Pathology

Question 1

What causes reflux esophagitis?

Answer 1

Incontinence of the esophago-gastric valve leading to regurgitation of gastric acid into the esophagus

Question 2

What is GERD?

Answer 2

Gastro-esophageal reflux disease

Question 3

What are common symptoms of GERD?

Answer 3

• Food regurgitation
• Heartburn
• Dysphagia

Question 4

What is Barrett’s esophagus?

Answer 4

Metaplasia where the stratified squamous epithelium is replaced by columnar or intestinal epithelium

Question 5

What is the appearance of Barrett’s esophagus during endoscopic examination?

Answer 5

Single or multiple finger-like protrusions of columnar mucosa with salmon-pink coloration above the Z-line

Question 6

What complication can arise from Barrett’s esophagus?

Answer 6

Adenocarcinoma

Question 7

What is the process of malignant transformation in Barrett’s esophagus?

Answer 7

• Reflux esophagitis
• Columnar metaplasia
• Dysplasia (intra-epithelial neoplasia)
• Invasive cancer

Question 10

What is the most common site for esophageal peptic ulcers?

Answer 10

Lower third of the esophagus

Question 11

What is a significant cause of esophageal peptic ulcers?

Answer 11

Erosion of the mucosa by gastric acid secretion

Question 12

What complications can arise from esophageal peptic ulcers?

Answer 12

• Bleeding
• Perforation
• Stenosis

Question 13

Fill in the blank: Barrett’s esophagus is characterized by the transformation of the esophagus from _______ to columnar or intestinal epithelium.

Answer 13

stratified squamous epithelium

Question 14

True or False: Dysplasia in Barrett’s esophagus shows decreased mucus secretion and nuclear atypia.

Answer 14

True

Question 16

What are the primary sites of peptic ulcers?

Answer 16

1. Stomach
2. First part of the duodenum
3. Esophagus
4. Jejunum after gastrojejunostomy
5. Meckel’s diverticulum

These sites are commonly affected by peptic ulcers.

Question 17

What age group is more commonly affected by peptic ulcers?

Answer 17

Adults

Peptic ulcers are more prevalent in adult life.

Question 18

Which sex is more likely to develop peptic ulcers?

Answer 18

Males

Peptic ulcers are more common in males than females.

Question 19

List three lifestyle factors that predispose to peptic ulcers.

Answer 19

• Spicy food
• Smoking
• Excess alcohol intake

These factors can irritate the gastric mucosa and increase the risk of ulceration.

Question 20

What type of drugs can lead to peptic ulcers?

Answer 20

Salicylates, such as aspirin

These drugs can cause acute infection, ulceration, and bleeding.

Question 21

What is the role of H. pylori in peptic ulcers?

Answer 21

It causes chronic gastritis that may lead to ulceration

H. pylori is a bacterium often found in patients with peptic ulcers.

Question 22

What hormonal factor may increase the risk of peptic ulcers?

Answer 22

Low estrogen levels in postmenopausal females

Estrogen has a protective function on the gastric mucosa.

Question 23

True or False: Psychological factors such as mental tension can contribute to the development of peptic ulcers.

Answer 23

True

Mental strain is known to be a risk factor for ulceration.

Question 24

What is Zollinger-Ellison syndrome?

Answer 24

A condition characterized by tumors or hyperplasia of glucagon-secreting cells leading to ulceration

This syndrome results in excessive acid secretion in the stomach.

Question 25

What are the three pathogenesis theories of peptic ulcers?

Answer 25

* Hyperacidity theory * Neurogenic theory * H. pylori theory ## Footnote These theories explain the multifactorial nature of ulcer development.

Question 26

What are some complications of peptic ulcers?

Answer 26

* Hemorrhage * Perforation * Penetration * Pyloric stenosis * Malignant transformation ## Footnote Each of these complications can lead to severe health issues.

Question 27

What is a common symptom of hemorrhage due to peptic ulcers?

Answer 27

Hematemesis or melena ## Footnote These symptoms indicate the presence of occult blood.

Question 28

What can happen if a deep peptic ulcer perforates?

Answer 28

It can cause subdiaphragmatic abscess ## Footnote Perforation is a serious complication that requires immediate medical attention.

Question 29

Fill in the blank: Pyloric ulcers can cause _______ with marked dilatation of the stomach.

Answer 29

pyloric stenosis ## Footnote This condition results from scarring and narrowing of the pylorus.

Question 30

What is the appearance of the base of a peptic ulcer?

Answer 30

Formed of fibrous tissue with complete destruction of muscle layers ## Footnote The ulcer base contains granulation tissue, necrotic tissue, and inflammatory cell exudate.

Question 31

True or False: Malignant transformation occurs commonly in long-standing peptic ulcers.

Answer 31

False ## Footnote Malignant transformation occurs in less than 1% of cases of long-standing untreated ulcers larger than 3 cm.