Session 5

Question 1

What is a hiatus hernia?

Answer 1

A small amount of stomach goes above the diaphragm

Question 2

What are some symptoms and complication associated into Gastric/Duodenal ulcers?

Answer 2

Pain (Not chronic)
Bleeding
Perforation
Gastric outlet obstruction (Usually scarring of ulcers in the pyloris)

Question 3

Define Dyspepsia

Answer 3

Pain or discomfort in the upper abdomen

Question 4

Define Gastritis

Answer 4

Mucosal inflammation

Question 5

Define an ulcer

Answer 5

Mucosal breakdown (So mucus and HCO3- has gone)

Question 6

What are some of the properties of Helicobacter pylori?

Answer 6

Microaerophillic (Needs O2)
Motile
Urease producing (Urea to Ammonia)

Question 7

Why doesn’t Helicobacter pylori get destroyed by stomach acid?

Answer 7

It adheres to the gastric mucosa so is protected by the mucus and HCO3-

Question 8

How is Helicobacter pylori usually passed on?

Answer 8

Oral-oral route

Oral-fecal route

Question 9

What causes ulcers?

Answer 9

Acid
Alcohol
Helicobacter pylori
Non Steroidal Anti Inflammatory Drugs
Aspirin
Smoking makes patient more likely to have a ulcer relapse quicker

Question 10

What arteries can ulcers erode?

Answer 10

Left & Right gastric arteries, would cause bleeding

Question 11

What level does the Inferior Vena Cava come through the diaphragm?

Answer 11

T8

Question 12

What level does the Oesophagus come through the diaphragm?

Answer 12

T10

Question 13

What level is the Aortic hiatus at the diaphragm?

Answer 13

T12

Question 14

What type of mucosa can Helicobacter pylori colonise?

Answer 14

Gastric mucosa only. However, increased Gastrin production and Parietal cell activity leads to Duodenal cap damage which causes metaplasia. Therefore, the Helicobacter Pylori spreads

Question 15

How can you manage ulcers?

Answer 15

H2 antagonists (Histamine antagonists)
Proton pump inhibitors
If there is perforation or gastric outlet obstruction an operation is necessary
Antibiotics to remove the Helicobacter pylori

Question 16

Why are Proton Pump Inhibitors a better course of treatment than H2 antagonists?

Answer 16

Because PPIs block all stimulants by preventing the proton pump from functioning whereas H2 antagonists just block Histamine

Question 17

What are elderly patients at a high risk of developing when being treated for Helicobacter pylori?

Answer 17

Clostridium difficile because they are on very strong antibiotics

Question 18

What are most gastric cancers?

Answer 18

Adenocarcinomas
Sometimes Lymphomas due to the antigens the Helicobacter pylori cause, but this usually goes when the Helicobacter pylori is treated

Question 19

What is the Ampulla ovata?

Answer 19

The site where Foregut turns into Midgut