gastric conditions

Question 1

what are carcinoid tumours?

Answer 1

slow growing malignant tumours that develop in neuroendocrine system.

Question 2

What does a patient with a carcinoid tumour present with?

Answer 2

abdominal pain
diarrhoea
flushing
wheeze
pulmonary stenosis

Question 3

What pharacological treatment can be offered for carcinoid tumours?

Answer 3

ocreotide - an analogue of somatostatin

Question 4

What is clostridium difficile?

Answer 4

gram positive bacteria that causes pseudomembranous colitis = diarrhoea

Question 5

risk factors for developing clostridium difficile

Answer 5

broad spectrum abx use e.g.

• clindamycin
• ciprofloxacin
• cephalosporins
• penicillins

Question 6

clinical features of CDI

Answer 6

watery diarrhoea that may contain blood
painful abdo cramps
nausea
dehydration
fever
confusion
loss of appetite

Question 7

management of CDI

Answer 7

vancomycin orally 4 times a day

Question 8

complications of CDI

Answer 8

• Massive colonic inflammation
• Toxic megacolon
• leucocytosis

Question 9

What is gastroenteritis?

Answer 9

common cause of diarrhoea and vomiting caused by ingestion of bacteria/toxins/viruses

Question 10

Common bacterial causes of gastroenteritis

Answer 10

staphylococcus aureus
campylobacter
salmonella
shigella
Ecoli 0157

Question 11

Viral causes of gastroenteritis

Answer 11

rotavirus
norovirus
adenoviruses

Question 12

Parasitic causes of gastroenteritis

Answer 12

cryptosporidium

schistosoma

Question 13

management of gastroenteritis

Answer 13

fluid replacement
oral rehydration
abx if severe

Question 14

indications for abx treatment for gastroenteritis

Answer 14

systemically unwell, immunosuppressed and elderly patients

Question 15

Norovirus duration

Answer 15

24-48 hours of GI upset after innoculation

Question 16

What can norovirus cause in elderly patients?

Answer 16

pre renal AKI

Question 17

What is gastroparesis?

Answer 17

delayed gastric emptying due to decreased activity of the stomach muscles

Question 18

Clinical features of gastroparesis

Answer 18

nausea, vomiting, feeling unwell after eating, abdominal pain and bloating

Question 19

what is gastroparesis associated with?

Answer 19

diabetes mellitus

Question 20

how is gastroparesis diagnosed?

Answer 20

solid meal gastric scintigraphy

Question 21

management of gastroparesis

Answer 21

domperidone and metoclopramide

Question 22

what is Giardiasis?

Answer 22

type of gastroenteritis caused by Giardia lamblia

Question 23

Clinical features of giardiasis

Answer 23

incubation period of one to three weeks

explosive, watery, non bloody diarrhoea

new onset lactose intolerance

treated with metronidazole

Question 24

treatment for H. pylori infection

Answer 24

amoxicillin, clarithromycin and PPI twice daily for seven days

Question 25

what is a MALT (mucosa associated lymphoid tissue) lymphoma?

Answer 25

non hodgkin’s lymphoma
presents in the stomach
develops from B lymphocytes in the marginal zone

Question 26

treatment for MALT lymphoma

Answer 26

H. pylori eradication triple therapy

chemotherapy and radiotherapy offered too

Question 27

What is peptic ulcer disease?

Answer 27

duodenal and gastric ulcers often caused by H. pylori

duodenal ulcers are more common

Question 28

Causes of peptic ulcer disease

Answer 28

1. NSAIDs
2. chronic steroid use
3. SSRIs
4. increased gastric acid secretion
5. smoking
6. blood group O

Question 29

follow up after giving PPI for peptic ulcer

Answer 29

repeat endoscopy 6-8 weeks after PPI trial

Question 30

Symptoms of an upper GI bleed

Answer 30

haematemesis - vomiting of blood or coffee grounds

melena - black tarry stools

Question 31

Rockall score for upper GI bleeds

Answer 31

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