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