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Life Maintenance > Week 9 > Flashcards

Week 9 Flashcards

1
Q

What is immunohistochemistry used for

A

Diagnostic use
Metastatic cancer
Looking at response to treatment

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2
Q

Describe epithelium - Arrangement, types, forms what surfaces? What sits below this layer?

A

Closely packed
Form membranes or glands
Separated from connective tissue by basement membrane
Squamous, columnar, cuboidal cells

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3
Q

Describe layers and purpose of stratified epithelium

A

Two or more cell layers

Purpose = protection

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4
Q

Describe the layers and purpose of transitional epithelium

A

Type of stratified - Transitional epithelium is a layer of cells that forms the mucosal lining of your ureters, a portion of your urethra, and your urinary bladder. These cells are called transitional because they can undergo a change in their shape and structure.

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5
Q

What is connective tissue composed of? And purpose

A

Extracellular matrix - Fibres, amorphous ground substance, ECF
A few cells - fibroblasts, adipocytes, macrophages, lymphoid cells (plasma, leucocytes)
Purpose = structure and metabolic support

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6
Q

What do adipose cells look like under a light microscope?

A

Look like clear gaps - because the dye shows where the fat cells were

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7
Q

What is cartilage? What are the different types?

A

Supporting framework

Hyaline cartilage (articular bone)
Elastic (ear)
Fibrocartilage (intervertebral discs)
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8
Q

Purpose of bone (3)

A

Support
Protect
Hemopoiesis

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9
Q

What are the three types of muscle? Describe

A

Skeletal - Striated, attached to skeleton
Smooth - No striations, present in hollow organs
Cardiac - connected by intercalated discs with gap junctions

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10
Q

Define metaplasia, dysplasia, neoplasia

A

Metaplasia - One cell type switched for another (ex. Squamous now columnar)
Dysplasia - Abnormality of development
Neoplasia - Abnormal and excessive growth of tissue (can be benign or malignant)

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11
Q

Describe the basic structure of GI tract from lumen outwards (5)

A

Mucosa (epithelium, lamina propia, muscularis mucosae), submucosa, muscularis propia, subserosa, serosa/adventitia

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12
Q

Three parts of the mucosa

A

epithelium, lamina propia, muscularis mucosae

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13
Q

Which structures have adventiatia rather than serosa?

A

Eosphagus and lower rectum (structures outside peritoneal cavity)

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14
Q

What lines the lumen of the oesophagus?

A

squamous epithelium

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15
Q

Causes of GORD

A

Pregnancy/obesity, hiatal diaphragm, stress, smoking, drinking

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16
Q

What are the key cells involved in inflammation during GORD

A

neutrophil polymorths

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17
Q

Complications of GORD

A

peptic ulceration, replacement of squamous mucosa by glandular mucosa
Stricture
Cancer risk increases

18
Q

What is granulation tissue?

A

Found during repair - loose arrangement of fibroblasts with new capillaries coming to repair

19
Q

What is barrett’s oesphagus?

A

Squamous mucosa undergoes metaplasia from normal squamous epithelium to columnar / glandular mucosa
Two types
Gastric - no goblet cells
Intestinal metaplasia - goblet cells

20
Q

How do you characterise dysplasia? (3)

A

Premalignant change

Impaired cell differentiation
Atypical nuclear features
Increased mitsosi

21
Q

adeno

A

glandular cell origin

22
Q

Two types of adenocarcinoma of oesophagus

A

Intestinal types

Diffuse (signet-ring cell) type

23
Q

Where do squamous cell vs adenocarcinoma tend to occur (most commonly)?

A

SCC - mid/upper oesophagus

AC - Lower oesophagues, gastro-oesophageal junction

24
Q

Cell types involved in gastritis

A

Plasma cell, lymphocyte, neutrophil

25
Q

Main causes of inflammation in the gut (2)

A

NSAIDs

H. pylori

26
Q

What are the complications of stomach/duodenum ulcers? (5)

A

Iron deficiency anaemia
Erosion of a major submucosal blood vessel (haematemesis, melaena)
Perforation into peritoneal cavity (chemical peritonitis)
Erosion into an adjacent organ (like pancreas)
Healing with scar formation, narrowing

27
Q

Various sensations from within the gut - discuss examples (from top to bottom) (8)

A 
Oesophageal distension
Gastric distension (fullness)
Nutrient density in stomach/duodenum
Nausea (toxins or excess nutrients)
Movement of gas
Pain
Urgency
Awareness of rectal content
28
Q

What are the mechanisms behind visceral sensation?

A

Afferent nerves send signals to CNS

29
Q

Types of sensory neurons in the gut? (6)

A 
Intraganglionic afferent
Enteric viscerofugal neuron
Intramuscular
Vascular afferent
Muscular-mucosal
Mucosal afferent
30
Q

Role of mucosal afferents

A

Respond to mucosal distortion / stroking

31
Q

Types of pain (4)

A

Somatic - musculoskeletal, cutaneous, well localized

Visceral - hollow organs, smooth muscle, usually referred (poorly localized)

32
Q

Which organs are not sensitive to pain? Why?

A

Liver, lungs, kidneys, others

No nociceptors

33
Q

Examples of stimuli for visceral pain (6)

A 
Hollow organ distension
Traction
Ischaemia
Acid/irritant chemicals
Inflammation
Electrical stimulation
'pinching' does NOT cause pain
34
Q

Describe pain caused by structural vs functional causes

A

Structural - inflammatory, neoplastic

Functional - IBS (inclu bloating), dyspepsia (inclu. nausea)

35
Q

Visceral pain becoming somatic - describe example

A

Acute appendicitis xxx

36
Q

Describes levels of hypersensitivity to pain (3)

A

Hyperalgesia (primary, local)
Allodynia (to non-painful stimuli)
Secondary hyperalgesia (generalised)

37
Q

When is it best for patients to take PPI?

A

30 mins before meal

38
Q

Signs that may differentiate gastric from duodenal pain

A

Duodenal - often awakens patient at night, 2-3 hrs after meal, relief from meal
Gastric - less relief from food/antacids, symptoms shortly after meal

39
Q

tachyphalyxis

A

lack of response to treatment develops over time

40
Q

Treatment options for GORD (3 types, with examples)

A

Lifestyle
Medical - antacids, alginates, H2RA, PPI, prokinetics
Surgical - fundoplication

Life Maintenance (6 decks)

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