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GI AM > Helicobacter pylori and gastric disease > Flashcards

Helicobacter pylori and gastric disease Flashcards

1
Q

What is dyspepsia?

A

A group of symptoms rather than a disease

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2
Q

What symptoms come under the term dyspepsia?

A 
Upper abdo discomfort
Retrosternal pain
Anorexia
Nausea
Vomiting
Bloating
Bloating
Fullness
Early satiety
Heartburn
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3
Q

What can cause dyspepsia in the upper GI tract?

A

Peptic ulcer
Gastritis
Non ulcer dyspepsia
Gastric cancer

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4
Q

What can cause dyspepsia in the lower GI tract?

A

IBS

Colonic cancer

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5
Q

What are the non GI tube causes of dyspepsia?

A 
Hepatic causes
Gallstones
Pancreatic disease
Coeliac
Metabolic and cardiac diseases
Drugs
Psychological
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6
Q

When would a patient presenting with dyspepsia be referred for an endoscopy?

A 
Anorexia
Loss of weight
Anaemia
Recent onset or persistent despite treatment
Melaena or haematemesis
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7
Q

What would be done if a patient presented with dyspepsia?

A

History and exam
Bloods
Drug history
Lifestyle history

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8
Q

What bloods would be done on a patient presenting with dyspepsia?

A 
FBC
Ferritin
LFTs
U+Es 
Ca
Glucose
Coeliac serology
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9
Q

What drugs would you look out for in a patient presenting with dyspepsia?

A 
NSAIDs
Steroids
Bisphosphates
Ca antagonists
Nitrates
Theophyllines
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10
Q

What lifestyle elements would you look out for in a patient presenting with dyspepsia?

A 
Alcohol
Diet
Smoking
Exercise
Weight reduction
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11
Q

What is Heliocobacter pylori?

A

Gram negative, microaerophillic flagellated spiral shaped bacteria

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12
Q

Where does H pylori reside?

A

Gastric type mucosa in surface mucus layer

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13
Q

What are the outcomes of H pylori colonisation?

A

80%- asymptomatic or have chronic gastritis
19%- Gastric/duodenal ulcers or chronic atrophic gastritis
1%- gastric cancer

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14
Q

What is the outcome of H pylori colonisation dependent on?

A

Site of colonisation
Characteristics of bacteria
Host factors
Environmental factors

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15
Q

What are the noninvasive methods of diagnosis for H pylori infection?

A

IgG against H pylori
Urea breath test
Stool antigen test

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16
Q

What are the invasive methods of diagnosis for H pylori infection?

A

Endoscopy

17
Q

How is endoscopy used for diagnosis of H pylori?

A

Gastric biopsies stained and/or cultured

Rapid slide urease test

18
Q

What is gastritis?

A

Inflammation of gastric mucosa

19
Q

What are peptic ulcers caused by?

A

H pylori most commonly
NSAIDs, smoking
Rarely caused by other conditions

20
Q

What are the symptoms of peptic ulcers?

A 
Epigastric pain
Nocturnal/hunger pain
Back pain
Nausea and vomiting
Weight loss and anorexia
Epigastric tenderness
Haemetemesis and/or melaena and/or anaemia
21
Q

What is the treatment for peptic ulcers?

A

Eradicate H pylori if present
Antacid medication
Stop NSAIDs
Surgery in severe cases

22
Q

How is H pylori eradicated in peptic ulcers?

A

Triple therapy for 7 days- clairythromycin, amoxicillin (or tetracycline) and a proton pump inhibitor e.g. omeprazole

23
Q

What are the 2 kinds of antacid used in treatment of peptic ulcers?

A

Proton pump inhibitors

H2 receptor antagonists

24
Q

How are peptic ulcers treated in a patient who needs to remain on their NSAIDs?

A

As usual but NSAIDs carried on with extra protection

25
Q

What are the complications of peptic ulcers?

A 
Acute bleeding
Chronic bleeding
Perforation
Fibrotic structure causing narrowing
Gastric outlet obstruction
26
Q

What are the possible symptoms of acute bleeding in peptic ulcers?

A

Haemetemesis

Melaena

27
Q

What is the possible effect of chronic bleeding in peptic ulcers?

A

Iron deficiency anaemia

28
Q

What are the symptoms of gastric outlet obstruction?

A 
Recurrent vomiting
Early satiety
Abdo distension
Weight loss
Gastric splash
Dehydration
Loss of H+ and Cl-
Metabolic alkalosis
29
Q

How can vomiting causing by gastric outlet obstruction be identified?

A

Lacks bile

Contains fermented foods

30
Q

What would bloods of a patient with gastric outlet obstruction show?

A

Low CL, Na and K

Renal impairment

31
Q

How is gastric outlet obstruction diagnosed?

A

Endoscopy

32
Q

What are the causes of gastric outlet obstruction?

A

Stricture
Ulcer
Cancer

33
Q

How is gastric outlet obstruction treated?

A

Balloon dilatation in stricture

Surgery

34
Q

What is the presentation of gastric cancer?

A 
Dyspepsia
Early satiety
Nausea and vomiting
Weight loss
GI bleeding
Anaemia
Gastric outlet obstruction
35
Q

What are the causes of gastric cancer?

A 
Diet
Genetics
H pylori
Previous gastric resection
Biliary reflux
Premalignant gastric pathology
36
Q

How is gastric cancer diagnosed?

A

Endoscopy

Biopsies

37
Q

What staging investigation is done for gastric cancer?

A

CT chest/adbo

38
Q

Where does gastric cancer primarily spread to?

A

Lymph nodes
Liver/lungs
Peritoneum
Bone marrow

39
Q

What is the treatment of gastric cancer?

A

Surgical and chemo

GI AM (34 decks)

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