Upper Gastrointestinal Tract: Mouth
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Questions and Answers

What is the main characteristic of the epithelial surface of the hard palate, gingiva, and some regions of the dorsum of the tongue?

  • Keratinized stratified squamous epithelium (correct)
  • Nonkeratinized stratified squamous epithelium
  • Columnar epithelium
  • Cuboidal epithelium

    • What is the name of the condition characterized by the formation of stones in the salivary ducts?

  • Leukoplakia
  • Sjogren syndrome
  • Pleomorphic adenoma
  • Sialolithiasis (correct)

    • What is the primary site of attack in Sjogren syndrome?

  • Adrenal glands
  • Lacrimal glands (correct)
  • Thyroid glands
  • Salivary glands (correct)

    • What is the type of epithelium present on the lips, buccal mucosa, and alveolar mucosa?

    <p>Nonkeratinized stratified squamous epithelium</p> Signup and view all the answers

    What is the diagnosis of Sjogren syndrome based on?

    <p>All of the above</p> Signup and view all the answers

    What is the name of the tumor that affects the mouth?

    <p>Pleomorphic adenoma</p> Signup and view all the answers

    What is the name of the condition characterized by a white patch on the oral mucosa?

    <p>Leukoplakia</p> Signup and view all the answers

    What is the name of the condition characterized by cancer of the oral cavity?

    <p>Oral cancer</p> Signup and view all the answers

    What is the likely diagnosis for a 50-year-old male with a twenty-year history of gastro-oesophageal reflux symptoms?

    <p>Gastro-oesophageal reflux disease</p> Signup and view all the answers

    What is the treatment provided to the 50-year-old male with gastro-oesophageal reflux symptoms?

    <p>Proton-pump inhibitor</p> Signup and view all the answers

    What is the characteristic feature of Zenker diverticulum?

    <p>Outpouching above upper oesophageal sphincter</p> Signup and view all the answers

    What is the condition associated with repetitive distal oesophageal contractions?

    <p>Diffuse oesophageal spasm</p> Signup and view all the answers

    What is the characteristic feature of Oesophageal mucosal web?

    <p>Mucosal semi-circumferential protrusion</p> Signup and view all the answers

    What is the condition associated with mucosal/submucosal circumferential protrusion?

    <p>Oesophageal (Schatzki) ring</p> Signup and view all the answers

    What is the likely cause of the child's oesophagus being almost completely occluded?

    <p>Food impaction</p> Signup and view all the answers

    What is the diagnosis for the 30-year-old man with sudden onset of hematemesis after consuming large amounts of alcohol?

    <p>Mallory-Weiss tear</p> Signup and view all the answers

    What is the most common type of oesophageal cancer worldwide?

    <p>Squamous Cell Carcinoma</p> Signup and view all the answers

    What is the main characteristic of Barrett's oesophagus?

    <p>A metaplastic, columnar, glandular, intestine-like mucosa</p> Signup and view all the answers

    What is a complication of gastro-oesophageal reflux disease (GORD)?

    <p>Oesophageal stricture</p> Signup and view all the answers

    What is a risk factor for Squamous Cell Carcinoma Oesophagus (SCC)?

    <p>All of the above</p> Signup and view all the answers

    What is the diagnosis for a 32-year-old man with difficulty swallowing, regurgitation of food, and manometric studies showing a complete absence of peristalsis?

    <p>Achalasia</p> Signup and view all the answers

    What is a cause of lower oesophageal sphincter (LES) incompetence?

    <p>All of the above</p> Signup and view all the answers

    What is a complication of Barrett's oesophagus?

    <p>All of the above</p> Signup and view all the answers

    What is a normal characteristic of the oesophagus?

    <p>Stratified squamous epithelium</p> Signup and view all the answers

    What is a risk factor for gastric cancer?

    <p>Smoking</p> Signup and view all the answers

    Which type of gastric cancer is associated with environmental factors?

    <p>Intestinal type</p> Signup and view all the answers

    What is the term for the left supraclavicular lymph node metastasis?

    <p>Virchow node</p> Signup and view all the answers

    What is the characteristic of diffuse gastric adenocarcinoma?

    <p>Absence of cell cohesion</p> Signup and view all the answers

    What is the term for the periumbilical lymph node metastasis?

    <p>Sister Mary Joseph node</p> Signup and view all the answers

    Which of the following is a route of spread of gastric cancer?

    <p>Hematogenous spread</p> Signup and view all the answers

    What is the term for the direct seeding of the pouch of Douglas?

    <p>Blumer shelf</p> Signup and view all the answers

    Which of the following is a type of gastric cancer?

