gastro qurestions Flashcards
how does hypomotility cause problems?
loss of motility due to neural defects and muscle atrophy
this casues reflux
what are the CREST symtoms?
CALCINOSIS RENAUDS ESOPHAGAL SCLERODACTILY TELECTASIA
what is given in hypomotility
prokinetics - cisapride
how is corkscrew oesophagus treated?
pnuematic dilation of cardia
how does a perforated oesophagus present
chest pain
fever
dysphagia
emphysema
investgations for oesophageal perfoation
cxr
ct
gastrogaffin swallow
ogd
factors what rasie los pressure?
ach
histamine
pgf
outline some factors which lower oesopahageal pressure
caffeine
chocolate
no
dopamine
3 mechanisms that protect following reflux?
ph clearance
peristalisis
epithelium barrier
how is GORD investigated
ogd
manometry
24h ph monitoring
what 2 surgical procedures treat gord
fundoplication and dilation of peptic strictures
what and where causes atrophic gastritis
IN THE FUNDUS.
AUTOANTIBODIES AGAINST PARIETAL CELLS
CAUSES PERNICIOUS ANAEMIA AS WELL AS LESS ACIDD.
CAN CAUSE HYPERPLASIA AND CARCINOMA
3 things stimulate gastrin production
histamine
gastrin
ach
what 3 things inhibit gastrin production
prostaglandins somatostatin adenosine secretin tng alpha
4 ways in which the stomach muosa is protected from acis
MUCUS FILM
HCO3 DECRETINO
EPITHELIALS
BLOOD PERFUSION
what are the spinal levels for each type of reffered pain?
FOREGUT T5-9
MIDCUT 10-11
HINDGUT L1-2
3 inputs into arcuate nucleus?
NEURAL FROM VAGUS NERVE, LEPTIN, GHRELIN, PYY, GUT HORMONES
what does the paraventricular necleus contain
neurones that project to the posteior pituitary
what effect does agrp have on mc4r
inhibits it
where is leptin made
adipose and enterocytes
how does ghrlin regulate appetite
INCREASES BEFORE FOOD AND INCREASES APPETIRE AND INHIBITS GASTRIC EMPTYING
major phyla of bacteria in gut?
FERMICUTES
BACTERIOIDETES
ACTINOBACTERIA
PROTEOBACTERIA
3 components of epithelial barrier
tight junctions
goblet cells
paneth cells
what is the structure of MALT
LIMPHOID FOLLICLES SURROINDED BY HEV POST CAPILARY VENULES
4 EXAMPLES OF ORGANISED GALT
PEYERS PATCHES, MESENTERIC LYMPH NODES CAECAL PATCHES, MESENTERIC LYMPH NODES
2 EXAMPLES OF NON ORGANISED GALT
INTRAEPITHELIAL LYMPHOCYTES,
LAMINA PROPRTIA LYMPHOCYTES
WHAT IS THE ROLE OF madcam1 in the lamina propria
MADCAM HELPS CELLS GET INTO THE LAMINA PROPRIA. ADHESION PROTEIN . FOUND ON HEVS
outline the mechanism of cholera
SECRETES TOXIN WHICH ALTERS THE CAMP PATHWEAY,
MORE ADENYLATE CYCLASE LEADS TO MORE CFTR BEING ON
AND LOSS OF SALT AND WATER - DIARRHOEA
how is campylobacter transmitted
undercooked meat
treat with macrolide
how is c fidd managed
vancomycin and metronizadole
how is oesophageal cancer diagnosed
ogd and biopsy
4 ways to stage oesopageal cance r
ct
laparascopy
euss
pet
3 major forms of colon cance r
sporadic
familial
hereditary syndrome
4 things in history that increase risk of colon cancer
previous cancer
polyps
uc
radiotherapy
how do caecal and right sided cancer often present?
palpable mass
iron deficiecny anaemia
weight loss
change in bowel habit
what does the faecal occult blood test look for?
guaiac test (avoid red meat and nsaids)
also fit testing
tumour marker for colon cancer
cea
when is a pelvic mri done for colon cance r
MESORECTLY LYMPH NODE INVOLVEMENT. CHOOSE BETWEEN CHEMO OR STRAIGHT TO SRUGERY .
what is courvoisiers sign
palpable gallbladder
how does tail of pancreas cancer present?
weight loss and back pain
which tumour marker is present in pancreatic cancer
ca19-9
what can an ercp confirm?
double duct sign
billary stenting
3 causes of gallbladder cance r
gallstones
porcelain gallbladder
chronic typhoid
3 causes of cholangiocarcinoma?
psc and uc
liver fluke
choledochal cyst
