GI Pathology Flashcards
(311 cards)
1
Q
What is oesophageal reflux?
A
Reflux of gastric acid into oesophagus
2
Q
What happens when there is secrete oesophageal reflex?
A
Ulceration of oesophageal epithelium
3
Q
What is the affect of oesophageal reflex on the epithelium?
A
Thickening
4
Q
Name the complications of oesophageal reflex
A
Healing by fibrosis
Barretts oesophagus
5
Q
What are the affects of healing by fibrosis for oesophageal reflux?
A
Stricture formation
Impaired oesophageal motility
oesophageal obstruction
6
Q
What is Barrett’s oesophagus?
A
Transformation from squamous epithelium to glandular epithelium
7
Q
Name the histological types of oesophageal cancer?
A
Squamous carcinoma
Adenocarcinoma
8
Q
What are the risk factors for squamous oesophageal carcinoma?
A
Smoking
Alcohol
Diet
9
Q
What are the risk factors for adenocarcinoma oesophageal cancer?
A
Barrett’s oesophagus
Obesity
10
Q
Name the local affects of oesophageal cancer?
A
Obstruction
Ulceration
Perforation
11
Q
How does oesophagus cancer spread?
A
Direct
Lymphatic spread
Blood spread
12
Q
Where does oesophageal cancer spread to though the blood?
A
Liver
13
Q
What is the prognosis of oesophageal cancer?
A
Very poor
5 year survival rate >15%
14
Q
What is type A gastritis?
A
autoimmune
15
Q
What is type B gastritis?
A
Bacterial
16
Q
What is type C gastritis?
A
Chemical injury
17
Q
What is autoimmune gastritis caused by?
A
Autoantibodies to parietal cells and intrinsic factor
18
Q
What is gastritis?
A
inflammation of the gastric mucosa
19
Q
What are the affects of loss of specialised cells in autoimmune gastritis?
A
Decreased acid secretion
Loss of intrinsic factor
20
Q
How does autoimmune gastritis affects the epithelium?
A
Atrophy of specialised acid secreting gastric epithelium
21
Q
What is the most common type of gastritis?
A
type B
22
Q
What bacteria causes bacterial gastritis?
A
Helicobacter pylori
23
Q
Where is Helicobacter pylori found?
A
In gastric mucus on surface of gastric epithelium
24
Q
What type of bacterium is helicobacter pylori?
A
Gram negative
25
What does Helicobacter pylori do?
Increased acid production
26
What are the causes of chemical gastritis?
Drugs
Alcohol
Bile reflex
27
What drugs most commonly cause chemical gastritis?
NSAIDS
28
What is peptic ulceration?
Imbalance between acid secretion and mucosal barrier
29
What parts of the oesophagus does peptic ulceration affect?
Lower oesophagus
30
What parts of the stomach does peptic ulceration affect?
Body
Antrum
31
What parts of the duodenum does peptic ulceration affect?
First and second parts
32
What parts of the GI tract does peptic ulceration affect?
Oesophagus
Stomach
Duodenum
33
What bacteria is peptic ulceration associated with?
H. Pylori
34
Name the complications of peptic ulceration?
Bleeding
Perforation
Healing by fibrosis
35
What is stomach cancer associated with?
Previous H. Pylori infection
36
How does stomach cancer develop?
Develops though phases of intestinal meta plasma and dysplasia
37
What is the histology of stomach cancer?
Adenocarcinoma
38
Name the ways stomach cancer spreads?
Direct
Lymphatic
Blood
Transoelomic
39
Where does transcoelomic spread of stomach cancer occur?
Within peritoneal cavity
40
What is the prognosis of stomach cancer?
Very poor
5 year survival \>20%
41
What is liver failure a complication of?
Acute liver injury
Chronic liver injury
42
What can cause acute liver injury?
Hepatitis
Bile duct obstruction
43
What can cause hepatitis?
Viruses
Alcohol
Drugs
44
How does viral hepatitis affect the liver?
Inflammation of liver
Liver cell damage and death of individual liver cells
45
What type of hepatitis progresses to chronic hepatitis and cirrhosis?
