Upper GIT Pathology Flashcards

1
Q

What can diseases of the upper GIT cause?

A
  • Upper abdominal/retrosternal discomfort
  • Pain
  • Indigestion
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2
Q

What is the pathology of oesophageal reflux?

A
  • Reflux of gastric acid into oesophagus
  • Thickening of squamous epithelium
  • Ulceration of oesophagus when severe reflux
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3
Q

What are complications of oesophageal reflux?

A
  • Healing by fibrosis

- Barrett’s oesophagus

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4
Q

What can healing of the oesophagus by fibrosis lead to?

A
  • Stricture formation
  • Impaired oesophageal motility
  • Oesophageal obstruction
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5
Q

What is Barrett’s oesophagus?

A
  • Type of metaplasia
  • Pre-malignant condition
  • Response in some patients to oesophageal reflux
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6
Q

What metaplasia takes place with Barrett’s oesophagus?

A

Transformation from squamous epithelium to glandular epithelium

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7
Q

How common is oesophageal cancer?

A

Third most common cancer of the alimentary tract

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8
Q

What are the 2 histological types of oesophageal cancer?

A
  • Squamous carcinoma

- Adenocarcinoma

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9
Q

Which histological type of oesophageal cancer develops from Barrett’s oesophagus?

A

Adenocarcinoma

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10
Q

What oesophageal cancer linked to?

A
  • Geographic variation

- Environmental factors

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11
Q

What are the risk factors for squamous carcinoma oesophageal cancer?

A
  • Smoking
  • Alcohol
  • Dietary carcinogens
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12
Q

What are the risk factors for adenocarcinoma oesophageal cancer?

A
  • Barrett’s metaplasia

- Obesity

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13
Q

What are the local effects of oesophageal cancer?

A
  • Obstruction
  • Ulceration
  • Perforation
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14
Q

How can oesophageal cancer spread?

A
  • Direct
  • Lymphatic spread
  • Blood spread
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15
Q

Where can oesophageal cancer spread directly?

A

To surrounding areas

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16
Q

Where can oesophageal cancer spread through lymphatic spread?

A

To regional lymph nodes

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17
Q

Where can oesophageal cancer spread through the blood?

18
Q

What is the prognosis for oesophageal cancer?

A
  • Very poor

- 5 year survival rate less than 15%

19
Q

What are the 3 types of pathologies of gastritis?

A
  • Type A: autoimmune
  • Type B: bacterial
  • Type C: chemical injury
20
Q

What is autoimmune gastritis?

A

Organ-specific autoimmune disease

21
Q

What is autoimmune gastritis associated with?

A

Other autoimmune diseases

22
Q

What happens in autoimmune gastritis?

A

Autoantibodies to parietal cells and intrinsic factor

23
Q

What is the pathology of autoimmune gastritis?

A
  • Atrophy of specialised acid secreting gastric epithelium
  • Loss of specialised gastric epithelial cells
  • Decreased acid secretion
  • Loss of intrinsic factor
  • Vitamin B12 deficiency
24
Q

What is the most common type of gastritis?

25
What organism is bacterial gastritis related to?
Helicobacter pylori
26
What is helicobacter pylori?
- Gram negative bacterium - Found in gastric mucus on surface of epithelium - Produces acute and chronic inflammatory response - Increased acid production
27
What can cause chemical gastritis?
- Drugs (NSAIDs) - Alcohol - Bile reflux
28
What is peptic ulceration caused by?
-Imbalance between acid secretion and mucosa barrier
29
What does peptic ulceration affect?
- Lower oesophagus - Body and antrum of stomach - First and second parts of duodenum
30
What bacteria is usually associated with peptic ulceration?
Helicobacter pylori which increases gastric acid
31
What are the complications of peptic ulceration?
- Bleeding - Perforation - Healing by fibrosis
32
What kind of bleeding can result from peptic ulceration?
- Acute haemorrhage | - Chronic anaemia
33
What can perforation as a result of peptic ulceration result in?
Peritonitis
34
What can healing by fibrosis as a result of peptic ulceration result in?
Obstruction
35
How common is stomach cancer?
Second commonest cancer of the alimentary tract
36
How does stomach cancer develop?
Develops through phases of intestinal metaplasia and dysplasia
37
What is stomach cancer associated with
Previous helicobacter pylori infection
38
What is the histology of stomach cancer?
Adenocarcinoma
39
How can stomach cancer spread?
- Direct (surrounding structures) - Lymphatic (regional lymph nodes) - Blood (liver) - Transcoelomic (within peritoneal cavity)
40
What is the prognosis of stomach cancer?
- Very poor | - 5 year survival rate less than 20%