Gastric Disease Flashcards
List 8 causes of GERD.
Delayed gastric emptying Increased gastric volume Hiatal hernia Tobacco use Alcohol CNS depressants Pregnancy Obesity
Describe the histopathological features of GERD.
Significant eosinophillic infiltrate followed by neutrophillic infiltrate
Basal zone hyperplasia - 20% of thickness of total epithelium
Lamina propria papillae projection into the upper 1/3 of epithelium
Give 4 symptoms of GERD.
heart burn
acidic taste in mouth
Dysphagia
Cough
Give some complications of GERD.
(Eosinophillic) Oesophagitis Barrett’s Strictures Oesophageal Ulceration Haematemesis Malaena
Give 3 pharmacological and 1 surgical treatment of GERD.
H2 antagonists
PPIs
Antacids
Nissans fundoplication
Why are elderly people more prone to gastritis?
Reduced mucous and bicarbonate production
Where does H pylori colonisation have to occur in order for it be asymptomatic?
Body and antrum
What is the difference in Pathophysiology between if H-pylori colonisation occurred in the antrum vs the body of the stomach?
Antrum - increased Gastrin - more acid - duodenal Cell metaplasia - duodenal colonisation - duodenal ulceration
Body - atrophic effect - Chornic atrophic gastritis - gastric ulcer - intestinal metaplasia - dysplasia - gastric cancer.
What is the treatment for H pylori?
PPIs
Amoxicillin + clarithromycin or metronidazole.
Give 4 symptoms of autoimmune gastritis.
Where does damage in autoimmune gastritis typically occur?
Anaemia
Anorexia
Neurological symptoms
Glossitis
Oxyntic mucosa in the body and fundus.
Give 3 sequelae related to H pylori associated chronic gastritis.
Peptic ulcer
Adenocarcinoma
MALT Lymphoma
Give 5 consequences of PUD.
Scarring Perforation - peritonitis Erosion into adjacent structure Haemorrhage Malignancy (rare)
Give symptoms of PUD.
Epigastric pain that may radiate to the back
- 1-3 hours post meal if duodenal
- Shortly after meals with gastric
Haematemesis
Malaena
Weight loss
Anaemic symptoms
What is the cause of Zollinger-Ellison syndrome?
Non-beta islet cell gastrin secreting tumour of the pancreas
Give some causes of stress ulceration.
Severe burns Sepsis Raised ICP (Cushing’s ulcer) Severe trauma Multiple organ failure
