h pylori and gastric disease Flashcards
what is dyspepsia
generalised indigesion and upset stomach including pai
just genalised symptoms
symptons of dyspepsisa
epidgstic pain, burning, fullnes, bloating, satiety, nausea, sickness, heartburn, reflux, disconfort
causes of upper gi dyspepsia
Gord, peptic ulcer, gastritis, non-ulcer dyspepsia, gastric cancer
what are the symptoms of lower gi dyspepsia
gall stones
drugs
cardiac-related
psychological
coeliac disease
IBS
pancreatic diseases
colon cancer
What are important parts of a drug history for a presenting complaint of dyspepsia
NSAIDs, steroids, bisphosphonates, ca antagonists, nitrates, theophyllines,
what to ask about lifestyle for dyspepsia
alcohol, diet, smoking, exercise, weight reduction
What blood can be useful for dyspepsia
fbc, ferritin, lft, u and e, calckum, glucose, coelica serolgy, serum iga
what are the alarms pneumonic
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
what are the risks of endoscopy
1; 2000 risk for perforation, bleeding or reaction to drgus
why do NSAIDs cause damage to the stomach
they reduce prostaglandins, thus meaning histamine will work too effectively producing too much stomach acid
what percent of the world’s population is infected with h pylori
50%
what type of mucosa can h pylori infect and colonise
gastric mucosa only , no where else
can h pylori penetrate the epithelial layer
no
what factors determine the reaction to h pylori
the individual genetics, colanasitiaon size and site, strain of bacteria, environmental factors such as smoking
what chemical does h pylori release
urease
What is the function of urease
produce ammonia reducing the ph of stomach acid helping the bacteria to survive and to colonise
what is chemotaxis
Bacteria move to an area of favorability for survival
what is the role of flagella on bacteria
help the bacteria move
what is the role of adhesin toxins on bacteria
adhere bacteria to the stomach
what happens when h pylori release toxins once adhered
it causes inflation and cytokine reaction in the area
what are the main outcomes of h pylori infection
gastritis
chronic atrophic gastritis with intestinal metaplasia
gastric or duodenal ulcer
gastric cancer, malt lymphoma (<1%)
does h pylori inection in the antral cause an increase or decrease in stomach acid
increase in stomach acid
what are the main side effect of h pylori infection in the antrum
duodenal disease
does h pylori inection int eh corpus increases or decrease stomach acid
decrease stoamch acid
what is the main effect of h pylori infection int eh corpus of the stomach
gastric cancer
ways to test for h pylori inefection which are non invasive
serology - iga agiains h pylori
urea braht teas
stool antigesn test - for pppi for 2 weeks
what are the invasive test for h pylori
endostocpys
- histology f gasti cbipo;ys
cultre of gastic biopsy
rapid slide urease tests obtained through endoscopy
how does urease rapid slide work
colour change of ph indicator due to bacteria produces amonia
what type of carbon is deteced in urea breath test
13 or 14 c labbeled co2
3 types of gastritis
autoimmune
bacterial
chemical
who do peptic ucler mianly effect
men and the elderly
are peptice ulcers increasing or decresing
decreasing
what other conditions than h pyloric can cause peptic ulcers
zollinger ellison syndrome, hyperparathyroidism, chron’s disease
why does smoking cuase peptic uclers
nicotine damages prostaglain production
main symptons of peptic ulcer
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
treatment for peptic ulcer triple therapy
clarithromyic i - 500mg
amyoxicillin 1 g
omeprazole 20mg
what is treatment for penicilin allergy with peptic ulcer
clarithromyicin - 500mg
tetracycline
omepraxol 20mg
main complications for ulcer
bleeding, acute and chonic leading to haematessi, melaena, ior defection
perforation
fibrotic sticture
gastic outlet obstion
symptoms of gastric outlet obstuction
vommiting
abdomial distension, weight loss, gastric splah
what type of ions are lost in commit in gastic outlet obstuction
h+ and cl-
what happens to ph in gastic outlet obstion
metabolic alkalosis
what is seeen in blood of gastric outlet obstruciton
low cl, low na, low k , renal impairment
what is the treatment for outlet obsiton
endoscopic ballow dialatio or surgery
what is the main type of cancer in gastic cancer
adenocarcionam of the epitheal cells
what are non common type of gastic cancers
malt - mucoasase associed lympathic tissue
gastial intesail stoma tumours
symptoms of gastic cancer
dyspepsia, nausea, vomminting , weight loss, gi bleed, iron deficey anemai, gastic outlet obstuction
what perecnet of gastic cancer are familar
15%
what are hertibaleg gens tha cause gastic cacer
cdh -1 gene (e cadherin)
What staging is done for gastric cancer
endoscopy and biopsy
ct achest and Abdo, lymph nodes
treatment for gastric cancer
surgery and chemotherapy
