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Medicine > Gastro - GORD > Flashcards

Gastro - GORD Flashcards

1
Q

What are the oesophagus and stomach lined with?

A

Oesophagus
Squamous epithelial

Stomach
Columnar epithelial

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2
Q

What can cause GORD?

A

Hiatus hernia
Greasy and spicy foods
Alcohol
NSAIDs
Coffee and tea
Stress
Smoking
Obesity

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3
Q

What term is used to describe indigestion?

A

Dyspepsia

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4
Q

What are the symptoms of GORD?

A

Heartburn
Acid regurgitation
Retrosternal or epigastric pain
Bloating
Nocturnal cough
Hoarse voice
Halitosis

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5
Q

What are the red flag features of GORD?

A

Dysphagia
Over 55
Weight loss
Upper abdominal pain
Reflux
Treatment-resistant dyspepsia
Nausea and vomiting
Upper abdominal mass
Low Hb
Raised platelet count

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6
Q

What do the red flag features of GORD suggest?

A

Suspected cancer

Two week wait referral

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7
Q

What is an OGD?

A

Oesophago-gastro-duodenoscopy

Camera inserted through mouth down to duodenum

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8
Q

What is an OGD used for?

A

Assess for :
- Gastritis
- Peptic ulcers
- Upper GI bleeding
- Oesophageal varices
- Barrett’s oesophagus
- Oesophageal stricture
- Malignancy of the oesophagus

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9
Q

If patients have evidence of upper GI bleeding what should be done?

A

Admission
Urgent endoscopy

Melaena
Coffee ground vomiting

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10
Q

What are the 4 types of hiatus hernia?

A

Type 1
Sliding

Type 2
Rolling

Type 3
Sliding and rolling

Type 4
Large opening with additional abdominal organs entering thorax

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11
Q

What may hiatus hernia be seen on?

A

CXR
CT scan
Endoscopy
Barium swallow test

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12
Q

What is the management of GORD?

A

Lifestyle changes
Medication review
Antacids
PPIs
Histamine H2-receptor antagonists
Surgery

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13
Q

What lifestyle changes are indicated in GORD?

A

Reduce tea, coffee and alcohol
Weight loss
Avoid smoking
Smaller, lighter meals
Avoid heavy meals before bedtime
Stay upright

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14
Q

What surgery is done for GORD?

A

Laparoscopic reverse fundoplication

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15
Q

What type of bacteria is Helicobacter pylori?

A

Gram-negative aerobic bacteria

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16
Q

What does Helicobacter pylori do in the stomach?

A

Damages epithelial lining resulting in gastritis, ulcers and increased risk of stomach cancer

Avoids acidic environment by forcing its way into the gastric mucosa using flagella to propel itself

Creates a gap in the mucosa exposing the epithelial cells to damage from stomach acid

17
Q

What does Helicobacter pylori produce?

A

Ammonium hydroxide, neutralising stomach acid

Toxins

Both damage gastric mucosa

18
Q

What investigations are done for Helicobacter pylori?

A

Stool antigen test
Urease breath test
Pylori antibody test
Rapid urease test

19
Q

What does a rapid urease test involve?

A

Taking a biopsy of stomach mucosa

Added to liquid medium containing urea

Pylori produce urease enzymes converting urea to ammonia

Ammonia makes the solution more alkaline

pH indicator used to indicate change if Pylori are there

20
Q

How is Helicobacter pylori treated?

A

Triple therapy with a PPI

Omeprazole
Amoxicillin
Clarithromycin

For 7 days

21
Q

What is Barrett’s oesophagus?

A

Premalignant condition
Metaplasia of the lower oesophageal epithelium

Changes from squamous to columnar epithelium

Patients may notice improved reflux symptoms after they develop Barrett’s oesophagus

22
Q

What is Barrett’s oesophagus a risk factor for?

A

Developing oesophageal adenocarcinoma

Can be stepwise progression from no dysplasia to low-grade, high-grade and adenocarcinoma

23
Q

What is treatment of Barrett’s oesophagus with?

A

Endoscopic monitoring (for progression to adenocarcinoma)
PPIs
Endoscopic ablation

24
Q

What is endoscopic ablation used for?

A

Destroy abnormal columnar epithelial cells, then replaced with normal squamous epithelial cells

Reduces cancer risk

25
Q

What is Zollinger-Ellison syndrome?

A

Rare condition where duodenal or pancreatic tumour secretes excessive gastrin

Gastrin stimulates acid secretion

Excess production of stomach acid causing severe dyspepsia, diarrhoea and peptic ulcers

26
Q

What are gastrinomas associated with?

A

MEN-1

Autosomal dominant condition

Parathyroids
Pituitary

Medicine (91 decks)

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