Brainscape's Knowledge GenomeTM

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


See full index

GI > Lecture 9 - Gastric disease > Flashcards

Lecture 9 - Gastric disease Flashcards

1
Q

Dyspepsia

A

Indigestion

Upper GIT symptoms:

  • abdominal pain
  • heartburn
  • acid reflux
  • nausea and vomiting

Functional dyspepsia diagnosis of exclusion

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

GORD

A

Gastric-oesophageal reflux disease

Causes:

  • Increased intra-abdominal pressure
  • Damage to LOS

Symptoms:

  • chest pain
  • acid taste in mouth
  • cough

Consequences:

  • Nothing
  • Oesophagitis
  • Strictures - vomit
  • Barret’s oesophagus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lower oesophageal sphincter

A
  • Lower 4cm of oesophagus is made of smooth muscle
  • Right diaphragmatic crus tightens
  • Oblique angle of entry by the oesophagus into the stomach
  • When abdominal pressure increases the lumen collapses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

LOS at rest

A

Contracted

Highest pressure at night

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

Treatment of GORD

A

Lifestyle modification - not eating before sleeping
- eating slower and less more often

Pharmacological:
Antacids
H2 antagonists - less H+ release
PPI - proton pump inhibitors

Surgery:
Fundoplication

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

Hiatal hernias

A

Small section of stomach through the diaphragm to thorax

GORD oesophagitis more common in people with hiatal hernias

  • oesophagus higher up in thorax decreases basal constriction
  • Reduces the normal increase in tone when straining
  • Retention of gastric fluid in hernial sac
  • Loss of support from the LOS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Gastritis

A

Inflammation of the gastric mucosal lining the stomach

Can be acute or chronic

Symptoms:

  • epigastric pain
  • nausea and vomiting
  • bleeding
  • asymptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Severe gastritis symptoms

A 
Mucosal erosion 
Ulceration
Haemorrhage
Melena
Haematemesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acute gastritis

A

Acute inflammatory response of the mucosal lining due to:

  • NSAIDs - decrease prostaglandins
  • Excessive alcohol - dissolves mucosal lining
  • Chemotherapy - Kills rapidly dividing epithelial cells
  • Bile reflux - irritant

Damaged epithelium and decreased mucous production

Therefore:

  • Neutrophil invasion
  • Vasodilation
  • mucosal oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gastropathy

A

Cell injury and regeneration with no neutrophils present

Causese:
- NSAIDs
- Excessive alcohol
_ Bile
- Stress induced injury 
- Mucosal erosion - ulcers or lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Symptoms and treatment of acute gastritis

A
  • Abdominal pain
  • Nausea and vomiting
  • Occasional bleeding can be fatal due to hypovalaemia

Treatment:
- Remove irritant

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

Chronic gastritis

A

Causes:

  • Helicobacter pylori (most common)
  • Autoimmune
  • Chronic use of alcohol, NSAIDs and bile reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

H pylori

A
  • Inhibition of gastric bicarbonate transporters by ammonium ions
  • Can be asymptomatic or symptoms similar to acute gastritis
  • symptoms can develop due to peptic ulcers, adenocarcinoma or MALT lymphoma
  • less severe but more persistant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Autoimmune cause of chronic gastrits

A

Immune destruction of parietal cells in the body of the stomach

  • Pernicious anaemia
  • Less HCL secreted causing increased gastrin release as decreased somatostatin release and decreased iron absorption
  • Less intrinsic factor therefore less absorption of vit B12
  • Symptoms of anaemia
  • Glossitis
  • Anorexia
  • Neurological symptoms due to Vit B12 deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

H pylori organism

A

Helix shaped (spiral)
Gram negative
Microaerophillic - requires low O2 to survive
Adhesins - resistance to peristalsis as adhered to foveolar cells
- Urease - neutralises acid
- Releases cytotoxins - causes ulcers and cancer
- Flagella - motile

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

Urease

A

Produces ammonium from urea

Increases local pH

17
Q

H pylori in antrum

A

Most common

  • Increased gastrin secretion due to decreased D cell activity so less somatostain released
  • Parietal cell hyperplasia and over stimulation
  • Increased acid production and peptic ulcers
  • Duodenal epithelial metaplasia, colonisation and ulceration
18
Q

H pylori in body

A

Atrophy
Gastric ulcers not due to acid
Intestinal metaplasia, dysplasia and cancer

  • Parietal mass and decreased acid secretion causing hypergastrinaemia
  • If in antrum and body = ASYMPTOMATIC
19
Q

H pylori diagnosis

A

Urea breath tests to detect CO2
Gastric endoscopy and biopsy
Stool antigen test

20
Q

Treatment H pylori

A

Proton pump inhibitor
Amoxicillin
+ clarithropmycin or metronidazole

21
Q

Difference between chronic and acute gastritis

A

Acute:

  • surface epithelial damage
  • regenerative hyperplasia
  • vasodilation
  • neutrophils

Chronic:

  • Lymphocytes
  • glandular atrophy
  • Lamina propria fibrosis
  • Metaplasia
22
Q

Peptic ulcer disease

A

Defect in the gastric or duodenal mucosa extending through the muscularis mucosa

Most common in proximal 1/3rd of duodenum, lesser curve and antrum

23
Q

Pathogenesis of peptic ulcer disease

A
  • Defect in body’s defences against acid

- Rapid gastric emptying causes inadequate acid neutralisation causing duodenal ulcers

24
Q

Causes of peptic ulcers

A

H pylori
NSAIDs
Smoking - relapse of ulcer disease
Stress - extensive burns

25
Q

Acute ulcers

A

Develop due to acute gastritis

26
Q

Chronic ulcers

A

Occurs at mucosal junctions where antrum meets body on the lesser curve

In duodenum where the antrum meets the small intestines

27
Q

Structure of peptic ulcer

A

Normally less than 2cm

Base of ulcer is necrotic with granulation tissue

Muscularis mucosa replaced by scar tissue - pyloric stenosis causing vomiting blood

28
Q

Consequences of peptic ulcer

A 
Haematemesis
Perforation causing peritonitis 
Fistula 
Erosion into liver or pancreas
Haemorrhage of splenic artery 
Malignancy
29
Q

Peptic ulcer symptoms

A

Epigastric pain - sometimes radiates to back

  • following meals
  • at night
  • burning sensation
  • Haematemesis
  • Maleana
  • Anaemia - blood loss
  • Weight loss
  • Early satiety
30
Q

Management of peptic ulcers

A 
Lifestyle modification - eat less 
Stop exacerbating medications e.g. NSAIDs 
Test for H pylori 
PPI
Endoscopy
31
Q

Tests for gastric pathology

A 
Endoscopy - biopsy 
H pylori
Urease breath test 
CXR - perforation of fundus
Blood test FBC - anaemia
32
Q

H2 blockers

A

Cimetidine
Ranitidine

Block histamine modulation so less HCL is secreted from parietal cells

33
Q

PPI

A

Omeprazole

34
Q

Zollinger Ellison syndrome

A

Non beta islet cell gastrin secreting tumour of the pancreas

Proliferation of parietal cells

Increases secretion of gastrin and HCL

Severe ulceration of stomach and small bowel

  • abdominal pain
  • diarrhoea
35
Q

Stomach cancer

A

Presents late as large for symptoms to appear

  • dysphagia
  • loss of appetite and eight loss
  • Maleana
  • Nausea and vomiting
  • Spread to virchow’s nodes (left supraclavicular)
36
Q

Risk factors of stomach cancer

A

Male
H pylori
High salt intake - Japan
Smoking

GI (18 decks)

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