OESOPHAGUS AND GI DISEASE Flashcards
Medications for upper GI disease
antacids
H2 receptor blockers and PPIs
antacids action
elimination of formed acids
H2 receptor blockers and PPIs action
reduction of acid secretion
what neurotransmitters are triggers to stomach acid production
acetylcholine
gastrin
histamine
h2 receptor antagonists
cimetidine
ranitidine
PPI examples
omeprazole
lanzoprazolem
pantoprazole
GORD cause
defective lower oesophageal sphincter
impaired lower clearing
impaired gastric emptying
GORD results
ulceration, inflammation and metaplasia
Barretts Oesophagitis
signs and symptoms of GORD
epigastric burning, dysphagia, GI bleeding, severe pain which mimics MI
hiatus hernia
part of the stomach is in the thorax
GORD management
stop smoking
lose weight
antacids
H2 blockers and PPIs
where can you find peptic ulcer disease
any acid affected site - oesophagus, stomach, duodenum
cause of peptic ulcer disease
high acid secretion (duodenal)
normal acid secretion (stomach)
drugs (NSAIDs, and steroids)
what microbes can cause gastritis
helicobacter pylori
gastritis symptoms
sometimes asymptomatic
burning pain and bleeding
chronic gastric wall inflammation can lead to lymphoma of the stomach
peptic ulcer disease management
triple therapy
2 antibiotics and 1 PPI
peptic ulcer disease investigations
endoscopy
radiology (barium meal)
anaemia blood test
H.Pylori breath
antibodies
mucosa
local complications of PUD
perforation and escape of gastric contents into peritoneum
haemorrhage
structure
malignancy
what does a haemorrhage look like if thrown up
brown coffee grains
systemic complications of PUD
anaemia
PUD tx medical
H2 receptor blockers
PPIs
NSAIDs - reduce steroid use
triple therapy
triple therapy
amoxycillan
metronidazole
omeprazole
PUD tx surgical
endoscopy
surgical repair - gastrectomy
vagotomy
ceoliac and penicious anaemia
malabsorption - small bowel disease
coeliac
sensitivity to A-gliden component of gluten
coeliac aetiology
genetic
environment
gluten consumption
t lymphocyte damage to mucosal tissue
villous atrophy of the jejunum
coeliac symptoms
weight loss
lassitude
weakness
abdominal pain/ swelling
steatorrhoea
how does coeliac present in the mouth
oral apthae
tongue papillary loss
malabsorption in coeliac
iron
folate
vit b12
fat
coeliac investigations
autoantibody test - TTG, anti-gliadin antibodies
jejunal biopsy
faecal fat - increased
haematinics - B12, folate, ferritin
outcome of a gluten free diet in pt with coeliac
reversal of jejunal atrophy
improved well being
reduced risk of lymphoma
associated skin disease with coeliac
dermatitis herpetiformis
granular IgA deposit in skin and mucosa
pernicious anaemia deficiency
vit B12
intrinsic factor
Where is vitb12 absorbed
terminal ilium
pernicious anaemia diagnosis
intrinsic factor def.
cobalamin def. and macrocytic anaemia
cause of pernicious anaemia
lack of vitb12 from diet
gastric parietal cell disease
IBD of terminal ileum
bowel cancer at ilio-coecal junction
tx for vitb12 def.
diet
IM injectiond of vitb12
bowel cancer symptoms
anaemia
rectal blood loss
bowel cancer aetiology
polyps bleed when irritated - most take 5 years to turn malignant
bowel cancer gene
p53
are polyps in the small intestine high or low risk
low risk (peutz-jehgers syndrome)
are polyps in the large intestine low or high risk
high risk (gardiners/ cowdens syndrome)
staging of bowel cancer
A - submucosal
B - muscularis
C - lymph nodes
D - liver
bowel cancer tx
colon cancer surgery
hepatic metastases
radiotherapy
chemotherapy
when does bowel cancer become incurable
if spread to liver
colonic carcinoma screening
FiT test - all adults over 60
2 years repeat
endoscopy if positive
ABCDE for acute severe asthma attack
A - wheezing on expiration
B - increased RR, decreased sp02, rapid shallow breaths
C - increased HR, hypertension, pallor
D - ACVPU: alert but anxious
E - pale, distressed, use of accessory muscles, inability to complete sentence in one breath
ABCDE for life threatening asthma attack
A - severe wheeze on expiration
B - decreased RR and effort, severely decreased Sp02, laboured breathing
C - decreased HR, cyanosis in lips/ nose
D - ACVPU: confused due to hypoxia
E - grey/ blue in colour, exhausted, sleepy
