General

Question 0

Hilicobacter Pylori

Answer 0

Gram negative, spiral bacillus, urease positive, transmissible via oral-oral or faecal-oral routes

Question 1

Causes of dyspepsia

Answer 1

Idiopathic, ulcers, GORD, hiatus hernia, H Pylori, medication, cancer

Question 2

Possible consequences of H Pylori infection?

Answer 2

No symptoms, Mild gastritis, PUD, dyspepsia, adenocarcinoma, MALToma

Question 3

3 most important causes of gastritis?

Answer 3

H Pylori, drugs ie NSAIDS, autoimmunity

Question 4

2 commonest causes if peptic ulcers?

Answer 4

H Pylori and NSAIDS

Question 5

How do you test for H Pylori?

Answer 5

Serology - IgG Ab, Urea breath test for active infection

Question 6

What is the standard triple combination therapy of H Pylori eradication?

Answer 6

PPI and 2 antibiotics - amoxicillin, Clarithromycin or metronidazole

Question 7

What is used in macrolide resistance?

Answer 7

Levofloxacin

Question 8

Apart from triple, what other therapies can be used?

Answer 8

Quadriple and sequential (5 day PPI and amoxicillin followed by 5 day pop and Clarithromycin and metronidazole)

Question 9

What differentiates physiological from pathological reflux

Answer 9

Mucosal injury, nocturnal episodes

Question 10

Complications of GORD?

Answer 10

Stricture, ulcers, Barrets oesophagus, cancer, laryngeal and respiratory complications

Question 11

What is the difference between pan gastritis and antral gastritis caused by H Pylori?

Answer 11

Pan gastritis causes decreased acid production, antral gastritis - increased acid production

Question 12

What is Zollinger-Ellison syndrome?

Answer 12

A tumour producing excess gastrin causing excess acid release

Question 13

Causes of acute ulcers?

Answer 13

NSAIDS, ischaemia, sock, burns, organ failure, ingestion of caustics

Question 14

Causes of chronic ulcers?

Answer 14

NSAIDS and H Pylori, lifestyle factors?

Question 15

Investigations in suspected cancer

Answer 15

Endoscopic ultrasound, CT, laparoscopy with biopsy of nodules of the peritoneal surface, laparoscopy ultrasound for liver metastasis

Question 16

Treatment of gastric adenocarcinoma

Answer 16

Endoscopic resection, gastrectomy, radiotherapy, chemotherapy

Question 17

What do parietal cells produce?

Answer 17

IF and acid

Question 18

What do chief cells do?

Answer 18

Secrete pepsinongens which initiate protein digestion

Question 19

What do endocrine cells do?(3)

Answer 19

Enterochromaffin link cells - histamine, G cells - gastrin, D cells - somatostatin

Question 20

Which pump releases acid?

Answer 20

H-K pump

Question 21

Role of prostaglandins in the stomach?

Answer 21

Central role in epithelial defence/repair, regulate release of HCO3 and mucus, maintain mucosal blood flow, cell restitution

Question 22

How are prostaglandins produced?

Answer 22

Phospholipids to arachadonic acid to prostaglandins via actions of phosholipase a2 and cyclooxygenase

Question 23

Molecular consequences of H Pylori infection?

Answer 23

Antral inflammation, increased gastrin, decreased somatostatin, increased acid, urease activity converting urea to ammonia and carbon dioxide