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1. Internal Medicine I > 4. Disorders of esophagus and GI > Flashcards

4. Disorders of esophagus and GI Flashcards

1
Q

What are the symptoms of esophageal diseases?

A

The symptoms of esophageal diseases include :
- epigastric pyrosis,
- heartburn,
- regurgitation,
- dysphagia,
- odynophagia
- NCCP

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2
Q

What are the examination methods for esophageal diseases?

A

The examination methods for esophageal diseases include
- laboratory parameters,
- barium swallow,
- upper GI endoscopy,
- examinations of motility-manometry
- impedance

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3
Q

What are the symptoms of hiatal hernia?

A

No symptoms / dysphagia / NCCP

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4
Q

What are the different types of esophageal diverticula?

A

The different types of esophageal diverticula are
- hypopharyngeal (Zenker),
- epiphrenic
- midesophageal

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5
Q

What are the symptoms of large esophageal diverticula?

A

Large esophageal diverticula can cause dysphagia, regurgitation, cough, halitosis

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6
Q

What are the main patogenetical factors of GERD?

A

Dysphunction of LES + decreased esophageal clearence + prolonged gastric emptying.

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7
Q

What are the aggressive factors of GERD?

A

Gastric acid, pepsin, (+ bile acids, tripsin in duodenogastric reflux)

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8
Q

What are the symptoms of GERD?

A
  • Heartburn,
  • acid regurgitation,
  • NCCP,
  • Dysphagia, odynophagia,
  • Coughing, hoarseness,
  • dyspnea.
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9
Q

What are the extraoesophageal symptoms of GERD?

A
  • Persistent couhing,
  • pharyngeal dysphagia,
  • throat pain,
  • recurrent pneumonia
  • caries
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10
Q

What are the complications of GERD?

A

Stenosis, ulcer, bleeding, Barrett’s oesophagus, adenocarcinoma.

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11
Q

What are the clinical phenotypes of GERD?

A
  • NERD (non erosive reflux disease) (+++)
  • ERD, (++)
  • barrett oesophagus (+)
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12
Q

What is the treatment for GERD?

A
  • Lifestyle changes,
  • surgical laparoscopy,
  • PPIs (omeprazole, panteprazole)
  • H2 blockers
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13
Q

What is Barrett’s esophagus?

A

It is a condition where the lining of the esophagus changes and becomes similar to the lining of the intestine (salmon pink in endoscopy)

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14
Q

What are the risk factors for Barrett’s esophagus?

A
  • Long history of GERD,
  • age over 50,
  • male gender,
  • Caucasian race,
  • obesity,
  • positive family history.
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15
Q

What is the treatment for Barrett’s esophagus?

A
  • Esophagectomy,
  • EMR
  • ESD
  • RFA.
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16
Q

What is eosinophilic esophagitis?

A

Allergen-driven inflammation of the esophagus, mostly affecting young male patients with atopic diseases such as asthma, food allergy, rhinitis.

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17
Q

What are the symptoms of eosinophilic esophagitis in children, young adults, and the elderly?

A
  • Children may experience nausea, abdominal pain, and eating difficulties,
  • young adults may experience dysphagia and food impaction,
  • the elderly may experience regurgitation and heartburn.
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18
Q

How is eosinophilic esophagitis diagnosed?

A

Diagnosis is based on histological examination of upper and lower esophageal biopsies after initial treatment with PPIs.

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19
Q

What are some treatments for EE?

A
  • Remove allergen from diet
  • Topical corticosteroids
  • leukotriene antagonists
  • esophageal dilation
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20
Q

What are some motility disorders that can affect the esophagus?

A
  • Cricopharyngeal disorder,
  • diffuse esophageal spasm,
  • hypo/hypercontractile esophagus (also known as “nutcracker”)
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21
Q

What are some symptoms and diagnostic methods for esophageal motility disorders?

A
  • Symptoms can include dysphagia and chest pain,
  • diagnostic methods can include radiography and manometry.
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22
Q

What is achalasia?

A

Achalasia is a condition where there is an inability of the LES to relax, leading to dysphagia, chest pain, passive regurgitation of undigested food, and aspiration.

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23
Q

What are some treatment options for achalasia?

A
  • ISDN to decrease LES pressure,
  • nifedipine to relax the LES,
  • botulinum toxin to inhibit Ach release,
  • dilation
  • Myotomy
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24
Q

What are the common infective diseases of the esophagus?

A
  • Candidiasis,
  • viral infections (HSV, CMV, VZV),
  • bacterial infections (caused by bacteria of physiological flora, Mycobacterium, syphilis, diphteria, Nocardia),
  • parasitic infections (Chagas disease).
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25
Q

What are the symptoms of esophagitis?

A
  • Asymptomatic,
  • odynophagia, dysphagia,
  • nausea/vomiting,
  • haematemesis.
26
Q

What are the complications of esophagitis?

A
  • Stenosis,
  • bleeding,
  • perforation.
27
Q

What is the treatment for candidiasis esophagitis?

A

Oral or intravenous imidazol or amphotericin B.

28
Q

What is the treatment for viral esophagitis?

