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JazGI > Other upper GI pathology > Flashcards

Other upper GI pathology Flashcards

1
Q

GORD basically is due to __ not closing and raised ___

A

LOS

intrabdominal pressure

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2
Q

With GORD if wake up coughing then may be due to

A

food passing UOS => lungs may => reflux bronchitis

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3
Q

4 grades of GORD ulceration:

A

1) less than 5mm
2) greater than 5mm
3) less than 70% of circumference
4) greater than 70% of circumference

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4
Q

Achalasia =

A

LOS in spasm and oeso body has poor motility

dysphagia for food and liquid

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5
Q

diagnosis of achalasia is by ___

A

manometry to measure P of LOS

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6
Q

treatment of achalasia =

A

botox to paralyse LOS

surgery - slit open LOS and tie ends

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7
Q

Nutcracker oesophagus =

Treatment =

A

oesophageal spasms with excessive amplification/duration of peristalsis that causes dysphagia
CCBs

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8
Q

Group of symptoms associated with dyspepsia

A

post-prandial fullness
epigastric pain/burning
early satiety
bloating

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9
Q

__% of dyspepsia is organic eg.s of causes =

A

25% - PUD, NSAIDs, gastric ca

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10
Q

___% of dyspepsia is functional (ie. ____)

A

75%

no underlying cause/idiopathic

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11
Q

Peptic ulcer which is better when eating

A

duodenal

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12
Q

Peptic ulcer made worse by eating =

A

gastric

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13
Q

H. pylori is the cause of ___% of duodenal and ___% of gastric ulcers

A

90% duodenal

60% gastric

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14
Q

Causes of PUD = (4)

A

H. pylori
NSAIDs
gastric dysmotility
outflow obstruction

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15
Q

H pylori is a gram __ microaeophilic flagellated ____

A

-ve

bacillus

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16
Q

H pylori may cause __+__ gastric cancers

may reduce + cancers

A

(almost all) non-cardia gastric adenocarcinoma
low grade B cell lymphoma
REDUCE: cardia adenocarcinoma, oeso adenocarcinoma

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17
Q

If H. pylori is predominant in the antrum and does not cause atrophy then ___ ulcers are caused as gastrin secretion ____ and acid secretion ____

A

duodenal

increased gastrin + acid production

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18
Q

If H. pylori is predominant in the body and causes atrophy then acid secretion is ____ and ___ ulcers + ____ is caused as gastrin and acid secretion ___

A

decreased
gastric ulcers and gastric cancer (adenocarcinoma)
are decreased

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19
Q

Cag ___ H. pylori are oncogenic
They inhibit ____ which causes increased gastrin
This causes duodenal ___ load to increase => duodenal ____ and H. pylori ___ => ulceration
there is no _____

A 
\+ve
somatostatin
acid
metaplasia
colonisation
body gastritis
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20
Q

to diagnose H. pylori infection must stop ___ (drug)

and tests = (4)

A 
PPIs
biopsy ( urease test, histology and culture)
urease breath test
FAT - faecal antigen test
serology (IgA)
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21
Q

Urease test is possitive for H. pylori because

A

H. pylori produce urease to produce ammonium and bicarbonate

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22
Q

H. pylori eradication therapy =

side effects =

A

omeprazole + amox. + clarithromycin
OR
omeprazole + metronidazole + clarithromycin
side effects: nausea and diarrhoea

23
Q

Follow-up for duodenal+/gastric ulcers after treatment?

A 
duodenal = only if symptomatic
gastric = endoscopy at 6-8wks so no malignancy
24
Q

Gastroenteritis definition

A

inflammation of the stomach/intestines =>

decreased nutrient absorption and increased fluid and electrolyte loss

25
Q

___% of gastroenteritis cases are infectious, mostly __ then __ then ___

A

85%

mostly viral > bac. > parasites

26
Q

S. aureus pre-formed toxin related gastroenteritis resolves after ___
There is ___ in faeces

A

6-10hrs

NO pus or blood

27
Q

Large outbreaks of this occur on cruise ships

mainly efffects older kids and adults

A

norovirus

28
Q

norovirus spread is __

A

faeco-oral, waterbourne, shell-fish

29
Q

Incubation period for norovirus
signs
resolution within

A

24-48hrs
abdominal cramps, abrupt nausea, vom and diarr, myalgia
24-48hrs

30
Q

acute enteritis presents with (4)

A

fever, diarrhoea, vomiting, abdominal pain

31
Q

acute colitis presents with (3)

A

fever, pain, bloody diarrhoea

32
Q

Diagnosis of paratyphoid/typhoid is by:

A

BLOOD cultures

and also stool and urine cultures

33
Q

Treatment for paratyphoid/typhoid =

A

azithomycin

34
Q

There is/is not a vaccine for typhoid+/paratyphoid

A

IS IV/PO vaccine for typhoid = 70% effective

none for paratyphoid

35
Q

signs and symptoms of enteric fever-like illness eg. typhoid/paratyphoid

A

fever
rigors
pain
v little diarrhoea (may have constipation)

36
Q

Campylobacter infection resolves within ___

A

5-14 days

37
Q

Campylobacter infection may cause ___

A

Guillain-Barre Syndrome = tingling of feet => paralysis of legs, arms and rest of body

38
Q

If camplyobacter is severe then treat with __

A

azithro/clarithromycin

39
Q

Causes of bloody diarrhoea eg.s

A

IBD
malignancy
ischaemia
infection (causing colitis) eg. Shigella, camplyobacter, E. coli, amoeba

40
Q

Parasites are diagnosed by:

A

stool microscopy

41
Q

salmonella enterica, campylobacter and Shigella are diagnosed by:

A

stool culture

42
Q

Stool toxin test is used to diagnose

A

C. diff and E. coli

43
Q

norovirus is diagnosed by

A

PCR

44
Q

anti-spasmodics/motilities are generally only short-term and not given to elderly or IBD because ___

A

may cause toxic megacolon

45
Q

Antibiotics are given for GI infections only if ___

eg.s of infections given in =

A

IC, severe, chance of spreading to blood/to others

Typhoid, shigellosis (not sonnei), cholera, C. diff, giardiasis, amoebiasis, invasive salmonellosis

46
Q

C. diff is a ____ gram ___ spore-forming ___

A

anaerobic
+ve
bacillus

47
Q

4Cs that cause C. diff infection

A

cephalosporins
co-amoxiclav
clindamycin
ciprofloxacin (quinolones)

48
Q

In C. diff infections must wash hands with ___

A

soap and water

49
Q

drug used for first relapse of C. diff

A

fidoxamicin

50
Q

most effective treatment for C. diff in future

A

FMT (faecal microbiota transplant)

51
Q

Amoebiasis causes _____ may spread to cause __
diagnosis =
treatment =

A

acute bloody diarrhoea commonly
liver abscess
serology
metronidazole - remove from lumen with diloxanide furoate/paromomycin

52
Q

Giardiasis causes ___ diarrhoea
common in ___ (geographical)
diagnosis:
treatment:

A

explosive diarrhoea
USSR/ eastern europe
stool/duodenal aspirate microscopy
metronidazole

53
Q

Most common cause of traveller’s diarrhoea =

A

E. coli enterotoxin

JazGI (26 decks)

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