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GI (Y1) > Dyspepsia & Peptic Ulcer Disease - Week 3 > Flashcards

Dyspepsia & Peptic Ulcer Disease - Week 3 Flashcards

1
Q

What is meant by dyspepsia?

A

Indigestion

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2
Q

What are the 3 characteristics of dyspepsia?

A

Epigastric pain/burning
postprandial fullness
Early satiety

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3
Q

What is meant by postprandial fullness?

A

Unusual feeling of fullness straight after a meal

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4
Q

What is meant by early satiety?

A

Very little intake of food at mealtimes

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5
Q

What are the foregut structures?

A 
Oesophagus
Stomach
Duodenum
Pancreas (1/2)
Gallbladder
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6
Q

Where does the foregut span from and to?

A

cricopharyngeus to ampulla of Vater

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7
Q

Give 3 organic causes of dyspepsia.

A

Gastric ulcer
Gastric cancer
Drugs - NSAIDs/ Cox 2 inhibitors

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8
Q

What is meant by functional dyspepsia?

A

no evidence of culprit structural disease

associated with other functional gut disorders e.g. IBS

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9
Q

What is likely to be found on examination of a patient with uncomplicated dyspepsia?

A

Epigastric tenderness only

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10
Q

What is likely to be found on examination of a patient with complicated dyspepsia?

A

cachexia
mass
evidence gastric outflow obstruction
peritonism

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11
Q

Give some examples of ‘alarm symptoms’ in dyspepsia.

A 
Dysphagia
GI bleeding
Persistent vomiting
Unexplained weight loss
Mass
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12
Q

How is dyspepsia treated in the absence of any alarm symptoms?

A

Check H Pylori status

if HP –ve, treat with acid inhibition as required

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13
Q

Which criteria is used to describe dyspepsia?

A

Rome III

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14
Q

How is functional dyspepsia diagnosed?

A

1 of diagnostic criteria for dyspepsia and clear endosocpy for upper GI tract. Symptoms must have had an onset of over 6 months ago.

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15
Q

Give 6 potential causes of functional dyspepsia.

A 
Visceral hypersensitivity
Gut immune issues
Abnormal motor & reflex functions
Psychosocial factors
Genetic factors
Altered gut-brain interactions
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16
Q

How may presentation of peptic ulcer disease differ from that of other forms of dyspepsia?

A

Often nocturnal, worse after food. Relapsing and remitting chronic illness.

17
Q

Which socioeconomic class is most likely to have peptic ulcer disease?

A

Lower SIMD

18
Q

What are the common causes of peptic ulcer disease?

A

H Pylori
NSAIDs
Gastric dysmotility
Outflow obstruction

19
Q

What kind of bacterium are H Pylori?

A

G -ve microaerophilic flagellated bacillus

20
Q

Almost all gastric cancers caused by H Pylori are…

A

non-cardia gastric adenocarcinoma

21
Q

How can H pylori result in duodenal ulcer?

A

Increased duodenal acid load leads to gastric metaplasia, H Pylori colonisation and ulceration

22
Q

How is H Pylori infection diagnosed?

A

Gastric biopsy: urease test, histology, culture
Urease breath test
FAT - Faecal antigen test

23
Q

What is the effect of H Pylori on the pH of its microenvironment?

A

Increases pH

24
Q

What is the treatment of Peptic Ulcer Disease?

A

Anti-secretory therapy
H Pylori - if +ve eradicate
Withdraw NSAIDs
Infrequently surgery

25
Q

What kind of anti-secretory therapies are used to treat peptic ulcer disease?

A

PPIs (preferred) and H2 receptor antagonists

26
Q

What is usual H Pylori eradication therapy?

A

PPI + amoxycillin 1g bd + clarithromycin 500mg bd OR

PPI + metronidazole 400mg bd + clarithromycin 250mg bd for ONE WEEK

27
Q

Give some possible complications of peptic ulcer disease.

A

anaemia
bleeding
perforation
gastric outlet/duodenal obstruction - fibrotic scar

28
Q

What post-duodenal ulcer follow up is required?

A

None if no symptoms

29
Q

What post-gastric ulcer follow up is required?

A

Endoscopy 6-8 weeks after to check no malignancy

30
Q

How does H Pylori inhibit acid secretion?

A

Increases levels of IL-1 which inhibits acid secretion by parietal cells

GI (Y1) (79 decks)

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