Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr2 GI Joe > H.pylori & gastric disease > Flashcards

H.pylori & gastric disease Flashcards

1
Q

What is dyspepsia?

A

Pain / discomfort in the upper abdomen (indigestion)

Also includes symptoms such as bloating, anorexia etc

For 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How common is dyspepsia?

A

Very common

80% of people get it at some point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What tends to cause dyspepsia?

A

Upper GI problems

Hepatic causes & gallstones

Pancreatic disease

Coeliac disease

Psychological

Drugs

Systemic/other illness

Lower GI rarely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What investigations can be done for a patient presenting with dyspepsia?

A

FBC

Ferritin

LFTs

U&Es

Calcium

Glucose

Coeliac serology/serum IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What aspects of a history are particularly important for patients with dyspepsia?

A

Drug history

Lifestyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What drugs are linked to causing dyspepsia?

A

NSAIDs

Steroids

Bisphosphonates

Ca antagonists

Nitrates

Theophyllines

Remember OTT?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What symptoms are ALARMS?

A

A - Anorexia

L - Loss of weight

A - Anaemia

R - Recent onset >55

M - Melaena/haematemesis*
S - Swallowing problems (dysphagia)

*Persistent vommiting is also serious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What would be done for a patient with ALARMS signs/symptoms?

A

Refer for endoscopy

(urgent investigation for cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

For a patient without ALARMS symptoms, what is the next course of action?

A

Lifestyle advice

Offer antacid medication such as Gaviscon

Offer H2 receptor antagonist: Ranitidine

H.Pylori SA test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of bacteria is Helicobacter pylori?

A

Gram negative, spiral-shaped, microaerophilic, flagellated Gram –ve bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How common is infection by H.pylori?

A

Infects 50% of the world population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where can H.pylori colonise in the GI tract?

A

H.pylori can only colonise gastric type mucosa

It resides in the mucous layer, and does not penetrate the mucosal epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What determines whether or not someone with H.pylori in their stomach will actually get sick?

A

Host genetic factors determine whether or not an immune response happens

Site of colonisation, characteristics of the bacteria

Environmental factors as well - eg smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the possible outcomes of infection by H.pylori

A

>80% - Asymptomatic or chronic gastritis

15-20% - Chronic atrophic gastritis, intestinal metaplasia or Gastric/duodenal ulceration

<1% - Gastric cancer, MALT lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens when there is chronic H. pylori infection in the Antrum of the stomach?

A

Antral predominent gastritis can lead to increased Acid production by parietal cells

Increased acidity causes duodenal ulceration, but has lower risk for cancer

(antral infection = ulcers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens when there is chronic H.pylori infection which exists more in the corpus area of the stomach?

A

Corpus predominent gastritis leads to decreased acid production and gastric atrophy

This causes an increased risk of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is H.pylori infection investigated/diagnosed?

A

Stool antigen (ELISA) test

Serology: IgG antibody against H.pylori

13C/14C urea breath test

Endoscopy:

  • Biopsy for staining
  • Biopsy for Culture
  • Rapid slide Urease test (CLO)
18
Q

How does a rapid slide urease test work?

A

Detects urease, an enzyme which is secreted by H.pylori

Red = positive

Yellow = negative

(Urease is also what makes the urea breath test work)

19
Q

What is gastritis and how is it diagnosed?

A

Inflammation of the gastric mucosa

Diagnosed histologically (needs biopsy)

20
Q

What are the causes of gastritis?

A

Think ABC

A - Autoimmune (parietal cells)

B - Bacterial (H.pylori)

C - Chemical (bile/NSAIDs)

21
Q

What type of peptic ulcer is most common?

A

Duodenal ulcers are more common than gastric ulcers

22
Q

What causes the majority of Peptic ulcers?

A

H.pylori infection

23
Q

What other conditions/things can cause Peptic ulcers?

A

Zollinger-Ellison syndrome

Hyperparathyroidism

Crohn’s disease

(NSAIDs & Smoking are risk but i cba asking that by itself)

24
Q

How do age and gender affect your likelihood of getting peptic ulcers?

A

Men > women

Old > young

25
Q

How are Gastric and duodenal ulcers diagnosed?

A

Through endoscopy (through mouth)

26
Q

Peptic ulcer symptoms?

A

Epigastric pain

Nocturnal hunger/pain

Nausea / vomitting

Anorexia / weight loss

GI bleeding symptoms

27
Q

Peptic ulcer clinical signs?

A

Epigastric tenderness

(GI bleeding may cause anaemia)

28
Q

How do you treat peptic ulcers?

A

H.pylori eradication therapy

Antacid (Omeprazole, Ranitidine)

Stop NSAIDs (or protect against them)

Treat complications

Surgery only if complicated/serious enough

29
Q

What type of drug is Omeprazole?

A

Proton pump inhibitor

Type of antacid

30
Q

What type of drug is Ranitidine?

A

H2 receptor antagonist

Type of antacid

31
Q

Describe the process of H.pylori eradication

A

7 days Triple therapy

  1. Clarithromycin 500mg bd
  2. Amoxycillin 1g bd*
  3. PPI eg Omeprazole 20mg bd

*or Metronidazole 400mg bd OR Tetracycline if allegic to penicillin

32
Q

What are the complications of peptic ulcers?

A

Acute bleeding - Melaena/haematemesis

Chronic bleeding - Iron deficiency anaemia

Perforation

Fibrotic stricturing

Gastric outlet obstruction - oedema or strictures

33
Q

What are the symptoms of gastric outlet obstruction?

A

Vomitting

Early satiety (feel full quickly)

Weight loss

Abdo distension

34
Q

What signs on examination indicate gastric outlet obstruction?

A

Dehydration

Gastric splash

Metabollic alkalosis

35
Q

What investigations should be done for gastric outlet obstruction and why?

A

Bloods - these would show Low Cl-, low K+, low Na+, renal impairment

Upper GI endoscopy - will identify any ulcer/stricture/cancer causing the problem

36
Q

What are the different types of Gastric tumours?

A

Adenocarcinoma (epithelial cells) - most common

MALT lymphoma (mucosa-associated lymphoid tissue)

GIST (gastrointestinal stroma tumour) - type of sarcoma

37
Q

What is the prognosis for gastric cancer?

A

5 year survival < 20%

38
Q

What are the symptoms/signs of gastric cancer?

A

Dyspepsia

Early satiety (fullness when eating)

Nausea & vommiting

Weight loss

GI bleeding

ID anaemia

Gastric outlet obstruction

39
Q

What are the risk factors for gastric cancer?

A

Diet

Smoking

Genetics

History of H.pylori infection

Others: family history, previous gastric resection, biliary reflux, premalignant gastric pathology

40
Q

What is the Correa hypothesis?

A

The histological pathway from H.pylori infection to various subtypes of gastric cancer

Yr2 GI Joe (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions