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Year 1: Gastrointestinal > GI: Conditions of the Stomach + Duodenum > Flashcards

GI: Conditions of the Stomach + Duodenum Flashcards

1
Q

What are the functions of the stomach?

A

Emulsification of fat + mechanical breakdown of food
A reservoir for food
Secretion of intrinsic factor (needed for absorption of vitamin B12)
Secretion of gastric acid from parietal cells in the fundus

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2
Q

What is the role of gastric acid?

A

Begins process of protein digestion + protective role by destroying bacteria

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3
Q

What increases gastric acid secretion?

A

Stimulation of the vagus nerve, histamine and gastrin

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4
Q

What decreases gastric acid secretion?

A

Somatostatin release from antral D cells

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5
Q

What kind of organism is H.Pylori?

A

A gram negative urease producing spiral shaped bacterium

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6
Q

Where is H.Pylori predominately found?

A

Gastric antrum + areas of gastric metaplasia

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7
Q

By what route is H.Pylori transferred?

A

Oral- Oral

Faecal- Oral

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8
Q

What is the management for H.Pylori infection?

A

Management aimed at eradication.
PPI based triple therapy:
Omeprazole + Amoxicillin/Metronidazole + Claritromycin twice daily for 7 days

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9
Q

How is H.Pylori infection diagnosed?

A

C urea breath test
Rapid urease test (CLO) (invasive)
gastric mucosal biopsy (invasive)

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10
Q

Are duodenal or gastric ulcers more common?

A

Duodenal ulcers

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11
Q

What causes peptic ulcer disease?

A

H.Pylori
NSAIDS
Aspirin

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12
Q

What is the classic presentation of a gastric ulcer?

A

Burning epigastric pain made worse by eating

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13
Q

What is the classic presentation of a duodenal ulcer?

A

Burning epigastric pain relieved by eating + worse at night

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14
Q

What is the investigation of choice for patients under 55 with symptoms of peptic ulcer disease?

A

Urea breath test for H.Pylori infection

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15
Q

Alongside a urease breath test, what other investigation is done for patients over 55 with symptoms of peptic ulcer disease?

A

Endoscopy to check for malignancy

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16
Q

What is the management for H.Pylori associated ulcers?

A

PPI based triple therapy.

Eradication confirmed with urea breath test/stool antigen test

17
Q

What is the management for H.Pylori negative ulcers?

A

PPIs. Stop NSAIDs/Aspirin

18
Q

What are some complications of peptic ulcer disease?

A

Perforation- Duodenal ulcers more commonly than gastric

Gastric outlet obstruction due to oedema/scarring after healing

19
Q

What are the signs/symptoms of a gastric outlet obstruction?

A

Projectile vomiting, Succussion splash. Metabolic alkalosis due to acid loss

20
Q

What is gastropathy?

A

Injury to the gastric mucosa associated with epithelial damage and regeneration- little/no inflammation.

21
Q

What causes gastropathy?

A

NSAIDs + aspirin: depletion of mucosal prostaglandins by inhibiting COX pathway
Other less common causes include herpes simplex, cytomegalovirus and excessive alcohol use

22
Q

What are the symptoms of gastropathy?

A

Indigestion, vomiting blood

Erosions + sub endothelial haemorrhages seen on biopsy

23
Q

How is gastropathy treated?

A

PPIs

24
Q

What is gastritis?

A

Inflammation of the gastric mucosa

25
Q

What is the commonest cause of gastritis?

A

H.Pylori

26
Q

What is seen in an acute gastritis biopsy?

A

neutrophilic inflammation

27
Q

What is seen in a chronic gastritis biopsy?

A

Lymphocytes, plasma cells, macrophages

28
Q

Which is the most common gastric cancer and where is it most commonly found?

A

Adenocarcinoma

The antrum

29
Q

What does Virchows Node indicate?

A

GASTRIC CANCER

node felt in supraclavicular fossa

30
Q

What are the two types of gastric cancer?

A

Type 1- ulcerative lesion with rolled edges

Type 2- diffuse with extensive submucosal spread

31
Q

What are the symptoms of gastric cancer?

A

Early satiety, epigastric pain/mass, anorexia, nausea, weight loss

32
Q

What are the primary investigations for gastric cancer?

A

Endoscopy + biopsy

Year 1: Gastrointestinal (14 decks)

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