Pathophysiology Of Gastric Disease

Question 1

What is GORD?

Answer 1

The reflux of stomach contents into the osephagus (more then normal)

Question 2

What are some of the common causes of GORD?

Answer 2

Lower osephageal spincther problems, delayed gastric emptying due to raised intrathoaric pressure- eg in diabetes the movement of food is slowed down, hiatus hernia where the lower osephgeal spinther slides up into the thorax and obesity, as this rises the intrabdominal pressure

Question 3

What would be some of the treamtments for GORD?

Answer 3

Antacids, H2 antagnoists, PPIs, and surgery (rare) as well as lifestyle modifications

Question 4

What is acute gastritis?

Answer 4

An acute mucosal inflammtory proccess,

Question 5

What might some of the causes of acute gastritis be?

Answer 5

Heavy use of NSAIDS, chemothearpy (affects the rapidly diving cells of the stomahc) bile reflux ( causes significant symtoms) and lots of alcohol as this can dissolve the mucus layer

Question 6

What might be some of the problems that can result from GORD?

Answer 6

Osepgitis, strictures, and Barretts oesophagus with is metaplsis of the squamous epithelia to columnar, which can cause a adenocarcinoma

Question 7

Why do NSAIDS cause Gi problems?

Answer 7

They inhbit prostagladin sythesis which is involved in the prodcution of stomach acid

Question 8

What might some of the symptoms of acute gastritis be?

Answer 8

May be asymptomatic, or may result in pain, naseua and occasionly bleeding

Question 9

What might some of the causes of chronic gastritis be?

Answer 9

Bacterial (H Pylori infection) or autoimmune due to production of antibodies to gastric parietal cells, and chemical or reatative, such as chronic alcohol abuse, reflux of bile and NSAIDS

Question 10

What are some of the symptoms of autoimmune chronic gastritis?

Answer 10

Symptoms of anemia, anaroexia and neuroligcal symptoms

Question 11

What are some of the symptoms of chronic gastritis that is caused by h pylori?

Answer 11

Asymptomatic or similar to acute gastrictios, symptoms may develop due to complication such as peptic ulcers adenocarincoma, and MALT

Question 12

What is a peptic ulcer?

Answer 12

Defects in the gastric or duodenal mucoase, that must extend through the muscularis mucosa, and common areas they are found are the first part of the duodenum and the lesser curve of the stomach

Question 13

What are some of the causes of peptic ulcer disease?

Answer 13

Mucoasl injury, stomach acid, h pylori Ndais, and smoking only contributes to the relase of the disease, and massive stress such as burns

Question 14

What are some of the symptoms of peptic ulcer disease?

Answer 14

Epigastirc pain, that may be found in the back, that is typically burning of ganweing and is often worse at night, and serious symptoms can be bleeding or anarmia, saiety and weight loss

Question 15

What are some of the pharmoligcal treatments that you would use in peptic ulcer disease?

Answer 15

PPI, CLATHRIMOYCIN and AMOXICILLIN

Question 16

What are some of the non pharmolical treatments in peptic ulcer disease?

Answer 16

Stopping NSAIDS and using a endoscopy in bleeding ulcers

Question 17

What are some of the H2 blocker drugs available?

Answer 17

Cimetidne and rantidine

Question 18

Name a proton pump inhibitor?

Answer 18

Omepraozole

Question 19

What are some of the features of the H pylori bacteria?

Answer 19

It is a gram negative helix shaped bacteri, mircoaerphoilis, and has a oral to oral and a fecal to oral spread and has a flagellum that gives it a good motility, it lives in the mucus layer and adheres to the gastric epithelia

Question 20

What are some of the problems regarding H pylori?

Answer 20

It realeases cytotoxins that cuase direct eptiehal injury, it expresses the ezyme ureases, causes inflammation and therefore self damage, and possibly degrades the mucus layer

Question 21

What happens if h pylori colonises the anturm of the stomach/

Answer 21

This is the home of the g cells, and therefore there is increased gastrin secretion or a decrease in d cell activity, and there is increased parietal cell acid secretion, which can cause metaplasia of the duodenal cell epitheilatia and possibly ulceration

Question 22

What is Zollinger- ellision syndorme?

Answer 22

A non beta ilset cell gastrin secreting tumour of the pancreas, that causes proliferation of the parietal cells, and therefore seer sulceration of the stomach and the small bowel

Question 23

What is stress ulceration?

Answer 23

Symptoms of gastritis following sever bruns, riased intracranil pressure, sepsis, severe trauma and multiple orang failure

Question 24

What are some of the symptoms of stomach cancer?

Answer 24

Symptoms usually presen late, and has to be quite large but dysphagia, malena, nausea and vomiting loss of apepitie and vircohows nodes

Question 25

What type of cancer is stomach cancer commonly?

Answer 25

An adenocarcinoma