Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal > Gastric Pathology > Flashcards

Gastric Pathology Flashcards

1
Q

What is a peptic ulcer?

A

Imbalance between acid secretion and mucosal barrier, creating sores/break in mucosal membrane of stomach or duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common ulcer in the GI tract?

A

Duodenal ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common cause of GI bleed?

A

Gastric ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What sex are gastric ulcers most common in?

A

M>F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What age group are gastric ulcers most common?

A

Elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes gastric ulcers?

A

Helicobacter Pylori infection

Drugs

Zollinger-Ellison

Alcohol and smoking

Stress ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drugs can cause gastric ulcers?

A

NSAIDS

SSRI

Corticosteroids

Bisphosphonates

Causes multiple ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Zollinger-Ellison?

A

Excessive levels of gastrin, usually due to gastrin secreting tumour of the duodenum or pancreas (MEN1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do gastric ulcers present?

A

Epigastric pain and tenderness

  • Worse at night and when eating
  • Radiation to back suggests perforation

N&V

Haematemesis/coffee ground vomit, if haemorrhage

Bloating, increased while eating meal

Iron deficiency anaemia, if haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Compare peptic and duodenal ulcer symptoms

A

Epigastric pain worsens at night and when eating for peptic ulcers

Epigastric pain worsens when hungry for duodenal ulcers/improves when eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What investigations are used in gastric ulcer diagnosis?

A

Upper GI Endoscopy, with CLO test to assess H pylor and biopsy to exclude malignancy

Other H Pylori investigation

  • Urea breath test
  • Stool antigen test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Descibe the urea breath test

A

Breath in urea and if there is O2 detection, it shows that urea was split into CO2 and ammonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are gastric ulcers managed?

A

Stop offending drugs

If H.Pylori positive, eradication therapy

If H.Pylori negative, PPI until ulcer is healed

Endoscopy can be used for ulcer monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name complications of gastric ulcers

A

Gastric carcinoma

Haemorrhage

Perforation, resulting in peritonitis

Scarring and strictures, leading to narrowing of the pylorus, leading to GORD and gastric outlet obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are perforated ulcers managed?

A

IV fluids

Analgesia

CXR shows pneuomperitoneum

Laparotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the types of peritonitis?

A

Localised, caused by underlying organ inflammation

Generalised, caused by perforation

Spontaneous bacterial peritonitis, associated with ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does peritonitis present?

A

Guarding

Rebound tenderness

Percussion tenderness

Coughing tenderness

Rigidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the ALARMS symptoms?

A

Age over 55

Loss of weight

Anaemia

Recent onset of progressive symptoms

Masses and melaena/haematemesis

Swallowing difficulty

19
Q

What is the prognosis of gastric cancer?

A

Poor, 5 year survival is 15%

20
Q

What are the causes of gastric cancer?

A

Helicobacter Pylori Infection

Smoking

Diet

  • High salt and nitrate

FH

Previous gastric surgery

Blood group A

21
Q

How does gastric cancer present?

A

Dyspepsia/Epigastric pain

Weight loss

N&V

Melaena

Upper abdominal mass

Virchow’s lymph node

Dysphagia

Cachexia

22
Q

What are the classic metastatic signs of gastric cancer?

A

Hepatomegaly

Palpable Virchow’s node, located in the left supraclavicular fossa

23
Q

What investigations are used in gastric cancer diagnosis?

A

FBC

  • Iorn deficiency anaemia

Endoscopy with multiple biopsies

Barium/contrast meal

Staging imaging/CT

24
Q

What biopsy sign is seen in gastric adenocarcinoma?

A

Signet ring cells, the higher the number the worse the prognosis

25
Q

How is gastric cancer managed?

A

Gastrectomy plus lymph node resection

Palliative

  • Chemotherapy
  • Procedures centred on relieving gastric obstruction
26
Q

Name complications of a gastrectomy

A

B12 deficiency/subacute combined degeneration of the spinal cord

Iron deficiency anaemia

Dumping syndrome

Vitamin D deficiency

Osteoporosis

Weight loss

Increased gall stone risk

Increased gastric cancer risk

27
Q

What type of bacteria is H.Pylori?

A

Gram negative

28
Q

What enzyme does H.Pylori release and why is this clinically relevant?

A

Releases the enzyme urease which breaks down urea into ammonia and CO2, creating an alkaline shield

Urea breath test shows it has been split

29
Q

Describe the antibiotic therapy for H.Pylori

A

CAP 7

Triple therapy for 7 days

Clarithromycin

Amoxicillin

(PPI)

30
Q

What causes gastritis?

A

Autoimmune

Helicobacter Pylori infection

Chemical

31
Q

What are the chemical causes of gastritis?

A

Alcohol

NSAIDS

Duodenal reflux

Aspirin

32
Q

Name the complications of gastritis

A

Haemorrhage

Stomach ulcers

Stomach carcinoma

Pernicious anaemia

33
Q

When should a urea breath test not be done?

A

Should not be done within 4 weeks of treatment with an antibacterial or within 2 weeks of a PPI

34
Q

What investigation is used to check for H.Pylori eradication and when is this done?

A

Urea breath test 8 weeks after eradication therapy

35
Q

What condition is H.pylori most associated with?

A

Duodenal ulcers

36
Q

Give side effects of PPIs

A

Hyponatraemia

Hypomagnasaemia

Osteoporosis

Microscopic colitis

Clostridium difficile infection

37
Q

What patients should be offered an urgent endoscopy?

A

Any patient with dysphagia

Upper abdominal mass consitent with stomach cancer

Patients aged over 55 with weight loss and any of the following

  • Upper abdominal pain
  • Reflux
  • Dyspepsia
38
Q

What patients should be offered a non-urgent/routine endoscopy?

A

Patients with haematemesis

Patients over 55 who have

  • Treatment resistant dyspepsia
  • Upper abdominal pain with low haemoglobin levels
  • Raised platelet count with N&V, dyspepsia, reflux, weight loss etc
39
Q

What is MALT lymphoma?

A

Lymphoma involving the mucosa-associated lymphoid tissue (MALT), frequently of the antrum of the stomach, but virtually any mucosal site can be affected

40
Q

What is associated with MALT lymphoma?

A

H pylori infection

41
Q

What is the prognosis of MALT lymphoma?

A

Good prognosis

42
Q

How are gastric MALT lymphomas managed?

A

If low grade, 80% respond to H pylori eradication therapy

In high grade or atypical cases, chemo and/or radiotherapy may be required

43
Q

What artery is associated with perforated gastric ulcers?

A

Gastroduodenal

Gastrointestinal (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions