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Exam - M - GI Diseases > can u stomach this? > Flashcards

can u stomach this? Flashcards

1
Q

what is a peptic ulcer

A

a breakdown of the mucosa in the stomach or duodenum

duodenal ulcers are more common

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2
Q

what can cause a peptic ulcer

A

H. pylori infection
medications - steroids, NSAIDS
increased acid production from stress, alcohol, caffeine, spicy food, smoking
hyperparathyroidism

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3
Q

how may a peptic ulcer present

A 
epigastric pain/discomfort 
nausea 
vomiting 
dyspepsia 
regurgitation 
reflux 
haematemesis
melaena 
anaemia 
epigastric tenderness 
backpain 
gastric ulcers worsen symptoms after eating, duodenal ulcer symptoms improve after eating
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4
Q

what investigations could you do for a gastric ulcer

A

endoscopy
urease test
biopsy
bloods - look for iron deficiency anaemia

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5
Q

how could you treat a peptic ulcer

A

PPIs
stop NSAIDS, steroids
treat h.pylori
antacids

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6
Q

what are complications of peptic ulcers

A

could cause an acute GI bleed
perforation - peritonitis - requires urgent surgery
the scar tissue from healing ulcers can cause pyloric strictures
chronic ulcers can cause iron deficiency anaemia
can cause malignancy
pyloric stenosis

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7
Q

what effect does H. pylori have on the GI system

A

the bacteria produces urease which then synthesises ammonia and breaks down the mucosa of the stomach/duodenum, it also neutralises the pH so it can live in the stomach for longer

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8
Q

how could H. pylori present

A

usually asymptomatic until an ulcer forms

fever

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9
Q

what tests could you do to diagnose a H.pylori infection

A

urea breath test
stool antigen test
rapid urease test during endoscopy

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10
Q

how could you treat h. pylori infection

A

triple therapy - PPI + 2 antibiotics
clarithromycin 500mg + amoxicillin 1g
clarithromycin 400mg + metronidazole 250mg

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11
Q

what is gastric cancer

A

adenocarcinoma of glandular epithelium in the stomach

2nd most common malignancy

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12
Q

what can cause gastric cancer

A

h. pylori
reflux
genetics - CDH-1 gene

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13
Q

what are risk factors for gastric cancer

A 
alcohol 
smoking 
nitrogenous food 
diet 
genetics 
h. pylori
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14
Q

how may gastric cancer present

A 
dyspepsia 
nausea + vomiting 
weight loss
anorexia 
melaena  
anaemia 
gastric outlet obstruction
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15
Q

what investigations could you do for gastric cancer

A 
laparoscopy 
endoscopy 
biopsy 
CT
barium swallow
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16
Q

how could you treat gastric cancer

A

chemotherapy

gastrectomy

17
Q

what are complications of gastric cancer

A

presents late so has poor prognosis

18
Q

what is gastric outlet obstruction

A

when the pyloric sphincter does not allow the most or all of the contents of the stomach into the duodenum because it is blocked in some way

19
Q

what van cause gastric outlet obstruction

A

strictures - usually from scar tissue of previous trauma/infection
gastritis
deformity

20
Q

how may gastric outlet obstruction present

A

vomiting - no bile because the food can’t get past the stomach
nausea
dehydration
abdominal distention

21
Q

what investigations could you do for gastric outlet obstruction

A

endoscopy

CT

22
Q

how could you treat gastric outlet obstruction

A

endoscopic balloon dilatation

gastrectomy - laparoscopic or open

23
Q

what is gastritis

A

inflammation of stomach lining

can be acute or chronic

24
Q

what causes acute gastritis

A 
stress 
NSAIDs
alcohol 
uraemia 
burns - curlings ulcers (due to dehydration and ischaemia from burns)
25
Q

what are the types of chronic gastritis

A

type A - autoimmune, parietal cells undergo autoimmune attack, reduced secretion of HCL and IF, atrophy of cells - VB12 deficiency

type B - bacterial, usually due to H.Pylori

type C - chemical, NSAIDs, alcohol, bile reflux

26
Q

what investigations could you do for chronic gastritis

A

type A - bloods, look for anaemia
type B - test for H pylori - urea breath test, urinalysis, rapid slide urease test, blood for antibodies, stool microscopy and culture

27
Q

how do you manage gastritis

A

mild - antacids of H2 receptor antagonists
moderate/severe - PPIs
treat H pylori with PPI and antibiotics
1g amoxicillin + 500mg clarithromycin
or
400mg metronidazole + 250mg clarithromycin

28
Q

what are complications of gastritis

A

pernicious anaemia
stricture formation
mucosa associated lymphoid tissue lymphoma (MALT lymphoma)

Exam - M - GI Diseases (35 decks)

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