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GI - Pathology > H. Pylori and Gastric Disease > Flashcards

H. Pylori and Gastric Disease Flashcards

1
Q

what is dyspepsia

A

pain or discomfort in the upper abdomen:

  • retrosternal pain
  • heartburn
  • early satiety
  • fullness/bloating
  • nausea and vomiting
  • weight loss
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2
Q

upper GI causes of dyspepsia

A

ulcer, gastritis, gastric cancer

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3
Q

lower GI causes of dyspepsia

A

IBD, colon cancer, coeliac disease

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4
Q

what is anorexia

A

loss of appetite

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5
Q

what are red flag symptoms

A 
Anorexia
weight Loss
Anaemia
Recent onset
Melaena/Haematemesis
Mass
Swallowing (dysphagia)
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6
Q

what acronym is used to remember the red flag symptoms

A

ALARMS

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7
Q

if someone presents with red flag symptoms what is the next step

A

refer for an endoscopy

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8
Q

what must someone have done all day before an endoscopy

A

have fasted (24 hours)

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9
Q

what lifestyle factors would you address in dyspepsia

A

smoking, alcohol, diet, exercise and weight loss

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10
Q

if someone presents with dyspepsia and NO red flag symptoms what factor determines whether or not you do an endoscopy

A

if they are over the age of 55

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11
Q

if someone presents under 55 y/o, dyspeptic, no red flag symptoms, what is the next step

A

test for H. Pylori

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12
Q

how prevalent is H. Pylori

A

~50%

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13
Q

H. Pylori is gram negative or positive

A

gram negative

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14
Q

what is the only type of mucosa that h. pylori can colonise

A

gastric

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15
Q

what proportion of h. pylori is asymptomatic or with mild gastritis

A

> 80%

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16
Q

what differs in the outcomes of h. pylori infection between being in the antrum and in the body

A

when in the antrum it causes increased acid and a risk of duodenal disease

when in the body the acid is reduced, gastric atrophy and a risk of gastric cancer

17
Q

how can you non-invasively diagnose h. pylori infection

A

blood serum for IgG against h. pylori
urea breath test
stool antigen test

18
Q

invasive diagnosis of h. pylori

A

endoscopy to gain a biopsy for culture, histology and rapid slide urease test

19
Q

principle of urea breath test

A

labelled urea orally administered –> urea broken down by urease into ammonia and CO2 –> CO2 is labelled in breath and can be measured

20
Q

what enzyme does h. pylori make in great quantities

A

urease

21
Q

what is a CLO test

A

a rapid slide urease: biopsy of stomach is put on slide and it changes colour if h. pylori is present by urease breaking down the slide contents

22
Q

what is a positive result on a CLO test

A

red

23
Q

symptoms of peptic ulcer

A 
epigastric pain
nausea and vomiting
weight loss
loss of appetite
haematemesis
24
Q

what ulcer symptoms are more common in a duodenal ulcer

A

nocturnal or hunger pain

back pain

25
Q

treatment of h. pylori caused ulcer

A

eradication therapy

26
Q

eradication therapy

A

3 drugs for 7 days:

  1. clarithromycin
  2. amoxycillin
  3. proton pump inhibitor (reduce HCl)
27
Q

what do PPIs like omeprazole do

A

inhibit the H+/K+ pump to reduce acid production

28
Q

gastric outlet obstruction can be caused by the presence of…

A

oedema or a stricture

29
Q

features of gastric outlet obstruction

A 
vomit is fermented and has no bile
early satiety
abdominal distension
weight loss
gastric splash
dehydration
METABOLIC ALKALOSIS
30
Q

how do you treat gastric outlet obstruction

A

with an endoscopic balloon dilatation or with surgery

31
Q

how would you diagnose GOO

A

upper GI endoscopy

32
Q

what does UGIE stand for

A

upper GI endoscopy

33
Q

what would bloods in GOO show

A

low Cl, Na and K

34
Q

what condition is zollinger-ellison syndrome a rare cause of

A

peptic ulcers

35
Q

what is the 2nd commonest alimentary cancer

A

gastric cancer

36
Q

gastric cancer has a good/poor prognosis

A

poor - 5 year <20%

37
Q

presentation of gastric cancer

A 
dyspepsia
weight loss
GI bleeding
anaemia
GOO
38
Q

majority of gastric cancers are sporadic/hereditary

A

sporadic - <15% are familial

GI - Pathology (23 decks)

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