h pylori and gastric disease Flashcards

1
Q

what is dyspepsia

A

generalised indigesion and upset stomach including pai
just genalised symptoms

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2
Q

symptons of dyspepsisa

A

epidgstic pain, burning, fullnes, bloating, satiety, nausea, sickness, heartburn, reflux, disconfort

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3
Q

causes of upper gi dyspepsia

A

Gord, peptic ulcer, gastritis, non-ulcer dyspepsia, gastric cancer

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4
Q

what are the symptoms of lower gi dyspepsia

A

gall stones
drugs
cardiac-related
psychological
coeliac disease
IBS
pancreatic diseases
colon cancer

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5
Q

What are important parts of a drug history for a presenting complaint of dyspepsia

A

NSAIDs, steroids, bisphosphonates, ca antagonists, nitrates, theophyllines,

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6
Q

what to ask about lifestyle for dyspepsia

A

alcohol, diet, smoking, exercise, weight reduction

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7
Q

What blood can be useful for dyspepsia

A

fbc, ferritin, lft, u and e, calckum, glucose, coelica serolgy, serum iga

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8
Q

what are the alarms pneumonic

A

a - anorexia
l - loss of weight
a - anaemia
r - recent onset in over 55 or persistent despite treatment
m - melaena (dark stools) haematemesis, or mass
s - swallowing problems

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9
Q

what are the risks of endoscopy

A

1; 2000 risk for perforation, bleeding or reaction to drgus

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10
Q

why do NSAIDs cause damage to the stomach

A

they reduce prostaglandins, thus meaning histamine will work too effectively producing too much stomach acid

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11
Q

what percent of the world’s population is infected with h pylori

A

50%

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12
Q

what type of mucosa can h pylori infect and colonise

A

gastric mucosa only , no where else

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13
Q

can h pylori penetrate the epithelial layer

A

no

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14
Q

what factors determine the reaction to h pylori

A

the individual genetics, colanasitiaon size and site, strain of bacteria, environmental factors such as smoking

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15
Q

what chemical does h pylori release

A

urease

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16
Q

What is the function of urease

A

produce ammonia reducing the ph of stomach acid helping the bacteria to survive and to colonise

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17
Q

what is chemotaxis

A

Bacteria move to an area of favorability for survival

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18
Q

what is the role of flagella on bacteria

A

help the bacteria move

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19
Q

what is the role of adhesin toxins on bacteria

A

adhere bacteria to the stomach

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20
Q

what happens when h pylori release toxins once adhered

A

it causes inflation and cytokine reaction in the area

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21
Q

what are the main outcomes of h pylori infection

A

gastritis
chronic atrophic gastritis with intestinal metaplasia
gastric or duodenal ulcer
gastric cancer, malt lymphoma (<1%)

22
Q

does h pylori inection in the antral cause an increase or decrease in stomach acid

A

increase in stomach acid

23
Q

what are the main side effect of h pylori infection in the antrum

A

duodenal disease

24
Q

does h pylori inection int eh corpus increases or decrease stomach acid

A

decrease stoamch acid

25
Q

what is the main effect of h pylori infection int eh corpus of the stomach

A

gastric cancer

26
Q

ways to test for h pylori inefection which are non invasive

A

serology - iga agiains h pylori
urea braht teas
stool antigesn test - for pppi for 2 weeks

27
Q

what are the invasive test for h pylori

A

endostocpys
- histology f gasti cbipo;ys
cultre of gastic biopsy
rapid slide urease tests obtained through endoscopy

28
Q

how does urease rapid slide work

A

colour change of ph indicator due to bacteria produces amonia

29
Q

what type of carbon is deteced in urea breath test

A

13 or 14 c labbeled co2

30
Q

3 types of gastritis

A

autoimmune
bacterial
chemical

31
Q

who do peptic ucler mianly effect

A

men and the elderly

32
Q

are peptice ulcers increasing or decresing

A

decreasing

33
Q

what other conditions than h pyloric can cause peptic ulcers

A

zollinger ellison syndrome, hyperparathyroidism, chron’s disease

34
Q

why does smoking cuase peptic uclers

A

nicotine damages prostaglain production

35
Q

main symptons of peptic ulcer

A

epigastic pain
nocturanl / huger pain
back pain (perneation of a posteiral du)
nausea and occasional vommintion
wiehgt loss and anorexia
epgastic tenderness
if bleeding - haematemteis, melaena, or anameia

36
Q

treatment for peptic ulcer triple therapy

A

clarithromyic i - 500mg
amyoxicillin 1 g
omeprazole 20mg

37
Q

what is treatment for penicilin allergy with peptic ulcer

A

clarithromyicin - 500mg
tetracycline
omepraxol 20mg

38
Q

main complications for ulcer

A

bleeding, acute and chonic leading to haematessi, melaena, ior defection
perforation
fibrotic sticture
gastic outlet obstion

39
Q

symptoms of gastric outlet obstuction

A

vommiting
abdomial distension, weight loss, gastric splah

40
Q

what type of ions are lost in commit in gastic outlet obstuction

A

h+ and cl-

41
Q

what happens to ph in gastic outlet obstion

A

metabolic alkalosis

42
Q

what is seeen in blood of gastric outlet obstruciton

A

low cl, low na, low k , renal impairment

43
Q

what is the treatment for outlet obsiton

A

endoscopic ballow dialatio or surgery

44
Q

what is the main type of cancer in gastic cancer

A

adenocarcionam of the epitheal cells

45
Q

what are non common type of gastic cancers

A

malt - mucoasase associed lympathic tissue
gastial intesail stoma tumours

46
Q

symptoms of gastic cancer

A

dyspepsia, nausea, vomminting , weight loss, gi bleed, iron deficey anemai, gastic outlet obstuction

47
Q

what perecnet of gastic cancer are familar

A

15%

48
Q

what are hertibaleg gens tha cause gastic cacer

A

cdh -1 gene (e cadherin)

49
Q

What staging is done for gastric cancer

A

endoscopy and biopsy
ct achest and Abdo, lymph nodes

50
Q

treatment for gastric cancer

A

surgery and chemotherapy