Al-Mehdi: Motility Disorders

Question 1

difficulty swallowing food or liquid (fx impaired)

Answer 1

dysphagia

Question 2

painful swallowing due to mucosal ulceration

Answer 2

odynophagia

Question 3

inability to swallow due to complete esophageal obstruction by food bolus or foreign body

Answer 3

Aphagia

Question 4

CN X, CN V, CN VII, and CNXII innervate what

Answer 4

UES

Question 5

what autonomics constrict the sphincters

Answer 5

sympathetics

Question 6

what autonomics relax the sphincters

Answer 6

parasympathetics

Question 7

proximal esophagus innervated by _____ to regulate peristalsis

Answer 7

CN X

Question 8

distal esophagus innervated by _____ to regulate peristalsis

Answer 8

myenteric plexus neurons in ENS

Question 9

excitatory neurons in ENS (myenteric plexus)

Answer 9

Ach, substance P

Question 10

inhibitory neurons in ENS (myenteric plexus)

Answer 10

VIP, NO

Question 11

liquid + solid dysphagia

Answer 11

motility disorder (motor)

Question 12

only solid food dysphagia

Answer 12

structural dysphagia

Question 13

hoarseness 1st then dysphagia

Answer 13

vocal cord tumor

Question 14

dysphagia 1st then hoarseness

Answer 14

recurrent laryngeal n. damage

Question 15

episodic dysphagia to solids unchanged over years

Answer 15

Schatzki ring
eosinophilic esophagitis

Question 16

pathogenesis of this includes:
autoimmine myenteric plexopathy——loss of ganglion cells to loss of esophageal peristalsis

Answer 16

Achalasia

Question 17

another cause of this includes loss of NO——insufficient relaxation of LES

Answer 17

Achalasia

Question 18

to dx Achalasia

Answer 18

esophageal manometry
barium radiography

Question 19

drug contraindicated in Achalasia

Answer 19

anti-D2 metoclopramide

Question 20

_____causes Chagas disease (prevalent in south america)

Answer 20

Trypanosoma cruzi

Question 21

chronic phase of this disease after many years of infection has destruction of autonomic ganglion cells

Answer 21

Chagas disease

Question 22

most common cause of death in Chagas disease

Answer 22

Chronic cardiomyopathy

Question 23

organs most affected in Chagas disease

Answer 23

esophagus, duodenum, colon

Question 24

Rx of Achalasia

Answer 24

surgery

Question 25

marker for ICC (pacemaker of stomach)

Answer 25

KIT

Question 26

_____mutation leads to hypertrophic pyloric stenosis

Answer 26

KIT

Question 27

2 things that can happen from pt with gastroparesis vomiting

Answer 27

mallory-weiss tear or boerhaave syndrome

Question 28

PE to detect gastroparesis

Answer 28

succussion splash

Question 29

D2 blockers used to treat gastroparesis

Answer 29

Metoclopramide Domperidone

Question 30

motilin receptor agonist used to treat gastroparesis

Answer 30

Erythromycin

Question 31

somatostatin analogue used to treat gastroparesis that stimulates MMC activity

Answer 31

Octreotide

Question 32

occurs when the muscles that move food through the intestines are temporarily paralyzed, which can lead to constipation, bloating, and gas

Answer 32

ileus

Question 33

THE drug to use for ileus

Answer 33

anti-D2 METOCLOPRAMIDE

Question 34

Answer 34

D2 blocker METOCLOPRAMIDE

Question 35

drug used for post op ileus, gastroparesis, and GERD; N/V

Answer 35

Metoclopramide

Question 36

CI in Achalasia

Answer 36

Metoclopramide

Question 37

main way to treat constipation

Answer 37

12-30g fiber

Question 39

treatment of constipation if fiber doesnt help

Answer 39

PEG (osmotic laxative)

Question 40

treatment of constipation if PEG doesnt work

Answer 40

Bisacodyl (stimulant)

Question 41

bulk forming laxatives for chronic constipation

Answer 41

PSYLLIUM

Question 42

salt osmotic laxative

Answer 42

MgSO4 (PO)

Question 43

non-salt osmotic laxatives

Answer 43

lactulose PEG Sorbitol

Question 44

Cl- channel activator used for IBS-C

Answer 44

LUBIPROSTONE

Question 45

u blockers used for constipation

Answer 45

Methylnaltrexone naloxone

Question 46

CLONIDINE ALOSETRON LOPERAMIDE DIPHENOXYLATE

Answer 46

drugs to treat diarrhea

Question 47

opioids used to treat diarrhea

Answer 47

diphenoxylate loperamide

Question 48

this drug decreases liquid content of stool and is an anti-diarrheal

Answer 48

bismuth

Question 49

Rx for diarrhea in carcinoid syndrome (somatostatin analog)

Answer 49

OCTREOTIDE

Question 50

this drug that confuses me stimulates MMC to help with gastroparesis and inhibits intestinal secretion to help with diarrhea

Answer 50

OCTREOTIDE

Question 51

2 exchangers that mediate fluid influx in mucosal cells of gut

Answer 51

Na/H (NHE) Na/glucose (SGLT-1) (water is brought in when these are functioning)

Question 52

____inactivates NHE (Na/H exchanger)

Answer 52

Cholera

Question 53

Rx cholera induced dehydration

Answer 53

Na+ and glucose (SGLT-1)

Question 54

3 forms of IBS

Answer 54

IBS-C IBS-D IBS-A

Question 55

antidepressant used to treat IBS

Answer 55

Amitryptiline

Question 56

anti-M drug used to treat IBS pain

Answer 56

Dicyclomine

Question 57

drug to treat IBS-D

Answer 57

Alosetron (5-HT3 blocker)

Question 58

drug to treat IBS-C

Answer 58

LUBIPROSTONE (EP4 agonist)

Question 59

what 2 things can increase risk for C. diff

Answer 59

antibiotics and PPIs

Question 60

2 Ab's to treat C. diff

Answer 60

Vancomycin (cell wall synthesis inhibitor) Fidaxomicin (50S binder)

Question 61

narrowing of distal colon due to non-development of myenteric neurons and ICC (hypomotility disorder) (RET mutation); diagnosed at birth

Answer 61

Hirschsprung disease

Question 62

difficulty swallowing food for 2 weeks; child; peanut allergy

Answer 62

Eosinophilic Esophagitis

Question 63

Rx hiccups (hiccough)

Answer 63

Baclofen (GABA agonist that will stop diaphragmatic spasms) and hypoventilation can work too (distracts diaphragm and phrenic n.)