Week 9 Flashcards by Sarah Piper

What is immunohistochemistry used for

Diagnostic use
Metastatic cancer
Looking at response to treatment

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

Describe layers and purpose of stratified epithelium

Two or more cell layers

Purpose = protection

How well did you know this?

Not at all

Perfectly

Describe the layers and purpose of transitional epithelium

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.

How well did you know this?

Not at all

Perfectly

What is connective tissue composed of? And purpose

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

How well did you know this?

Not at all

Perfectly

What do adipose cells look like under a light microscope?

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

How well did you know this?

Not at all

Perfectly

What is cartilage? What are the different types?

Supporting framework

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

How well did you know this?

Not at all

Perfectly

Purpose of bone (3)

Support
Protect
Hemopoiesis

How well did you know this?

Not at all

Perfectly

What are the three types of muscle? Describe

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

How well did you know this?

Not at all

Perfectly

Define metaplasia, dysplasia, neoplasia

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)

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

Three parts of the mucosa

epithelium, lamina propia, muscularis mucosae

How well did you know this?

Not at all

Perfectly

Which structures have adventiatia rather than serosa?

Eosphagus and lower rectum (structures outside peritoneal cavity)

How well did you know this?

Not at all

Perfectly

What lines the lumen of the oesophagus?

squamous epithelium

How well did you know this?

Not at all

Perfectly

Causes of GORD

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

How well did you know this?

Not at all

Perfectly

What are the key cells involved in inflammation during GORD

neutrophil polymorths

How well did you know this?

Not at all

Perfectly

Complications of GORD

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

What is granulation tissue?

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

What is barrett’s oesphagus?

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

How do you characterise dysplasia? (3)

Premalignant change

Impaired cell differentiation
Atypical nuclear features
Increased mitsosi

adeno

glandular cell origin

Two types of adenocarcinoma of oesophagus

Intestinal types

Diffuse (signet-ring cell) type

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

SCC - mid/upper oesophagus

AC - Lower oesophagues, gastro-oesophageal junction

Cell types involved in gastritis

Plasma cell, lymphocyte, neutrophil

Main causes of inflammation in the gut (2)

NSAIDs | H. pylori

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

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

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

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

What are the mechanisms behind visceral sensation?

Afferent nerves send signals to CNS

Types of sensory neurons in the gut? (6)

``` Intraganglionic afferent Enteric viscerofugal neuron Intramuscular Vascular afferent Muscular-mucosal Mucosal afferent ```

Role of mucosal afferents

Respond to mucosal distortion / stroking

Types of pain (4)

Somatic - musculoskeletal, cutaneous, well localized | Visceral - hollow organs, smooth muscle, usually referred (poorly localized)

Which organs are not sensitive to pain? Why?

Liver, lungs, kidneys, others | No nociceptors

Examples of stimuli for visceral pain (6)

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

Describe pain caused by structural vs functional causes

Structural - inflammatory, neoplastic | Functional - IBS (inclu bloating), dyspepsia (inclu. nausea)

Visceral pain becoming somatic - describe example

Acute appendicitis xxx

Describes levels of hypersensitivity to pain (3)

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

When is it best for patients to take PPI?

30 mins before meal

Signs that may differentiate gastric from duodenal pain

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

tachyphalyxis

lack of response to treatment develops over time

Treatment options for GORD (3 types, with examples)

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