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Gastrointestinal System > Stomach Disorders > Flashcards

Stomach Disorders Flashcards

1
Q

define peptic ulcers

A

ulceration of the either the gastric or duodenal mucosa that occurs either due to medications or H.Pylori infection

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2
Q

which is more common, gastric or duodenal ulcers?

A

duodenal ulcers are more common

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3
Q

name and define the 2 types of gastric ulcers

A

Type I - found in stomach and more likely to cause gastric bleed
Type II - found in pylorus and antrum

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4
Q

risk factors for peptic ulcers

A 
prolonged NSAID and/or steroid use
excessive alcohol intake
chronic stress/anxiety 
smoking 
high caffeine intake or spicy foods 
abnormal gastric emptying
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5
Q

clinical features of peptic ulcers (no ulcer bleed)

A 
epigastric pain 
heartburn 
dyspepsia 
nausea (sometimes with vomiting)
weight loss
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6
Q

clinical features if ulcer bleeds in peptic ulcers

A

haematemesis
‘coffee ground’ vomiting
melaena

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7
Q

what type of ulcer pain eases with food intake?

A

duodenal ulcers

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8
Q

differentials of peptic ulcers

A 
oesophagitis/gastritis 
GORD
malignancy 
biliary causes 
zollinger-ellison syndrome
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9
Q

investigations of peptic ulcers (invasive)

A

upper GI endoscopy with rapid urease test (CLO) and maybe biopsy to exclude malignancy
bloods - FBC and IgG serum

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10
Q

non-invasive investigations for peptic ulcers

A

urea breath test for H.Pylori presence

stool antigen test

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11
Q

conservative management of peptic ulcers

A

advise to avoid NSAIDs
advise to cease smoking
advise to reduce/limit caffeine and alcohol intake

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12
Q

medical management of peptic ulcers (H.Pylori cause)

A

7 days triple therapy of PPI, antibiotic and antacid

  • omezaprole
  • clarithromycin and amoxicillin
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13
Q

medical management of peptic ulcers (non H.pylori)

A
  • 4-8wk PPI trial for GORD symptoms

- H2 receptor antagonist (e.g. ranitidine) if PPI unsuccessful

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14
Q

common complications of peptic ulcers

A

haemorrhage
perforation
gastric cancer
pyloric stenosis

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15
Q

what type of bacterium is Helicobacter Pylori?

A

a gram -ve bacterium

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16
Q

define gastroenteritis

A

a transient disorder that occurs due to enteric infection with virus, bacteria or parasites
- causes characteristic sudden onset of diarrhoea with/without vomiting

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17
Q

name 3 common bacteria that cause gastroenteritis

A

clostridium perfringens
bacillus cereus
straphylococcus aureus

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18
Q

clinical features of gastroenteritis

A

sudden-onset diarrhoea (>3x stools in 24hrs)
nausea or sudden-onset vomiting
fever/general malaise
abdominal pain or cramps

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19
Q

risk factors of gastroenteritis

A

immunocompromised patients
poor personal hygiene
poor food hygiene
contact with infectious person/environment

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20
Q

differentials of gastroenteritis

A

UTI
IBD
traveller’s diarrhoea
food-sensitivity

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21
Q

investigations for gastroenteritis in certain circumstances

A
  • stool sample (if patient immunocompromised and blood/mucus in stool)
  • bloods (FBC, U+E and RFTs) if unwell
22
Q

management of gastroenteritis

A

assess for dehydration and risk going forward
advise exclusion from work
only provide antibiotics if bacterial cause is known
take measures to prevent infection
food consumption should be guided by appetite

23
Q

complications of gastroenteritis

A

dehydration and electrolyte disturbance
Guilian-Barre Syndrome
haemolytic uraemia syndrome

24
Q

define dyspepsia and its clinical features

A

a discomfort/pain within the upper abdomen that presents with excessive flatulence, fullness/bloating, nausea and fatty food intolerance

25
Q

what are red flag symptoms to look for in dyspepsia?

A

unintentional weight loss, recurrent vomiting, dysphagia and evidence of GI bleed

26
Q

investigations for dyspepsia

A

abdominal examination to check for mass
test for H.Pylori infection
bloods - FBC, LFTs, RFTs, platelets

27
Q

risk factors of dyspepsia

A

prolonged NSAID usage
smoking
excessive alcohol intake

28
Q

conservative management of dyspepsia

A

offer advice on lifestyle modifications
provide advice/refer for help with associated stress, anxiety or mood disorders
consider stopping/reducing exacerbating drugs

29
Q

medical management of dyspepsia and circumstance

A

if symptoms persist:

prescribe 1 month full-dose PPI OR retest for H.Pylori infection

30
Q

when is endoscopy considered in suspected dyspepsia

A

if patient >55yrs, if symptoms persist, if raised platelet count, if vomiting/nausea or previous Barretts diagnosis

31
Q

differentials of dyspepsia

A 
peptic ulcer
GORD (atypical)
achlasia 
biliary pain 
pregnancy (in women)
malignancy of oesophagus or stomach
32
Q

management of dyspepsia in patients with no ALARM symptoms or need for investigation

A

review medications for possible cause
offer lifestyle advice (e.g. weight loss, more frequent + smaller meals, avoid excess alcohol & smoking cessation)
recommend OTC antacid use

33
Q

define gastritis

A

inflammation of the mucosa of the stomach that occurs either due to infection, damage or erosion

34
Q

causes of gastritis

A 
H.Pylori infection
prolonged NSAID use
excessive alcohol consumption
autoimmune disease
major gastric surgery
35
Q

risk factors of gastritis

A

H.pylori infection
prolonged NSAID use
critical illness
alcohol abuse

36
Q

clinical features of gastritis

A 
epigastric pain 
nausea + vomiting 
loss of appetite 
MH of autoimmune disease 
PMH of gastric surgery
37
Q

differentials of gastritis

A

peptic ulcer disease
gastric cancer
GORD

38
Q

investigations of gastritis

A

urea breath test OR faecal antigen for H.Pylori

OGD endoscopy to visualise mucosa in elderly patients or those with ALARM symptoms

39
Q

conservative management of gastritis

A

recommend avoidance of triggers (e.g. NSAIDS and alcohol)

40
Q

medical management of gastritis

A

if H.Pylori cause:
- eradication triple therapy (PPI, antibiotic, antacid)
other cause:
- PPI or H2 receptor antagonist (if PPI unsuccessful)

41
Q

when is surgery indicated in gastritis?

A

if gastritis due to acid or biliary reflux due to previous surgery

42
Q

common complications of gastritis

A

gastric cancer
peptic ulcer disease
vitamin B12 deficiency

43
Q

most common form of gastric cancer

A

adenocarcinoma due to tumour suppressor gene p53

44
Q

risk factors of gastric cancer

A 
increasing age 
male sex
smoking 
PMH of h.pylori infection
poor diet and/or obesity
PFH of gastric cancer
45
Q

clinical features of gastric cancer

A 
dyspepsia 
weight loss
vomiting + nausea
dysphagia 
anaemia
46
Q

differentials of gastric cancer

A

IBS
IBD
achlasia
barrett’s

47
Q

investigations for gastric cancer

A

bloods - FBC and LFTs
CT abdomen + pelvis
OGD with biopsy

48
Q

management of gastric cancer

A

screen for nutritional deficiency and consider support

control symptoms of pain, nausea, constipation etc

49
Q

what is treatment of choice for gastric cancer?

A

surgery - either gastrectomy or lymphadenocetomy

50
Q

common complications of gastric cancer

A

metastasis

death

Gastrointestinal System (9 decks)

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