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BDS2 BAMS Gastroenterology > 1. Upper GI Disease > Flashcards

1. Upper GI Disease Flashcards

1
Q

Medication used to treat upper GI disease can (3)

A

Eliminate formed acid/neutralise stomach acid
Reduce acid secretion
Improve mucosal barrier

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2
Q

Which medication eliminates formed acid/neutralises stomach acid

A

Antacids

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3
Q

Which medications reduced acid secretion (2)

A

Hydrogen receptor pump

Proton pump inhibitors

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4
Q

How do medications improve mucosal barrier (2)

A

Eliminate helicobacter

Inhibit prostaglandin removal

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5
Q

Drugs that exacerbate upper GI disease (2)

A

NSAIDs (stop PG production and prevent healing)

Steroids - damage ulcer healing process

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6
Q

Mechanism of hydrogen receptor antagonists

A

Reduce acid production by preventing histamine activation of acid production

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7
Q

Limitations of hydrogen receptor antagonists

A

Alternative pathways still operate (that can be inhibited by ACh and gastrin)

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8
Q

Types of hydrogen receptor antagonists (2)

A

Ranitidine

Cimetidine

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9
Q

Types of proton pump inhibitors (3)

A

Omeprazole
Lansoprazole
Pantoprazole

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10
Q

Examples of oral diseases (3)

A

ROU
Lichen planus
OFG

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11
Q

Examples of oesophageal disorders (3)

A

Dysphagia
Dysmobility disorders
GORD

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12
Q

Definition of dysphagia

A

Food sticking in throat

Mechanical block/compression, may be intermittent

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13
Q

Types of dysphagia (3)

A

Functional
Dysmobility
Due to external compression

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14
Q

Causes of GORD (3)

A

Deective lower oesophageal sphincter
Impaired lower clearing
Impaired gastric emptying

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15
Q

GORD may cause (3)

A

Ulceration
Inflammation
Metaplasia

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16
Q

Signs/symptoms of GORD (4)

A

Epigastric burning - worse when lying down, bending, during pregnancy
Dysphagia - oesophagi’s, stricture, dysmobility
GI bleeding
Severe pain (mimics MI) - oesophageal muscle spasm/suspected MI

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17
Q

What might Barrett’s oesophagus be caused by

A

Recurrent acid reflux into the lower part of the oesophagus

18
Q

Tissue change of Barrett’s oesophagus (2)

A

Metaplasia of oesophageal lining (metaplastic change to gastric-type mucosa)
Associated with a malignant change (adenocarcinoma)

19
Q

Definition of hiatus hernia

A

When a part of the stomach pushes above the diaphragm into the thorax

20
Q

Symptoms of hiatus hernia are similar to

A

GORD symptoms

21
Q

Hiatus hernia is more common in

A

Women

22
Q

GORD management involves (4)

A

Smoking cessation (improves sphincter)
Lose weight, avoid triggering activity
Medication
Increase GI motility and gastric emptying

23
Q

Medications involved with GORD management (2)

A

Antacids
Hydrogen blockers
Proton pump inhibitors

24
Q

Where can PUD appear

A

On any acid affected site (oesophagus, stomach, duodenum)

25
Q

Causes of PUD (3)

A

High acid secretion (duodenal)
Normal acid secretion but reduced protective barrier (stomach)
Drugs (NSAIDs, steroids)

26
Q

Excessive acid production can lead to (2)

A

Oesophageal ulcers

Duodenal ulcers

27
Q

Normal acid levels lead to

A

Reduced protective barrier

28
Q

PUD due to normal acid levels usually involves

A

H. pylori

29
Q

H. pylori infection causes (2)

A

Gastric ulcers

Chronic gastric wall inflammation (stomach lymphoma)

30
Q

H. pylori treatment (2)

A

Triple therapy

Involves two antibiotics and one PPI

31
Q

Antibiotics used in H. pylori treatment (2)

A

Amoxicillin (clarithromycin if allergic)

Metronidazole

32
Q

PPI used in H. pylori treatment

A

Omeprazole

33
Q

Signs and symptoms of PUD (3)

A

Often asymptomatic/none
Epigastric burning pain
Usually no physical signs

34
Q

Description of PUD related epigastric pain (3)

A

Worse before/just after meals
Worse at night
Relieved by food, alkali, vomiting

35
Q

When do PUD physical signs occur

A

When complications occur (bleeding, perforation, etc.)

36
Q

PUD investigations (4)

A

Endoscopy (oesophagus, stomach, duodenum)
Radiology (barium meal/swallow)
Anaemia tests (FBC, FOB)
H. pylori tests (breath, antibodies, mucosa)

37
Q

Complications of PUD can be (2)

A

Local

Systemic

38
Q

Local complications of PUD include (4)

A

Perforation
Haemorrhage
Stricture
Malignancy

39
Q

Systemic complications of PUD include

A

Anaemia

40
Q

PUD treatment (9)

A 
Smoking cessation
Eat small, regular meals
Eradication therapy
Ulcer healing drugs
Endoscope
Medical intervention
Surgical intervention
Gastrectomy
Vagotomy
41
Q

When does PUD treatment involve medical intervention (2)

A

When reversible problems are present (lifestyle changes)

When H. pylori is present

42
Q

When does PUD treatment involve surgical intervention

A

When complications occur

BDS2 BAMS Gastroenterology (7 decks)

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