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Gastric disease Flashcards

1
Q

Name 4 acute causes of gastritis

A

Alcohol
irritant chemical injury
severe burns
shock/trauma

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2
Q

What is H.Pylori?

A

Gram -ve flagellated bacillus

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3
Q

What is PUD?

A

Peptic ulcer disease

Breach in GI mucosa due to a failure of defense against acid and pepsin attack

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4
Q

Where are PUD found?

A

Stomach

Duodenum

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5
Q

Macroscopically how do PUD look?

A

Edges clear cut and punched out

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6
Q

The causes of PUD and gastritis are very similar but what are the two most common?

A

H.pylori

NSAIDS

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7
Q

How does H.pylori damage the GI mucosa?

A

H.pylori lives between epi and mucous barrier
Releases ammonia and proteases which damage epi
This allows mucosal barrier to be exposed to HCl

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8
Q

What enzyme do we test for in breath test for diagnosing H.pylori?

A

Urease (this enzyme creates ammonia)

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9
Q

First line of investigation of PUD?

A

Carbon-13 urea breath test (same to test if someone has got rid of H.pylori)

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10
Q

What treatment is used for H.pylori? When do you retest?

A 
Triple therapy for 7 days
PPI
Amoxicillin
Clarithromycin/metronidazole
(PAM/PAC)

Retest after 6-8 weeks

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11
Q

What is dyspepsia?

A 
A collection of symtpoms
Epigastric pain syndrome
-Epigastric pain 
-Bloating
-Reflux

Post prandial distress syndrome

  • Post prandial fullness/early satiety
  • Nausea/vomiting
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12
Q

What is the difference between organic and functional dysppesia?

A

Organic - know what the underlying cause is - structural issues e.g. PUD, GORD etc.
Functional - no evidence of structural disease

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13
Q

What are the ALARM symtpoms?

A 
A - anaemia
L - loss of weight
A - anorexia
R - recent onset of progressive symtoms
M - masses and melena/haematemesis
S - swallowing difficultes
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14
Q

If a patient presents with dyspesia/GORD when would they immediately get an upper GI endoscipy?

A

ALARM
OR
over 55

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15
Q

How do you manage and treat dyspesia in the absence of ALARM sytpoms?

A
  • Lifestyle changes - classic lot
  • Reduce/stop use of NSAIDS
  • Test for H.pylori

PPI treatment for 1month

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16
Q

What is the biggest risk factor for gastric cancer? And what are 3 other risk factors?

A

H.pylori
Diet high in processed meats
Obesity
Smoking

17
Q

Name the 3 kinds of gastric canker?

A

90% adenocarcinoma
- intestinal (more polyp)/diffuse (worse outcome and into the wall of stomach)

Lymphomas - most in MALT

Carcinoid and stromal tumours (rare)

18
Q

What is the Virchow’s Node?

A

Lymph node above left clavicle - gastric cancer often mestassis to there

19
Q

What is gastroparesis?

A

Delayed gastric empyting that is NOT due to an obstruction

20
Q

How do you investiagte gastroparesis?

A

Gastric emptying studies

Manometry

21
Q

How to manage gastroparesis?

A

Nutritional support
Metroclopramide
Surgery

22
Q

What must be ensured before performing the carbon-13 urea test?

A

No PPIs for 2 weeks

No antibiotics for 4 weeks

23
Q

Why does NSAID use cause gastritis and PUD?

A

Decrease prostaglandin production via COX-2 inhibition -> increased acidity
(PGE2 and PGI2 decrease pH)

24
Q

What are the symptoms of PUD?

A 
Pain predominant dyspesia 
Often nocturnal symtpoms - aggrevated/relived by eating
Relapsing and remitting
Nausea/vomiting
Reflux
25
Q

How do you treat a paitent with PUD that is -ve for H.pylori

A

NSAID user

  • stop NSAID use
  • full dose PPI for 8 weeks
  • ve for NSAID and H.pylori
  • full dose PPI 4-8 weeks
26
Q

Symptoms of gastroparesis?

A

Bloating
Abdo pain
Fullness
Nausea/vomiting after meals

27
Q

What 3 things are known to cause gastroparesis?

A

Chemo
Diabetes
Weed smoking

28
Q

Symptoms of gastric cancer?

A

ALARM/ > 55 yo

Dyspepsia

29
Q

Treatment of gastric cancer

A

Surgery
Chemo/radio
MALT - remision in most cases by H.pylori treatment

30
Q

Investigation of gastric cancer?

A

Endoscopy and biopsy

CT scan

31
Q

What pain is associated with eating in terms of duodenal and gastric ulcers?

A

Duodenal - pain relieved by eating

Gastric - pain worsened by eating

32
Q

What is Fe2+ anaemia associated with gastrically?

A

Gastric cancer

Gastric ulcer

GI (26 decks)

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