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Gastrointestinal System > Week 5 - Pathophysiology Of Gastric Disease > Flashcards

Week 5 - Pathophysiology Of Gastric Disease Flashcards

1
Q

What is dyspepsia?

A

Heart burn/indigestion for 3 or more months

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2
Q

What is gastro-oesophageal reflux disease (GORD)?

A

Reflux of stomach contents into oesophagus

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3
Q

What are the symptoms of GORD?

A

Heartburn
Cough
Sore throat
Disphagia

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4
Q

What are the main causes of GORD?

A

Lower esophageal sphincter problems
Delayed gastric emptying
Hiatus hernia
Obesity

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5
Q

Why does delayed gastric emptying cause GORD?

A

Because it causes raised intra-gastric pressure

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6
Q

What is a hiatus hernia?

A

Lower esophageal sphincter goes into thorax

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7
Q

What Robles does GORD cause?

A

Oesophagitis
Strictures
Barrett’s oesophagus

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8
Q

What is Barrett’s oesophagus?

A

Metaplasia of squamous epithelium of oesophagus to columnar

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9
Q

What complications may occur due to Barrett’s oesophagus?

A

Adenocarcinoma

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10
Q

How is GORD treated?

A

Lifestyle modifications
Pharmacologically - antacids, H2 antagonists, proton pump inhibitors (PPIs)
Surgery (rare)

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11
Q

What surgery is performed to treat GORD?

A

Wrap fundus of stomach around to support lower oesophageal sphincter

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12
Q

What is acute gastritis?

A

Acute mucosal inflammation of stomach

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13
Q

What may cause acute gastritis?

A

Heavy use of NSAIDs
Lots of alcohol - dissolves mucous layer
Chemotherapy - affects highly proliferating cells
Bile reflux

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14
Q

What are the symptoms of acute gastritis?

A 
Asymptomatic or
Pain
Nausea
Vomiting
Occasionally bleeding - may be fatal
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15
Q

What may cause chronic gastritis?

A

Bacterial - H-Pylori (most common cause)
Autoimmune - antibodies to gastric parietal cells
Chemical/reactive - chronic alcohol abuse, NSAIDs, reflux of bile

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16
Q

What would the symptoms of chronic gastritis caused by H-pylori be?

A

Asymptomatic or similar to acute gastritis

Other symptoms may develop due to complications such as peptic ulcers and adenocarcinoma

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17
Q

Why might complications with chronic gastritis occur?

A

Not as protective against acid as mucous secreting cells are inflamed

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18
Q

What would the symptoms of chronic gastritis caused by autoimmune response be?

A

Symptoms of Angelia, gloss it is (inflammation of tongue), anorexia, neurological symptoms

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19
Q

What are peptic ulcers?

A

Defects in gastric/duodenal mucosa extending though the muscular is mucosa

20
Q

Were are peptic ulcers most commonly found?

A

Most commonly in first part of duodenum

Also commonly found in lesser curve of stomach

21
Q

What is the cause of peptic ulcers?

A

Mucosal injury due to stomach acid, H-pylori, NSAIDs, smoking (only really contributes to relapse of ulcer disease), massive physiological stress e.g. Burns

22
Q

What are the symptoms of peptic ulcers?

A 
Epigastric pain - burning/gnawing pain
Following meal times if stomach
At night if duodenal
Bleeding/anaemia
Satiety early (feeling full)
Weight loss
23
Q

What is functional dyspepsia?

A

Symptoms of ulcer disease but no physical evidence

24
Q

How can H-pylori be detected?

A

Urease breath test

25
Q

How does a urease breath test work?

A

H-pylori breaks down urea which increases surrounding pH
Give patient radiolabel
If CO2 given off on breath the H-pylori present

26
Q

How are peptic ulcers treated?

A

Eradicate H-pylori - PPI, clarithromycin, amoxicillin
Stop NSAIDs
Endoscopy for bleeding ulcers
PpIs

27
Q

What are the most common H2 blockers used?

A

Cimetidine

Ranitidine

28
Q

What is the he most common proton pump inhibitor?

A

Omeprazole

29
Q

How is H-pylori spread?

A

Oral to oral

Faecal to oral

30
Q

Describe what type of bacteria H=pylori is?

A

Helix shaped
Gram negative
Microaerophillic

31
Q

What does urease do?

A

Converts yea to ammonium which is basic in solution so increases the local pH around the bacteria

32
Q

How does the H-pylori cause problems?

A

Releases cytotoxins
Expresses enzymes
Possibly degrades mucous layer
Promotes inflammatory response

33
Q

How does promoting an inflammatory response cause injury?

A

Causes self injury

34
Q

How do cytotoxins cause damage?

A

Direct epithelial injury

35
Q

Where in the stomach is H-pylori usually found?

A

The antrum

36
Q

If H-pylori are colonising the antrum and the body of the stomach what will the symptoms be?

A

Asymptomatic

37
Q

If H-pylori is only colonising the stomach what will the symptoms be?

A

Its where most of the G cells are located so there will be an increase in gastrin secretion which will cause increase in parietal cells acid secretion
This may cause duodenal epithelial metaplasia, colonisation of duodenum, duodenal ulceration

38
Q

If H-pylori are predominantly colonising the body of the stomach what will the symptoms be?

A

Will have an atrophic affect cause in gastric ulcers and intestinal metaplasia which may lead to cancer

39
Q

What is zollinger-ellison syndrome?

A

A non beta islet cell gastrin secreting tumour of the pancreas
Causes proliferation of parietal cells, this means lots of acid produced and causes severe ulceration of the stomach and small bowel

40
Q

What are the symptoms of Zollinger-Ellison syndrome?

A

Abdominal pain, diarrhea

41
Q

What may cause stress peptic ulcers?

A 
Severe burns
raised intercranial pressure
Sepsis
Severe trauma
Multiple organ faliure
42
Q

What are the symptoms of stomach cancer?

A 
Presents late, has to be quite large before symptoms arise
Diphagia
Loss of appetite
Malaena
Weight loss
Nausea
Vomiting
Virchow's nodes
43
Q

What is melaena?

A

Iron in blood is oxidised causing stool to be black

44
Q

What areas of the world is stomach cancer most common and why?

A

Chile, japan, South America

Their diets predispose them to it

45
Q

What are the risk factors for stomach cancer?

A

Male
H-pylori
Dietary factors
Smoking

Gastrointestinal System (15 decks)

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