Gastritis + Appendicitis

Question 1

What is gastritis?

Answer 1

stomach mucosal inflammation + injury

Question 2

Causes of gastritis?

Answer 2

Autoimmune (related to pernicious anemia + anti IF Abs)
H.pylori
NSAIDS (cause gastropathy - injury WITHOUT inflammation)
Mucosal ischemia
campylobacter (Guillain barre)
(+ viral; CMV)

Question 3

Sx of gastritis?

Answer 3

Epigastric pain with diarrhoea, N+V, Indigestion (dyspepsia)

Question 4

Dx of gastritis?

Answer 4

If H.pylori suspected, stool antigen test/Urea breath test
GS = endoscopy and biopsy

Question 5

Tx if H.Pylori?

Answer 5

TRIPLE THERAPY ; CAP
PPI + 2 Abx
twice a day for 7 days

Question 6

what is a complication of gastritis?

Answer 6

PUD

Question 7

H.pylori
where is it commensed?
virulence?

Answer 7

in stomach, not usually diarrhoea causing
Low virulence, typically opportunistic

Question 8

H.Pylori
mechanism of work?

Answer 8

1. low somatostatin
2. low luminal HCO3-
3. Secrete urease
   Urea –(urease)–> CO2 + NH3
   NH3 + H+ <—> NH4+ (Toxic)
4. increased gastrin release

Question 9

what is autoimmune gastritis?
What does it affect and cause?

Answer 9

affects funds portion of stomach
esp causes atrophy of parietal cells

Question 10

What’s appendicitis?

Answer 10

inflamed appendix, usually due to lumen obstruction - SURGICAL EMERGENCY
Peak age 10-20

Question 11

causes of appendicitis?

Answer 11

Fat colith (hard solidified faeces)
Lymphoid hyperplasia (in teens, of peyers path)
filarial worms

Question 12

What happens to the blockage which causes appendicitis?

Answer 12

Blockage typically infected with E.coli and as pressure increases inside appendix, inflammation and increased rupture risk (SBP - Spontaneous bacterial peritonitis)

Question 13

appendicitis
Sx?

Answer 13

Umbilical pain which locates to Mcburneys point (right iliac fossa) - 1/3 from umbilicus to ASIS

+ rebound tenderness, abdo guarding, pyrexic (fever), n+v, loss of appetite

Question 14

What are 3 other Sx of appendicitis?

Answer 14

Rosving - press on RLQ causes LLQ pain

Obturator - internal left rotation of thigh pain

Psoas - lying on left side, extending right leg = painful

Question 15

complication of appendicitis?

Answer 15

SBP (rupture)
periappendical abcess

Question 16

Dx of appendicitis?

Answer 16

Based on clinical presentation + raised inflammatory

CT abdo + pelvis - GS
(pregnancy test - rule out ectopic pregnancy - presents with right iliac fossa pain)

Question 17

Tx of appendicitis?

Answer 17

Abx then appendectomy (laparoscopic)
Must drain abscess; resistant to Abx

(Abscess = walled off bacterial collection, systemic Abx will be unuseful, needs to be dealt with directly - drainage and intra abscess Abx)