Hepatitis B, C
46
What type of hepatitis can cause liver failure due to severe damage?
Hepatitis A,B,E
47
In what type of hepatitis does the liver return to normal?
Hepatitis A,E
48
What is alcoholic liver disease?
Response of liver to excess alcohol
49
What can alcoholic liver disease progress to?
Cirrhosis
50
What are the affects of alcoholic hepatitis?
Acute inflammation
Liver cell death
Liver failure
51
What is jaundice caused by?
Altered metabolism of bilirubin
52
What is jaundice?
Increased circulating bilirubin
53
Name the pathways of bilirubin metabolism
Pre-hepatic
Hepatic
Post-hepatic
54
Describe pre-hepatic bilirubin metabolism
Breakdown of haemoglobin in spleen to form haem and glob in
Haem converted to bilirubin which is released
55
Describe hepatic bilirubin metabolism
Uptake of bilirubin by hepatocytes
Conjugation of bilirubin in hepatocytes
Excretion of conjugated bilirubin into the biliary system
56
Describe post- hepatic bilirubin metabolism?
Transport of conjugated bilirubin in biliary system
Breakdown of bilirubin conjugate in intestine
Re-absorption
57
What is the cause of pre-hepatic jaundice?
Increased release of haemoglobin from red cells
58
What are the causes of hepatic jaundice?
Cholestasis
Intra-hepatic bile duct obstruction
59
What is cholestasis?
Accumulation of bile within hepatocytes or bile canaliculi
60
What are the causes of cholestasis?
Viral hepatitis
Alcoholic hepatitis
Liver failure
Drugs
61
What is predicable drug induced cholestasis
Dose related
62
Give examples of intra-hepatic bile duct obstruction
Primary bile cholangitis
Primary sclerosing cholagnits
Tumours of the liver
63
Name the tumours of the liver
Hepatocellular carcinoma
Tumours of intra-hepatic bile duct
Metastatic tumours
64
What sex does primary biliary cholangitis affect?
Females
65
What is primary biliary cholangitis?
Organ specific auto-immune disease
66
What are the effects of primary biliary cholangitis?
Anti-mitochondrial auto-antibodies in serum
Raised serum alkaline phosphatase
67
What happens to the bile ducts in primary biliary cholangitis?
Gramulamous inflammtion
Loss of intra-hepatic bile ducts
68
What is primary sclerosing cholangitis?
Chronic inflammation and fibrous obliteration of bile ducts
69
What is primary sclerosing cholangitis associated with?
inflammatory bowel disease
70
What does primary sclerosing cholangitis give an increased risk of?
Development of cholangiocarcinoma
71
What is hepatic cirrhosis?
End stage chronic liver disease
72
What are the causes of cirrhosis?
Alcohol
Hepatitis
Immune mediated liver disease
Metabolic disorders
Obesity
73
What metabolic disorders cause cirrhosis
Primary haemochromatosis
Wilson's disease
74
What is Wilson's disease?
Excess copper
75
What is primary haemochromatosis?
Excess iron
76
What immune mediated liver diseases cause cirrhosis?
Auto-immune hepatitis
Primary biliary cholangitis
77
What are the affects of cirrhosis on liver structure?
Loss of normal structure
Replaced by nodules of hepatocytes and fibrous tissues
78
Name the complications of cirrhosis?
Liver failure
Portal hypertension
79
What does cirrhosis increase the risk for?
Hepatocellular carcinoma
80
What is hepatocellular carcinoma?
Malignant tumor of hepatocytes.
81
What is cholangiocarcinoma?
Malignant tumour of bile duct epithelium
82
What are the risk factors for gallstones?
Obesity
Diabetes
83
What is acute cholecystitis?
Acute inflammation of the gallbladder
84
How does acute cholecystitis affect the gallbladder?
Perforation of gall bladder
Biliary peritonitis
85
What is chronic cholecystitis?
Chronic inflammation and fibrosis of the gallbladder
86
What are the common causes of common bile duct obstruction
Gallstones
Bile duct tumours
Benign stricture
External compression
87
What are the affects of common bile duct obstruction?
