2.1. Gastric Disease - Helicobacter Pylori Infection Flashcards Preview

2nd Year - Alimentary Diseases > 2.1. Gastric Disease - Helicobacter Pylori Infection > Flashcards

Flashcards in 2.1. Gastric Disease - Helicobacter Pylori Infection Deck (31)
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1
Q

What type of Bacteria is Helicobacter Pylori?

A

Gram Negative

2
Q

What percentage of the Population are infected with this at some point?

A

50%

3
Q

When is Helicobacter Pylori infection acquired?

A

In childhood

4
Q

Where does Helicobacter Pylori colonize?

A

On the Surface of Gastric-type Mucosa

5
Q

Does the Helicobacter Pylori infection penetrate the Epithelium?

A

No

6
Q

Does the Helicobacter Pylori evoke an immune response?

A

Yes, even though it does not penetrate the Epithelium, an immune response still takes place

7
Q

Where does the Immune Response to Helicobacter Pylori take place?

A

In the Underlying Mucosa

8
Q

What is the Immune Response dependent on?

A

The Hosts Genetic Factors

9
Q

What does the Immune Response cause?

A
  1. Chronic Gastritis
  2. Peptic Ulceration
  3. Gastric Cancer
10
Q

What percentage of the Immune Response leads to Asymptomatic Chronic Gastritis?

A

80%

11
Q

What percentage of the Immune Response leads to Chronic Atrophic Gastritis?

A

15-20%

12
Q

What occurs with Chronic Atrophic Gastritis?

A

Intestinal Metaplasia

13
Q

What percentage of the Immune Response leads to Peptic Ulceration?

A

15-20% - Continuation from Chronic Atrophic Gastritis

14
Q

What percentage of the Immune Response to Helicobacter Pylori, leads to Gastric Cancer?

A

Less than 1%

15
Q

What occurs with Gastric Cancer caused by Helicbacter Pylori?

A

Mucosa Associated Lymphoid Tissue (MALT)

16
Q

What does Helicobacter Pylori release?

A

Urease

17
Q

What is the action of Urease?

A

It breaks down Urea into:

  1. CO2
  2. Bicarbonate
  3. Ammonium
18
Q

What does the Bicarbonate, released from the Urea, cause?

A

Localized increase in Gastric pH

19
Q

What does the localised increase in Gastric pH stimulate?

A

The production of more Gastric Acid throughout the Stomach - which can cause damage to the Gastric Epithelial Cells

20
Q

What are the Clinical Signs of Helicobacter Pylori infection?

A
  1. A raised White Cell Count

2. Inflammatory markers in the blood (CRP and ESR)

21
Q

What symptoms will a person with a Helicobacter Pylori infection present with?

A
  1. None - 80% are asymptomatic

2. Symptoms dependent on how the Disease progresses

22
Q

What investigations are needed for a Helicobacter Pylori infection?

A
  1. Upper G.I. Endoscopy with Biopsy
  2. Serology
  3. ELISA test
  4. Bacterial Cultures
  5. Urea Breath Test
23
Q

What is the purpose of the Endoscopy with Biopsy?

A
  1. To visualize the inside of the Gastric Lumen

2. This should be taken for a Rapid Slide Urease Test (CLO)

24
Q

What is the purpose of the Serology?

A
  1. To look for IgG produced in response to the infection
  2. To look for a raised WCC
  3. To look for inflammatory markers (CRP and ESR)
25
Q

What is the purpose of the ELISA test?

A

This is stool antigen test is to look for the presence the associated antigens

26
Q

What is the purpose of the Bacterial Culture?

A

To identify the infective organism

27
Q

What is the purpose of the Urea Breath Test?

A

As the Ureas will break down Urea, ingestion of a radioactively marked Urea will show it being broken down and exhaled

28
Q

What is the name of the Treatment of Helicobacter Pylori infection?

A

Eradication Therapy

29
Q

What does Eradication Therapy consist of?

A

1 x Proton Pump Inhibitor

2 x Antibiotics

30
Q

What Proton Pump Inhibitor is used?

A

Omeprazole

31
Q

Which 2 Antibiotics are used?

A
  1. Clarithromycin
  2. Amoxicillin
    (Tetracycline if allergic to Penicillin)

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