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GI Medicine > Oesophageal and Upper GI Disease > Flashcards

Oesophageal and Upper GI Disease Flashcards

1
Q

What medicines are commonly used in upper GI diseases

A

Antacids
H2 receptor blockers
Proton pump inhibitors

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2
Q

How do antacids work

A

They are alkalis which form a salt with the gastric acid - neutralising its effect on the tissues

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3
Q

What are the 3 main triggers for stomach acid production

A

Acetylcholine
Gastrin
Histamine

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4
Q

Why is stopping stomach acid production

A

Each trigger works independently so blocking one will not stop acid production

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5
Q

How can acetylcholine be reduced

A

By reducing the vagus nerve innervation to the stomach - surgically by cutting the nerve

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6
Q

How can histamine be stopped

A

By using histamine blockers - H2 receptor blockers

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7
Q

Which drug is most commonly used to prevent stomach acid production and how does it work

A

Proton pump inhibitors

They block acid secretion irrespective of whether the stimulation continues at the bottom

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8
Q

Give examples of different H2 receptor antigens and their pros and cons

A

Cimetidine - many drug interactions and not very effective

Ranitidine - not any more effective but safer in clinical use and licensed for over the counter sale

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9
Q

Give examples of different proton pump inhibitors

A

Omeprazole
Lansoprazole
Pantoprazole

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10
Q

Why do GI tract diseases usually stop mid-oesophagus

A

Above this point is embryologically not part of the GI tract

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11
Q

How is the upper GI system easily accessed

A

Using an endoscope

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12
Q

Why do some endoscopes carry forceps

A

To allow them to take a snip of the lining tissue of the stomach which can be used for histological examination

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13
Q

Why can diathermy be used with an endoscope

A

To cauterise any bleeding vessels the patient has in the stomach

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14
Q

Explain how a capsule endoscopy works

A

The capsule has a small camera
The patient will swallow the capsule, then it will take pictures of the lining of the bowel every few seconds
The capsule will then wirelessly transmit this to a receiver

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15
Q

What is dysphagia

A

Difficulty in swallowing

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16
Q

Describe the oesophagus’ anatomical position

A

Passes through the mediastinum on its way from the pharynx to the stomach
Stomach is below the diaphragm and pharynx is above the larynx
Sits related to the trachea and the aortic arch

17
Q

How may the oesophagus become compressed

A

Any swelling or lump will compress the oesophagus eg - a lung tumour or aortic aneurysm

18
Q

Which dysmotility disorders can cause dysphagia

A

Scleroderma

Acid related fibrosis (GORD)

19
Q

Describe how scleroderma can cause dysphagia

A

Elastic tissue is replaced by fibrous tissue

20
Q

Describe how GORD can cause dysphagia

A

Causes burning and irritation and eventual loss of specialised tissue such as muscle or elastic tissue which is replaced by fibrous tissue

21
Q

Which neuromuscular dysfunctions can cause dysphagia

A

Parkinson’s disease
Diabetes mellitus
Achalasia

22
Q

Describe achalasia

A

The nerve supplied to the oesophagus doesn’t form properly

23
Q

Describe functional dysphagia

A

Patient may have an anxiety disorder which is causing loss of normal control of oesophageal function

24
Q

What is GORD commonly known as

A

Heartburn

25
Q

What are the 3 main causes of GORD

A

Defective lower oesophageal sphincter
Impaired lower clearing
Impaired gastric emptying

26
Q

What are the effects of GORD

A

Ulceration
Inflammation
Barrett’s Oesophagus

27
Q

Describe Barrett’s Oesophagus

A

A metastatic change in oesophageal epithelium from squamous to one related to the gastric mucosa
Potentially malignant and can lead to the development of an adenocarcinoma

28
Q

What are the signs and symptoms of GORD

A

Epigastric burning
Dysphagia
GI bleeding
Severe pain that mimics an MI

29
Q

Describe a hiatus hernia

A

When part of the stomach is in the thorax making it easier for gastric contents into the oesophagus
Symptoms similar to GORD
Commoner in women

30
Q

How can GORD be managed

A

Stop smoking
Reduce coffee intake
Lose weight
Avoid triggering activity eg - bending over
Antacids
H2 blockers and PPIs
Increase GI motility and gastric emptying

GI Medicine (7 decks)

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