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GI Pathology Flashcards

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1
Q

How long is the oesophagus?

A

25cm

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2
Q

What type of epithelium lines the oesophagus?

A

Squamous epithelium

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3
Q

What is the name of the spinchter at the upper and lower end of the oesophagus?

A

Cricopharyngeal sphincter

Gastro-oesophageal sphincter

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4
Q

What type of epithelium lines the distal 2cm below the diaphragm?

A

Glandular (columnar) mucosa

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5
Q

The squamo-columnar junction is usually located at ___cm frm the incisor teeth

A

40cm

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6
Q

Reflux of gastric acid

A

gastro-oesophageal reflux

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7
Q

Reflux of gastric acid and/or bile

A

Duodeno-gastric reflux

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8
Q

2 types of hernia

A

Sliding hiatus hernia

Para-oesophageal hernia

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9
Q

What is a serious complication of para-oesophageal hernias?

A

Strangulation

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10
Q

What 3 histological changes occur in the squamous epithlium during reflex oesophagitis?

A

Basal cell hyperplasia
Elongation of papillae
Increase in cell desquamation

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11
Q

How might a benign stricture in reflux oesophagitis present?

A

Dysphagia

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12
Q

Risk factors for barrett’s oesophagus

A

Male, caucasian, overweight

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13
Q

Define barrett’s oesophagus in macroscopic terms

A

Proximal extention of squamo-columnar junction- squamous mucosa replaced by columnar mucosa (glandular metaplasia)

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14
Q

What are the 3 types of columnar mucosa in the GI tract

A

Gastric cardia type
Gastric body type
Intestinal type ‘specialised barrett’s oesophagu’

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15
Q

What are the 2 histological types of oesophageal carcinoma?

A

Squamous cell carcinoma

Adenocarcinoma

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16
Q

Risk factors for adenocarcinoma

A

Mle, caucasian, obestiy, Barrett’s oesophagus, tobacco

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17
Q

What are the 3 types of oesophageal adenocarcinoma

A

Polypoidal
Stricturing
Ulcerated

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18
Q

A tumour that projects into the lumen of the oesophagus

A

Polypoidal

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19
Q

Risk factors for squamous carcinoma

A

Tobacco, alcohol, nutrition, thermal injury, HPV, male, black ethnicity

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20
Q

Location of oesophageal adenocarcinoma

A

lower oesophagus

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21
Q

Location of squamous carcinoma

A

Middle and lower 1/3rd

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22
Q

Tumour invades lamina propria, muscularis mucosae or submucosa

A

PT1

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23
Q

Tumour invades muscularis propria

A

PT2

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24
Q

Tumour invades adventitia

A

PT3

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25
Tumour invades adjacent structures
PT4
26
No lymph node metastasis
PN0
27
Metastasises to 1 or 2 nodes
PN1
28
Metastasises to 3-6 nodes
PN2
29
Metastasises to 7 or more lymph nodes
PN3
30
No distant metastasis
MO
31
Distant metastases
M1
32
4 anatomical regions of the normal stomach
Cardia Fundus Body Antrum
33
3 histological regions of the stomach and the type of glands found in each
Cardia-mucinous glands Body-specialised glands Antrum-mucinous glands
34
Types of chronic gastritis
``` ABC Autoimmune (glandular atrophy) Bacterial infection e.g. H.Pylori Chemical injury (foveolar hyperplasia) (NSAIDs, Bile reflux, alcohol) ```
35
How does bile reflux present histologically
Degranulation of mast cells- vasodilation
36
How does overuse of NSAIDs present histologically
Disruption of mucous layer- oedema
37
Describe the shape and type of H.Pylori
Gram -ve spiral shaped bacterium with flagellae
38
Which part of the stomach is H.Pylori more common?
Antrum
39
Result of H.Pylori infection in the stomach
Glandular atrophy, replacement fibrosis and intestinal metaplasia
40
Complications of H.Pylori
85% no symptoms Gastric or duodenal (more common) ulcer Gastric cancer (usually adenocarcinoma) MALT lymphoma (mucosa associated lymphoid tissue)
41
Major sites for peptic ulcer disease
Junction of antral and body mucosa First part of duodenum Distal oesophagus
42
Risk factors for peptic ulcer disease
``` Hyperacidity H.Pylori infection duodeno-gastric reflux Drugs (NSAIDS) Smoking ```
43
Full thickness coagulative necrosis of mucosa (or deeper layers) covered with ulcer slough (necrotic debris and fibrin and neutrophils) Granulation tissue at ulcer floor
Peptic Ulcer Disease
44
Difference between peptic ulcer disease and chronic gastric ulcer?
Chronic gastric ulcer- clear cut edges overhanging the base. Extensive graulation and scar tissue at ulcer floor.
45
Complications of chronic gastric ulcer
Haemorrhage (-->anaemia) Perforation (-->peritonitis) Stricturing
46
What is more common- gastric or duodenal ulcer?
Duodenal
47
Which type of ulcer is more common in older patients?
Gastric
48
Which type of ulcer is more common in people with blood group A?
Gastric
49
Which type of ulcer is more common in people with blood group O?
Duodenal
50
What are the different types of gastric cancer?
Adenocarcinoma (most common) Endocrine tumours MALT lymphomas Stromal tumours (GIST)
51
Risk factors for gastric adenocarcinoma?
``` Diet (smoked/cured meats) H.Pylori Bile Reflux Hypochlorhydria (low HCl concentration- allows bacterial growth) Mutation in E.cadherin gene ```
52
Is there an asoociation between H. pylori/diet and carcinoma of gastro-oesophageal junction?
no
53
Is there an asoociation between H. pylori/diet and carcinoma of gastric body/antrum?
yes
54
Is there an asoociation between GO reflux and carcinoma of gastro-oesophageal junction?
yes
55
Is there an asoociation between GO reflux and carcinoma of gastric body/antrum?
no
56
A gastric carcinoma that a) bulges out of the epithlium b) Neither bulges out or is depressed within c) Depressed within epithelium
Exophytic Flat/depressed Excavated
57
Diffuse type gastric carcinoma is a result of what mutation?
E.cadherin loss/mutation
58
What type of cells is characteristic of diffuse type gastric cancer?
Signet ring shape cells.
59
Cells infiltrate widely-marked thickening of the wall
Linitis plastica
60
What type of gastric cancer arises from a germline CDH1/E.Cadherin mutation?
Hereditory diffuse type gastric cancer (HDGC)
61
What is the coeliac disease producing component and what effect does it have on the epithelial cells of the intestines?
Gliadin, induces epithelial cells to express IL-15 which activates CD8 and intraepithelial lymphocytes (IELs) which are cytotoxic and kill enterocytes. Net results is atrophy of villi, mucosa flattens and malabsorption sundrome
62
Positive serology for coealiac disease and villous atrophy but no symptoms
Silent disease
63
Positive serology for coealiac disease, no villous atrophy
Latent disease
64
Clinical features of coeliac disease
Anaemia, chronic diarrhoea, bloating, chronic fatigue
65
Disease associations with coeliac disease
Dermatitis herpetiformis Lymphocytic gastritis and colitis Enteropathy-associated T cell lymphoma

Clinical Pathology (53 decks)

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