Jaundice
No bile excreted into duodenum
Ascending cholangitis
88
What is ascending cholangitis?
Infection of bile prosimians to obstruction
89
What can happen if there is prolonged common bile duct obstruction?
Secondary biliary cirrhosis
90
How often are the cells in the small bowel renewed?
every 4-6 days
91
What type of crypts are found in the small bowel?
Stem
Goblet
Endocrine
Paneth
92
What cell types are found in the small bowel?
Goblet dells
Columnar absorptive cells
Endocrine cells
93
What type of crypts are found in the large bowel?
Tubular
94
What must the immune system balance in the GI tract?
Tolerance of harmless ingested substances against active defence reactions to potential microbial invaders
95
What is the bowel peristalsis mediated by?
Intrinsic myenteric plexus and extrinsic autonomic innervation neural control
96
What is the myenteric plexus made up of?
Meissener's plexus
Auerbach plexus
97
Where is Meisseners plexus located?
Base of the submucosa
98
Where is Auerbach's plexus located?
between the inner circular and outer longitudinal muscle layers of the muscularis propria
99
Define idiopathic inflammatory bowel disease
Chronic inflammatory conditions resulting from inappropriate and persistent activation of the mucosal immune system driven by the presence of normal intraluminal flora
100
Name the main idiopathic inflammatory bowel diseases
Crohn's disease
Ulcerative colitis
101
What gene mutation is associated with Crohn's disease?
NOD2
102
what gene is associated with ulcerative colitis?
HLA
103
What is the cause of IBD?
Strong immune response against normal flora with defects in epithelial barrier
104
What is used to diagnose IBD
pANCA
105
which type of IBD is associated with p-ANCA
UC
106
What age does UC peak?
20-30 years
70-80 years
107
Where is UC found?
Localised to rectum
108
Where does UC commonly spread
Proximally
109
What is found in UC?
Psudopolyps
Ulceration
Inflammation
110
What is UC associated with?
Systemic manifestations
111
Are granumolas present in UC?
No
112
Where is the wall is UC limited to?
Mucosa and submucosa
113
How does UC affect the mucosa?
Mucosal atrophy
114
How does UC affect crypts?
Cyptisis
Crypt abscesses
Architectural disarray of crypts
115
Name complications of UC
Haemorrhage
Perforation
Toxic dilation
116
Describe dysplasia of UC progressing to cancer
Flat epithelial atypica
Adenomatous change
Invasive cancer
117
What is there an increased risk of if pancolitis is present in UC?
20-30 x higher risk of developing cancer
118
Where is Crohn's disease located?
Anywhere from mouth to anus
119
What sex does Crohn's disease affect more?
Females
120
What age does Crohn's disease peak?
20-30 years
60-70 years
121
What race is Crohn's disease most common?
Caucasians - Jewish population
122
Where is most Crohn's disease located?
Small intestine
123
How does CD affect the mesentary?
Thickened
Oedematous
Fibrotic
Wrapping mesenteric fat
124
How does CD affect the lumen?
Narrowing of lumen due to thickened wall
125
Describe ulceration in CD
Deep
Cobblestone apperance
126
What granulomas are found in CD
Non-caseating granulomas
127
How does CD affect crypt?
Cryptitis
Crypt destruction to due atrophy
Distortion
128
Define lymphagiectasia
Dilation of lymph vessels
Seen in CD
129
What type of inflammation is seen in CD?
Transmural
130
What are the long term features of CD
Malabsorption
Strictures
Fistulas
Perforation
131
How much increased risk of cancer is there due to CD?
5x increased risk
132
What leads to infarction in colon?
Acute occlusion of 1 of 3 major supply vessels
133
Where are ischaemic lesions found?
Either restricted to SI or LI
Or can affect both depending on vessel affected
134
What causes ischaemic enteritis?
Transmural injury
Acute/ chronic hypoperfusion
135
Name predisposing conditions for ischaemia
Arterial thrombosis/ embolism
Non- occlusive ischaemia
136
What flexure is vulnerable in acute ischaemia?
Splenic flexure
137
What occurs if acute ischaemia last for several days?
Bacteria gangrene and perforation
138
What does the lumen contain in acute ischaemia?
