Pathophysiology of Gastric Disease Flashcards

1
Q

What name is given to a common condition that describes a group of symptoms rather than one predominant symptom. These symptoms include:

  • Belly pain or discomfort
  • Bloating
  • Feeling uncomfortably full after eating
  • Nausea
  • Loss of appetite
  • Heartburn
  • Burping up food or liquid (regurgitation)
  • Burping
A

Dyspepsia

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2
Q

Name the 2 locations peptic ulcers are commonly found.

A
  1. Lesser curvature

2. Duodenum

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3
Q

Describe what zollinger-ellison syndrome is.

A

Zollinger-Ellison syndrome is a rare condition in which one or more tumors form in your pancreas or the upper part of the small intestine (duodenum). These tumors, called gastrinomas, secrete large amounts of the hormone gastrin, which causes the stomach to produce too much acid.

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4
Q

Give some symptoms of gastro-oesophageal reflux disease (GORD).

A
  • Heartburn
  • Cough
  • Sore throat
  • Dysphagia (difficulty swallowing)
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5
Q

Give some causes of gastro-oesophageal reflux disease (GORD).

A
  • Lower oesophageal sphincter problems
  • Delayed gastric emptying (which causes raised intra gastric pressure which in turn opens the lower oesophageal sphincter)
  • Hiatus hernia (When part of your stomach moves up into your chest
  • Obesity
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6
Q

What problems may arise as a result of gastro-oesophageal reflux disease (GORD)?

A
  • Oesophagitis
  • Strictures (as a result of inflammation and subsequent fibrosis)
  • Barrett’s oesophagus
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7
Q

How can gastro-oesophageal reflux disease (GORD) be treated?

A
  • Lifestyle modifications i.e. diet
  • Surgery i.e. to improve sphincter but wrapping fundus around
  • Antacids
  • H2 antagonists
  • Proton pumps inhibitors
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8
Q

Give some causes of acute gastritis.

A
  • Heavy use of NSAIDS (i.e. aspirin)
  • Lots of alcohol
  • Chemotherapy
  • Bile reflux
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9
Q

Why does heavy use of NSAIDS cause gastritis?

A

They cause an increase in prostaglandins which are required to provide sufficient blood supply to the mucus layer of the stomach.

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10
Q

Give some causes of chronic gastritis.

A
  • H-pylori infection
  • Autoimmue disease against gastric parietal cells
  • Chronic alcohol abuse
  • Chronic NSAID abuse
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11
Q

Name 3 complications of a H-pylori infection.

A
  1. Peptic ulcers
  2. Adenocarcinoma
  3. MALT lymphoma
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12
Q

Define ulceration.

A

Breaking

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13
Q

Name some of the normal defence mechanisms the stomach has to defend itself.

A
  • Mucus layer
  • Bicarbonate
  • Adequate mucosal blood flow
  • Prostaglandins (stimulates above)
  • Epithelial renewal
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14
Q

Give some symptoms of peptic ulcer disease.

A
  • Epigastric pain
  • Burning following meals
  • Often pain at night in duodenum gastric ulcers)
  • Bleeding/anemia
  • Weight loss
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15
Q

How is gastric pathology investigated?

A
  • Endoscopy
  • Chest X-ray checking for presence of gas due to perforation
  • Blood test checking for anemia
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16
Q

What test is used to determine is H.Pylori is present?

A

Urease breath test

17
Q

How is H.Pylori treated?

A

PPI+ Clarithromycin+ Amoxicillin

18
Q

How is H.Pylori spread?

A

Oral to oral, or faecal to oral

19
Q

What gram stain is H.Pylori?

A

Gram negative

20
Q

How does H.Pylori cause problems within the stomach?

A
  • Releases cytotoxins
  • Expresses enzymes i.e. urease which produces ammonia which is toxic to epithelial
  • Promotes inflammatory responce
21
Q

How does H.Pylori affect stomach activity if it colonises the antrum?

A
  • Increased gastrin secretion
  • Increased partial cell activation
  • Increased acid secretion
  • This leads to epithelial metaplasia and ulceration
22
Q

How does H.Pylori affect stomach activity if it colonises the antrum and the body?

A

Asymptomatic

23
Q

How does H.Pylori affect stomach activity if it colonises the body?

A

Atrophic effect which results in gastric ulcers and intestinal metaplasia which could in turn lead to dysplasia and eventually cancer.

24
Q

Name some symptoms of stomach cancer.

A
  • Dysphagia
  • Loss of appetite
  • Malaena (refers to the dark black, tarry feces that are associated with upper gastrointestinal bleeding)
  • Weight loss
  • Virchows nodes (a lymph node in the left supraclavicular fossa)