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finals - gi > gastric: ulcers, bleeds + cancer > Flashcards

gastric: ulcers, bleeds + cancer Flashcards

1
Q

what warrant urgent dyspepsia cancer referrals (5/6)

A

dysphagia // upper abdo mass // >55 with weight loss + dyspepsia OR reflex OR abdo pain

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2
Q

what warrants non-urgent dyspepsia cancer referrals

A

haematemesis // treatment resistant dyspepsia // low hb // raised platelets

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3
Q

what is treatment for dyspepsia without need for OGD

A
  1. med review 2. lifestyle 3. 1 month PPI OR H pylori treatment
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4
Q

what gram is H pylori

A

negative

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5
Q

what conditions are associated with H pylori (4)

A

peptic ulcers // gastric cancer // MALT // atrophic gastritis

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6
Q

what is the most sensitive and specific test for H pylori (3)

A

urea breath test // rapid urea test (CLO) - less sensitive // stool antigen

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7
Q

what test is used to determine eradication of H pylori

A

urea breath test

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8
Q

mx H pylori

A

PPI + amox + clarithromycin OR metro // triple therapy no amox if pen allergy

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9
Q

what drugs can cause peptic ulcers

A

NSAIDs, SSRIs, corticosteroids, biphosphonates

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10
Q

how do gastric and duedenal ulcers present differently and which is most common

A

duodenal - more common and relieved by eating // gastric worse on eating

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11
Q

how are peptic ulcers treated if H. pylori negative

A

PPI until healed

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12
Q

what artery is usually involved in peptic ulcer acute bleeds

A

gastroduodenal

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13
Q

presentation of peptic ulcer acute bleeds

A

haematemesis, maleana, hypotension, tachycardia

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14
Q

mx peptic ulcer acute bleeds

A

ABCDE —>first line endoscopy

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15
Q

what symptom is common in peptic ulcer perforation

A

syncope

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16
Q

invx for perforated peptic ulcer

A

erect CXR

17
Q

what are risk cancers/ demographic for gastric cancer (7)

A

male, elderly, H pylori, atrophic gastritis, diet, smoking

18
Q

what lymph nodes does gastric cancer spread too

A

left supraclavicular (virchow’s) and periumbilical

19
Q

what type of gastric cancer is H pylori accos with

A

adenocarcinoma (most common) and MALT lymphoma

20
Q

what is seen on biopsy in gastric cancer

A

OGD + biopsy –> signet cells

21
Q

how js gastric cancer staged

A

CT

22
Q

what surgical options are available for gastric cancer

A

endoscopic mucosal resection –> partial gastrectomy –> total gastrectomy

23
Q

what adjuvant can be given in gastric cancer

A

chemo

24
Q

what are complications of gastrectomy

A

dumping syndrome / weight loss / anaemia / osteoporosis / vit B12

25
Q

what is dumping syndrome

A

rebound hypoglycaemia

26
Q

what blood restult can a MALT lymphoma be associated with

A

paraproteinaemia

27
Q

what autoimmune condition is MALT assoc with

A

Thyroid + sjorgens

28
Q

what are the most common causes of an upper GI bleed

A

varisces, peptic ulcer, (mallor weiss, boeerhaave)

29
Q

what blood test may indicate upper GI bleed

A

raised urea (blood in stomach broken down to urea)

30
Q

what is the glasgow blatchford score used for

A

determine whether GI bleeds need urgent care

31
Q

what are the components of the glasgow blatchford score (4)

A

urea // Hb // BP // pulse or malena or syncope or hepatic or cardiac disease

32
Q

what score on glasgow blatchford score would indicate discharge

A

0

33
Q

what is 1st mx step in upper GI bleed

A

ABC, wide bore IV // platelets if bleeding // FFP if needed //

34
Q

when would prothrombin complex be indicated in upper GI bleed

A

if on warfarin and actively bleeding

35
Q

in what time frame should all upper GI patients have an endoscopy

A

24hrs

36
Q

when should PPI’s be given in a GI bleed

A

after OGD if non-variceal bleed ie peptic ulcer

finals - gi (18 decks)

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