Al-Mehdi: Motility Disorders Flashcards

1
Q

difficulty swallowing food or liquid (fx impaired)

A

dysphagia

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2
Q

painful swallowing due to mucosal ulceration

A

odynophagia

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3
Q

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

A

Aphagia

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4
Q

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

A

UES

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5
Q

what autonomics constrict the sphincters

A

sympathetics

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6
Q

what autonomics relax the sphincters

A

parasympathetics

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7
Q

proximal esophagus innervated by _____ to regulate peristalsis

A

CN X

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8
Q

distal esophagus innervated by _____ to regulate peristalsis

A

myenteric plexus neurons in ENS

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9
Q

excitatory neurons in ENS (myenteric plexus)

A

Ach, substance P

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10
Q

inhibitory neurons in ENS (myenteric plexus)

A

VIP, NO

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11
Q

liquid + solid dysphagia

A

motility disorder (motor)

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12
Q

only solid food dysphagia

A

structural dysphagia

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13
Q

hoarseness 1st then dysphagia

A

vocal cord tumor

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14
Q

dysphagia 1st then hoarseness

A

recurrent laryngeal n. damage

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15
Q

episodic dysphagia to solids unchanged over years

A

Schatzki ring
eosinophilic esophagitis

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16
Q

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

A

Achalasia

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17
Q

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

A

Achalasia

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18
Q

to dx Achalasia

A

esophageal manometry
barium radiography

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19
Q

drug contraindicated in Achalasia

A

anti-D2 metoclopramide

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20
Q

_____causes Chagas disease (prevalent in south america)

A

Trypanosoma cruzi

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21
Q

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

A

Chagas disease

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22
Q

most common cause of death in Chagas disease

A

Chronic cardiomyopathy

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23
Q

organs most affected in Chagas disease

A

esophagus, duodenum, colon

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24
Q

Rx of Achalasia

A

surgery

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25
Q

marker for ICC (pacemaker of stomach)

A

KIT

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26
Q

_____mutation leads to hypertrophic pyloric stenosis

A

KIT

27
Q

2 things that can happen from pt with gastroparesis vomiting

A

mallory-weiss tear or boerhaave syndrome

28
Q

PE to detect gastroparesis

A

succussion splash

29
Q

D2 blockers used to treat gastroparesis

A

Metoclopramide
Domperidone

30
Q

motilin receptor agonist used to treat gastroparesis

A

Erythromycin

31
Q

somatostatin analogue used to treat gastroparesis that stimulates MMC activity

A

Octreotide

32
Q

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

A

ileus

32
Q
A
33
Q

THE drug to use for ileus

A

anti-D2 METOCLOPRAMIDE

34
Q
A

D2 blocker METOCLOPRAMIDE

35
Q

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

A

Metoclopramide

36
Q

CI in Achalasia

A

Metoclopramide

37
Q

main way to treat constipation

A

12-30g fiber

39
Q

treatment of constipation if fiber doesnt help

A

PEG (osmotic laxative)

40
Q

treatment of constipation if PEG doesnt work

A

Bisacodyl (stimulant)

41
Q

bulk forming laxatives for chronic constipation

A

PSYLLIUM

42
Q

salt osmotic laxative

A

MgSO4 (PO)

43
Q

non-salt osmotic laxatives

A

lactulose
PEG
Sorbitol

44
Q

Cl- channel activator used for IBS-C

A

LUBIPROSTONE

45
Q

u blockers used for constipation

A

Methylnaltrexone
naloxone

46
Q

CLONIDINE
ALOSETRON
LOPERAMIDE
DIPHENOXYLATE

A

drugs to treat diarrhea

47
Q

opioids used to treat diarrhea

A

diphenoxylate
loperamide

48
Q

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

A

bismuth

49
Q

Rx for diarrhea in carcinoid syndrome (somatostatin analog)

A

OCTREOTIDE

50
Q

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

A

OCTREOTIDE

51
Q

2 exchangers that mediate fluid influx in mucosal cells of gut

A

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

52
Q

____inactivates NHE (Na/H exchanger)

A

Cholera

53
Q

Rx cholera induced dehydration

A

Na+ and glucose (SGLT-1)

54
Q

3 forms of IBS

A

IBS-C
IBS-D
IBS-A

55
Q

antidepressant used to treat IBS

A

Amitryptiline

56
Q

anti-M drug used to treat IBS pain

A

Dicyclomine

57
Q

drug to treat IBS-D

A

Alosetron (5-HT3 blocker)

58
Q

drug to treat IBS-C

A

LUBIPROSTONE (EP4 agonist)

59
Q

what 2 things can increase risk for C. diff

A

antibiotics and PPIs

60
Q

2 Ab’s to treat C. diff

A

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

61
Q

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

A

Hirschsprung disease

62
Q

difficulty swallowing food for 2 weeks; child; peanut allergy

A

Eosinophilic Esophagitis

63
Q

Rx hiccups (hiccough)

A

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