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GASTRO - RIA > Upper GI > Flashcards

Upper GI Flashcards

1
Q

what does a barium swallow show in achlasia?

A

dilated tapering of oesophagus

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2
Q

treatment of achlasia

A

endoscopic balloon dilatation

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3
Q

ALARMS pneumonic for red flags linked to dyspepsia

A 
Anaemia 
Loss of weight 
Anorexia 
Recent onset/progressive
Manaemia/haematemesis
Swallowing difficulty
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4
Q

motility disorders causing dysphagia (

A
  • systemic sclerosis
  • achlasia
  • neuromuscular bulbar palsy (myasthenia gravis, wilsons, parkinsons, pseudobulbar palsy)
  • diffuse oesophageal spasm
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5
Q

malignant stricture causing dysphagia

A
  • pharyngeal cancer
  • gastric cancer
  • oesophageal cancer
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6
Q

benign strictures causing dysphagia

A
  • oesophageal web/ring

- peptic structure

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7
Q

extrinsic pressure causing dysphagia

A
  • mediastinal lymph nodes
  • lung cancer
  • retrosternal goitre
  • left atrial enlargement
  • aortic aneurysm
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8
Q

which ulcer is more common (duodenal or gastric)

A

duodenal ulcer

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9
Q

factors contributing to increased acid (5)

A
  • smoking
  • alcohol
  • too much caffeine
  • stress
  • spicy foods
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10
Q

eating worsens which ulcer

A

eating worsens a gastric ulcer

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11
Q

complications of peptic ulcers (3)

A
  • perforation
  • bleeding
  • scarring & strictures
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12
Q

what (3) can breakdown the protective layer of the stomach mucosa?

A
  • Medications (Steroids/NSADIs)
  • Helicobacter Pylori
  • increased acid
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13
Q

medications causing peptic ulcer disease

A

NSAIDs
Corticosteroids
Alcohol

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14
Q

Other causes of peptic ulcer disease

A

zollinger ellison syndrome

acute stress

malignancy

inflammatory - chrons

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15
Q

describe H pylori

A

gram negative, spiral shaped, flagellated, micro-aerophilic bacterium

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16
Q

mechanism of NSAIDs

A

COX 1 inhibitor

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17
Q

what causes zollinger ellison sydnrome?

A

hyper-secreting gastrinoma within the pancreas, leading to the development of multiple peptic ulcers

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18
Q

zollinger ellison syndrome is part of what genetic condition?

A

MEN type 1

19
Q

what consists of 7-day course of triple-therapy

A

PPI
Amoxicillin
Clarithromycin/metronidazole

20
Q

peptic ulcer eroding through which artery can lead to massive haemorrhage

A

gastroduodenal artery

21
Q

type of lining in stomach

A

columnar epithelial lining

22
Q

type of lining in oesopahgus

A

squamous epithelial lining

23
Q

red flags indicating 2 week wait referral:

A
  • Dysphagia at any age
  • Age over 55
  • Weight loss
  • Upper abdo pain/reflux
  • Treatment resistant dyspepsia
  • N &V
  • Low haemoglobin
  • Raised platelet count
24
Q

medication that is alternative to PPI

A

Ranitidine

25
Q

Ranitidine mechanism?

A

H2 receptor antagonist

26
Q

name of surgery for acid reflux

A

Laparoscopic fundoplication

27
Q

PPI mechanism

A

inhibition of H+/K+ ATPases in parietal cells

thereby preventing acid production

28
Q

what is a stricture

A

scarring and narrowing of the oesophagus due to repeated damage. Can cause dysphagia. May require dilatation or stenting.

29
Q

what do chief cells secrete

A

pepsinogen

30
Q

what cells are in the cardia & fundus of stomach?

A

peptic cells & chief cells

31
Q

what do G cells secrete and where are they located

A

gastrin

located un pyloric antrum

32
Q

role & location of brunner glands?

A

located in duodenum

secrete mucus & bicarbonate ions that neutralize the acid

33
Q

blood vessel in stomach that can be eroded by gastric ulcers causing massive haemorrhage

A

left gastric artery, in lesser curvature of stomach

34
Q

what is the metaplasia that occurs in barrets oesopahgus?

A

transformation of cells from squamous epithelium to columnar epithelium

35
Q

2 cancers of the oesophagus

A

squamous cell carcinoma

adenocarcinoma

36
Q

4 most common causes of upper GI bleeding

A
  • oesophageal varices
  • mallory weiss tear
  • peptic ulcers
  • cancers of stomach/duodenum
37
Q

scoring system in suspected upper GI bleed

A

Glasgow-Blatchford score

38
Q

what factors does Glasgow-Blatchford take into account?(6)

A
  • Drop in Hb
  • Rise in Urea
  • Blood pressure
  • Heart rate
  • Melaena
  • Syncopy
39
Q

score used to calculate the risk of rebleeding & overall mortality in patients that have had an endoscopy

A

Rockall score

40
Q

factors the Rockall score takes into account? (5) (ABCDE)

A 
Age 
Blood pressure & HR 
Comorbidity 
Diagnosis 
Endoscopic findings
41
Q

3 components of fresh frozen plasma

A
  • blood
  • platelets
  • clotting factors
42
Q

medical (2) & endoscopic (2) management of variceal upper GI bleeding

A

Medical

  • Terlipressin
  • Prophylactic abx

Endoscopic

  • Band ligation
  • TIPS
43
Q

mechanism of terlipressin

A

terlipressin in a vasopressin analogue & causes splanchic vasoconstiction which reduces portal pressures

44
Q

why give antibiotic prophylaxis in variceal bleeding?

A

reduces the risk of spontaneous bacterial peritonitis

GASTRO - RIA (10 decks)

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