Session 5 Flashcards
What is a hiatus hernia?
A small amount of stomach goes above the diaphragm
What are some symptoms and complication associated into Gastric/Duodenal ulcers?
Pain (Not chronic)
Bleeding
Perforation
Gastric outlet obstruction (Usually scarring of ulcers in the pyloris)
Define Dyspepsia
Pain or discomfort in the upper abdomen
Define Gastritis
Mucosal inflammation
Define an ulcer
Mucosal breakdown (So mucus and HCO3- has gone)
What are some of the properties of Helicobacter pylori?
Microaerophillic (Needs O2)
Motile
Urease producing (Urea to Ammonia)
Why doesn’t Helicobacter pylori get destroyed by stomach acid?
It adheres to the gastric mucosa so is protected by the mucus and HCO3-
How is Helicobacter pylori usually passed on?
Oral-oral route
Oral-fecal route
What causes ulcers?
Acid Alcohol Helicobacter pylori Non Steroidal Anti Inflammatory Drugs Aspirin Smoking makes patient more likely to have a ulcer relapse quicker
What arteries can ulcers erode?
Left & Right gastric arteries, would cause bleeding
What level does the Inferior Vena Cava come through the diaphragm?
T8
What level does the Oesophagus come through the diaphragm?
T10
What level is the Aortic hiatus at the diaphragm?
T12
What type of mucosa can Helicobacter pylori colonise?
Gastric mucosa only. However, increased Gastrin production and Parietal cell activity leads to Duodenal cap damage which causes metaplasia. Therefore, the Helicobacter Pylori spreads
How can you manage ulcers?
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
Why are Proton Pump Inhibitors a better course of treatment than H2 antagonists?
Because PPIs block all stimulants by preventing the proton pump from functioning whereas H2 antagonists just block Histamine
What are elderly patients at a high risk of developing when being treated for Helicobacter pylori?
Clostridium difficile because they are on very strong antibiotics
What are most gastric cancers?
Adenocarcinomas
Sometimes Lymphomas due to the antigens the Helicobacter pylori cause, but this usually goes when the Helicobacter pylori is treated
What is the Ampulla ovata?
The site where Foregut turns into Midgut
