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GI Learning Outcomes > H.pylori and gastric disease > Flashcards

H.pylori and gastric disease Flashcards

1
Q

what are the group of systems that cause dyspepsia ?

A

epigastric pain
burning
fullness
bloating
satiety
nausea
sickness
heartburn
reflux
discomfort

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2
Q

how long do you need symptoms for them to be considered as dyspepsia ?

A

4 weeks

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3
Q

what type of conditions can cause dyspepsia?

A

GORD
peptic ulcers
gastritis
gastric cancer
non ulcer dyspepsia
pancreatic disease
coeliac
cardio
drugs
psychological
IBS

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4
Q

what are the alarm symptoms of dyspepsia ?

A

anorexia

loss of weight

anaemia (iron deficicency)

recent onset >55 yrs

melaena/haematemesis

swallowing problems/dysphagia

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5
Q

what are the features of an endoscopy of the upper GI ?

A

local anaesthetic under day case

1:2000 risk of perforation, bleeding or a reaction to drugs given

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6
Q

what kind of bacteria is helicobacter pylori ?

A

gram negative spiral flagellated

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7
Q

how much of the world does H.Pylori affect ?

A

50% mainly acquired in childhood

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8
Q

how does H.pylori infection in the gut colonise ?

A

resides in the mucosa of the gastric cells and produces urease

urease creates an alkaline pH arround the bacteria (creates ammonia) to allow it to motilise to the epithelium and release toxins to damage the shot

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9
Q

what are some possible clinical outcomes of H.Pylori ?

A

chronic gastritis, intestinal metaplasua, duodenal and gastric ulcers, gastric cancer and MALT lymphoma

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10
Q

what condition is prone from antral predominant gastritis ?

A

duodenal disease due to increase in gastric acid

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11
Q

what condition is prone from corpus predominant gastritis ?

A

gastric cancer from gastric atrophy

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12
Q

how do we test for H.Pylori ?

A

serology IgG

13c/14c urea breath test

stool antigen test ELISA (need to be off PPI for 2 weeks prior to testing)

invasively an endoscopic biopsy for a rapid slide urease (CLO), if ammonia is present then the biopsy will become a red colour

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13
Q

what can cause gastritis ?

A

Autoimmune (parietal cells)
bacterial (H.pylori)
chemical (bile/NSAIDS)

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14
Q

what are the common causes of peptic ulcers ?

A

H.pylori
smoking
NSAIDS
stress
Caffeine
crohns

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15
Q

what are the main symptoms for peptic ulcers ?

A

epigastric pain
nocturnal/hunger pain
back pain (more common in DU)
nausea and vommiting
weight loss
epigastric tenderness
haematemesis
melaena
anaemia

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16
Q

how do we treat peptic uclers ?

A

H.pylori eradication therapy

antacid medication (PPI such as omeprazole) or H2RA (ranitidine)

stop NSAIDS

17
Q

how do we eradicate H.pylori ?

A

triple therapy for 7 day
clarithromycin 500mg
amoxicillin 1g (or tetracyline 1g, metronidazole 400mg)
PPI such as omeprazole 20mg

18
Q

what are the main causes of failure for H.pylori eradication ?

A

resistance to antibiotics

poor compliance

19
Q

what are the complications of gastric ulcers ?

A

acute bleeding (melaena)
chronic bleeding (anaemia)
perforation
fibrotic stricture
gastric outlet obstruction

20
Q

what are the symptoms of gastric outlet obstruction ?

A

vomiting (lacks bile and fermented food)
abdominal distension
weight loss
gastric splash
dehydration (loss of H+,Cl- in vomit)

21
Q

what do bloods show in gastric outlet obstruction ?

A

low Cl, low Na, low K, renal impairment

22
Q

how do we treat gastric outlet obstruction ?

A

endoscopic balloon dilatation or surgery

23
Q

what are the majority of gastric cancers ?

A

adenocarcinomas

24
Q

how do patients with gastric cancer present ?

A

dyspepsia
nausea and vomiting
weight loss
GI bleeding
iron deficient anaemia
gastric outlet obstruction

24
Q

how do patients with gastric cancer present ?

A

dyspepsia
nausea and vomiting
weight loss
GI bleeding
iron deficient anaemia
gastric outlet obstruction

25
Q

what are the main aeitiologies of gastric cancer ?

A

diet
smoking
helicobacter
genetics
family history
biliary reflux

26
Q

what are the genetics involved with gastric cancer ?

A

majority are sporadic

familial <15%

1-3% inheritable through AD, CDH-1, E-cadherin and HDGC

27
Q

how do we investigate gastric cancer ?

A

endoscopic biopsies
CT chest/abdo
MDT discussion

28
Q

how do we treat gastric cancer ?

A

surgery total/sub total gasterectomy and chemotherapy

GI Learning Outcomes (13 decks)

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