Robbins and Davidson’s

How would this infection appear macroscopically and what kind of population would you expect to receive this sample from.

• Name one other organism that commonly causes oesophagitis.

• CMV, candidiasis, aspergillus, macronycosis

• Name four other causes of oesophagitis.

• Pill induced.• Irritants – alcohol, acids, alkalis, hot fluids,

smoking• Skin diseases – bullous pemphigoid etc• Reflux• Eosinophilic• Rarely – Crohn’s

• How would you differentiate between a mallory-weiss tear and rupture of oesophageal varices?

The following condition predisposes to what?

• All of the following characteristics are associated with Barrett’s oesophagus except:

• A metaplastic goblet cells• B metaplastic parietal cells• C intranuclear inclusion bodies• D epitheliel dysplasia• E adenocarcinoma of the oesophagus

• What other complications can be caused by GORD?

• Oesophagitis• Anemia• Benign oesophageal stricture• Gastric volvulus

• What conditions predispose to the development of GORD?

• Abnormalities of the LES• Hiatus hernia• Delayed oseophageal clearance• Defective gastric empyting• Dietary and environmental factors• etc….

• Name three different approaches to the management of GORD.

• Lifestyle advice• PPI, H2 receptor antagonists• Laparoscopic anti-reflux surgery

• Your next patient is a 53 yo male. Mr William T admits to going to the toilet often to pass urine during the night, rising 3 to 5 times. He states that his flow is reduced at night and that he dribbles a little at the end of micturition. He states that he is fine during the day.

• What are the three types of diverticulae that form in the oesophagus?

• Zenker• Traction• Epiphrenic

• Diverticulae are often secondary to obstruction. One such oesophageal obstruction is achalasia. What is achalasia?

• List at least one primary and one secondary cause of achalasia.

• Achalasia – incomplete LES relaxation, increased LES tone, aperistalsis of the oesophagus

• Primary – idiopathic• Secondary – Chaga’s, diabetic autonomic

neuropathy, malignancy, amyloidosis

• You perform an endoscopy on a patient you suspect of having chronic gastritis. You notice that there is marked inflammation in the fundus and the body, but the antrum appears to be spared. In the areas of inflammation there are no rugae and there appears to be small polyps or nodules. What form of gastritis seems most likely?

• A H. pylori chronic gastritis• B Autoimmune gastritis• C Eosinophilic gastritis• D Zolligner-Ellison syndrome

• For each of the characteristics listed below, choose whether it describes acute gastritis, chronic gastritis or both.

• Associated with alcohol consumption.• Associated with smoking.• Causally related to autoantibodes against gastric mucosal

cells.• Associated with the use of aspirin.• Productive of GIT bleeding.• Associated with gastric peptic ulcers.• Associated with Hpylori infection.

• For each of the characteristics listed below, choose whether it describes acute gastritis, chronic gastritis or both.

• Associated with alcohol consumption. A• Associated with smoking. A • Causally related to autoantibodes against gastric mucosal

cells. C • Associated with the use of aspirin. A• Productive of GIT bleeding. A• Associated with gastric peptic ulcers. C• Associated with Hpylori infection. C

Give five symptoms that are commonly associated with the above slide taken from a biopsy of the stomach.

Dyspepsia, dysphagia, nausea.Weight loss, anorexia, anemia, haemorraghe.

This sort of diffuse infiltrative growth leads to a macroscopic appearance termed…?

• Linitis plastica

• Which type of hiatus hernia is not likely to cause regurgitation?

• What symptoms may these type of hernia cause?

• What is the difference between a direct and indirect inguinal hernia?

• Through palpation how can one differentiate between a femoral and an inguinal hernia?