Sanguinous mucin
139
Is inflammation present in acute ischaemia?
Initial absence of inflammation
140
What is radiation colitis?
Abdominal irradiation can impaired the normal proliferative activity of the bowel epithelium
141
What radiotherapy usually caused radiation colitis?
Rectum- pelvic radiotherapy
142
What does radiation colitis target?
Actively dividing cells especially blood vessels and crypt epithelium
143
What are the symptoms of radiation colitis?
Anorexia
Abdominal cramps
Diarrhoea
Malabsorption
144
What cells are inflamed due to radiation colitis?
Crypt abscesses and eosinophils
145
What type of stenosis does radiation colitis cause?
Arterial stenosis
146
What are the affects of severe radiation colitis?
Ulceration
Necrosis
Haemorrhage
Perforation
147
What happens to the lymphoid tissue in the appendix?
Regresses with age
148
What is the cause of appendicitis?
Obstruction
149
What causes obstruction in the appendix?
Foe coli the
Enterobius vermicularis
150
What causes ischaemia in appendicitis?
Increased intraluminal pressure
151
What occurs in acute gangrenous appendicitis?
Full thickness necrosis and perforation
152
What is dysplasia?
abnormal changes in the size, shape, and organization of mature cells
153
Name the types of adenoma dysplasia?
Tubular
Villus
Tubulovillous
154
What are the affects of low grade dysplasia?
Increased nuclear no and size
Reduced mucin
155
What is the difference between high grade dysplasia and carcinoma?
Dysplasia is not yet invasive
156
What do the cells look like in high-grade dysplasia?
Crowded
Very irregular
157
What genes are a risk factor for colorectal adenocarcinoma?
FAP
HNPCC
Peutz-jeghers
158
What are the risk factors for colorectal adenocarcinoma?
Lifestyle
Family history
IBD
Genetics
159
Describe the characterises of left sided colorectal adenocarcinoma?
Annular
160
Describe the characterises of right sided colorectal adenocarcinoma?
Exophytic/ polypoid
161
How does left-sided colorectal adenocarcinoma affect the blood?
Bleeding flesh/ altered blood rectally
162
How does right-sided colorectal adenocarcinoma affect the blood?
Anaemia
163
What are the effects of left-sided colorectal adenocarcinoma?
Altered bowel habit
Obstruction
164
What are the effects of right-sided colorectal adenocarcinoma?
Vague pain
Weakness
Obstruction
165
What does the prognosis of colorectal adenocarcinoma depend on?
Tumour grade
Tumour stage
Extramural venous invasion
166
What is extramural venous invasion?
Direct invasion of a blood vessel by a tumour
167
What is the treatment for colorectal cancer?
Resection
168
What is oesophageal peristalsis produced by?
Oesophageal circular muscles
169
What mediates contraction and relation of LOS?
Vagus nerve
170
What muscle is the lower oesophageal sphincter?
Striated muscle of right crus of diaphragm
171
Where is there high pressure is the LOS?
In distal smooth muscle
172
What is a heart burn?
Restrosternal discomfort or burning
173
What are the symptoms of oesophageal disease
Heartburn
Dysphagia
174
What is heartburn associated with?
Waterbrash
Cough
175
What is waterbrash?
Acidic taste at back of throat
176
What is heartburn the consequence of?
Reflux of acid/ bilious gastric contents into the oesophagus
177
What can reduce LOS pressure resulting in heartburn?
Drugs
Food
178
What can persistent heartburn lead to?
Gastro-oesophageal reflux disease
179
What is dysphagia?
subjective sensation of difficulty or abnormality of swallowing
180
What is odynophagia?
painful swallowing
181
Where are the locations of dysphagia?
Oropharyngeal
Oesophageal
182
What are the causes of oesophageal dysphagia?
Benign stricture
Malignant stricture
Motility disorder
Eosinophilia oesophagitis
183
What are the common investigations done for oesophageal disease?
Oesophago-gastro-duodenoscropy (OGD)
Upper GI endoscopy
184
What are the less common investigations done for oesophageal disease?
