Carmen - Itis

Question 1

Factors leading to GERD

Answer 1

• Lower LES resting pressure
• Hiatal hernia (stomach pinching up into esophagus)
• impaired esophageal clearance
• impaired distal esophageal mucosal defense
• delayed gastric emptying

Question 2

Barrett’s esophagus

Answer 2

Replacement of normal squamous epithelium with specialized columnar epithelium. The longer you have this acid reflux without treatment, you can actually have genetic changes.

Question 3

Murphys sign

Answer 3

The patients breath is sharply curtailed as your hand on the RUQ encounters the enflamed gallbladder

Question 4

Biliary colic

Answer 4

RUQ Pain lasting for less. Than 4 hours. Stone lodged in the cystic duct. But then the stone falls in the fundus and the pain is relieved. There is radiation of pain.

Question 5

Acute cholecystitis

Answer 5

RUQ pain lasting more than 4 hours. Could radiate. Nausea/vomiting, Positive Murhys signs. Elevated WBC and ALT/AST
– chemical irritation of gallbladder will cause damage to the mucosa of the gallbladder due to bile salts. Prostaglandins will be released and an inflammatory response will occur. This will cause a gallstone formation.

Question 6

GERD

Answer 6

Acid reflux, Dysphagia, odynophagia, bronchus past, chronic couch, laryngitis, chest pain, glob us sensation, nausea, excessive salivation