Upper GI Flashcards
What are the three main presentations that have upper GI causes?
- Dyspepsia- eg heartburn
- Dysphagia- difficulty swallowing
- Haematemesis- vomiting blood
What are the main GI conditions that cause dyspepsia?
- GORD
- Barrett’s oesophagus
- Peptic ulcer disease
What are the main GI conditions causing dysphagia?
- Oesophageal stricture
- Oesophageal web
- Oesophageal cancer
What are the main GI conditions that cause haematemesis?
- Perforated peptic ulcer disease
- Oesophageal tear
- > Mallory Weiss tear
- > Boerhaave’s perforation
SBA 1
45 year old female
2 month history of upper abdominal pain, 2-3 hours after meals
Blood tests (see picture attached)
Microcytic anaemia
Which of these is the most likely diagnosis?
A.GORD
B.Duodenal ulcer
C.Gastric ulcer
D.Biliary colic
E.Cholecystitis
B. Duodenal Ulcer
**SBA 2
61 year old male
3 month history of burning, localised, upper abdominal pain after meals
Weight loss
Long history of headaches
Which of these is the most important investigation to arrange? (and what is the most likely differential diagnosis?)
A. H. Pylori breath test
B. Full Blood Count
C. OGD Endoscopy
D. Trial of Proton pump inhibitor (PPI)
E. Abdominal X-ray
A.OGD Endoscopy
Important to rule out oesophageal/gastric cancer esp b/c over 55y
Most likely diagnosis=
gastric ulcer
Headaches: either mets of gastric cancer
or NSAIDS for headache contributed to ulcer
SBA 3
40 year old lady
Heartburn and problems swallowing
Worse at night
Funny taste in mouth and when coughs
No change in weight + no systemic symptoms
Which of these should be the next step?
A.OGD endoscopy
B.Barium Swallow
C.Manometry
D.Serum gastrin levels
E. Trial of Proton pump inhibitor (PPI)
E. Trial of Proton pump inhibitor (PPI)
SBA 4
59 year old man
Severe retrosternal burning pain
Upper GI endoscopy= metaplastic epithelial changes
Which of these is the most likely diagnosis?
A.Gastric ulcer
B.Gastric carcinoma
C.Oesophageal carcinoma
D.GORD
E.Barrett’s oesophagus
E.Barrett’s oesophagus
Dyspepsia
Definition
Aetiology
Dyspepsia
Definition
Collection of (6) symptoms:
- Epigastric burning/pain- retrosternal (heartburn)
- Upper abdominal discomfort/indigestion
- Belching
- Nausea
- Early satiety/post prandial fullness
- Bloating
Aetiology
Peptic ulcer disease
Gastric cancer
GORD
Hiatus hernia
Oesophageal cancer
Barrett’s oesophague
Biliary/pancreatic pathology
Non-ulcer dyspepsia
Peptic Ulcer disease
Definition
Break in lining of stomach/upper GI tract
Types of ulcer
Aetiology
(Risk factors
Epidemiology)
Symptoms
Signs
Investigations + results
Management
Complications
Peptic Ulcer disease
Definition
Break in lining of stomach/upper GI tract
Types of ulcer
Gastric
Duodenal
Aetiology
Increased stomach acid- increased irritation- leads to break in stomach lining + inflammation
(Risk factors
Eating certain foods- spicy, sour
Smoking
Alcohol
H Pylori infection)
Zollinger-Ellison syndrome
Epidemiology
Duodenal ulcers more common
Symptoms
Dypepsia (heartburn + indigestion)
Recurrent sharp burning/gnawing epigastric pain- related to eating
Nausea and Vomiting
Sometimes- anorexia + weight loss
Early satiety
Tiredness
Signs
Epigastric tenderness
Pointing sign- can point to exactly where pain is
Conjunctival pallor- anaemia
Investigations + results
Management
Complications
- Perforation
- Anaemia (due to blood loss)
What is an additional symptom specific to duodenal ulcers?
Severe abdominal pain
Radiating to back
Has