Barium swallow
Ph- metry
Manometry
185
What does pH-metry measure?
Acid levels in stomach
186
What does manometry measure?
Pressure waves
187
Name motility disorders?
Achalasia
Hypermotility
Hypomotilty
188
What is hypermotility also known as?
Diffuse oesophageal spasm
189
What are the symptoms of hypermotility?
Severe, episodic chest pain
Dysphagia
190
What does manometry show in hypermotility?
Exaggerated, uncoordinated, hypertonic contractions
191
What is the treatment for hypermotility?
Smooth muscle relaxants
192
What is hypomobility associated with?
Connective tissue disease
Diabetes
Neuropathy
193
What causes the symptoms of hypomotility?
Failure of LOS mechanism
194
What are the symptoms of hypomotility?
Heartburn
Reflux
195
What is achalasia?
Functional loss of myenteric plexus ganglion cells in distal oesophagus and LOS
196
What is the cardinal feature of achalasia?
Failure of LOS to relax
197
In what age is achalasia the most common?
30-50 years
198
What can achalasia lead to?
Functional distal obstruction of oesophagus
199
What are the symptoms of achalasia?
Progressive dysphagia
Regurgitation
Chest pain
Weight loss
200
What are the pharmacological treatments of achalasia?
Nitrates
Calcium channel blockers
201
What are the endoscopic treatments of achalasia?
Botulinum toxin pneumatic balloon dilation
202
What are the surgical treatments of achalasia?
Myotomy
203
What are the radiological treatments of achalasia?
Pneumatic balloon dilation
204
What are the complications of achalasia?
Aspiration pneumonia and lung disease
Increased risk of squamous cell oesophageal carcinoma
205
What is GORD due to?
Pathological acid exposure in lower oesophagus
206
What are the symptoms of GORD?
Heartburn
Cough
Waterbrash
Sleep disturbances
207
What are the risk factors for GORD?
Pregnancy
Obesity
Drugs lowering LOS pressure
Smoking
Alcoholism
Hypomotility
208
What sex is more affecte by GORD?
Men
209
What race is more affected by GORD?
Caucasian
210
How can GORD be diagnosed?
Basis of the characteristic symptoms, without diagnostic testing
211
When would endoscopy be performed for GORD?
In presence of alarm features suggestive of malignancy
212
What is the cause of GORD due to hiatus hernia?
Anatomical distortion of the OG junction
213
What is the cause of GORD without abnormal anatomy?
Relaxed/ hypotension LOS
Delayed oesophageal/gastric emptying
Delayed oesophageal acid clearing
214
What are the two main types of hiatus hernia?
Sliding
Para-oesophageal
215
What happens in a hiatus hernia?
Fundus of stomach moves proximally through the diaphragmatic hiatus
216
What are risk factors for hiatus hernia?
Obesity
Age
217
What can happen to the oesophagus in severe cases of GORD?
Erosive oesophagitis
218
What happens to the cells in GORD?
Mucosa exposed to acid-pepsin and bile
Increased cell loss and regenerative activity
219
What are the complications of GORD?
Ulceration
Stricture
Glandular metaplasia
Carcinoma
220
What is Barretts oesophagus a precursor to?
Dysplasia
Adenocarcinoma
221
What is Barrett's oesophagus?
Intestinal metaplasia related to prolonged acid exposure in distal oesophagus
222
What sex is most affected by Barrett's oesophagus
Men
223
What is the risk of developing oesophageal cancer due to Barretts oesophagus
6%/ year
224
What are the main treatment for Barretts oesophagus ?
Endoscopic mucosal resection
Radio-frequency ablation
225
What is Oesophagectomy rarely done for treatment of Barretts oesophagus?
Due to mortality of 10%
226
What are the pharmacological treatments for empirical GORD?
Alginates
H2RA
Proton pump inhibitor
227
What is the treatment of refractory GORD
Anti-reflux surgery
228
What is the median age of diagnosis for oesophageal cancer?
65
229
What type of oesophageal cancer is most common?
Adenocarcinoma is Western Europe/USA
Squamous everywhere else
230
What are the main symptoms of oesophageal cancer?
