Luminal Flashcards
(46 cards)
What is the 1st and 2nd line treatment for GORD?
1st line treatment - omeprazole PPI
2nd line treatment - ranitidine H2 antagonist ON
What type of bacteria is H. pylori?
A gram negative aerobic bacteria which lives in the stomach.
What are the tests for H. pylori?
- urea breath test
- stool antigen testing
- rapid urease test (CLO test)
What is the treatment for H. pylori?
Triple therapy of a PPI and two antibiotics for 7 days.
How does barretts oesophagus develop?
Constant reflux of acid results in the lower oesophagus epithelium changing in a process known as metaplasia from squamous to columnar epithelial cells.
What is the risk of barretts oesophagus?
It’s a premalignant state, but increases the likelihood of developing adenocarcinoma of the oesophagus.
What is the treatment for barretts oesophagus?
PPI and aspirin but not yet in guidelines
What are the causes of a UGIB?
Varices, cancer, ulcers, mallory-weiss tear
What is seen on a blood test of a patient with a UGIB?
Raised urea and a drop in Hb.
What is the treatment of UGIB?
Blood transfusion, OGD, terlipressin, prophylactic antibiotics.
What are the specific aspects of Crohn’s disease?
No blood or mucus, entire GIT, skip lesions, terminal ileum most affected and transmurial (full thickness), smoking is a risk factor.
What are the specific aspects of UC?
Continuous inflammation, limited to colon and rectum, only superficial mucosa affected, smoking is protective, excrete blood and mucus, use aminosalicylates, primary sclerosing cholangitis.
What is faecal calprotectin screening test used for?
Indication of how inflamed the intestines are
What is the 1st line treatment of Crohn’s disease to put the patient into remission?
Steroids - prednisolone
What is a curative treatment of UC?
Ulcerative colitis typically only affects the colon and rectum. Therefore, removing the colon and rectum (panproctocolectomy) will remove the disease. The patient is then left with either a permanent ileostomy or something called an ileo-anal anastomosis (J-pouch). This is where the ileum is folded back in itself and fashioned into a larger pouch that functions a bit like a rectum. This “J-pouch” which is then attached to the anus and collects stools prior to the person passing the motion.
What are the 2 auto antibodies that are present in patients with coeliac disease?
Anti-tissue transglutaminase (anti-TTG) and anti-endomysial (anti-EMA).
What is the pathophysiology of coeliac disease?
Inflammation affects the small bowel, particularly the jejunum. It causes atrophy of the intestinal villi. The intestinal cells have villi on them that help with absorbing nutrients from the food passing through the intestine. The inflammation causes malabsorption of nutrients and the symptoms of the disease.
What are symptoms of coeliac disease?
Weight loss, diarrhoea, fatigue, mouth ulcers, anaemia secondary to iron deficiency, dermatitis herpetiformis (an itchy blistering rash on the abdomen).
Which patients are always tested for coeliac disease?
T1DM as the two conditions can be linked.
Coeliac tests must take place when the patient…
is on a gluten containing diet.
What may be seen on an endoscopy of a patient with coeliac disease?
Villous atrophy and crypt hypertrophy
A diagnosis on Barrett’s Oesophagus canot be made without this test…
Upper GI endoscopy with biopsy
What is the treatment for a low grade dysplasia Barrett’s oesophagus?
Radiofrequency ablation should be the standard of care for flat (non-nodular) low-grade dysplasia in Barrett’s oesophagus.
What is the first line treatment of a patient with an active bleeding MWT?
First-line treatment in an actively bleeding patient is therapeutic endoscopy. Endoscopy is probably the most sensitive and specific diagnostic test for MWT and can also help to rule out other causes of upper GI bleeding.
