wk 3 10 Pathology of Oesophagus and mouth

Question 1

epithelium of oesophagus

Answer 1

stratified squamous epithelium

Question 2

more common - acute or chronic oesophagitis

Answer 2

chronic

Question 3

associated with acute oesophagitis

Answer 3

corrosion following chemical ingestion

also can occur as an acute infection i immunocompromised pts - HIV, aids

Question 4

another name for chronic oesophagitis

Answer 4

reflux oesophagitis

Question 5

define reflux oesophagitis

Answer 5

inflammation due to refluxed low pH gastric content

Question 6

what causes reflex oesophagitis

Answer 6

mostly idiopathic

big cause is obesity - increased intra-abdominal pressure (pregnancy)

Question 7

other than intra-abdominal pressure, hwat can cause reflex

Answer 7

defectvie sphincter mechanism (hiatus hernia)

Question 8

difference in epithelium of healthy - reflux

Answer 8

normal - dividing cells, cell desquamation

reflex - incr cell desquamation, incr cell division, immune cells

Question 9

complications of reflux

Answer 9

ulceration (bleeding)
fibrosis
stricture - narrowing

Question 10

what happens to epithelium in barrets oesophagus

Answer 10

replacement of stratified squamous epithelium - columnar epithelium (this type is found in sml intestine/stomach)

Question 11

what causes barrets oesophagus

Answer 11

persistent reflux acid/bile

expansion of columnar epithelium from gastric glands/submucosal glands

due to differentiation from oesophageal stem cells

Question 12

histologically, what does barrets oesophagus look like

Answer 12

columnar lined with mucosa with intestinal metaplasia

Question 13

increased risk of developing dysplasia and carcinoma of oesophagus if the patient has

Answer 13

barrets - unstable mucosa, continues to damage

adenocarcinoma at junction- most likely

Question 14

t/f allergic oesophagitis occurs more in females than males

Answer 14

false

males more

Question 15

t/f allergic oesophagitis is not due to reflux

Answer 15

true

Question 16

what does allergic oesophagitis look like

Answer 16

rings - similar to trachea

Question 17

t/f there is a large number of intraepithelial eosinophils in allergic oesophagitis

Answer 17

true

Question 18

likely treatment of allergic oesophagitis

Answer 18

treated like allergy
steroids
chromoglycate
montelukast

Question 19

t/f benign oesophageal tumours are rare

Answer 19

true

squamous papilloma (wart like)

Question 20

2 main types of malignant oesophagea; tumours

Answer 20

squamous cell carcinoma

adenocarcinoma (most)

Question 21

which deficiencys are usually seen in squamous cell carcinoma

Answer 21

vit a

zinc

Question 22

how does dysphagia occur in malignancy

Answer 22

reduces lumen to narrow slit

unable to pass food through

Question 23

t/f keratin is produced by squamous cell carcinoma

Answer 23

true

Question 24

outine pathogenesis leading to adenocarcinoma

Answer 24

geneticfactors/reflux/others
chronic reflux 
barrets (intestinal metaplasia)
low grade dysplasia 
high grade
adenocarcinoma

Question 25

t/f stricture indicates malignancy

Answer 25

false

could be benign

Question 26

what are the mechanisms of metastases of oesophageal carcinoma (and many others )

Answer 26

direct invasion
lymphatic permeation
vascular invasion

Question 27

clinical presentation of oesophagus carcinoma

Answer 27

dysphagia

general symptoms of lamignancy -
anaemia
weight loss/lethargy

Question 28

90% of oral cancers are

Answer 28

squamous cell carcinomas

Question 29

variable presentation of SCC oral

Answer 29

white
red
speckled
ulcer
lump

Question 30

therapy for carcinoma oesophagis

Answer 30

surgery best

- adjuvant therapy (Chemo)`