Stomach

Question 1

What type of bacteria is H. Pylori?

Answer 1

Gram negative
urease producing
spiral shaped bacteria.

Question 2

How to treat h. Pylori?

Answer 2

Triple therapy:
PPI (omeprazole 20mg) + amoxicillin (1g) + clarithromycin (500mg). All BDS

Or in pen-allergic PPI, clarithromycin, and metronidazole (400mg). All BDS.

Question 3

Non invasive tests for h. Pylori diagnosis?

Answer 3

C13 Urea breath test, (high Sen and spec)
Stool antigen
Serum antibody

If doing an ODG (can do CLO test - rapid urease test)

Question 4

What are the complications of peptic ulcer disease?

Answer 4

Perforation (DU>GU)

Gastric outlet obstruction (rare) might have metabolic alkalosis due to vomiting - should settle with consevative Mx.

Haemorrhage

Question 5

Most common site for gastric cancer?

Answer 5

Antrum - usually adenocarcinoma.

Local ulcerated, with rolled edges (type 1)
Or diffuse with extensive submucosal spread (type 2)

Question 6

What are the clinical signs in gastric cancer?

Answer 6

Virchows node, mass in epigastrum,, liver mets (ascites and hepatomegaly), skin (acanthosis nigricans, and dermatomyosistis)