Stomach and Duodenum Flashcards Preview

Gastrointestinal (LECTURE NOTES) > Stomach and Duodenum > Flashcards

Flashcards in Stomach and Duodenum Deck (44):
1

What is Menetrier's disease

A rare condition presenting with weight loss and diarrhoea

2

What is Menetrier's disease linked to

H pylori

3

What can be seen endoscopically in Menetrier's disease

Hypertrophy of mucosal folds of the body and fundus

4

What is the treatment for Menetrier's disease

To eradicate H pylori
Reduce recretion (PPIs)
Monitor endoscopically due to risk of gastric cancer

5

How are peptic ulcers caused

By an imbalance between luminal acid and mucosal defences

6

How are peptic ulcers distinct from erosions

They penetrate the muscularis mucosae

7

Are gastric ulcers usually benign or malifnant

Benign

8

What are 3 main causes of gastric ulcers

H pylori and NSAID use
Steroid and NSAID use
Stress

9

What are the clinical presentations of gastric ulcers

usually pain that is relieved on eating

10

What are some complications of a gastric ulcer

Haematemesis
perforation are commoner in the elderly

11

What are the clinical presentations of gastric ulcers

usually pain that comes on soon after eating

12

What are some complications of a gastric ulcer

Haematemesis
perforation are commoner in the elderly

13

What is the management for a peptic ulcer

Eradication of H pylori
4 weeks PPI
Smoking cessation and alcohol moderation
Stop NSAIDs if possible

14

When should surgery be considered in gastric ulcers

If there is haemmorhage
perforation
failure to heal or gastric outlet obstruction

15

What are the 4 main causes of a duodenal ulcer

H pylori
NSAID use
Smoking
Stress

16

Is perforation as a complication more common in gastric or duodenal ulcers

Gastric

17

What is the management of duodenal ulcers

Eradication of H pylori - routine use of PPI if there is haemorrhage
Smoking cessation
alcohol moderation
stop ulcerogenic drugs (NSAIDs and bisphosphonates)

18

What is the mortality rate for perforated ulcers

25%

19

What is the mortality rate for perforated ulcers

25%

20

What is the initial management for gastric outlet obstruction

Drip and suck - IV rehydration and NG aspiration

21

What is the later management for gastric outlet obstruction

Balloon dilatation or surgical resection

22

What is Zollinger-Ellison syndrome

A rare disorder with the triad of:
severe or recurrent peptic ulceration
Increased gastric acid secretion
Hypergastrinaemia due to a secretion from a non-beta cell islet pancreatic tumour

23

What often occurs with Zollinger-Ellison syndrome

Diarrhoea and steatorrhoea

24

What are the investigations for Zollinger-Ellison syndrome

Gastric acid secretion elevated and serum gastrin elevated

25

How is the cause investigated in Zollinger-Ellison syndrome

Endoscopic ultrasound or Oxtreoscan

26

What is the management for Zollinger Ellison syndrome

30% resectable
Lifelong PPI in high dose
Octreotide may help

27

What is gastroparesis

Delayed gastric emptying without mechanical obstruction

28

What are some characteristic of gastroparesis

recurrent vomiting
abdominal bloating
distension

29

What might help with gastroparesis

Peripherally acting antiemetics (domperidone)

30

What is indicated if malnutrition develops

Jejunostomy or parenteral nutrition

31

What is the most commonest cause of cancer death worldwide

Gastric carcinoma

32

Who is more likely to get gastric carcinoma

Men and those over 50

33

What are 6 causes of gastric carcinoma

Chronic H pylori infection
Familial: blood group A is associated
Genetic
Diet containing pickled or smoked foods, diets low in fruit and veg
Environment; smoking and alcohol
Rare, organic disorders; Menetrier's disease and previous partial gastrectomy

34

What does adenocarcinoma develope from

Regions of intestinal metaplasia in the stomach which then develop secondary to chronic atrophic gastritis

35

What does early gastric cancer refer to

Adenocarcinoma confined to the mucosa or submucosa

36

What does early gastric cancer refer to

Adenocarcinoma confined to the mucosa or submucosa

37

What are the clincial features of gastric carcinoma

Epigastric pain
Loss of appetite
loss of weigh
haematemesis is rare

38

What is the investigation for the gastric carcinoma

Endoscopy - rolled irregular edged ulcers

39

What are some of the investigations for the complications of gastric carcinoma

Staging: FBC, LFT, CXR, Abdo CT, endoscopic US, laparoscopy

40

How is gastric cancer managed

Surgery: resection is only possible in a minority of cases and most surgery is palliative
Chemotherapy: Post op may improve survival and can also be used palliatively

41

How could prognosis of gastric cancer be improved

Public awareness and early diagnosis

42

Where is the most commonest site for non-nodal non-Hodgkin's lymphoma

The stomach

43

What is MALT lymphoma

A B cell tumour caused by an immune response to chronic H pylori infection with cagA strains

44

Where do Gastrointestinal stromal tumours arise from

The interstitial cells of Cajal