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GI System > H. Pylori and upper GI disease > Flashcards

H. Pylori and upper GI disease Flashcards

1
Q

What is dyspepsia?

A

Indigestion

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2
Q

What is significant dyspepsia?

A

Dyspepsia which persists for 4 weeks or more

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3
Q

What are some symptoms of dyspepsia?

A 
Epigastric pain
Nausea
Gastric reflux
Burning
Bloating
Discomfort
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4
Q

What factors warrant use of an endoscopy?

A 
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Malaena
Swallowing problems
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5
Q

What are some upper GI disorders in the differential diagnosis of dyspepsia?

A

Peptic ulcer
Gastritis
Gastric cancer

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6
Q

What are some lower GI disorders in the differential diagnosis of dyspepsia?

A

IBS

Colonic cancer

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7
Q

What are some other causes of dyspepsia?

A 
Hepatic
Psych
Pancreatic
Coeliac
Drugs
Metabolic
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8
Q

What are some useful blood tests for dyspepsia?

A 
FBC
Ferritin
U&Es
Calcium
Glucose
Serum IgA
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9
Q

What drug classes may aggravate dyspepsia?

A

NSAIDs

Steroids

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10
Q

What patient habits may cause dyspepsia?

A

Alcohol
Smoking
Diet

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11
Q

Describe H. Pylori.

A

Gram negative baccili
Microaerophilic
Flagellated
Resides on mucosal surface

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12
Q

Does H Pylori penetrate the epithelium?

A

No

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13
Q

How does H Pylori manage the acidic environment?

A

Releases urease to make immediate environment slightly less acidic

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14
Q

What are some useful tests for H Pylori infection?

A

Serology -IgA
Urea breath test
Stool antigen test (ELISA)

Endoscopy
Biopsy
Culture

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15
Q

What group are peptic and duodenal ulcers more common in?

A

Elderly

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16
Q

What is Zollinger-Ellison syndrome?

A

Tumour formed in pancreas or duodenum and triggers massive gastrin production
Leading to excess acid production

Can cause ulcers

17
Q

What are 3 principles of peptic ulcer treatment?

A

Eradication therapy
Acid suppression
NSAIDs must be stopped if they are in use

18
Q

What are some drugs used for acid suppression?

A

Omeprazole

Ranitidine

19
Q

What is the 7 day triple therapy used for H Pylori eradication?

A

Amoxycilin
Clarithromycin
Proton Pump Inhibitor (Omeprazole)

20
Q

What are some complications of peptic ulcers?

A 
Acute bleeding
Chronic bleeding
Perforation
Fibrotic stricture
Gastric outlet obstruction
21
Q

What may Zollinger-Ellison syndrome cause?

A

Recurrent poor healing duodenal ulcers

22
Q

Why do we test for serum calcium?

A

Hypercalcaemia can cause pancreatitis which can cause hypocalcaemia
Calcium is an indicator of pancreatitis severity

23
Q

Why do we measure U&Es in dyspepsia and peptic ulcers?

A

They may have changed due to renal hypotension or vomiting

Also to establish a baseline before fluid resuscitation

24
Q

What are we looking for on an FBC?

A

Signs of inflammation like raised WBC or low Hb due to bleeding
Neutrophilia would be present in pancreatitis

25
Q

Why do we check glucose levels?

A

Hyperglycaemia indicates sever pancreatitis as it reflects pancreatic insulin production

26
Q

What are some hepatic causes of dyspepsia?

A

Cirrhosis
AFLD
NAFLD

27
Q

What are some psychiatric causes of dyspepsia?

A

Anxiety

Depression

GI System (20 decks)

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