Common Disease of the GI tract

Question 1

What are the 4 layers of the GI tract?

Answer 1

Mucosal layer
Muscularis Mucosa
Sub-mucosa
Muscular layer

Question 2

The mucosal layer is made of ____________, _____ are separated by _______ tissue called the ___________

Answer 2

Glandular tissue
Glands
Connective tissue called the Lamina Propria

Question 3

The muscularis mucosa is a thin layer of _____________ that separates the ________ and __________

Answer 3

Smooth Muscle

Mucosa and Sub-mucosa

Question 4

What are the general symptoms of GI disease?

Answer 4

• Pain
• Nausea and vomiting
• Malabsorption
• Loss of appetite
• Weight loss
• Diarrhoea
• Constipation

Question 5

The oesophagus is a _________ tube with ______ at either end. It’s normally lined by _______________________. It’s function is to _________ food to the stomach.

Answer 5

Muscular tube
Sphincters
Stratified squamous epithelium
Transport

Question 6

What are the main diseases affecting the oesophagus?

Answer 6

• Reflux Oesophagitis = Failure of the lower sphincter
• Tears in the muscosal lining = bleeding
• Dysphagia = Difficulty swallowing due to obstruction

Question 7

If the cardiac sphincter is not functional, Oesophageal mucosa becomes _________ and _________ by the _________.

Answer 7

Irritated
Inflamed
Stomach acid

Question 8

If the oesophageal mucosa becomes inflamed it may undergo _________ and become _____________. If _______ cells are present in this tissue we call it Barret’s Oesphagus

Answer 8

Metaplasia
Glandular tissue
Goblet cells

Question 9

Barret’s oesophagus leads to an increased risk of ________ and therefore _______.

Answer 9

Dysplasia

Cancer

Question 10

How can we treat Oesophageal inflammation?

Answer 10

• Modify posture
• Take antacids
• Proton Pump Inhibitor drugs
• Change diet

Question 11

What are 2 types of malignant Oesophageal cancers?

Answer 11

• Most commonly Squamous Cell Cancer (SCC)

- Adenocarcinoma usually in lower end and associated with reflux

Question 12

What causes Oesophageal obstruction?

Answer 12

• Cancers
• Stricture - scarring due to inflammation or corrosives
• Food impactation - large, poorly chewed food

Question 13

Carcinomas of the oesophagus accounts for __% of GI cancers. It is most common in __________. They are releated to _______, _______ and _________.

Answer 13

6%
Men over 50
Smoking, Alcohol and Oesophagitis

Question 14

Carcinomas of the oesophagus cause _______________ of the oesophagus. It have a ____ prognosis due to ________________.

Answer 14

Progressive Obstruction
Poor
Frequent Metastasis

Question 15

Oesophageal carcinomas often spread to the ______ causing a _________________.

Answer 15

Trachea

Tracheo-oesophageal fistula

Question 16

What are the most important diseases of the stomach?

Answer 16

• Gastritis (Acute and Chronic)
• Peptic Ulcer
• Tumours (Benign and Malignant)

Question 17

Peptic ulcers are ___________ that occur in places of ____________ digestion. _____________ are often involved in the pathogenesis

Answer 17

Chronic ulcers
Acid-pepsin digestion
Helicobacter Pylori

Question 18

Peptic ulcers are associated with ________, _______ and ____ like _______ and _______.

Answer 18

Hyper-acidity, Smoking and Drugs

NSAIDs and steroids

Question 19

Peptic ulcers present as _____ that is releived by _______ or ______.

Answer 19

Pain

Food or Antacids

Question 20

What complications are associated with Peptic Ulcers?

Answer 20

• Haemorrhage
• Perforation - can cause peritonitis
• Scarring - can cause outlet obstruction

Question 21

How do we treat Peptic Ulcers?

Answer 21

• Eradicate Helicobacter Pylori
• Drugs to neutralise or decrease acid secretion
• Surgery although this is rare

Question 22

______________ of the stomach is the most common gastric malignancy. It is related to ________, _________, ______________ and ______

Answer 22

Adenocarcinoma
Smoking
Helicobacter Pylori
Autoimmune gastritis
Diet

Question 23

Adenocarcinomas of the stomach have a _____ prognosis this is because ______________________________

Answer 23

Poor

It spreads very quickly to Lymphnodes, liver and peritoneum

Question 24

The most common GI tract inflammatory disorder is ________________ it is usually caused by __________

Answer 24

Acute Appendicitis

Obstruction

Question 25

Acute appendicitis usually presents as:

Answer 25

``` Periumbillical pain Malaise Anorexia Nausea Vomiting ``` Pain then localises to the right illiac fossa

Question 26

What complications can arise from Acute appendicitis?

Answer 26

Rupture Peritonitis Liver Abscess

Question 27

How do we treat Acute appendicitis?

Answer 27

Surgery - Appendicectomy

Question 28

Diverticular disease aka Diverticulosis is __________ in areas of bowel __________. It occurs mainly where ________________.

Answer 28

Outpouchings Weakness Vessels come in

Question 29

Diverticular disease aka Diverticulosis is an __________ disease related to ______, _________ which causes increase __________.

Answer 29

Acquired Refined, Low-fibre diet Intraluminal pressure

Question 30

Diverticular disease is often _________ but can be associated with ________ and __________. It may be complicated by _________, _________ and ________

Answer 30

Asymptomatic Cramping and Constipation Scarring, Perforation and bleeding

Question 31

How do we treat Diverticular disease?

Answer 31

With a high fibre diet

Question 32

___% of intestinal obstruction are due to mechaical abnormalities and ______% due to tumours and infarction

Answer 32

80% | 10-15%

Question 33

Symptoms of intestinal obstruction depend on:

Answer 33

- Site of obstruction - Completeness of obstruction - If the blood supply is impaired

Question 34

What are the 4 main causes of mechanical intestinal obstructions:

Answer 34

- Herniation - Bulging out of muscle wall - Adhesions - can cause kinking - Intussusception - portion of bowel protrudes into another piece - Volvus - ties around itself

Question 35

What is a Hernia?

Answer 35

A protrusion of bowel through a small opening usually in the abdominal wall

Question 36

Hernias may be _________ (Pushed back in), __________ or _________ (Blood supply is compromised)

Answer 36

Reducible Incarcerated Strangulated

Question 37

What is Intussusception?

Answer 37

Telescoping of one segment of the bowel into an adjacent segment

Question 38

Tumours of the bowel are usually _________. _________ tumours are most common in the rectum and sigmoid colon. Symptoms are related to ________ and _________

Answer 38

Benign Malignant Obstruction Blood loss