Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal > Pathophysiology Of Gastric Disease > Flashcards

Pathophysiology Of Gastric Disease Flashcards

1
Q

What is dyspepsia?

A

A complex of upper GIT symptoms which present for 4+ weeks.

Including: upper abdominal pain, heartburn, acid reflux, nausea and vomiting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Identify 5 common gastric disorders.

A
  1. GORD.
  2. Gastritis.
  3. Peptic Ulcer Disease.
  4. Zollinger-Ellison Disease.
  5. Stomach Cancer.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the common symptoms of Gastro-Oesophageal Reflux Disease?

A
  1. Chest pain.
  2. Acidic taste in mouth.
  3. Cough.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the potential outcomes of GORD?

A
  1. Nothing.
  2. Oesophagitis.
  3. Strictures.
  4. Barrett’s oesophagus.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What characteristics of the Lower Oesophageal Sphincter prevent GORD?

A
  1. Muscular element.
  2. Right crus of diaphragm.
  3. Angle of entry of oesophagus into the stomach.
  4. Intra-abdominal pressure.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What classifies as the Lower Oesophageal Sphincter?

A

The distal 4cm of the oesophagus that has a lower pressure after meals and a higher pressure at night.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can you treat GORD?

A
  1. Lifestyle modification.
  2. Pharmacological: antacids, H2 agonists and PPI.
  3. Surgery (uncommon) where the fundus of the stomach is wrapped around the base of the oesophagus.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the link between GORD and hiatal hernias?

A

If someone has a hiatal hernia they are much more likely to get GORD. It is due to moving the LOS, which reduces the basal tone and thus reflux is easier.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Gastritis?

A

Inflammation of the stomach mucosa with a symptom complex of pain, nausea, vomiting and bleeding).
Has a endoscopic red hyperaemic appearance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can cause Acute Gastritis?

A
  1. Heavy use of NSAIDS: decrease prostaglandin and thus decrease blood flow to mucosa.
  2. Lots of alcohol: dissolving mucus.
  3. Chemotherapy: affecting cell rapid turnover.
  4. Bile reflux.
    Basically anything that exposes the mucosa to chemical injury causes damage and reduction in mucus production.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does the Mucosa respond to chemical injury?

A

Vasodilation and oedema occurs and there is appearances of inflammatory cells (mainly neutrophils as in acute inflammation).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you treat acute gastritis?

A

Remove the irritant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can cause Chronic Gastritis?

A
  1. Bacterial: H-pylori infection.
  2. Autoimmune: antibodies against the parietal cells which can lead to pernicious anaemia from a lack of intrinsic factor and thus B12.
  3. Chemical/reactive: Chronic alcohol abuse, NSAIDS or reflux of bile.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the symptoms of H-pylori causes Chronic Gastritis?

A

Asymptomatic or nausea, vomiting, bleeding, pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What complications can arise from H-pylori chronic gastritis?

A
  1. Peptic ulcer.
  2. Adenocarcinoma.
  3. MALT lymphoma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the symptoms of autoimmune chronic gastritis?

A
  1. Megaloblastic anaemia.
  2. Glossitis (swollen tongue).
  3. Anorexia.
  4. Neurological symptoms.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the structure of Helicobacter pylori bacteria?

A

Helix shaped.
Gram negative.
Microerophilic (like between anaerobic and aerobic areas).

18
Q

How is Helicobacter Pylori spread?

A

Oral to oral/faecal to oral.

19
Q

What makes Helicobacter pylori good at damaging the stomach?

A
  1. Produces urease: converting urea to ammonium which increases the local pH. Ammonia is toxic to epithelia.
  2. Has flagella so has good motility. Living in the mucus layer and adhering to the gastric epithelia.
  3. Releases cytotoxins: direct epithelial injury.
  4. Promote inflammatory response.
20
Q

What will happen if the Helicobacter Pylori colonisation is in the antrum?

A

G cells are found in the antrum so there is increased gastrin secretion and so increased parietal acid secretion. This can lead to duodenal epithelial metaplasia and colonisation of the duodenum resulting in duodenal ulceration.

21
Q

What are the symptoms if the Helicobacter colonisation is found in the antrum and the body?

A

Asymptomatic- balance each other out.

22
Q

What are the consequences of a body only Helicobacter pylori colonisation?

