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BLOCK E - High Yield > Gastric Disorders > Flashcards

Gastric Disorders Flashcards

1
Q

Most to least common peptic ulcers

A

Duodenal > Gastric > Esophageal

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2
Q

Gastric vs duodenal ulcer cause

A

Gastric: Decreased mucosal barrier protection
Duodenal: Increased acid

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3
Q

Gastric vs duodenal ulcer risk factors

A

Gastric: ASA/NSAIDs, smoking, stress, alcohol
Duodenal: Gastrin-secreting tumours (Zollinger-Ellison syndrome)

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4
Q

Gastric vs duodenal ulcer association with H. pylori

A

Gastric: 70%
Duodenal: 100%

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5
Q

Gastric vs duodenal ulcer risk of progression to carcinoma

A

Gastric: High
Duodenal: Low

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6
Q

Gastric vs duodenal ulcer clinical presentation

A

Gastric:
- Weight loss
- Pain exacerbated by meals

Duodenal:
- Weight gain
- Pain relieved by meals

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7
Q

Treatment for peptic ulcer disease (gastric and duodenal)

A
  1. Eliminate H. pylori with triple therapy (PPI, amoxicillin, clarythromycin)
  2. Acid suppression (H2 blocker, PPI)
  3. Avoid ASA, NSAIDs, alcohol
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8
Q

Complications for peptic ulcer disease (4)

A
  1. UGIB: hematemesis, melena, coffe ground emesis
  2. Iron deficiency anemia
  3. Perforation -> peritonitis
  4. Gastric outlet obstruction
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9
Q

Gastric cancer types

A

Gastric adenocarcinoma
Lymphoma

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10
Q

2 subtypes of gastric adenocarcinoma

A

Intestinal
Diffuse

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11
Q

Intestinal vs diffuse adenocarcinoma risk factors

A

Intestinal: Chronic H. pylori infection, smoking, smoked foods (nitrosamines), chronic gastritis

Diffuse: unknown

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12
Q

Intestinal vs diffuse adenocarcinoma histology

A

Intestinal: Intestinal and dysplasia metaplasia secondary to H.pylori infection
Diffuse: Signet ring cells

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13
Q

Intestinal vs diffuse adenocarcinoma morphology

A

Intestinal: Exophytic masses, ulcerated tumours, on lesser curvature

Diffuse: Diffuse thickening and infiltration of stomach wall + effacement of gastric folds

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14
Q

Specific type of diffuse adenocarcinoma and its associated symptom

A

Linitis Plastica (early satiety)

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15
Q

Clinical presentation of both subtypes of gastric adenocarcinoma

A
  • Asymptomatic early stages
  • Non-specific symptoms (nausea, vomiting, anemia, weight loss, epigastric pain)
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16
Q

Classic metastatic site for gastric adenocarcinoma

A

Left supraclavicular lymph node (Virchow node)

17
Q

2 common types of lymphoma (gastric cancer)

A

MALT lymphoma (H.pylori)
Diffuse large B cell lymphoma

18
Q

Peptic ulcer vs ulcerated tumour size

A

Peptic ulcer: small (<2cm)
Ulcerated tumour: large (>2cm)

19
Q

Peptic ulcer vs ulcerated tumour shape

A

Peptic ulcer: Round/oval, regular punched out borders
Ulcerated tumour: Irregular, thick borders

20
Q

Peptic ulcer vs ulcerated tumour borders

A

Peptic ulcer: Flat, edges touch the rugae
Ulcerated tumour: Elevated, rugae do not reach edges

21
Q

Peptic ulcer vs ulcerated tumour base

A

Peptic ulcer: Smooth base, sometimes with blood clot
Ulcerated tumour: necrotic base, irregular

22
Q

3 types of gastritis

A

Acute gastritis
Chronic H. pylori (atrophic) gastritis
Chronic autoimmune gastritis

23
Q

Causes/risk factors for acute gastritis (5)

A

ASA/NSAID use
High-dose steroids
Brain injury
Alcohol
Severe systemic stress (sepsis, burns)

24
Q

Complications of acute gastritis (2)

A

Hemorrhagic gastritis
Perforation -> peritonitis

25
Q

Acute gastritis treatment

A

Acid suppression (H2 blockers, PPIs)
Acid neutralization (antacids)
Mucosal protection (sucralfate)

26
Q

Chronic H. pylori gastritis
- When is it usually acquired?
- Persistent infection of…

A

Usually acquired in childhood
Persistent infection of antrum
Most common type of chronic gastritis

27
Q

Diagnosis of H. pylori gastritis

A

H. pylori detection via:
- Urease breath test
- Anti-H. pylori IgG
- Endoscopic biopsy with urease test

28
Q

Complications of H. pylori gastritis

A
  1. Adenocarcinoma (intestinal)
  2. Peptic ulcer disease (duodenal)
  3. MALT lymphoma
  4. Achlorhydria
  5. Malignancy
29
Q

Treatment for H. pylori gastritis

A

Triple therapy against H. pylori (PPI, clarythromycin, amoxicillin)

30
Q

Chronic autoimmune gastritis pathogenesis

A

Autoimmune destruction of parietal and chief cells

31
Q

Chronic autoimmune gastritis usually affects

A

fundus/body

32
Q

Clinical presentation of chronic autoimmune gastritis

A

Symptoms of anemia (pallor, fatigue, dyspnea)
Symptoms of VB12 deficiency (numbness, weakness, paresthesias)
Weight loss

33
Q

How can we diagnose autoimmune gastritis?

A

Anti-IF antibodies

34
Q

Complications of autoimmune gastritis

A
  1. Pernicious anemia
  2. Other autoimmune diseases
  3. Achlorhydria
  4. Increased risk of carcinoid tumours & gastric adenocarcinoma
35
Q

Treatment for autoimmune gastritis

A

Monthly VB12 injections

BLOCK E - High Yield (19 decks)

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