gastric conditions Flashcards
what are carcinoid tumours?
slow growing malignant tumours that develop in neuroendocrine system.
What does a patient with a carcinoid tumour present with?
abdominal pain diarrhoea flushing wheeze pulmonary stenosis
What pharacological treatment can be offered for carcinoid tumours?
ocreotide - an analogue of somatostatin
What is clostridium difficile?
gram positive bacteria that causes pseudomembranous colitis = diarrhoea
risk factors for developing clostridium difficile
broad spectrum abx use e.g.
- clindamycin
- ciprofloxacin
- cephalosporins
- penicillins
clinical features of CDI
watery diarrhoea that may contain blood painful abdo cramps nausea dehydration fever confusion loss of appetite
management of CDI
vancomycin orally 4 times a day
complications of CDI
- Massive colonic inflammation
- Toxic megacolon
- leucocytosis
What is gastroenteritis?
common cause of diarrhoea and vomiting caused by ingestion of bacteria/toxins/viruses
Common bacterial causes of gastroenteritis
staphylococcus aureus campylobacter salmonella shigella Ecoli 0157
Viral causes of gastroenteritis
rotavirus
norovirus
adenoviruses
Parasitic causes of gastroenteritis
cryptosporidium
schistosoma
management of gastroenteritis
fluid replacement
oral rehydration
abx if severe
indications for abx treatment for gastroenteritis
systemically unwell, immunosuppressed and elderly patients
Norovirus duration
24-48 hours of GI upset after innoculation
What can norovirus cause in elderly patients?
pre renal AKI
What is gastroparesis?
delayed gastric emptying due to decreased activity of the stomach muscles
Clinical features of gastroparesis
nausea, vomiting, feeling unwell after eating, abdominal pain and bloating
what is gastroparesis associated with?
diabetes mellitus
how is gastroparesis diagnosed?
solid meal gastric scintigraphy
management of gastroparesis
domperidone and metoclopramide
what is Giardiasis?
type of gastroenteritis caused by Giardia lamblia
Clinical features of giardiasis
incubation period of one to three weeks
explosive, watery, non bloody diarrhoea
new onset lactose intolerance
treated with metronidazole
treatment for H. pylori infection
amoxicillin, clarithromycin and PPI twice daily for seven days
what is a MALT (mucosa associated lymphoid tissue) lymphoma?
non hodgkin’s lymphoma
presents in the stomach
develops from B lymphocytes in the marginal zone
treatment for MALT lymphoma
H. pylori eradication triple therapy
chemotherapy and radiotherapy offered too
What is peptic ulcer disease?
duodenal and gastric ulcers often caused by H. pylori
duodenal ulcers are more common
Causes of peptic ulcer disease
- NSAIDs
- chronic steroid use
- SSRIs
- increased gastric acid secretion
- smoking
- blood group O
follow up after giving PPI for peptic ulcer
repeat endoscopy 6-8 weeks after PPI trial
Symptoms of an upper GI bleed
haematemesis - vomiting of blood or coffee grounds
melena - black tarry stools
Rockall score for upper GI bleeds
0 points = under 60, no blood or dark red spot and a mallory weiss tear
1 point = 60-79 y/o
2 points = over 80, IHD or cardiac failure, upper GI MALIGNANCY
3 POINTS = LIVER FAILURE