    <p>Gastric adenocarcinoma</p> Signup and view all the answers

    What is the characteristic of Hyperchromatism?

    <p>Abnormal nuclear staining</p> Signup and view all the answers

    What is the result of Dysplasia++ plus invasion?

    <p>Cancer</p> Signup and view all the answers

    What is the characteristic of Anaplasia?

    <p>Lack of differentiation</p> Signup and view all the answers

    What is the diagnosis of the patient with difficulty swallowing food and blurred vision?

    <p>Sjogren syndrome</p> Signup and view all the answers

    What is the microscopic feature of salivary gland biopsy in Sjogren syndrome?

    <p>Lymphocytes</p> Signup and view all the answers

    What is the result of Hyperkeratosis of oral epithelium?

    <p>Dysplasia of oral epithelium</p> Signup and view all the answers

    What is the characteristic of Dysplasia of oral epithelium?

    <p>Increased and abnormal mitotic activity</p> Signup and view all the answers

    What is the final step in the development of oral squamous cell carcinoma?

    <p>Oral squamous cell carcinoma</p> Signup and view all the answers

    What is the primary characteristic of Sjogren syndrome?

    <p>Chronic autoimmune disease attacking lacrimal and salivary glands</p> Signup and view all the answers

    What is the term for the formation of stones in the salivary ducts?

    <p>Sialolithiasis</p> Signup and view all the answers

    What is the characteristic of the epithelial surface of the hard palate, gingiva, and some regions of the dorsum of the tongue?

    <p>Keratinized</p> Signup and view all the answers

    What is the diagnosis of a patient with a white patch on the oral mucosa?

    <p>Leukoplakia</p> Signup and view all the answers

    What is the name of the tumor that affects the mouth?

    <p>Pleomorphic adenoma</p> Signup and view all the answers

    What is the diagnosis of a patient with chronic inflammation of the stomach lining?

    <p>Gastritis</p> Signup and view all the answers

    What is the diagnosis of a patient with difficulty swallowing food and blurred vision?

    <p>Sjogren syndrome</p> Signup and view all the answers

    What is the characteristic feature of oral cancer?

    <p>Uncontrolled growth and spread of abnormal cells</p> Signup and view all the answers

    What is the likely diagnosis for a patient with difficulty swallowing and regurgitation of food, and manometric studies showing a complete absence of peristalsis?

    <p>Achalasia</p> Signup and view all the answers

    What is the likely diagnosis for a 58-year-old woman with a history of alcoholic cirrhosis who presents with vomiting blood and experiencing bloody stools?

    <p>Gastric varices</p> Signup and view all the answers

    What is a complication of gastro-oesophageal reflux disease (GORD)?

    <p>All of the above</p> Signup and view all the answers

    What is the most appropriate clinical condition for a patient with a feature of mucosal semi-circumferential protrusion?

    <p>Oesophageal mucosal web</p> Signup and view all the answers

    What is a risk factor for Squamous Cell Carcinoma Oesophagus (SCC)?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment provided to a 50-year-old male with a twenty-year history of gastro-oesophageal reflux symptoms?

    <p>Proton-pump inhibitor</p> Signup and view all the answers

    What is the characteristic feature of Barrett's oesophagus?

    <p>Metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells</p> Signup and view all the answers

    What is the cause of lower oesophageal sphincter (LES) incompetence?

    <p>All of the above</p> Signup and view all the answers

    What is the likely diagnosis for a 30-year-old man with sudden onset of hematemesis after consuming large amounts of alcohol?

    <p>Mallory-Weiss tear</p> Signup and view all the answers

    What is the diagnosis for a newborn boy who regurgitates at every feeding?

    <p>Normal physiological reflux</p> Signup and view all the answers

    What is the characteristic feature of a Zenker diverticulum?

    <p>Outpouching above upper oesophageal sphincter</p> Signup and view all the answers

    What is the condition associated with repetitive distal oesophageal contractions?

    <p>Diffuse oesophageal spasm</p> Signup and view all the answers

    What is a complication of Barrett's oesophagus?

    <p>All of the above</p> Signup and view all the answers

    What is the likely cause of the child's oesophagus being almost completely occluded?

    <p>Foreign body obstruction</p> Signup and view all the answers

    What is the most common type of oesophageal cancer worldwide?

    <p>Squamous Cell Carcinoma Oesophagus (SCC)</p> Signup and view all the answers

    What is the condition associated with mucosal/submucosal circumferential protrusion?

    <p>Oesophageal (Schatzki) ring</p> Signup and view all the answers

    What is the most common risk factor for gastric cancer?

