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Flashcards in Other upper GI pathology Deck (53):
1

GORD basically is due to __ not closing and raised ___

LOS
intrabdominal pressure

2

With GORD if wake up coughing then may be due to

food passing UOS => lungs may => reflux bronchitis

3

4 grades of GORD ulceration:

1) less than 5mm
2) greater than 5mm
3) less than 70% of circumference
4) greater than 70% of circumference

4

Achalasia =

LOS in spasm and oeso body has poor motility
dysphagia for food and liquid

5

diagnosis of achalasia is by ___

manometry to measure P of LOS

6

treatment of achalasia =

botox to paralyse LOS
surgery - slit open LOS and tie ends

7

Nutcracker oesophagus =
Treatment =

oesophageal spasms with excessive amplification/duration of peristalsis that causes dysphagia
CCBs

8

Group of symptoms associated with dyspepsia

post-prandial fullness
epigastric pain/burning
early satiety
bloating

9

__% of dyspepsia is organic eg.s of causes =

25% - PUD, NSAIDs, gastric ca

10

___% of dyspepsia is functional (ie. ____)

75%
no underlying cause/idiopathic

11

Peptic ulcer which is better when eating

duodenal

12

Peptic ulcer made worse by eating =

gastric

13

H. pylori is the cause of ___% of duodenal and ___% of gastric ulcers

90% duodenal
60% gastric

14

Causes of PUD = (4)

H. pylori
NSAIDs
gastric dysmotility
outflow obstruction

15

H pylori is a gram __ microaeophilic flagellated ____

-ve
bacillus

16

H pylori may cause __+__ gastric cancers
may reduce _+_ cancers

(almost all) non-cardia gastric adenocarcinoma
low grade B cell lymphoma
REDUCE: cardia adenocarcinoma, oeso adenocarcinoma

17

If H. pylori is predominant in the antrum and does not cause atrophy then ___ ulcers are caused as gastrin secretion ____ and acid secretion ____

duodenal
increased gastrin + acid production

18

If H. pylori is predominant in the body and causes atrophy then acid secretion is ____ and ___ ulcers + ____ is caused as gastrin and acid secretion ___

decreased
gastric ulcers and gastric cancer (adenocarcinoma)
are decreased

19

Cag ___ H. pylori are oncogenic
They inhibit ____ which causes increased gastrin
This causes duodenal ___ load to increase => duodenal ____ and H. pylori ___ => ulceration
there is no _____

+ve
somatostatin
acid
metaplasia
colonisation
body gastritis

20

to diagnose H. pylori infection must stop ___ (drug)
and tests = (4)

PPIs
biopsy ( urease test, histology and culture)
urease breath test
FAT - faecal antigen test
serology (IgA)

21

Urease test is possitive for H. pylori because

H. pylori produce urease to produce ammonium and bicarbonate

22

H. pylori eradication therapy =
side effects =

omeprazole + amox. + clarithromycin
OR
omeprazole + metronidazole + clarithromycin
side effects: nausea and diarrhoea

23

Follow-up for duodenal+/gastric ulcers after treatment?

duodenal = only if symptomatic
gastric = endoscopy at 6-8wks so no malignancy

24

Gastroenteritis definition

inflammation of the stomach/intestines =>
decreased nutrient absorption and increased fluid and electrolyte loss

25

___% of gastroenteritis cases are infectious, mostly __ then __ then ___

85%
mostly viral > bac. > parasites

26

S. aureus pre-formed toxin related gastroenteritis resolves after ___
There is ___ in faeces

6-10hrs
NO pus or blood

27

Large outbreaks of this occur on cruise ships
mainly efffects older kids and adults

norovirus

28

norovirus spread is __

faeco-oral, waterbourne, shell-fish

29

Incubation period for norovirus
signs
resolution within

24-48hrs
abdominal cramps, abrupt nausea, vom and diarr, myalgia
24-48hrs

30

acute enteritis presents with (4)

fever, diarrhoea, vomiting, abdominal pain

31

acute colitis presents with (3)

fever, pain, bloody diarrhoea

32

Diagnosis of paratyphoid/typhoid is by:

BLOOD cultures
and also stool and urine cultures

33

Treatment for paratyphoid/typhoid =

azithomycin

34

There is/is not a vaccine for typhoid+/paratyphoid

IS IV/PO vaccine for typhoid = 70% effective
none for paratyphoid

35

signs and symptoms of enteric fever-like illness eg. typhoid/paratyphoid

fever
rigors
pain
v little diarrhoea (may have constipation)

36

Campylobacter infection resolves within ___

5-14 days

37

Campylobacter infection may cause ___

Guillain-Barre Syndrome = tingling of feet => paralysis of legs, arms and rest of body

38

If camplyobacter is severe then treat with __

azithro/clarithromycin

39

Causes of bloody diarrhoea eg.s

IBD
malignancy
ischaemia
infection (causing colitis) eg. Shigella, camplyobacter, E. coli, amoeba

40

Parasites are diagnosed by:

stool microscopy

41

salmonella enterica, campylobacter and Shigella are diagnosed by:

stool culture

42

Stool toxin test is used to diagnose

C. diff and E. coli

43

norovirus is diagnosed by

PCR

44

anti-spasmodics/motilities are generally only short-term and not given to elderly or IBD because ___

may cause toxic megacolon

45

Antibiotics are given for GI infections only if ___
eg.s of infections given in =

IC, severe, chance of spreading to blood/to others
Typhoid, shigellosis (not sonnei), cholera, C. diff, giardiasis, amoebiasis, invasive salmonellosis

46

C. diff is a ____ gram ___ spore-forming ___

anaerobic
+ve
bacillus

47

4Cs that cause C. diff infection

cephalosporins
co-amoxiclav
clindamycin
ciprofloxacin (quinolones)

48

In C. diff infections must wash hands with ___

soap and water

49

drug used for first relapse of C. diff

fidoxamicin

50

most effective treatment for C. diff in future

FMT (faecal microbiota transplant)

51

Amoebiasis causes _____ may spread to cause __
diagnosis =
treatment =

acute bloody diarrhoea commonly
liver abscess
serology
metronidazole - remove from lumen with diloxanide furoate/paromomycin

52

Giardiasis causes ___ diarrhoea
common in ___ (geographical)
diagnosis:
treatment:

explosive diarrhoea
USSR/ eastern europe
stool/duodenal aspirate microscopy
metronidazole

53

Most common cause of traveller's diarrhoea =

E. coli enterotoxin