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Jamie GI > Gastro-duodenal Disease and H Pylori > Flashcards

Gastro-duodenal Disease and H Pylori Flashcards

1
Q

What is dyspepsia?

A

Indigestion (pain or discomfort in the upper abdomen)

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2
Q

What conditions indicate a patient with dyspepsia should be referred to endoscopy? (6 ALARMS)

A 
Anorexia
Loss of Weight
Anaemia (iron deficiency)
Recent onset (over 55s or persistent after treatment)
Malaena/haematemesis or mass
Swallowing problems - dysphagia
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3
Q

When should you perform Upper GI Endoscopy in patients with dyspepsia? (2)

A

If they demonstrate ALARM features
or
Are older than 55

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4
Q

What should you test for in patients with dyspepsia who are under 55 and don’t exhibit ALARM features?

A

Helicobacter pylori

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5
Q

What Gram type and shape of bacteria is Helicobacter pylori?

A

Gram negative

Spiral shaped

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6
Q

What are 3 non-asymptomatic clinical outcomes for Helicobacter pylori infections?

A

Chronic gastritis
Gastric or Duodenal ulcer
Gastric Cancer

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7
Q

What type of cell is H.pylori only able to colonise in?

A

Gastric type mucosa

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8
Q

What are 3 non-invasive methods to diagnose an H.pylori infection?

A

Serology
Urea breath test (13C/14C)
Stool antigen test

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9
Q

What are 3 invasive (requires endoscopy) methods to diagnose an H.pylori infection?

A

Histology of gastric biopsies
Culture of gastric biopsies
Rapid slide urease test

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10
Q

Define gastritis?

A

Inflammation in the gastric mucosa

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11
Q

What are some clinical features of peptic ulcers? (8)

A 
Epigastric pain
Nocturnal/hunger pain
Back pain
Nausea
Vomiting
Weight loss
Anorexia
Haematemesis and/or melaena (if peptic ulcer bleeds)
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12
Q

What is the main treatment for eradication of peptic ulcers?

A

Antacid medication (Proton pump inhibitors or H2 receptor antagonists)

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13
Q

What drug should be stopped if a patient has peptic ulcers?

A

NSAIDs

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14
Q

What triple therapy is given for the eradication of H.pylori therapy?

A

Clarithromycin (500 mg twice a day)
Amoxycillin (1 g twice a day)
Proton Pump Inhibitors (e.g. omeprazole 20 mg twice a day)

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15
Q

What are the 5 main complications for peptic ulcers?

A 
Acute bleeding - malaena/haematemesis 
Chronic bleeding - Fe anaemia
Perforation - hole in the GI
Fibrotic stricture
Gastric outlet obstruction - caused by oedema or stricture
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16
Q

What is the main symptom of gastric outlet obstruction?

A

Vomiting - lacks bile

17
Q

What are 3 signs upon examination that can be found for gastric outlet obstruction?

A

Abdominal distension
Weight loss
Gastric splash

18
Q

How do you diagnose gastric outlet obstruction?

A

Upper GI Endoscopy

Jamie GI (12 decks)

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