H Pylori and Gastric Disease

Question 1

Is helicobacter pylori gram - or +?

Answer 1

Gram negative

Question 2

Which type of tissue is the only tissue that H.pylori can colonise?

Answer 2

Gastric mucosa

Question 3

Which enzyme can Hi.pylori produce?

Answer 3

Urease

Question 4

What does urease allow the bacteria to do?

Answer 4

Creates an acidic microclimate so it can penetrate through the mucus layer and attach itself to the stomach epithelium

Question 5

What % of the population is affected by H.pylori?

Answer 5

50%

Question 6

What are some of the clinical outcomes of having a H.pylori infection?

Answer 6

Majority remain asymptomatic
Gastritis
Gastric ulcer
Gastric cancer

Question 7

If the H.pylori affects the antrum of the stomach with gastritis, what could this develop into?

Answer 7

Duodenal ulcer disease

Question 8

Does gastritis affecting the antrum lead to increased or decrease in acid production?

Answer 8

Increase

Question 9

Does gastritis affecting the body lead to increased or decrease in acid production?

Answer 9

Decrease

Question 10

If the H.pylori affects the body of the stomach with gastritis, what could this develop into?

Answer 10

Gastric cancer

Question 11

How do you diagnose a H.pylori infection non-invasively?

Answer 11

Serology for immunoglobulins
Urea breath test C13/C14
Stool antigen test

Question 12

How do you diagnose a H.pylori infection invasively?

Answer 12

Gastric biopsies for histology
Culture of gastric biopsies
Rapid slide urease test (CLO)

Question 13

Which colour does the CLO test turn to indicate H.pylori is present?

Answer 13

Pink

Question 14

What is gastritis?

Answer 14

Inflammation of the gastric mucosa

Question 15

What are the three subdivions of gastritis?

Answer 15

Autoimmune
Bacterial
Chemical

ABC

Question 16

Which are more common- gastric ulcers or duodenal ulcers?

Answer 16

Duodenal ulcers

Question 17

What are the majority of peptic ulcers caused by?

Answer 17

H.pylori infection

Question 18

What other things can cause peptic ulcers?

Answer 18

Smoking
NSAIDs

Question 19

Which symptoms are associated with a peptic ulcer?

Answer 19

Epigastric pain
Back pain
Nausea, occasionally vomiting
Weight loss, anorexia
Epigastric tenderness

Question 20

Which symptoms may present if the ulcer is bleeding?

Answer 20

Haematemesis
Anaemia

Question 21

Which drugs help to reduce the acid and help treat peptic ulcers?

Answer 21

Proton pump inhibitors

Question 22

Which drug should be stopped if a patient has a peptic ulcer?

Answer 22

NSAIDs

Question 23

Which three drugs are part of the eradication therapy for H.pylori?

Answer 23

Clarithromycin
Amoxicillin
Proton Pump Inhibitor e.g. omeprazole

Question 24

What is the main reason that triple eradication therapy would not eradicate H.pylori?

Answer 24

Resistance to antibiotics
Or lack of compliance to medication

Question 25

What are the complications of peptic ulcer disease?

Answer 25

Bleeding- acute or chronic
Perforation
Fibrotic stricture (narrowing)
Gastric outlet obstruction

Question 26

What can happen as a result of acute bleeding of a peptic ulcer?

Answer 26

Melaena (black poo)
Haematemesis

Question 27

What can happen as a result of chronic bleeding of a peptic ulcer?

Answer 27

Iron deficiency anaemia

Question 28

How do people present with gastric outlet obstruction?

Answer 28

Vomiting but vomit lacks bile and is of fermented foodstuffs

Question 29

Why do people with gastric outlet obstruction have dehydration?

Answer 29

All the vomiting

Question 30

How can gastric outlet obstruction be treated?

Answer 30

Endoscopic balloon dilation surgery

Question 31

Are the majority of gastric cancers adenocarcinomas or squamous cell carciomas?

Answer 31

Adenocarcinomas