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GI PATHOLOGY > H Pylori and Gastric Disease > Flashcards

H Pylori and Gastric Disease Flashcards

1
Q

Upper GIT consists of what?

A

Oesophagus

Stomach

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2
Q

What is the function of the stomach?

A

Storage, digestion, defence, secretion, intrinsic factor

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3
Q

What is dyspepsia?

A

A group of symptoms:

Pain/discomfort in upper abdomen

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4
Q

What symptoms make up dyspepsia?

A 
Upper abdomen discomfort
Retrosternal pain
Nausia/vom
Bloating/fullness
Early satiety
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5
Q

What is organic disease?

A

A visible, definitive pathology

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6
Q

What is functional disease?

A

Normal cells + structure with incorrect function

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7
Q

What is the pnemonic for when to refer to endoscopy?

A

ALARMS

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8
Q

What does ALARMS stand for

A 
Anorexia
Loss of weight
Anaemia
Resent onset >55, persistent
Melaena/haemoptysis or Mass
Swallowing dysphagia
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9
Q

What to do in presentation of dyspepsia?

A

History+examination
Blood
Drug History
Lifestyle

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10
Q

What blood examinations are made in a patient presenting with dyspepsia?

A 
FBC, LFT, U+E
Ferritin
Glucose
Calcium
Coeliac serology
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11
Q

A patient with dyspepsia and high LFTs is suggestive of what?

A

Liver disease

Gallstones

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12
Q

What drugs increase the risk of dyspepsia?

A 
NSAIDSs
Steroids
Bisphosphonates
Ca antagonists
Nitrates
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13
Q

When is an upper GI endoscopy indicated in dyspepsia?

A

Alarm features

>55

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14
Q

What do you test for in a dypepsia patient, no alarm features, <55?

A

Helicobacter pylori

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15
Q

What is the indicated therapy if H pylori positive?

A

Eradication therapy

Symptomatic therapy

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16
Q

What type of bacteria is H pylori?

A

Gram -ve, spiral shaped, microaerophilic

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17
Q

How does H. pylori colonise the stomach?

A

Penetrates only the mucus layer, not the epithelial layer of antrum or corpus

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18
Q

How does H. pylori survive in the stomach?

A

Production of urease (alkali halo)

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19
Q

How does H. pylori cause disease?

A

Triggering if immune response in underlying mucosa

20
Q

What does H. pylori cause in 80% of patients?

A

Asymptomatic

Chronic gastritis

21
Q

What does H. pylori cause in 15-20% of patients?

A

Atrophic gastritis

Gastric/duodenal ulcer

22
Q

What does H. pylori cause in 1% of patients?

A

Gastric cancer

MALT lymphoma

23
Q

What factors effect the outcome of H pylori infection?

A

Colonisation site
Host factors
Environmental factors

24
Q

Antral predominent gastritis increases the risk of what?

A

Duodenal disease

25
Q

Corpus predominant gastritis increases the risk of what?

A

Gastric cancer

26
Q

Non-invasive tests for H. pylori

A

Serology: H. pylori IgG

Stool antigen - ELISA

27
Q

What is the invasive test for H. pylori?

A

Rapid slide urease test (CLO)

28
Q

What are the potential causes of Gastritis?

A

A - autoimmune
B - Bacterial
C - chemical (bile/nsaid)

29
Q

The majority of peptic ulcers are caused by what?

A

H. pylori
NSAIDs
Smoking

30
Q

Symptoms of peptic ulcer

A 
Epigastric pain
Nocturnal hunger/pain
Back pain
Nausea/vom
Weight loss
31
Q

How may a patient present with a bleeding ulcer?

A

Haematemesis
Melaena
Anaemia

32
Q

Treatment for peptic ulcer

A

Eradication therapy
PPI, H2A
Stopping NSAIDs
Surgery if complicated

33
Q

What is the eradication therapy for H. pylori?

A

(Triple therapy, 7 days)
Clarithromycin
Amoxycillin or metronidazole
PPI

34
Q

What drug is given in place for amoxycillin if the patient is penicillin allergic?

A

Tetracycline

35
Q

Complications of peptic ulcer

A 
Acute bleed
Chronic bleed
Perforation
Fibrotic stricture
Obstruction
36
Q

What are the symptoms of gastric outlet obstruction?

A 
Vomiting - no bile, fermented food
Early satiety, distension, weight loss
Dehydration, loss of acid in vom
Alkalosis
Gastric splash
37
Q

Why does metabolic alkalosis appear in gastric outlet obstruction?

A

Vomiting out H+ and Cl-

38
Q

Blood results in gastric outlet obstruction?

A

Low Cl-
Low Na
Low K
Renal impairment

39
Q

How is a gastric outlet obstruction diagnosed?

A

Upper GI endoscopy

cause found

40
Q

Treatment for gastric outlet obstruction?

A

Stricture - balloon

Ulcer/tumour - surgery

41
Q

Prognosis of gastric cancer?

A

5 year suvival <20%

42
Q

What type of cancer occurs in most gastric cancers?

A

Adenocarcinoma

43
Q

How does gastric cancer present?

A 
Dypepsia
Early satiety
Naus/vom
Weight loss
GI bleed
Fe deficient anaemia
Obstruction
44
Q

What is the cause of the majority of gastric cancers?

A

Sporadic with no discernible inherited component

45
Q

What are <15% of gastric cancers called?

A

Familial, definitive germline mutation

46
Q

What are 1-3% of gastric cancers caused by?

A

Cancer syndromes

47
Q

How is gastric cancer managed?

A

Histology diagnosis
Staging investigations (CT abdo/chest)
MDT discussion
Surgery/chemotherapy

GI PATHOLOGY (20 decks)

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