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GIHEP > 16. Upper GI > Flashcards

16. Upper GI Flashcards

(60 cards)

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1
Q

What kind of epithelium is found in the oesophagus?

A

Squamous

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2
Q

What are the layers of the oesophagus?

A

Mucosa
Submucosa
Circular and longitudal muscle
Adventitia

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3
Q

Name a developmental disorder of the oesophagus

A

Atresia

Fistula between trachea and oesophagus

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4
Q

What is the difference between a true and false diverticula?

A

True involves all 4 layers

False only involves the mucosa and submucosa

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5
Q

What are webs and rings?

A

Webs are mucosal folds

Rings are made of mucosa and submucosa, fibrosis over time

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6
Q

What are the 2 types of hiatus hernias?

A

Sliding and paraoesophageal

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7
Q

What are the features of achalasia?

A

No peristalsis

LOS doesn’t relax when swallowing

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8
Q

What are the secondary causes of achalasia?

A

Trypanosoma, polio

Tumour, amyloidosis, sarcoidosis

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9
Q

How can the oesophagus be perforated?

A

Severe vomiting

Instruments

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10
Q

What is a longitudinal tear in the oesophagus known as?

A

Mallory-Weiss

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11
Q

What complication is associated with perforated oesophagus?

A

Mediastinitis

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12
Q

What are the infective causes of oesophagitis?

A

Candida, herpes, CMV

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13
Q

What are the physical causes of oesophagitis?

A

Irradiation
Hot liquids
Reflux

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14
Q

What are the signs of reflux on histology?

A

Basal cell hyperplasia
Eosinophils
Long lamina propia papillae

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15
Q

What is barret’s oesophagus?

A

Metaplasia of the lower oesophagus from squamous to glandular epithelium
Always in lower 1/3

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16
Q

What type of tumour does barret’s increase the risk of?

A

Adenocarcinoma

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17
Q

What benign tumours can be found in the oesophagus?

A

Leiomyomas
Lipoma
Fibroma

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18
Q

How is a tumour diagnosed in the oesophagus?

A

Barium swallow
Endoscopy
Biopsy

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19
Q

What are the causes of reflux?

A

Increased abdominal pressure
Hiatus hernia
Smoking and alcohol

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20
Q

What part of the oesophagus are squamous cell carcinomas found in?

A

Mid 1/3

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21
Q

What are the risk factors for squamous cell carcinoma in the oesophagus?

A

Alcohol, smoking, vitamin deficiencies, high nitrites in diet
Achalasia, long standing oesophagitis, coeliac disease
Plummer-Vinson syndrome

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22
Q

What is Plummer Vinson syndrome?

A

Iron deficiency, webs and glossitis

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23
Q

What are the causes of acute gastritis?

A

Alcohol and smoking
NSAIDs and steroids
Shock
Irradiation

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24
Q

What are important features in the history of a patient with acute gastritis?

A

Haematemesis

Malaena

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25
What cell is found on histology in acute gastritis?
Neutrophils
26
What are the features of chronic gastritis on histology?
Mucosal atrophy Epithelial metaplasia Infiltration by lymphocytes and plasma cells
27
What are the causes of chronic gastritis?
H.pylori Autoimmune Chemical
28
What parts of the stomach can h.pylori be found?
Antrum and corpus of stomach
29
What stain is used to show h.pylori?
PAS stain
30
What is autoimmune chronic gastritis?
Autoantibodies produced against parietal cells and intrinsic factor, resulting in pernicious anaemia
31
What other diseases is autoimmune gastritis associated with?
Thyroiditis | Addison's
32
What is the pattern of autoimmune gastritis on histology?
Gland destruction and mucosal atrophy of fundic region, less in the antrum
33
What is chemical gastritis?
Reflux of duodenal fluid and bile into the stomach | Seen in previous gastric surgery
34
What are the features of chemical gastritis on histology?
``` Foveolar hyperplasia (overgrowth of mucous cells) Fibrosis in lamina propia ```
35
What are the features of a peptic ulcer?
Sharp 'punched out' lesions Smooth base Surrounding inflammation
36
What are the symptoms of stomach ulcers?
Epigastric pain, nausea, bloating Pain worse at night and 1-3 hours after eating
37
What are the symptoms of duodenal ulcers?
May be relieved by eating and alkalis Pain referred to back, chest, LUQ Iron deficiency anaemia, haematemesis, malaena
38
How can acute stress ulcers be differentiated from chronic ulcers?
Acute ulcers don't have scarring or thickening of blood vessels
39
What syndrome are hamartomas in the stomach associated with?
Peutz-Jeghers syndrome
40
What are the types of malignant stomach cancers?
``` Carcinoma MALTomas Carcinoid GIST Leiomyosarcoma ```
41
What organs does stomach cancer spread to locally?
Duodenum Pancreas Retroperitoneum
42
Give an example of transcoelomic spread of stomach cancer
Krukenberg tumour of ovaries
43
What is Virchow's node?
Supraclavicular node seen in gastric cancer
44
What is a GIST?
Tumour of interstitial cells of Cajal
45
What mutation is seen in GISTs?
CD117 mutation/ c-kit tyrosine kinase | Can be treated with imatinib
46
What is the most common benign tumour in the mouth?
Papillomas caused by HPV 6 and 11
47
What is the most common malignant tumour in the mouth?
Squamous
48
What disease are apthous ulcers associated with?
Crohn's disease
49
What are the causes of xerostomia?
Autoimmune Drugs Radiation
50
What are the causes of glossitis?
Low B12 and iron | Plummer Vinson syndrome
51
What is erythroplakia a sign of?
Oral cancer
52
What name is given to salivary gland inflammation?
Sialadenitis
53
What are the causes of inflammation in the parotid gland?
Mumps Staph aureus Sjogrens
54
What is the most common benign salivary gland tumour?
Pleomorphic adenoma
55
What name is given to a pleomorphic adenoma when it becomes malignant?
Carcinoma ex pleomorphic adenoma
56
What is the other kind of benign salivary gland tumour?
Warthin's tumour
57
How does warthin's tumour appear on histology?
Double layer of epithelial cells and dense lymphoid stroma
58
What are the types of malignant salivary gland tumours?
Mucoepidermoid Adenoid cystic carcinoma Acinic cell carcinoma
59
What kind of spread is favoured by adenoid cystic carcinomas?
Perineural
60
What benign polyp can be found in the setting of chronic gastritis?
Hyperplastic

GIHEP (30 decks)

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