Gastric Disease

Question 1

At least 1 of which 3 Rome II criteria for functional dyspepsia?

Answer 1

Epigastric pain
Post-prandial fullness
Early-satiety

Question 2

3 main causes of organic dyspepsia (+ most common)?

Answer 2

Peptic ulcer disease (most common)
NSAIDs
Gastric cancer

Question 3

How is dyspepsia different to GORD?

Answer 3

GORD = reflux
Dyspepsia = stomach discomfort

Question 4

2 causes of peptic ulcer disease + why they allow ulcers to form?

Answer 4

H. pylori
NSAIDs
Expose mucosa to HCl and pepsin

Question 5

2 places peptic ulcers are most common (+ most common)?

Answer 5

Duodenum (most common)

Stomach

Question 6

3 drugs used to treat peptic ulcer disease (+ example)?

Answer 6

Antacids (Gaviscon)
H2 antagonists (ranitidine)
PPI (omeprazole)

Question 7

When is duodenal ulcer pain worse and better?

Answer 7

Worse at night

Better with meals

Question 8

When is gastric ulcer pain worse?

Answer 8

Straight after meal

Question 9

Apperance of peptic ulcers?

Answer 9

2-12cm
Clear edges
Fibrotic base

Question 10

2 complications of peptic ulcers?

Answer 10

Pernicious anaemia

Perforation

Question 11

3 tests for H. Pylori?

Answer 11

Urea breath test
Faecal antigen test
IgA serology

Question 12

Treatment for +ve H. Pylori depedning on age?

Answer 12

> 55 = endoscopy

< 55 = PPI + amox + clarith

Question 13

Treatment for dyspepsia or peptic ulcer with -ve H. Pylori?

Answer 13

PPI

Question 14

How long should a PPI be stopped before an endoscopy?

Answer 14

2 weeks

Question 15

Pernicious anaemia is associated with?

Answer 15

Vitamin B12 deficiency

Question 16

IL associated with H. Pylori infection?

Answer 16

IL-8

Question 17

Between which layers does H. Pylori reside?

Answer 17

Epithelium and mucosal barrier

Question 18

2 causes of acute gastritis?

Answer 18

Chemical

Head trauma

Question 19

3 causes of chronic gastritis (+ most common)?

Answer 19

Chemical (most common)
Autoimmune
H. Pylori

Question 20

What type of autoimmune disease is autoimmune gastritis + 2 key antibodies?

Answer 20

Type IV
Anti-parietal cell
Anti-intrinsic factor

Question 21

Chronic gastritis and loss of parietal cells is associated with which main cancer risk?

Answer 21

Atrophy

Question 22

What is gastroparesis + how does it present?

Answer 22

Delayed gastric emptying

Fullness, nausea, weight loss

Question 23

2 causes of gastroparesis?

Answer 23

Diabetes

Elicit drugs e.g. opiates

Question 24

3 treatments for gastroparesis?

Answer 24

Small/low fat meals
Motility agents
Gastric pacemaker

Question 25

Benign gastric cancer presents as?

Answer 25

Polyps

Question 26

Does gastric cancer present early or late?

Answer 26

Late

Question 27

2 places that gastric cancer spreads + key sign?

Answer 27

``` Lymph nodes (Virchow's node) Liver ```

Question 28

3 types of gastric cancer?

Answer 28

Adenocarcinoma MALToma Stromal stumour

Question 29

Does intestinal or diffuse adeocarcinoma have a better prognosis?

Answer 29

Intestinal

Question 30

Intestinal adenocarcinoma affects the .... and is/is not associated with H. Pylori?

Answer 30

Lesser curvature | Is associated

Question 31

Diffuse adenocarcinoma affects the .... and is/is not associated with H. Pylori?

Answer 31

Stomach wall | Is not

Question 32

Other name for diffuse carcinoma + key histological finding?

Answer 32

Linitus plastica | Signet cells

Question 33

Describe the position of Virchow’s node?

Answer 33

Left supraclavicular