4: Dyspepsia And Heartburn

Question 1

Atypical sx of GERD

Answer 1

Asthma, laryngitis, chronic cough**, aspiration pneumonitis, chronic bronchitis, sleep apnea, dental caries, halitosis, hiccups

Question 2

Alarm features in GERD

Answer 2

Unexplained WL, persistent vomiting, constant/severe pain, dysphagia, odynophagia, palpable mass, hematemesis, melena, anemia

Question 3

What to do if pt has alarm features in GERD

Answer 3

Endoscopy for evaluation

Question 4

What causes non-erosive acute gastritis

Answer 4

H pylori

Question 5

2 Complications of both type A and B chronic gastritis

Answer 5

B12 deficiency + increased risk of adenocarcinoma

Question 6

Complications of type A vs type B chronic gastritis

Answer 6

1. Type A: hypergastrinemia,, carcinoid tumors, pernicious anemia
2. Type B: MALT lymphoma

Question 7

What % of H pylori infections are asymptomatic and wont need treatment?

Answer 7

90%

Question 8

Describe the micro of H pylori

Answer 8

Gram negative, curved bacilli with flagella

Question 9

What major enzyme does H pylori create

Answer 9

Urease

Question 10

Toxin that H pylori can be positive for that is associated with increased risk of ulcer and gastric CA

Answer 10

Cag-A toxin

Question 11

How to treat MALToma from H pylori

Answer 11

Treat the H pylori

Question 12

When to confirm successful eradication of H pylori

Answer 12

4 weeks after completion of Abs

Question 13

Krukenberg tumor

Answer 13

Metastatic GI tumor (usually stomach) to the ovary