GORD

Question 1

what

Answer 1

acid from stomach refluxes through LOS and irriates oesophageal lining

Question 2

oesophagus - type of epithelium

Answer 2

squamous

Question 3

stomach - type of epithelium

Answer 3

columnar

Question 4

presentation

Answer 4

dyspepsia
heartburn 
retrosternal/epigastric pain 
bloating
nocturnal cough

Question 5

Endoscopy - when to admit and do urgent one

Answer 5

evidence of GI bleed

Question 6

Endoscopy - when todo within 2wks

Answer 6

supicious of cancer

Question 7

red flags for endoscopy

Answer 7

dysphagia
>55yrs
weight loss
upper abdo pain 
treatment resistant dyspepsia
N+V
low Hb
raised platelet count

Question 8

Mx - lifestyle advice

Answer 8

reduce tea, coffee, alcohol
weight loss
avoid smoking
smaller meals

Question 9

Mx - medications

Answer 9

PPIs - omeprazole, lansoprazole

Ranitidine - H2 receptor antagonist

Question 10

Mx - surgery

Answer 10

Nissens Fundoplication

Question 11

what is H.pylori

Answer 11

gram negative areobic bacteria

Question 12

what does H.pylori do

Answer 12

causes damage to epithelial lining of stomach resulting in gastritis

increases risk of stomach cancer

Question 13

H.pylori testing is offered to ….

Answer 13

anyone with dyspepsia

need 2wks without use PPI for accurate resutl

Question 14

H.pylori tests

Answer 14

urea breath test
stool antigen test
rapid urease test (during endoscopy)

Question 15

H.pylori erradication

Answer 15

PPI

2x antib for 7 days: amoxicillin + clarithromycin

Question 16

Barret’s oesophagus

Answer 16

metaplasia from squamous to columnar epithelium

premalignant - risk for adenocarinoma of oesohagus

Question 17

Barret’s oesophagus - how does it effect GORD symptoms

Answer 17

improves them

Question 18

Barret’s oesophagus Mx

Answer 18

PPI

ablation treatmetn

Question 19

H. pylori eradication:

Answer 19

PPI + amoxicillin + clarithromycin, or

PPI + metronidazole + clarithromycin