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Gastrointestinal (LECTURE NOTES) > Stomach and Duodenum > Flashcards

Stomach and Duodenum Flashcards

1
Q

What is Menetrier’s disease

A

A rare condition presenting with weight loss and diarrhoea

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2
Q

What is Menetrier’s disease linked to

A

H pylori

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3
Q

What can be seen endoscopically in Menetrier’s disease

A

Hypertrophy of mucosal folds of the body and fundus

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4
Q

What is the treatment for Menetrier’s disease

A 
To eradicate H pylori
Reduce recretion (PPIs) 
Monitor endoscopically due to risk of gastric cancer
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5
Q

How are peptic ulcers caused

A

By an imbalance between luminal acid and mucosal defences

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6
Q

How are peptic ulcers distinct from erosions

A

They penetrate the muscularis mucosae

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7
Q

Are gastric ulcers usually benign or malifnant

A

Benign

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8
Q

What are 3 main causes of gastric ulcers

A

H pylori and NSAID use
Steroid and NSAID use
Stress

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9
Q

What are the clinical presentations of gastric ulcers

A

usually pain that is relieved on eating

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10
Q

What are some complications of a gastric ulcer

A

Haematemesis

perforation are commoner in the elderly

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11
Q

What are the clinical presentations of gastric ulcers

A

usually pain that comes on soon after eating

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12
Q

What are some complications of a gastric ulcer

A

Haematemesis

perforation are commoner in the elderly

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13
Q

What is the management for a peptic ulcer

A

Eradication of H pylori
4 weeks PPI
Smoking cessation and alcohol moderation
Stop NSAIDs if possible

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14
Q

When should surgery be considered in gastric ulcers

A

If there is haemmorhage
perforation
failure to heal or gastric outlet obstruction

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15
Q

What are the 4 main causes of a duodenal ulcer

A

H pylori
NSAID use
Smoking
Stress

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16
Q

Is perforation as a complication more common in gastric or duodenal ulcers

A

Gastric

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17
Q

What is the management of duodenal ulcers

A

Eradication of H pylori - routine use of PPI if there is haemorrhage
Smoking cessation
alcohol moderation
stop ulcerogenic drugs (NSAIDs and bisphosphonates)

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18
Q

What is the mortality rate for perforated ulcers

A

25%

19
Q

What is the mortality rate for perforated ulcers

A

25%

20
Q

What is the initial management for gastric outlet obstruction

A

Drip and suck - IV rehydration and NG aspiration

21
Q

What is the later management for gastric outlet obstruction

A

Balloon dilatation or surgical resection

22
Q

What is Zollinger-Ellison syndrome

A

A rare disorder with the triad of:
severe or recurrent peptic ulceration
Increased gastric acid secretion
Hypergastrinaemia due to a secretion from a non-beta cell islet pancreatic tumour

23
Q

What often occurs with Zollinger-Ellison syndrome

A

Diarrhoea and steatorrhoea

24
Q

What are the investigations for Zollinger-Ellison syndrome

A

Gastric acid secretion elevated and serum gastrin elevated

25
Q

How is the cause investigated in Zollinger-Ellison syndrome

A

Endoscopic ultrasound or Oxtreoscan

26
Q

What is the management for Zollinger Ellison syndrome

A

30% resectable
Lifelong PPI in high dose
Octreotide may help

27
Q

What is gastroparesis

A

Delayed gastric emptying without mechanical obstruction

28
Q

What are some characteristic of gastroparesis

A

recurrent vomiting
abdominal bloating
distension

29
Q

What might help with gastroparesis

A

Peripherally acting antiemetics (domperidone)

30
Q

What is indicated if malnutrition develops

A

Jejunostomy or parenteral nutrition

31
Q

What is the most commonest cause of cancer death worldwide

A

Gastric carcinoma

32
Q

Who is more likely to get gastric carcinoma

A

Men and those over 50

33
Q

What are 6 causes of gastric carcinoma

A

Chronic H pylori infection
Familial: blood group A is associated
Genetic
Diet containing pickled or smoked foods, diets low in fruit and veg
Environment; smoking and alcohol
Rare, organic disorders; Menetrier’s disease and previous partial gastrectomy

34
Q

What does adenocarcinoma develope from

A

Regions of intestinal metaplasia in the stomach which then develop secondary to chronic atrophic gastritis

35
Q

What does early gastric cancer refer to

A

Adenocarcinoma confined to the mucosa or submucosa

36
Q

What does early gastric cancer refer to

A

Adenocarcinoma confined to the mucosa or submucosa

37
Q

What are the clincial features of gastric carcinoma

A

Epigastric pain
Loss of appetite
loss of weigh
haematemesis is rare

38
Q

What is the investigation for the gastric carcinoma

A

Endoscopy - rolled irregular edged ulcers

39
Q

What are some of the investigations for the complications of gastric carcinoma

A

Staging: FBC, LFT, CXR, Abdo CT, endoscopic US, laparoscopy

40
Q

How is gastric cancer managed

A

Surgery: resection is only possible in a minority of cases and most surgery is palliative
Chemotherapy: Post op may improve survival and can also be used palliatively

41
Q

How could prognosis of gastric cancer be improved

A

Public awareness and early diagnosis

42
Q

Where is the most commonest site for non-nodal non-Hodgkin’s lymphoma

A

The stomach

43
Q

What is MALT lymphoma

A

A B cell tumour caused by an immune response to chronic H pylori infection with cagA strains

44
Q

Where do Gastrointestinal stromal tumours arise from

A

The interstitial cells of Cajal

Gastrointestinal (LECTURE NOTES) (29 decks)

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