Clinical- GERD Flashcards
What is the most common cause of non-cardiac chest pain?
reflux
Patients with what respiratory condition must you consider reflux?
Asthma
What is the first test u have to do for GERD?
EGD
What is the first medication you give to treat GERD and rule it out?
a proton pump inhibitor (PPI)
A definitive Dx of GERD is made by seeing what on an EGD?
Esophagitis
White men > 50 y/o with reflux > 5-7 years should be checked for what condition?
Barrett’s (w/dysplasia for adenocarcinomas)
How often should you screen for dysplasia in Barretts if there is no dysplasia on 2 EGD’s in 1 year?
every 3 years
If there is low grade dysplasia on EGD, when should u repeat the EGD?
within 6 months
If there is presence of high grade dysplasia, when should you re-do the EGD to rule out malignancy?
in 3 months
What treatments can u give to a pt if there is a presence of high grade dysplasia?
esophagectomy (surgery) or photodynamic therapy
If you do a EGD to Dx GERD but there is no esophagitis, what other test can you do to Dx reflux?
24-hour intraesophageal pH monitoring
This test is reserved for patients with suspected esophageal motility disorders or preop evaluation of surgical cadidates.
Esophageal manometry
When is the best time to take a PPI?
30-60 minutes BEFORE a meal.
Younger patients who respond well to PPI therapy but want to avoid lifelong treatment can consider what?
antireflux surgery
What is the surgery for severe GERD called?
nissen fundoplication
What is the spontaneous perforation of the esophagus after violent vomiting, and is common after alcohol binge?
Boerhaave’s
What is the most common site of perforation in Boerhaave’s?
left posterior aspect of the distal esophagus
What is increased in the pleural fluid in Boerhaave’s?
amylase
If there are perforations in the cervical area in Boerhaave’s, what are the 2 likely causes?
posterior intubation or zenker’s diverticulum
