Upper GI

Question 1

What is the time scale for something to be classed as chronic?

Answer 1

3 months

Question 2

Itis =

Answer 2

Inflammation

Question 3

Define chronic gastritis

Answer 3

Ongoing inflammation of the stomach mucosa

Question 4

Inflammation of the stomach mucosa can…

Answer 4

Make you more vulnerable to other diseases (carcinoma/dysplasia)

Question 5

Compare to acute gastritis symptoms of chronic gastritis are less ______ but more _______

Answer 5

Severe

Persistent

Question 6

Upper abdo pain
Indegestion/bloating
Socially uncomfortable sounds
N&V
Loss of appetite/weight loss 
Are symptoms of...

Answer 6

Chronic gastritis

Question 7

Causes of chronic gastritis are… (ABCO)

Answer 7

Autoimmune diseases
Bacterial (H Pylori)
Chemical
Other = stress

Question 8

H Pylori is gram…

Answer 8

-

Question 9

How does H Pylori survive in the bowel? (2)

Answer 9

1. By penetrating the surface and ‘hiding’ in the mucosa.
2. Produces urease
   * will not live on surface because it will die due to o2 supply*

Question 10

How is H Pylori (probably) acquired?

Answer 10

Faecal-oral route

Question 11

80% of H Pylori is

Answer 11

Asymptomatic

Question 12

5-10% of H Pylori causes

Answer 12

Peptic ulcer disease

Question 13

H Pylori can affect any part of the main body of the stomach
True
False

Answer 13

True

Question 14

What are the 2 most common causes of peptic ulcer disease (PUD)?

Answer 14

H Pylori

NSAIDs

Question 15

If pain comes 2hrs after eating this would indicate that the ulcer is located in the…

Answer 15

Duodenum

Question 16

If pain comes straight after eating this would indicate that the ulcer is located in the…

Answer 16

Stomach

Question 17

Pain worse after eating and at night are symptoms of

Answer 17

PUD

Question 18

Define peptic ulcer disease…

Answer 18

A lesion in the digestive tract lining (mucosa)

Question 19

Name the complications associated with PUD…

Answer 19

Bleeding leading to anaemia
Massive haematemsis
Perforation leading to peritonitis
Long term cancer on the edge of the ulcer

Question 20

What happens to the cells in the oesophagus during Barrett’s oesophagus (BO)?

Answer 20

Metplasia

squamous epithelium is replaced with columnar epithelium and goblet cells

Question 21

What is the reasons the cells adapt in BO?

Answer 21

Due to chronic acid exposure from refulx

Question 22

During endoscopy what would BO show?

Answer 22

Red and white patches

Question 23

What does BO have a strong association with?

Answer 23

Oesophageal adenocarcinoma

Question 24

Upper GI malignancy areas (3)

Answer 24

Oesophageal
Stomach
Small bowel

Question 25

Name the risk factors of oesphogeal squamous cell carcinoma...

Answer 25

Alcohol Tobacco Caustic injury Achlasia (damage to nerves in oesoph)

Question 26

What can patients with oesophogeal cancer develop?

Answer 26

Chest infections

Question 27

Name the late symptoms of oesophageal squamous cell carcinoma...

Answer 27

``` Dysphagia Weight loss Haemorrahge Sepsis Resipratory fistula with aspiration ```

Question 28

Define adenocarcinoma...

Answer 28

Cancer developing from a gland

Question 29

What is oesophageal adenocarcinoma largely caused by?

Answer 29

Dysplastic changes in BO

Question 30

How does oesophageal carcinoma sprerad?

Answer 30

Direct (quickly to surrounding tissues) Lymphatics Haematogenous (via blood)

Question 31

``` Adenocarcinoma stomach makes up A: 50% B: 90% C: 5% Of gastric malignancies ```

Answer 31

B

Question 32

``` Pernicious anemia Intestinal metplasia Neoplastic polyps Helicobacter associated gastritis are... ```

Answer 32

Precursor lesions | *Change in the appearance or nature of a cell before it becomes cancerous*

Question 33

Early symptoms of adenocarcinoma stomach can often be mistaken for...

Answer 33

Gastritis

Question 34

Advance symptoms of adenocarcinoma stomach are...

Answer 34

Weight loss Anaemia Anorexia Haemorrhage

Question 35

How does adenocarcinoma spread?

Answer 35

``` Direct Lymphatics (virchows node= inflamm) Haematogenous Transcolemic Omentum Mesentry Ovary ```

Question 36

Define neoplasia...

Answer 36

The presence or formation of new abnormal growth or tissue

Question 37

Name the different types of small bowel neoplasia...

Answer 37

Adenocarcinoma (rare) GI stromal tumor Lymphoma Carcinoid tumour

Question 38

Name the risk factors for small bowel neoplasia...

Answer 38

Crohns disease Coeliac disease Radiation expsoure Hereditary

Question 39

Define coeliac disease...

Answer 39

Extensive mucosal disease disease related to sensitivity to gluten

Question 40

Is coeliac disease an autoimmune disease?

Answer 40

Yes

Question 41

How can coeliac disease be diagnosed?

Answer 41

``` Biopsy Blood test (TTG) ```

Question 42

Coeliac disease can lead to...

Answer 42

Adenocarcinoma and lymphoma of the small bowel

Question 43

-Anaemia -Fatigue -Failure to thrive (kids) -Chronic -Constipation/diarrhoea -Pain and discomfort of the digestive track Are symptoms of...

Answer 43

Coeliac disease