    <p>Helicobacter pylori infection</p> Signup and view all the answers

    Which type of gastric cancer is associated with mutations in E-cadherin?

    <p>Diffuse type</p> Signup and view all the answers

    What is the term for the periumbilical lymph node metastasis?

    <p>Sister Mary Joseph node</p> Signup and view all the answers

    What is the characteristic of the intestinal type of gastric cancer?

    <p>Characterized by cohesive neoplastic cells</p> Signup and view all the answers

    What is the route of spread of gastric cancer to the left supraclavicular lymph node?

    <p>Lymphangitic spread</p> Signup and view all the answers

    Which of the following is a type of gastric cancer that is associated with environmental factors?

    <p>Intestinal type</p> Signup and view all the answers

    What is the term for the direct seeding of the pouch of Douglas?

    <p>Blumer shelf</p> Signup and view all the answers

    What is the characteristic of the diffuse type of gastric cancer?

    <p>Characterized by absence of cell cohesion</p> Signup and view all the answers

    What is the characteristic of Moderate Dysplasia in oral epithelium?

    <p>Increased nuclear cytoplasmic ratio</p> Signup and view all the answers

    What is the final step in the development of oral squamous cell carcinoma from Normal oral epithelium?

    <p>Dysplasia++ plus invasion</p> Signup and view all the answers

    What is the characteristic of Severe Dysplasia/Carcinoma in situ in oral epithelium?

    <p>Pleomorphism</p> Signup and view all the answers

    What is the diagnosis of a patient with difficulty swallowing food and blurred vision, and positive anti SS-A and anti SS-B antibodies?

    <p>Sjogren syndrome</p> Signup and view all the answers

    What is the microscopic feature of salivary gland biopsy in Sjogren syndrome?

    <p>Lymphocytes</p> Signup and view all the answers

    What is the result of Hyperkeratosis of oral epithelium?

    <p>Leukoplakia</p> Signup and view all the answers

    What is the characteristic of Dysplasia of oral epithelium?

    <p>Increased nuclear cytoplasmic ratio</p> Signup and view all the answers

    What is the result of Dysplasia++ plus invasion?

    <p>Cancer</p> Signup and view all the answers

    Study Notes

    Upper Gastrointestinal Tract

    Mouth

    • Oral mucosa composed of stratified squamous epithelium, present on lips, buccal mucosa, alveolar mucosa, soft palate, underside of the tongue, and floor of the mouth
    • Epithelial surface of hard palate, gingiva, and some regions of specialized mucosa on the dorsum of the tongue
    • Sjogren syndrome: a chronic inflammatory autoimmune disease that mainly attacks lacrimal and salivary glands
    • Leukoplakia: a condition characterized by hyperkeratosis of oral epithelium
    • Oral cancer: can arise from oral squamous epithelium, with risk factors including tobacco, alcohol, and HPV
    • Development of oral squamous cell carcinoma:
      • Normal oral epithelium → Hyperkeratosis of oral epithelium → Dysplasia of oral epithelium → Oral squamous cell carcinoma

    Sialolithiasis

    • Formation of stones in salivary ducts

    Oesophagus

    • Congenital and acquired diseases of the oesophagus
    • Neoplasms: oesophageal cancer can be classified into two main types, squamous cell carcinoma (SCC) and adenocarcinoma
    • Squamous cell carcinoma:
      • Most common type of oesophageal cancer worldwide
      • Occurs in the upper/middle part of the oesophagus
      • Risk factors: alcohol, tobacco, caustic injury, achalasia, radiation exposure, and carcinogen (acetyl aldehyde)
    • Adenocarcinoma:
      • Metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
      • Dysplasia in Barrett's oesophagus can progress to adenocarcinoma
    • Oesophageal obstruction:
      • Diffuse oesophageal spasm: repetitive distal oesophageal contractions
      • Zenker diverticulum: outpouching above upper oesophageal sphincter
      • Oesophageal mucosal web: mucosal semi-circumferential protrusion
      • Oesophageal (Schatzki) ring: mucosal/submucosal circumferential protrusion
    • Barrett's oesophagus:
      • A metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
      • Dysplasia in Barrett's oesophagus can progress to adenocarcinoma

    Stomach

    • Gastritis
    • Peptic ulcer disease
    • Neoplasms: gastric adenocarcinoma, gastric lymphomas, carcinoid tumors, and gastrointestinal stromal tumor
    • Gastric cancer:
      • Risk factors: Helicobacter pylori infection, autoimmune atrophic gastritis, smoking, diet (smoked, dried, and preserved food), gastric polyps, and genetic factors
      • Histological types:
        • Gastric adenocarcinoma
        • Gastric lymphomas
        • Carcinoid tumors
        • Gastrointestinal stromal tumor
      • Lauren's classification:
        • Intestinal type: common, affects older people, associated with environmental factors, and characterized by cohesive neoplastic cells that form glandlike tubular structures
        • Diffuse type: not common, affects young people, associated with mutations in E-cadherin, and characterized by absence of cell cohesion
      • Routes of spread:
        • Local invasion of adjacent structures
        • Hematogenous spread
        • Lymphangitic spread
        • Peritoneal spread

