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alimentary system > Upper GI Tract Pathology > Flashcards

Upper GI Tract Pathology Flashcards

1
Q

What are some examples of pathologies of the upper GI tract?

A

Oesophageal reflux

Oesophageal cancer

Gastritis

Peptic ulceration

Gastric cancer

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2
Q

What is the upper GI tract formed from?

A

Oesophagus

Stomach

Duodenum

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3
Q

What is oesophageal reflux?

A

Reflux of gastric acid into the oesophagus

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4
Q

What is the pathology of oesophageal reflux?

A

Hiatus hernia

Thickening of squamous epithelium

Ulceration of oesophageal epithelium with severe reflux

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5
Q

What is is called when the oesophagus passes through the diaphram into the stomach?

A

Hiatus hernia

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6
Q

What does the squamous epithelium of the oesopahgus thicken because of oesophageal reflux?

A

Try to increase the thickeness to protect itself, but it is rapidly overcame

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7
Q

What are complications of oesophageal reflux?

A

Healing by fibrosis (after ulceration)

Barrett’s oesophagus

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8
Q

Why is the oesophagus healing by fibrosis after oesophageal reflux a problem?

A

Stricture (narrowing in oesophagus because muscle has been replaced by fibrous tissue)

Impaired oesophageal motility (food and liquid accumulate in oesophagus)

Oesophageal obstruction

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9
Q

What is stricture?

A

Narrowing in the oesophagus

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10
Q

What is Barrett’s metaplasia?

A

Type of metaplasia where transformation from squamous epithelium to glandular epithelium occurs

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11
Q

What is an abnormal change in the nature of a tissue called?

A

Metaplasia

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12
Q

What is Barrett’s oesophagus associated with?

A

Increased risk of cancer, it is a pre-malignant condition

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13
Q

What is oesophageal cancer?

A

Type of cancer affecting the oesophagus

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14
Q

What is the most common cancer of the alimentary tract?

A

Colorectal cancer

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15
Q

What is the second most common cancer of the alimentary tract?

A

Stomach cancer

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16
Q

What is the third most common cancer of the alimentary tract?

A

Oesophageal cancer

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17
Q

Is incidence of oesophageal cancer rising or decreasing?

A

Rising

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18
Q

What can be said about environmental and genetic components of oesophageal cancer?

A

Linked with environmental factors, does not seem to have a big genetic component

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19
Q

What are the 2 histological types of oesophageal cancer?

A

Squamous carcinoma

Adenocarcinoma

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20
Q

Squamous carcinoma is cancer of what type of cell?

A

Squamous cell

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21
Q

Adenocarcinoma is cancer of what type of cell?

A

Glandular tissue

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22
Q

How does adenocarcinoma occur in the oesophagus?

A

If squamous cells of oesophagus have changed to glandular, such as due to Barrett’s oesophagus

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23
Q

What are risk factors for squamous carcinoma oesophageal cancer?

A

Smoking

Alcohol

Dietary carcinogens

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24
Q

What are risk factors for adenocarcinoma oesophageal cancer?

A

Barrett’s oesophagus

Obesity

25
Q

What are some local effects of oesophageal cancer?

A

Obstruction

Ulceration

Perforation

26
Q

What are the different methods that oesophageal cancer can use to spread?

A

Direct (to surrounding tissues)

Lymphatic spead (to regional lymph nodes)

Blood spread (usually to the liver)

27
Q

Where do most oesophageal tumours develop?

A

Distal oesophagus

28
Q

What is the prognosis of oesophageal cancer?

A

Very poor

5 year survival rate less than 15%

29
Q

Why is the 5 year survival rate of oesophageal cancer less than 15%?

A

Patients present with advanced disease at diagnosis, often with liver metastasis

30
Q

What is gastritis?

A

Inflammation of the lining of the stomach

31
Q

What are the different types of gastritis?

A

Autoimmune (type A)

Bacterial (type B)

Chemical (type C)

32
Q

What is the commonest kind of gastritis?

A

Bacterial gastritis

33
Q

What bacteria is usually responsible for bacterial gastritis?

A

Helicobacter pyloris

34
Q

What kind of bacteria is helicobacter pyloris?

A

Gram negative

35
Q

Where is helicobacter pyloris found in the stomach?

A

In gastric mucus on surface of gastric epithelium

36
Q

In what percentage of the adult population is helicobacter pyloris found in?

A

50%, but only a small amount generate an inflammatory response

37
Q

When helicobacter pyloris is pathological, what does it lead to that causes inflammation?

A

Increased acid production (due to increasing pH in stomach which makes the stomach think it needs to produce more acid)

38
Q

What are examples of things that can cause chemical injury gastritis?

A

Drugs such as NSAIDs

Alcohol

Bile reflux

39
Q

Explain the pathology of autoimmune gastritis?

A

Atrophy of specialised acid secreting gastric epithelium

Loss of intrinsic factor

40
Q

What does a loss of intrinsic factor lead to?

A

Vitamin B12 deficiency (pernicious anaemia)

41
Q

What is peptic ulceration?

A

Sores that develop in the lining of the stomach, lower oesophagus or small intestine due to inflammation

42
Q

Why does peptic ulceration occur?

A

Due to imbalance between acid secretion and mucosal barrier

43
Q

Where can peptic ulceration occur?

A

Anywhere acid and peptic comes into contact and the epithelium is not able to resist the damage

44
Q

Where does peptic ulceration commonly affect?

A

Lower oesophagus

Body and antrum of stomach

First and second parts of duodenum

45
Q

What is peptic ulceration usually associated with?

A

Helicobacter pyloris or increased gastric acid production leading to imbalance

46
Q

What is stomach cancer also known as?

A

Gastric cancer

47
Q

What are some complications of peptic ulceration?

A

Bleeding

Perforation

Healing by fibrosis

48
Q

What are the different kinds of bleeding that can occur due to peptic ulceration?

A

Acute (haemorrhage), due to large blood loss quickly

Chronic (anaemia), due to slow blood loss over time

49
Q

What does perforation due to gastric ulceration lead to?

A

Peritonitis

50
Q

What is peritonitis?

A

Infection of the inner lining of the stomach

51
Q

Why is healing by fibrosis after gastric ulceration a problem?

A

Causes obstruction (not really an issue in stomach of body due to being wide, but is elsewhere such as pyloric region, oesophagus and duodenum)

52
Q
A
53
Q

What does gastric cancer develop through phases of?

A

Metaplasia and dysplasia (abnormal growth or development of cells)

54
Q

What is dysplasia?

A

Presence of cells of an abnormal type within a tissue, may signify stage precipitating cancer

55
Q

What infection is gastric cancer associated with?

A

Helicobacter pyloris infection

56
Q

What is the histology of gastric cancer?

A

Adenocarcinoma

57
Q

What are the methods that gastric cancer uses to spread?

A

Direct (to surrounding tissues)

Lymphatics (to regional lymph nodes)

Blood (usually to liver)

Transcoelomic spread (within peritoneal cavity)

58
Q

What is the prognosis of stomach cancer?

A

Very poor

5 year survival rate less than 20%

alimentary system (41 decks)

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