GI - 4 Stomach pt 1

Question 1

List 4 causes of Erosive and Hemorrhagic Gastritis

Answer 1

Drugs (NSAIDS)
Etoh (alcohol)
Stress (illness)
Portal hypertension

Question 2

What are the Symptoms of Erosive and Hemorrhagic Gastritis?

Answer 2

None or some:
Dyspepsia
Epigastric pain
Nausea and vomiting
UGI bleed

Question 3

Endoscopy finds superficial lesions, subepithelial hemorrhages, petachiae (purple spot), and erosions

Answer 3

Erosive and Hemorrhagic Gastritis

Question 4

If there were any abnormal lab results for Hemorrhagic Gastritis what would they be?

Answer 4

Iron deficiency anemia

Question 5

Stress Gastritis is a specific cause of:

Answer 5

Erosive and Hemorrhagic Gastritis

Question 6

Tell me about Stress Gastritis (how it develops, how to cure it, treat it)

Answer 6

Develops within 72 hours of critical illness
To cure it we want a gastric pH > 4
We do so using PPI or H2 blockers (prophylaxis)
Treat using high dose PPI

Question 7

What are 5 alarm symptoms of Gastritis? What do yo do?

Answer 7

Severe pain, wt loss, vomiting, GI bleed, anemia

Do Endoscopy

Question 8

Congestion of capillaries and venules of gastric mucosa and submucosa. Has to do with serosis, portal hypertension, ability to drain to portal system. Correlates with liver disease. Appear to be chronic asymptomatic bleeders

Answer 8

Portal Hypertensive Gastropathy

Question 9

Tell me 3 things about Portal Hypertensive Gastropathy. What’s the treatment? (2)

Answer 9

Congestion of capillaries and venules of gastric mucosa and submucosa
Correlates with severity of liver ds
Often asymptomatic but may present as chronic bleed
Tx: Propanolol or nadolol to lower portal pressure and prevent rebleeding or portal decompressive procedures

Question 10

What are the 3 categories of Nonerosive Nonspecific Gastritis

Answer 10

H pylori infection
Pernicious Anemia
Lymphocytic Gastritis

Question 11

Tell me 4 things about H. Pylori Gastritis

Answer 11

Spiral gram negative rod
Resides below gastric mucus layer adjacent to gastric epithelial cells
Causes gastric mucosal inflammation with PMNs and lymphocytes
Increased in nonwhites and immigrants

Question 12

List 3 complications of H Pylori

Answer 12

15%develop PUD
Increased rate of gastric adenocarcinoma
Increased rate of low grade B cell gastric lymphoma

Question 13

4 groups tested for H pylori

Answer 13

H/o PUD (peptic ulcer disease)
H/o mucosa associated lymphoid tissue lymphoma (maltoma)
Family history of gastric CA especially if of Asian descent
Screening isn’t indicated in general population

Question 14

List 3 tests to diagnose H pylori Gastritis

Which is gold standard?

Answer 14

2 noninvasive tests:
Serologic tests sensitive but not specific (not recommended for eradication)
Fecal antigen tests and Urea breath tests > 95% sensitive and specific
1 Invasive test:
Endoscopy with bx of antrum and body is gold standard but expensive

Question 15

Why do you biopsy the antrum to test for H pylori?

Answer 15

Bacteria tends to settle in the antrum

Question 16

What is Pernicious Anemia?

What 2 problems result?

Answer 16

Hereditary autoimmune disorder involving the fundic glands and parietal cells within them.
Achlorohydria and vitamin B12 malabsorption (because they don’t have intrinsic factor..secreted by parietal cells)

Question 17

What is Achlorohydria?

Answer 17

A result of pernicious anemia. causes hypergastrinemia (high gastrin levels) due to loss of inhibition of gastrin G cells

Question 18

What disease is associated with celiac disease and H pylori? What’s the treatment?

Answer 18

Lymphocytic Gastritis

Tx: Steroids

Question 19

What’s the TREATMENT?
Acute bacterial infection of gastric submucosa and muscularis by a variety of anaerobic or aerobic organisms
Rare, rapidly progressive condition known as necrotizing gastritis

Answer 19

Gastric resection and antibiotics is the treatment for Infections

Question 20

Eosinophils infiltrate the antrum
Peripheral eosinophilia present on CBC
Anemia, abd pain, early satiety, postprandial vomiting

Name disorder and treatment for it

Answer 20

Eosinophilic gastritis.

Tx: steroids and PPI

Question 21

group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production.

Answer 21

PPI

Question 22

Break in gastric or duodenal mucosa
Mucosal defense impaired or overwhelmed by aggressive luminal factors (acid, pepsin)
Ulcer= 5mm diameter + through muscularis mucosa

Answer 22

Peptic Ulcer Disease

Question 23

Where does Peptic Ulcer Disease commonly occur?

Answer 23

Duodenum > Stomach