    Sjogren Syndrome

    • Chronic autoimmune inflammatory disorder characterized by diminished lacrimal and salivary gland function with resultant dryness of the eyes and mouth
    • Diagnosis: detection of autoantibodies (anti-SSA/Ro, ANA) and salivary gland biopsy
    • Features:
      • Bilateral enlargement of the salivary glands
      • Dryness of the eyes and mouth
      • Positive anti-SSA and anti-SS-B antibodies

    Upper Gastrointestinal Tract

    Mouth

    • Oral mucosa composed of stratified squamous epithelium, present on lips, buccal mucosa, alveolar mucosa, soft palate, underside of the tongue, and floor of the mouth
    • Epithelial surface of hard palate, gingiva, and some regions of specialized mucosa on the dorsum of the tongue
    • Sjogren syndrome: a chronic inflammatory autoimmune disease that mainly attacks lacrimal and salivary glands
    • Leukoplakia: a condition characterized by hyperkeratosis of oral epithelium
    • Oral cancer: can arise from oral squamous epithelium, with risk factors including tobacco, alcohol, and HPV
    • Development of oral squamous cell carcinoma:
      • Normal oral epithelium → Hyperkeratosis of oral epithelium → Dysplasia of oral epithelium → Oral squamous cell carcinoma

    Sialolithiasis

    • Formation of stones in salivary ducts

    Oesophagus

    • Congenital and acquired diseases of the oesophagus
    • Neoplasms: oesophageal cancer can be classified into two main types, squamous cell carcinoma (SCC) and adenocarcinoma
    • Squamous cell carcinoma:
      • Most common type of oesophageal cancer worldwide
      • Occurs in the upper/middle part of the oesophagus
      • Risk factors: alcohol, tobacco, caustic injury, achalasia, radiation exposure, and carcinogen (acetyl aldehyde)
    • Adenocarcinoma:
      • Metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
      • Dysplasia in Barrett's oesophagus can progress to adenocarcinoma
    • Oesophageal obstruction:
      • Diffuse oesophageal spasm: repetitive distal oesophageal contractions
      • Zenker diverticulum: outpouching above upper oesophageal sphincter
      • Oesophageal mucosal web: mucosal semi-circumferential protrusion
      • Oesophageal (Schatzki) ring: mucosal/submucosal circumferential protrusion
    • Barrett's oesophagus:
      • A metaplastic, columnar, glandular, intestine-like mucosa with brush border and goblet cells replaces normal stratified squamous epithelium of the distal esophagus
      • Dysplasia in Barrett's oesophagus can progress to adenocarcinoma

    Stomach

    • Gastritis
    • Peptic ulcer disease
    • Neoplasms: gastric adenocarcinoma, gastric lymphomas, carcinoid tumors, and gastrointestinal stromal tumor
    • Gastric cancer:
      • Risk factors: Helicobacter pylori infection, autoimmune atrophic gastritis, smoking, diet (smoked, dried, and preserved food), gastric polyps, and genetic factors
      • Histological types:
        • Gastric adenocarcinoma
        • Gastric lymphomas
        • Carcinoid tumors
        • Gastrointestinal stromal tumor
      • Lauren's classification:
        • Intestinal type: common, affects older people, associated with environmental factors, and characterized by cohesive neoplastic cells that form glandlike tubular structures
        • Diffuse type: not common, affects young people, associated with mutations in E-cadherin, and characterized by absence of cell cohesion
      • Routes of spread:
        • Local invasion of adjacent structures
        • Hematogenous spread
        • Lymphangitic spread
        • Peritoneal spread

    Sjogren Syndrome

    • Chronic autoimmune inflammatory disorder characterized by diminished lacrimal and salivary gland function with resultant dryness of the eyes and mouth
    • Diagnosis: detection of autoantibodies (anti-SSA/Ro, ANA) and salivary gland biopsy
    • Features:
      • Bilateral enlargement of the salivary glands
      • Dryness of the eyes and mouth
      • Positive anti-SSA and anti-SS-B antibodies

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    Description

    This quiz covers the anatomy and diseases of the mouth, including the oral mucosa, Sjogren syndrome, and leukoplakia.

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