A

Antiviral therapy such as acyclovir, gancyclovir, or foscarnet

29
Q

What is Boerhaave syndrome?

A

A rare but life-threatening condition that occurs when there is a tear in the esophagus, usually caused by forceful vomiting, caustic ingestion, or iatrogenic injury.

30
Q

What are the symptoms of Boerhaave syndrome?

A
  • Chest pain
  • odynophagia,
  • dyspnea,
  • cyanosis,
  • subcutaneous emphysema,
  • mediastinal crepitation,
  • shock.
31
Q

What is the treatment for Boerhaave syndrome?

A

Conservative treatment such as carentia, intravenous fluids, and antibiotics, or surgery.

32
Q

What is Mallory-Weiss syndrome?

A

It is a consequence of retching or forced vomiting that causes a tear of the mucosa at the esophagogastric transition

33
Q

What are the different types of functional diseases that can affect the stomach?

A
  • Globus pharyngeus,
  • rumination,
  • functional heartburn,
  • functional chest pain,
  • functional dysphagia.
34
Q

What are the ROME criteria used for?

A

They are used to diagnose functional diseases that affect the gastrointestinal tract.

35
Q

What are the different etiologies of gastritis?

A

Infection, autoimmune, and systemic diseases.

36
Q

What is the most common cause of acute gastritis?

A

H. Pylori

37
Q

What are the different types of chronic gastritis?

A
  • Autoimmune atrophic gastritis -type A
  • H. Pylori gastritis - type B
38
Q

What is are the symptoms of acute gastritis?

A

Asymptomatic or with symptoms such as epigastric pain, nausea, vomiting, and fever.

39
Q

What are the symptoms of chronic gastritis?

A

Asymptomatic.

40
Q

What is the gold standard for diagnosing Helicobacter pylori infection?

A

Histology (with a sensitivity of 90-95% and specificity of 95-98%)

41
Q

What is the purpose of the urease test for diagnosing Helicobacter pylori infection?

A

It is a quick and simple test used to detect the presence of urease enzyme produced by H.Pylori

42
Q

What are less invasive methods for diagnosing H.Pylori infection?

A
  • IgA
  • PCR of stool, gingiva, gastric juice
43
Q

What is the purpose of the UBT test for diagnosing Helicobacter pylori infection?

A

It is used to monitor the success of eradication of H.Pylori

44
Q

HP eradication method 1

A

PPI+ bismuth subsalicylate + metronidazole + tetracycline

45
Q

HP eradication method 2

A

PPI+ clarithromycin + amoxicillin or metronidazole

46
Q

What is gastropathy?

A

It refers to changes in the gastric mucosa without inflammation

47
Q

What are the types of gastropathy?

A
  • Haemorrhagic
  • Vascular
  • Hypertrophic (thickening of folds)
48
Q

What is the difference in prevalence between duodenal and gastric ulcers?

A

Duodenal ulcers are more common than gastric ulcers, with a male to female ratio of 3.5:1, while gastric ulcers have a 1:1 ratio and are more common in the elderly.

49
Q

What are some factors that contribute to the development of ulcers?

A
  • Gastric acid hypersecretion,
  • nervous system dysfunction
  • Genetic factors
  • Environmental factors
  • H pylori
50
Q

What are the symptoms of ulcers?

A

Abdominal pain, nausea, and vomiting are common symptoms of ulcers.

51
Q

What are the common symptoms of gastroparesis?

A

Abdominal pain, nausea, vomiting, early satiety, epigastric pain, discomfort, and loss of weight.

52
Q

What is the treatment for peptic ulcer disease?

A
  • Proton pump inhibitors
  • Eradication of H.Pylori
  • H2R antagonists
  • Sucralfat (protects)
53
Q

What is gastroparesis?

A

Altered gastric emptying lasting more than 3 months without mechanical obstruction.

54
Q

What are the causes of gastroparesis?

A
  • Idiopathic,
  • diabetes mellitus
  • postoperative complications
55
Q

What is the treatment for gastroparesis?

A
  • Diet,
  • medication (prokinetics, erythromycin, metoclopramide, antiemetic drugs),
  • electric stimulation of the stomach,
  • surgical interventions
56
Q

What are some epidemiological characteristics of intestinal gastric cancer?

A

It is more common in males, older age groups, and high-risk areas, and is likely linked to environmental factors.

57
Q

What are some epidemiological characteristics of diffuse / infiltrative gastric cancer?

A
  • It is equally frequent in both sexes, more common in younger age groups, and has a worse prognosis.
58
Q

What are the symptoms of gastric cancer?

A
  • weight loss,
  • abdominal pain (epigastric, vague, mild in early stages, more severe and constant as the disease progresses),
  • dysphagia (pseudoachalasia),
  • nausea,
  • early satiety,
  • occult GI bleeding.
59
Q

What are the metastatic sites of gastric cancer?

A
  • liver
  • peritoneum,
  • lymph nodes (ovary, CNS, bones)
60
Q

What are the treatment options for gastric cancer?

A

Treatment options for gastric cancer include surgery, chemotherapy, and radiation therapy.

1. Internal Medicine I (20 decks)

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