Brainscape's Knowledge GenomeTM

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


See full index

Gastroenterology > Oesophageal and Gastric Disorders > Flashcards

Oesophageal and Gastric Disorders Flashcards

1
Q

3 things that can cause GORD

A

incompetent LOS, poor oesophageal clearance, barrier function/ visceral sensitivity.

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

In GORD there is a _____ correlation between symptoms and endoscopic findings, this is because people have varying sensitivities to _____

A

poor

acid

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

9 symptoms of GORDS

A
  • Heartburn
  • Acid reflux
  • Waterbrash
  • Dysphagia
  • Odynophagia
  • Weight loss
  • Chest pain
  • Hoarseness
  • Coughing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 investigations for reflux?

A
  • Endoscopy
  • Barium swallow (much less likely to do this)
  • Oesophageal manometry and pH studies (put probe down and when you get acid in your oesophagus it will register this, probe stay there for 24hrs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In GORD what are alarm symptoms in which endoscopy will be immediately done?

A
  • Dysphagia
  • Weight loss
  • Anaemia
  • Vomiting
  • Family History
  • Barretts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two complications of GORD?

A
  • Adenocarcinoma

* Barretts

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

What drug for GORD provides both symptom relief and heals oesophagitis?

A

PPIs- omeprazole

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

What do all people with Barrett’s oesophagus go on?

A

Life long PPIs twice a day

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

If high grade dysplasia is found in Barretts oesophagus what is done?

A

Nodular lesions can be removed if not nodular can be given high dose protein pumps

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

What is Achalasia?

A

Lower oesophageal sphincter doesn’t open properly so get dysphagia and food sticks around in the oesophagus

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

Clinical features of achalasia?

A

Long history of Intermittent dysphagia

Regurgitation of food from dilated oesophagus

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

Complication of achalasia?

A

Aspiration pneumonia

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

What is gastroparesis?

A

Delayed gastric emptying but no physical obstruction, can be caused by diabetes, drugs or be idiopathic

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

Symptoms of gastroparesis?

A

Feeling full a lot of time, Nausea, Vomiting, Weight loss, Upper abdominal pain

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

Management of gastroparesis?

A

Removal of precipitating factors, eat more liquids, eat little and often

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

Define dyspepsia

A

Basically indigestion

symptoms of bothersome postprandial fullness, early satiation, epigastric pain, epigastric burning

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

Causes of dyspepsia

A

Peptic ulcer disease
Drugs NSAIDs
Gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of dyspepsia/ patient complaining of indigestion?

A

Consider other organs
If predominant heart burn manage as GORD
If it is true dyspepsia then check for alarm symptoms: dysphagia, weight loss, GI bleeding, persistent vomiting, unexplained weight loss, upper abdominal mass
If there are no alarm symptoms can manage as functional dyspepsia and give lifestyle advice if alarm symptoms make relevant referral.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is functional dyspepsia?

A

Presence of one of the symptoms of bothersome postprandial fullness, early satiation, epigastric pain, epigastric burning AND no evidence of structural disease on endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define a peptic ulcer

A

A break in the superficial epithelial cells penetrating down to the muscularis mucosa of either the stomach or the duodenum, there is a fibrous base and an increase in inflammatory cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Duodenal ulcers are most commonly found in the ___________ and gastric ulcers are most commonly seen on ___________. Duodenal ulcers are more _________

A

duodenal cap
the lesser curve near the incisura
common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

2 causes of peptic ulcer disease?

A

H. pylori infection or NSAID induced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical features of peptic ulcers?

A

Recurrent burning epigastric pain. Anorexia and weight loss may occur.
Gastric ulcers tend to have worse pain when eating and duodenal ulcer pain tends to be relieved by eating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe H pylori infection and how it relates to gastric disease

A

This is acquired in infancy
The majority of people have no pathology
Some develop ulcers
Even smaller amount get cancer

25
Q

Diagnosis of H. Pylori?

A
  • gastric biopsy and do urease test, histology or culture
  • urease breath test
  • FAT (faecal antigen test)
  • serology (IgA antibodies) - not accurate with increasing patient age
26
Q

Treatment of peptic ulcers?

A

Patients that are H. Pylori positive should have eradication therapy- this involves antibiotics and PPIs
PPI + amoxycillin 1g bd + clarithromycin/ metranidazole 500mg bd
PPI + metronidazole 400mg bd + clarithromycin 250mg bd (if pen allergic)

If H. pylori negative go on antisecretory therapy- PPIs

With gastric ulcers there is follow up at 6-8 weeks to ensure healing and no malignancy

27
Q

Achlorhydria increases risk of __________and this is absence of hydrochloric acid in secretions

A

gastric cancer

28
Q

Cardinal features of an acute upper GI bleed are?

A

haematesmesis (vomiting of blood) and melaena (the passage of black tarry stools the colour due to blood altered by passage through the gut)

29
Q

What is the most common cause of serious and life threatening upper GI bleeding?