Progressive dysphagia
Anorexia and weight loss
231
What part of the oesophagus does squamous cell carcinoma occur?
Proximal and middle third of oesophagus
232
What is oesophageal squamous cell carcinoma associated with?
Achalasia
Caustic stricture
Plummer-Vinson syndrome
233
What is oesophageal squamous cell carcinoma preceded by?
Dysplasia
Carcinoma in situ
234
Describe the characteristics of oesophageal squamous cell carcinoma
Large exophyic occluding tumours
235
what are significant risk factors for oesophageal squamous cell carcinoma?
Tobacco
Alcohol
236
What part of the oesophagus does adenocarcinoma occur?
Distal oesophagus
237
What are the predisposing factors for oesophageal adenocarcinoma?
Obesity
Male
Middle age
Caucasian
238
What limits surgery for oesophagus cancer?
Local invasion due to no peritoneal lining in mediastinum
239
Where does oesophageal cancer commonly metastasis?
Hepatic
Brain
Pulmonary
Bone
240
What is oesophageal cancer diagnosed by?
Endoscopy
Biopsy
241
What is used in the staging of oesophageal cancer?
CT scan
Endoscopic ultrasound
PET scan
Bone scan
242
What is the treatment for oesophageal cancer?
Surgical oesophagectomy +/- adjuvant or neoadjuvant chemotherapy
243
Who is oesophagectomy limited to?
Patients with localised disease, without co-morbid disease usually \<70 years of age
244
What is the mortality rate for oesophagectomy?
10%
245
What is the priority in oesophageal cancer treatment?
palliative treatment to Alleviate Symptoms
246
What are the treatment options of swallowing difficulties in oesophageal cancer?
Endoscopic
Chemotherapy
Radiotherapy
Brachytherapy
247
How is eosinophilic oesophagitis defined clinically?
Symptoms of oesophageal dysfunction
248
How is eosinophilia oesophagitis defined pathologically?
Eosinophilic infiltration of the oesophageal epithelium in the abscesses of secondary causes of local or systemic eosinophilia
249
What age is eosinophilia oesophagitis more commonly seen in?
Children and young adults
250
What are the symptoms of eosinophilic oesophagitis?
Dysphagia
Food bolus obstruction
251
What is the treatment for eosinophilic oesophagitis
Corticosteroids
Dietary elimination
252
What is the treatment for severe eosinophilic oesophagitis
Endoscopic dilatation
253
Define satiety
feeling of fullness
254
What is dyspepsia?
Pain or discomfort in the upper abdomen for 4 weeks
255
What causes the symptom of dyspeptisa?
Gallstones
Coeliac disease
Drugs
Psychological
GI
256
What are the symptoms of dyspepsia?
Upper abdominal discomfort
Retro sternal pain
Anorexia
Nausea
257
What drugs can cause dyspepsia?
NSAIDS
Steroids
Bisphophonates
Ca antagonists
Theophylline
258
When would you refer to endoscopy for dyspepsia?
Anorexia
Loss of weight
Anaemia
Recent onset \>55 years
Melaena
Swallowing problems
259
What are the risk factors of upper GI endoscopy
Bleeding
Perforation
Reaction to drugs given
260
What is the shape of helicobacter pylori?
Spiral
261
When is H.pylori acquired?
Childhood
262
Where does H.pylori colonize?
Gastric type mucosa
263
where does h.pylori reside?
In the surface mucous layer
264
What does H.pylori evoke?
Response in underlying mucosa
265
How does H. pylori survive in the stomach?
Produces ammonia from urea to neutralize the acid
266
What happens when H.pylori progresses to antral predominant gastritis?
Increased acid
Du disease
267
What happens when H.pylori progresses to corpus predominant gastritis?
Decreased acid
Gastric atrophy
Gastric cancer
268
What are the non invasive tests for diagnosis of H. Pylori?
Serology - IgG
Urea breath test
Stool antigen test - ELISA
269
What are the invasive tests for the diagnosis of H.pylori?
Culture of gastric biopsies
Rapid slide urease test
Histology
270
What is utilised in breath tests for H.pylori infection diagnosis?
