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CSI C8 > CSI C8 > Flashcards

CSI C8 Flashcards

1
Q

what muscles are the sphincters made from?

A

cricopharyngeus

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2
Q

why are both sphincter closed usually

A

Upper: stop air in
Lower: acid reflux

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3
Q

Barretts’ oesophagus

A

endoscopy
chronic acid exposure
squamous to columnar

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4
Q

Oesphagea carcinomas: two types + where, two main symptoms

A

Squamous cell caricnoma: all down oesophagus
adenocarcinoma: inferior third (from barretts)
dyphagia and weight loss

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5
Q

what muscle type in upper middle lower oesophagus

A

voluntary
mix
striated

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6
Q

how to help patients understand? (4 things)

A

speak slow
avoid jargon
repeat
ask patient what they understand

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7
Q

patients who face the most difficulties:

A

older people
first language not english
low grade jobs
poverty

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8
Q

what are oesophageal varices? what causes? treatment?

A

veins swollen, portal system high becuse of portal hypertension, obstruction in liver portal system\alcoholics\liver problems

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9
Q

treatment for reflux

A

PPI (omeprezole)
H2 inhibitor (ranitidine)
Antacids (not for long)

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10
Q

tretament for oesophagitis + if it comes back + doesnt work

A

PPI lowets dose
8 weeks than higher dose
diffeent ppi

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11
Q

surgery for oesophagitis

A

laparscopic fundoplication - make the disscetion shorter

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12
Q

dyspepsia

A

recuurent stomach pain… heartburn, bloating

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13
Q

4 reasons for dyspepsia

A

Gastritis
GORD
Peptic ulcer disease
functional dyspepsia (don’t know why, examination doesnt prove causative problems)

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14
Q

why gastritis comes under functional dyspepsia?

A

some caess gastritis isnt the cuase or shouldnt cuase the degree of symptoms. Even if it clears dyspepsia still continues

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15
Q

Why can ibueprofen be bad to take on an empty stomach

A

NSAIDs irritate mucus lining.

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16
Q

5 common causes of dyspepsia

A

GORD
Stress
Peptic ulcer disease
Fuctional dyspepsia
Oesophagitis

17
Q

5 less common causes of dyspepsia

A

Cancer
Coronary heart disease -> angina pain can be mistaken
Pancreaitis
IBD
gall bladder disease

18
Q

red flag for dyspepsia

A

upper gi cancer -> dysphagia, weight loss, anaemia

19
Q

NICE referrals:

A

urgent if: mass found (2 week)
-dyphagia (2 week OGD)
>55 and weight loss with dyspepsia/reflux/pain (2 week OGD)

non urgent: haematesis (vomiting blood)
>55 and treatemnt resistant dyspepsia, pain with low haem, platlet with anything else or vomititng with anything else

20
Q

7 tests used for mr muller

A

-ECG (pain to see if its coronary heart disease causing ischaemia
-weight
-alcohol history (varices, 14 units a week )
-medication history (CA channel blockers, beta blockers -> relax LOS)(NSAIDS -> gastric mucosa)
-full blood count (anaemia, high platlets (cancer))
- H.pylori (prescence doesnt cause symptoms always)
- LFTs

21
Q

3 ways H pylori survive

A

1) acid nuetralisation: local nuetralistaion: urease turns urea +water into ammonia + C02
2) motion; flagella into mucus layer
3) adhesion, LPS/BabA
4) toxins: cagA -> gastric diseases vacA-> stomach cells apoptose and die

22
Q

how to detetc H pylori

A

-stool antigen: disadv affected by meds and needs refridgettion- antigen of h PYLORI
-CLO test: invasive - urease
- Carbon 13:disadv other meds influence and fasting needed and specialist equiment -ureaese
- serum serology: igM poorly sensitive and igG (dk if curret) - human antigen

23
Q

run through HCl production

A

Carbonic anhydrase ->
bicrabonate exchange from cl-
h+ INTO LUMEN VIA H/K antiporter (proton pump (gastric hydrogen potassium ATPase)
Atpase for K in then K diffuses into lumen then out again^
cl- diffuses in through channels

24
Q

what 3 thing stimulate hcl production

A

1) H2 receptors
2) gastrin rceeptors
3) acetylcholine receptors

25
Q

treatment for h pylori

A

PPI (has anti urease activity already) + antibacterial

26
Q

lessen gastric secretions

A

PPI + H2 *on its own PPI reduces 80%

27
Q

what treatment did Mr mullen get?

A

omprezole and 2 antibiotics (amocilian and clarthryomycin)

28
Q

What is only test to see if H pylori is cured

A

Carbon 13!!!! (2 weeks no PPI and 4 weeks no anitbiotics)(others maje false negative)

29
Q

what is a hiatus hernia + 5 risk factors + 2 types

A

part of abdominal viscera slips through the diagraphm, males/age/obesity/pregnancy/genetic, sliding hiatus hernia: both bottom of esoephagus (GOJ) and portion slide into or rolling: only top of stomahc/spleen etc move alongside.

30
Q

raesons for having persisitent GORD even with meds

A
  • hiatus hernia, symptomatic non acid reflux or functional dyspepsia
31
Q

Alginate meds?

A

react to from a gel which acts as a barrier

32
Q

5 lifestyle changes

A

dont smoke
loose weight
raise head in bed
not a lot of alcohol
tight clothes

33
Q

differnce in metaplasia, dysplasia and cancer

A

metaplasia: reversible
dysplasia: not
cancer: invasive, rapid growth

CSI C8 (2 decks)

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