Lecture 12 Upper GI disease Flashcards Preview

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Flashcards in Lecture 12 Upper GI disease Deck (46):
1

Define chronic gastritis

Ongoing inflammation of the stomach mucosa. Symptoms less severe than acute gastritis.

2

What can arise from chronic gastritis?

Dysplasia and carcinoma

3

What are the symptoms of chronic gastritis?

Upper abdo pain. Indigestion/ bloating. N/V. Belching. Loss of appetite/weight loss.

4

Can chronic gastritis be asymptomatic?

yes

5

What can cause chronic gastritis?

ABC and other.
Autoimmune, bacterial, Chemical and other.

6

What can autoimmune problems (chronic gastritis) lead?

Pernicious anameia

7

What causes bacterial infection in stomach?

Helicobacter pylori infection

8

Notes on helicobacter pylori infection

Gram-neg bacteriain stomach, particularly antrum, infects over half the worlds population. Faecal-oral route. Untreated -> infection persists throughout life.

9

H.pylori is linked to what development?

Duodenal ulcers and stomach ulcers

10

What is the clinical presentation H.pylori.

80% asymptomatic. 5-15% peptic ulcer disease. 10% non-ulcer dyspepsia. 1-3% gastric adenocarcinoma.

11

What are the effects of h.pylori infections predominantly in body of stomach.

Gastric cancer
Hypochlorhydria
Gastric atrophy
Intestinal metaplasia

12

What are the effects of h.pylori infections predominantly in antrum.

Duodenal ulcers
Hyperchlorhydria

13

What chemicals can cause chronic gastritis?

Alcohol, tobacco and caffeine

14

What else (apart from ABC) can cause chronic gastritis?

Psychological stress

15

Where does peptic ulcer disease usually occur?

D1 or antrum (4:1)

16

What can cause peptic ulcer disease?

H. pylori (80-100% DU and 65% gastric). NSAIDs

17

When are peptic ulcers worse?

at night and after meals

18

What are the symptoms of peptic ulcer disease?

Pain (gnawing, burning and aching)

19

What are complications of peptic ulcer disease?

Bleeding -> iron deficiency anaemia. Massive haematemesis. Performation -> peritonitis. Long term cancer at edge of ulcer

20

What is Barrett's Oesophagus?

When lining of oesophagus changes from stratified squamous epithelium to columnar epithelium with goblet cells

21

Where is columnar epithelium and goblet cells normally found?

low in GIT

22

What is Barrett's Oesophagus dysplasia process?

Low grade to high grade to invasive carcinoma.

23

Where can oesophageal carcinoma be spread (haematogenous) to?

Liver or lung

24

Who can suffer from oesophagus squamous cell carcinoma?

Adults over 45. M:F 4:1

25

What are the survival rates for oesophagus squamous cell carcinoma?

5 year survival of 9%

26

What are the risk factors for Oesophagus sqaumous cell carcinoma?

Alcohol, tobacco, caustic injury, achalasia

27

Define achalasia?

when the lower part of the oesophagus fails to relax, preventing food passing to stomach

28

What are the symptoms of Oesophageal carcinoma?

Dysphagia, weight loss, haemorrhage, sepsis, resp fistula, aspiration.

29

What are the symptoms of Barrett's Oesophagus?

Dysphagia, weight loss, haematemesis, chest pain, vomiting

30

What are the gender statistics for Barrett's Oesophagus?

M:F 7:1

31

What is the survival rate for Barrett's?

5 year survival

32

What accounts for 90% of gastric malignances?

Adenocarcinoma

33

What are the precursor lesions for stomach adrenocarcinoma?

Pernicious anaemia, intestinal metaplasia, neoplastic polyps, Helicobacter gastritis.

34

What is the 2nd most common carcinoma world wide?

Stomach adrenocarcinoma

35

What are the early symptoms of stomach adenocarcinoma?

Same as gastritis

36

What are the advanced stomach adenocarcinoma symptoms?

Weight loss, anorexia, anaemia, haemorrhage, fungating exophytic growth.

37

What is the survival rates for stomach adenocarcinoma?

5 year survival (early) after surgery 90%!!!
Overall 5 year survival 30%

38

Where can stomach cancer directly spread to?

Duodenum, pancreas, colon, liver, spleen.

39

Define virchow's node?

Lymph node in left supraclavicular fossa. Takes blood supply from abdominal cavity

40

Where can stomach cancers spread to through haematogenous?

Liver and lungs

41

Small bowel neoplasia is

small chance. relatively rate compared to other GI mlignancies

42

What are risk factors for small bowel adenocarcinoma?

Crohn's disease and Coeliac disease, radiation, hereditary.

43

Define Coeliac disease?

Extensive mucosal disease related to gluten sensitivity. Immune mediated villous atrophy and malabsorption

44

How can Coeliac disease by diagnosed?

Serological blood test and biopsy

45

What are the symptoms of coeliac disease?

Pain in digestive tract, chronic constipation and diarrhoea, failure to thrive (children), anaemia, fatigue.

46

What can coeliac disease increase the risk of?

adenocarcinoma and lymphoma of small bowel