13C or 14C labelled CO2
271
What are the majority of peptic ulcers caused by?
H. Pylori infection
272
What sex is most affected by peptic ulcers?
Men
273
When are peptic ulcers more common?
In elderly
274
what are the risk factors for peptic ulcers?
NSAIDS
Smoking
275
What conditions can cause peptic ulcers?
Zollinger-Ellison syndrome
Hyper parathyroid so
Crohn's disease
276
What are the symptoms of peptic ulcer?
Epigastic pain
Hunger pain
Back pain
Nausea
277
What are the symptoms of a chronic peptic ulcer?
Weight loss and anorexia
278
What symptoms are more common in DU peptic ulcers?
Back pain
Nocturnal/ hunger pain
279
what are the symptoms of a peptic ulcer bleeding?
Haematemesis
Melaena
Anaemia
280
What is the treatment for complicated peptic ulcer?
Surgery
281
What is the treatment of peptic ulcers?
Antacid medication
Proton pump inhibitors
282
What is the treatment of a peptic ulcer caused by H.pylori?
Eradication therapy to get rid of the bacteria
283
How is a H.pylori infection eradication
Triple therapy for 7 days
Clarithromycin
Amoxicillin
PPI
284
What is given for treatment of H.pylori infection if patient has penicillin allergy?
Tetracycline instead of amoxicillin
285
What is the main reason for failure in eradicating H.pylori infection?
Resistance to antibiotics and poor compliance
286
What are the complications of a peptic ulcer?
Bleeding
Perforation
Fibrosis stricture
Gastric outlet obstruction
287
What are the complications of a peptic ulcer which is bleeding acutely?
Melaena
Haematemesis
288
What are the complications of a peptic ulcer which is bleeding chronically?
Iron deficiency anaemia
289
What is seen on bloods for gastric outlet obstruction?
Low Cl
Low Na
Low K
290
How is gastric outlet obstruction diagnosed?
endoscopy of upper gastrointestinal tract
291
What are the symptoms of gastric outlet obstruction?
Vomiting
Early satiety
Abdominal distension
Weight loss
Gastric splash
292
What does the vomit look like in gastric outlet obstruction?
Lacks bile
Fermented foodstuffs
293
How is gastric outlet obstruction treated?
Endoscopic balloon dilatation
Surgery
294
What are the majority of gastric cancers?
adenocarcinomas
295
What are the symptoms of gastric cancer?
Dyspepsia
Early satiety
Nausea
Weight loss
GI bleeding
296
What are the risk factors of gastric cancer?
H. Pylori
Smoking
Diet
Genetics
297
What genes are associated with gastric cancer?
HDGC
AD
CDH-1 gene
298
What are the majority of gastric cancers caused by?
Sporadic with no demonstratble inherited component
299
What is needed to made a histological diagnosis of gastric cancer?
Endoscopy
Biopsies
300
What is the treatment for gastric cancer?
Chemotherapy
Surgical
301
What are the staging investigations done for gastric cancer?
CT chest/abdo
302
Endoscopic mucosal resection or mucosal ablation, esophagectomy, and chemoradiation are treatment options for cancer.
options for esophageal cancer.
303
\_\_\_\_ is the most common type of esophageal carcinoma in the United uk.
Adenocarcinoma
304
The ____ segment of the esophagus is typically affected by esophageal adenocarcinoma.
The lower third segment
305
The most common presenting sign of esophageal cancer is \_\_\_\_, initially for solids and then for liquid
esophageal cancer is dysphagia,
306
Risk factors for squamous cell oesophagal carcinoma include \_\_\_\_
alcohol, hot liquids, caustic strictures, smoking, and achalasia
307
The _____ segments of the esophagus are typically affected by esophageal squamous cell carcinoma.
The upper two third segments
308
\_\_\_\_ is a neoplasm associated with Barrett esophagus.
Esophageal adenocarcinoma
309
\_\_\_\_ is the imaging study that allows direct visualization and biopsy of esophageal cancer
Esophagogastroduodenoscopy
310
\_\_\_\_ is the most common type of esophageal carcinoma worldwide.
Squamous cell carcinoma
311
