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Alimentary System > H.Pylori and Gastric Disease > Flashcards

H.Pylori and Gastric Disease Flashcards

1
Q

What are the functions of the stomach?

A 
Storage 
Start digestion 
Acid secretion 
Secretion of intrinsic factor 
Secretion of enzymes (e.g pepsin)
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2
Q

What is dyspepsia?

A

Group of symptoms used to describe pain or discomfort in the upper abdomen

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3
Q

What symptoms are included in dyspepsia?

A

Heart burn
Bloating
Fullness

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4
Q

What are some upper GI causes of dyspepsia?

A

Peptic ulcer
Gastric
Non ulcer dyspepsia
Gastric cancer

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5
Q

What is a hepatic cause of dyspepsia?

A

Gallstones

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6
Q

What are some lower GI causes for dyspepsia?

A

IBS

Colonic cancer

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7
Q

What is meant by the term organic?

A

Means there is a structural pathology that is driving the symptoms

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8
Q

What is meant by the term functional disorder?

A

Structurally everything is okay however not functioning as it should

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9
Q

What are the red flag symptoms that require further investigation?

A 
Anorexia 
Loss of weight 
Anaemia 
Recent onset or persistent despite treatment 
Melena 
Swallowing problems
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10
Q

What are the requirements before performing an endoscopy?

A

Local anaesthetic
Fasted
Gained consent

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11
Q

What are the investigations for presenting dyspepsia?

A 
History 
Full examination 
Bloods 
FBC 
Ferritin 
Calcium 
Glucose 
Coeliac serum 
Drug history (NSAIDS ect..)
Lifestyle - smoking, alcohol, diet ect..
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12
Q

Is H.pylori gram positive or negative?

A

Negative

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13
Q

When can H.pylori only colonise?

A

In the stomach

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14
Q

When would H.pylori be tested for?

A

When no alarm features are present
Patient is under 55
No UGIE to be performed

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15
Q

What % of the world population is infected with H.pylori?

A

50%

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16
Q

Where does H.pylori reside in the stomach?

A

In the surface mucous layer

should not penetrate the epithelium

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17
Q

In 15-20% of those with H.pylori what can develop?

A

Gastric ulcers

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18
Q

In <1% of those with H.pylori what can develop?

A

Gastric cancer

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19
Q

If H.pylori lives in the antrum what is more likely to develop?

A

Ulcer

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20
Q

Where in the stomach is H.pylori more likely to develop in to gastric cancer?

A

In the body of the stomach

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21
Q

How is diagnosis of H.pylori made non-invasively?

A

Serology: IgG against H.pylori

Stool antigen test

22
Q

How is diagnosis of H.pylori made invasively

A

Requires endoscopy
Histology
Culture of gastric biopsies
CLO

23
Q

What is gastritis?

A

Inflammation in the gastric mucosa

24
Q

What are the 3 types of gastritis?

A

Autoimmune
Bacterial
Chemical

25
Q

What is an example of autoimmune gastritis?

A

Attack on parietal cells

26
Q

What is an example of bacterial gastritis?

A

That caused by H.pylori

27
Q

What is potential cause of chemical gastritis?

A

NSAIDS

28
Q

What are the majority of peptic ulcers caused by?

A

H.pylori infection

29
Q

Are peptic ulcers more common in men or women?

A

Men

30
Q

What is another potential cause of peptic ulcers?

A

NSAIDS

31
Q

What are the symptoms of gastric ulcers?

A 
Epigastric pain 
Pain worse at night 
Nausea and occasional vomiting 
Only sign may be epigastric tenderness 
Haematemesis
32
Q

What would haematemesis suggest?

A

Bleeding of the ulcer

33
Q

What would back pain with gastric ulcers suggest?

A

May suggest penetration of the posterior DU

34
Q

What is the investigation for gastric ulcers?

A

Endoscopy

35
Q

Why do gastric ulcers have to be biopsied?

A

To establish that they are benign

36
Q

What is the treatment for gastric ulcers?

A

Get rid of H.pylori infection
Anti acid medication
NSAID removal (if applicable)
Surgery in complicated PUD

37
Q

What is the treatment for eradication of H.pylori infection?

A

Triple therapy for 7 days
Clarithromycin
Amoxycillin
PPI

38
Q

Why are PPI part of the triple therapy?

A

To protect the stomach from excess acid production

39
Q

How effective is triple therapy for H/pylori treatment?

A

90%

40
Q

What are potential complications of Peptic ulcers?

A 
Acute bleeding 
Chronic bleeding
Perforation 
Fibrotic stricture 
Gastric outlet obstruction
41
Q

What would signs of chronic ulcer bleeding be?

A

Iron deficiency

Anaemia

42
Q

What would signs of acute ulcer bleeding ben?

A

Melaena

Hematemesis

43
Q

Where would the ulcer be located if there was gastric outlet obstruction?

A

If the pyloric sphincter is affected

44
Q

What are the symptoms of gastric outlet obstruction?

A

Vomiting
Easily satiety
Lose weight
Metabolic alkalosis

45
Q

What is the prognosis of gastric cancer?

A

5yr survival <20%

46
Q

Why does gastric cancer present quite late?

A

Cause it is asymptomatic

47
Q

What type of cancer are the majority of gastric cancers?

A

Adenocarcinomas

48
Q

How does gastric cancer present?

A 
Dyspepsia 
Early satiety
Nausea and vomiting 
Weight loss 
GI bleeding 
Anaemia 
Gastric outlet obstruction
49
Q

What is the investigation to diagnose gastric cancer?

A

Endoscopy with biopsy

50
Q

What is the investigation to stage gastric cancer?

A

CT chest and abdo

51
Q

What are the treatments for gastric cancer?

A

Surgery

Chemotherapy

52
Q

What are some aetiologies for gastric cancer?

A 
FH
Previous gastric resection 
Mostly sporadic
Biliary reflux 
Premalignant gastric pathology

Alimentary System (29 decks)

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