GI DISEASE Flashcards
Medications for GI disorders
antacids
H2 receptor blockers
proton pump inhibitors
anatacids action
elimination of formed acids
h2 receptor blockers and PPI action
reduction of acid secretion
antacid examples
rennies
gaviscon
what triggers stomach acid production
acetylcholine
gastrin
histamine
h2 receptor antagonist examples
cimetidine
ranitidine
cimetidine and ranitidine mode of action
prevent histamine activation
PPI examples
omeprazole
lanzoprazolem
pantoprazole
heartburn
GORD
GORD cause
defective lower oesophageal and sphincter, impaired lower clearing, impaired gastric emptying
GORD effects
ulceration
inflammation
metaplasia
potentially malignant GORD
Barrett’s Oesophagitis
GORD signs and symptoms
epigastric burning
dysphagia
GI bleeding
severe pain which mimics an MI
Hiatus hernia
part of the stomach is in the thorax
GORD management
stop smoking
lose weight
antacids
H2 blockers
PPI
where is PUD
oesophagus stomach or duodenum
PUD cause
high acid secretion (duodenal)
normal acid secretion (stomach)
drugs (NSAIDs, steroids)
what infection causes inflammation of gastric mucosa
Helicobacter Pylori
PUD management
triple therapy - 2 antibiotics and 1 PPI
PUD investigations
endoscopy
radiology (barium seal)
anaemia blood test
H.pylori breath
antibodies
local PUD complications
perforation and escape of gastric contents into peritoneum
haemorrhage vomited up
stricture- chronic ulceration
malignancy from chronic ulceration
systemic PUD complications
anaemia
PUD medical tx outline
H2 receptor blockers and PPIs
NSAIDs
triple therapy
why NSAIDs for PUD
inhibit prostaglandin removal
what medications are used for triple therapy for PUD
amoxycillan
metronidazole
omeprazole
surgican tx for PUD
gastrectomy
vagotomy
why medical tx for PUD
REVERSIBLE PROBLEM and H.Pylori present
why surgical tx for PUD
stricture
acute bleed
perforation
malignancy
coeliac disease
sensitivity to a-gliaden component of gluten - malabsorption - small bowel disease
coeliac disease aetiology
genetic
environmental triggers
gluten consumption
T lymphocytes damage mucosal tissue
villous atrophy of the jejunum
coeliac disease effects
growth failure and oral ulceration
weight loss, lassitude, weakness, abdominal pain/ swelling, oral aphthae, tongue papillary loss, steatorrhea, dysphagia.
coeliac disease malabsorption issues
iron
folate
vit B12
fat
coeliac disease investigations
autoantibody test - serum transglutaminase, anti-gliadin/ anti-endomyseal antibodies.
jejunal biopsy
feacal fat increases if malabsorption
haematinics
associated skin diseases with coeliac disease
dermatitis herpetiformis
oral disease associated with coeliac disease
ulceration and blisters
what are pts with oral aphthous ulcers screened for?
folate/ combined ferritin and folate deficiency suggests malabsorption.
TTG tests
pernicious anaemia
vit B12 deficiency
vit B12 absorption site
terminal ileum
pernicious anaemia causes
lack of vitB12 in diet
gastric parietal cell disease (autoimmune)
IBD of terminal ileum (Crohn’s)
Bowel cancer at the ielo-coecal junction
vit B12 deficiency tx
diet
IM injections if absorption not possible
bowel cancer symptoms
none
anaemia
rectal blood loss
bowel cancer aetiology
carcinomas arise in polyps and they will bleed
5 years to turn malignant
bowel cancer causes
diet low in fibre and veg and high in fat and meat
smoking
alcohol
poor exercise
p53 gene
ulcerative colitis and intestinal polyps
Peutz-Jehgers syndrome
intestinal polyps in small intetsine - low risk
Gardiners/ Cowden’s syndrome
intestinal polyps in large intestine - high risk
Duke’s classification of bowel cancer
A - submucosal
B - muscularis
C - lymph nodes
D - liver
bowel cancer tx
colon cancer surgery
hepatic metastases
radiotherapy
chemotherapy
colonic carcinoma screening
FiT test - all adults over 60 - 2 year repeat - endoscopy if positive