A

Peptic ulcer

30
Q

Emergency endoscopic treatment of peptic ulcers?

A
  1. Injection
  2. Heater probe coagulation
  3. Combinations
  4. Clips
  5. Haemospray
31
Q

What are varices? Explain acute variceal bleeding

A

Varices are dilated blood vessels in the esophagus or stomach caused by portal hypertension.
If they rupture they will bleed
Complication of liver failure

32
Q

When do you suspect someone with varices with an upper GI bleed?

A

Known history of cirrhosis with varices
History: chronic alcohol excess, chronic viral hepatitis infection, metabolic or autoimmune liver disease, intra-abdominal sepsis/surgery

33
Q

Oesophageal tumours risk factors?

A

High levels of tobacco for both
Alcohol more for squamous
Adeno is associated with Barretts and therefore reflux

34
Q

What part of oesophagus do squamous cell carcinomas and adenocarcinomas affect?

A

Squamous affects mainly the upper oesophagus

Adenocarcinoma affects mainly the lower oesophagus

35
Q

Presentation of oesophageal cancer?

A 
Progressive dysphagia
Pain from impaction of food, more persistent pain may imply invasion of surrounding structures
Weight loss
Anrorexia
Lymphadenopathy
36
Q

Investigations that can be done for oesophageal cancer?

A

Endoscopy to obtain biopsy

Barium swallow allows you to rule out other diagnoses such as achalasia

37
Q

Treatment for oesophageal cancer?

A

Surgery is the best option but should only be used when imaging shows the tumour has not infiltrated outside the oesophageal wall. Some patients are given preoperative chen-radiation therapy. Often palliative therapy is the only option. It is important that patients are given nutritional support.

38
Q

Risk factors for gastric carcinomas?

A

H. pylori infection
Dietary factors
Tobacco smoking
Genetic abnormality

39
Q

Presentation of gastric carcinomas?

A

Often presents late as can be quite asymptomatic
Epigastric pain similar to peptic ulcers
Predominant symptom is usually weight loss
May also get nausea and get dysphagia if the tumour is in the funds
May only get symptoms of spread e.g. malignant ascites

40
Q

What investigation can be done to diagnose gastric carcinoma?

A

Gastroscopy

41
Q

Treatment for gastric carcinoma?

A

Non-ulcerated mucosal lesions can be removed endoscopically
Surgery is the most effective form of treatment and may be combined with chemotherapy
May need palliative care and relief of symptoms

42
Q

What do you inject into bleeds and why?

A

Dilute adrenaline- will cause vasoconstriction

43
Q

What is involved in dual therapy treatment of GI bleeds?

A

Injection of dilute adrenaline and heater probe treatment

44
Q

Bleeding peptic ulcer management plan?

A

Adrenaline – heater probe therapy
If bleed stops give IV omeprazole and potentially H. Pylori eradication
If they re-bleed give omeprazole with further endoscopic intervention. If this fails then they need surgery.

45
Q

Risk factors for variceal bleed?

A
  • portal pressure > 12mmHg
    - varices > 25% oesophageal lumen
    - presence of red signs
    - degree of liver failure (Child’s A<b></b>
46
Q

Treatment for variceal bleeding?

A
  1. Terlipressin (vasopressin analogue)- in everyone
  2. Endoscopic variceal ligation (banding)
  3. (Sclerotherapy)
  4. Sengstaken-Blakemore balloon
  5. TIPS

Secondary treatment involves banding and propranolol

47
Q

Are peptic ulcers more common in old or young people?

A

Old people as sanitation was poorer when they were younger so they are more likely to be infected with H. Pylori

48
Q

What allows helicobacter to infect the duodenum?

A

Gastric metaplasia that occurs in the duodenum to increased acid

49
Q

5 causes of dysphagia?

A 
Candidiaisis (white patches on mouth that don't wipe away)
Neuromuscular disorders (bulbar palsy)
Oesophageal motility disorders (spasm or achalasia)
Extrinsic pressure (mediastinal glands or enlarged LA)
Intrinsic lesion (stricture benign or malignant, webs, foreign bodies, pharyngeal pouches)
50
Q

Palliative treatment for oesophageal cancer?

A

Endoscopic dilation

51
Q

Treatment of achalasia?

A

Balloon dilation or myotomy (cut away part of stomach)

52
Q

Barium swallow of oesophageal spasm will show?

A

cork screw oesophagus

53
Q

First line investigations for most oesophageal disorders?

A

gastroscopy

54
Q

Manometry is done when

A

you can’t get diagnosis from endoscopy, this looks at motility

55
Q

Oesophageal dysplasia is managed by?

A

radio frequency ablation

56
Q

Peptic strictures are surgically managed by?

A

endoscopic dilation

57
Q

Surgical management of gord is?

A

Nissen fundoplication

58
Q

If someone has dysphagia more for liquids than solids what should you think?

A

More likely to be a motility issue as opposed to a physical obstruction

Gastroenterology (28 decks)

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