Upper GI pathology

15 flashcards · Other · by Anonymous Sloth

1. Name pathologies of the upper GI tract

   Oesophageal reflux Oesophageal cancer Gastritis Peptic ulceration Gastric cancer

2. Describe the pathogenesis of oesophageal reflux

   Gastric acid refluxes into the oesophagus (eg hiatus hernia) Squamous epithelium thickens Severe reflux causes ulceration of the oesophageal epithelium. The leads to fibrosis (formation of strictures, impaired motility, obstruction) Barrett's oesophageal

3. Describe Barrett's oesophagus

   Metaplasia of squamous epithelium into glandular epithelium Response to oesophageal reflux Pre-malignant

4. Describe the aetiology of oesophageal cancer

   Third most common cancer of the alimentary tract Linked with environmental factors (pollution) Two histological types Squamous carcinoma Adenocarcinoma (Barretts oesophagus Very poor prognosis (less than 15%)

5. Risk factors fro oesophageal cancer

   Squamous carcinoma Smoking Alcohol Dietary carcinogens Adenocarcinoma Barretts metaplasia Obesity

6. Effects of oesophageal cancer

   Obstruction from the tumour Ulceration Perforation

7. Describe the metastasis of oesophageal cancer

   Direct (surrounding tissue) Lymphatic spread (regional lymph nodes) Blood spread (liver and lungs)

8. Describe the aetiology of gastritis

   Autoimmune (type A) Bacterial (type B) Chemical injury (type C)

9. Describe the pathophysiology of autoimmune gastritis

   Organ specific Immune system produces autoantibodies to the parietal cells Atrophy of specialised gastric epithelial cells (decreased acid secretion and loss of intrinsic factor) Associated with other autoimmune disease

10. Describe the pathophysiology of bacterial gastritis

    Commonest type of gastritis Related to helicobacter pylori gram negative In gastric mucus on surface of gastric epithelium Produces acute and chronic inflammatory response

11. Describe the aetiology of chemical gastritis

    Drugs such as non-steroidal Alcohol Bile reflux

12. Describe the aetiology of peptic ulceration

    Imbalance between the proliferation of the mucosal barrier and acid secretion Affects oesophagus, stomach and duodenum Increased gastric acid can be H. pylori associated

13. Complications fo peptic ulceration

    Bleeding Acute (haemorrhage) Chronic (anaemia) Perforation Peritonitis Healing by fibrosis Strictures and obstruction

14. Aetiology of gastric cancer

    Develops through phases of intestinal metaplasia and dysplasia Associated with previous H. pylori infection Adenocarcinoma Very poor prognosis (less that 20%)

15. Describe the spread of stomach cancer

    Direct (surrounding tissue) Lymphatic (regional lymph nodes) Blood spread (liver) Transcoelomic spread (spread within peritoneal cavity)