A

Atrophic effect on the parietal cells. Can lead to a gastric ulcer, leading to intestinal metaplasia-> dysplasia-> cancer.

23
Q

How can you diagnose Helicobacter pylori?

A
  1. Urea breath test.
  2. Stool antigen test.
  3. Blood test.
24
Q

How do you treat someone with a Helicobacter Pylori infection?

A
  1. Proton pump inhibitors.

2. Amoxicillin + clarithromycin/metronidazole.

25
Q

What is Peptic Ulcer Disease?

A

A defect in the gastric/duodenal mucosa which extends through the muscularis mucosa.
Commonly found in the first part of the duodenum or the lesser curvature/antrum of the stomach.

26
Q

Compare duodenal and gastric peptic ulcer disease.

A

Duodenal ulcer is more common.
Gastric ulcers increase with age but duodenal ulcers increase up to 35y/o.
Acid levels or low or normal in gastric but elevated in duodenal due to parietal cells.
Duodenal ulcers are always associated with H.pylori.

27
Q

What is the pathogenesis of Peptic Ulcer Disease?

A

Breakdown of normal defences more important that excessive acid as ulcers can occur in people with normal acid amount.
Rapid gastric emptying/inadequate acid neutralisation from bile/pancreas has been linked to duodenal ulcers.

28
Q

What are the causes of Gastric Ulcer Disease?

A

Mucosal injury:

  1. Stomach acid.
  2. H-pylori.
  3. NSAIDs.
  4. Smoking: relapse.
  5. Stress: burns.
29
Q

When do Acute Ulcers develop?

A

As part of acute gastritis.

30
Q

Where to Chronic Ulcers occur?

A

At mucosal junctions, where the antrum meets the body on the lesser curvature or in the duodenum where the antrum meets the small intestine.

31
Q

What is the morphology of the peptic ulcer disease?

A

Less than 2cm usually.
Base of ulcer is necrotic/granulation.
Muscularis propria is replaced by scar tissue.

32
Q

What is the clinical consequence of peptic ulcer disease?

A
  1. Scar tissue shrinking can narrow stomach lumen/cause pyloric stenosis.
  2. Perforation-> peritonitis.
  3. Erosion into adjacent structure.
  4. Haemorrhage from vessel in base of ulcer.
  5. Malignancy.
33
Q

What are the symptoms of peptic ulcer disease?

A
  1. Epigastric pain, sometimes back pain.
  2. Burning.
  3. Follows meal times.
  4. Often at night (especially Duodenal ulcer).
    Serious:
  5. Bleeding/anaemia.
  6. Satiety.
  7. Weight loss.
34
Q

How do you manage Peptic Ulcer Disease?

A
  1. Lifestyle modification.
  2. Stopping any exacerbating medications.
  3. Testing for H-pylori.
  4. PPIs.
  5. Endoscopy.
35
Q

What is Functional Dyspepsia?

A

Person with symptoms of ulcer disease but no physical evidence of organic disease-> diagnosis of exclusion.

36
Q

How can you diagnose Gastric Pathology?

A
  1. Upper GI endoscopy: take a biopsy.
  2. Urease breath test for H-pylori.
  3. Erect chest X-ray to look for perforation.
  4. Blood test to look for anaemia.
37
Q

How can you treat Gastric Pathology?

A
  1. H2 blockers.

2. PPI.

38
Q

What is Zollinger-Ellison Syndrome?

A

A non-beta islet cell gastrin secreting tumour of the pancreas, leading to proliferation of the parietal cells, creating lots of acid and leading to severe ulceration of the stomach and bowel. This causes abdominal pain and diarrhoea.

39
Q

What does Stress Ulceration follow?

A
  1. Severe burns.
  2. Raised intracranial pressure.
  3. Sepsis.
  4. Severe trauma.
  5. Multiple organ failure.
40
Q

What are the symptoms of stomach cancer?

A

Third commonest in world, presenting late, having to be quite large before symptoms occur:

  1. Dysphagia.
  2. Loss of appetite.
  3. Weight loss.
  4. Malaena.
  5. Nausea/vomiting.
  6. Virchows nodes.
41
Q

What are the risk factors of stomach cancer?

A
  1. Male.
  2. H-pylori.
  3. Dietary factors.
  4. Smoking.
  5. Being chile/japan/South America.

Gastrointestinal (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions