
5 year survival rate < 15%
There are 3 type of gastritis. What are they?
Autoimmune (type A) Bacterial (type B) Chemical injury (type C)
(think ABC)
WHat is autoimmune gastritis?
Chronic inflammatory disease involving auto-destruction of parietal cells in the stomach
This is caused by autoantibodies attacking parietal cells and intrinsic factor
What is the histological effect of autoimmune gastritis?
Parietal cells normally chuck out HCl and intrinsic factor
Damage/loss of this gastric epithelium leads to decreased acid secretion and vitamin B12 deficiency
Vitamin B12 deficiency causes pernicious anaemia
Which type of gastritis is most common?
Bacterial
What bacterium is related to bacterial gastritis?
Helicobacter pylori
What is H pylori?
Gram negative bacterium which is found in gastric mucus on the surface of the gastric epithelium
Produces acute and chronic inflammatory response in gastritis and also causes an increased acid production
What are the main causes of chemical gastritis?
Drugs such as NSAIDs (aspirin etc)
Alcohol
Bile reflux
What are peptic ulcers?
Ulcers/sores that form in the lining of the stomach, oesophagus and/or duodenum
What bacterium is strongly associated with the formation of peptic ulcers?
Helicobacter pylori
What parts of the stomach can be affected by peptic ulcers?
Body and antrum
What are the complications of peptic ulcers?
1) Bleeding
- Can be acute (haemorrhage)
- Chronic bleeding leads to anaemia
2) Perforation (leading to peritonitis)
3) Obstruction due to healing by fibrosis
What histological type of cancer is stomach cancer?
Adenocarcinoma
What is the link between an infection and stomach cancer?
Stomach cancer associated with previous infection with H. pylori
In what ways can stomach cancer spread?
Blood (liver)
Lymph
Direct invasion
Transcoelomic spread
(Spread within peritoneal cavity)
What is the prognosis for a patient with stomach cancer?
Very poor
5 year survival rate less than 20%
