Clinicopathologic Considerations of Dyspepsia Flashcards

1
Q

What demographic is affected by infectious esophagitis?

A

Immune compromised individuals

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2
Q

What is dyspepsia?

A

Indigestion

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3
Q

What is dysphagia?

A

Difficulty swallowing

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4
Q

What is odynophagia?

A

Painful swallowing

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5
Q

What does postprandial mean?

A

After eating

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6
Q

What is GERD?

A

Gastroesophageal reflux disease

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7
Q

5 causes of esophagitis?

A
  1. ) Chemical/physical
  2. ) Infections
  3. ) Reflux (GERD)
  4. ) GVHD (Graft vs host disease)
  5. ) Eosinophilic esophagitis (EE)
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8
Q

What can cause infectious esophagitis?

A

HSV
CMV
Candidiasis

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9
Q

What causes GERD?

A

Incompetent LES

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10
Q

What occurs in GERD?

A

Refluxed gastric acid overwhelms mucous defenses: Mucous, HCO3-

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11
Q

Treatment of GERD?

A

First elimination of risks

Proton pump inhibitors

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12
Q

What is eosinophilic esophagitis?

A

Allergic reaction causing esophagus inflammation

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13
Q

Where does GERD affect?

A

Only distal 1/3 of the esophagus

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14
Q

Where does eosinophilic esophagitis affect?

A

Throughout the entire esophagus

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15
Q

What are symptoms of EE?

A

Abundance of eosinophils in the throat and atopic (dermatitis)

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16
Q

What is the treatment for EE?

A

Dietary change (PPI’s don’t work)

17
Q

What occurs in Barrett’s esophagus?

A

Squamous cells in distal 1/3 of esophagus changing to small intestinal epithelium with goblet cells; metaplastic (reversible)

18
Q

What does Barrett’s esophagus put the patient at risk for?

A

Adenocarcinoma

19
Q

Where does squamous cell carcinoma occur?

A

Proximal and distal end of esophagus

20
Q

Where does adenocarcinoma occur?

A

Near the GE junction

21
Q

Difference between erosion and ulcer:

A

Erosion: loss of epithelium
Ulcer: deep extension of erosion (submucosa)

22
Q

What causes stress ulcers?

A

Severe trauma, shock, sepsis

23
Q

What are Curling’s ulcers?

A

Proximal duodenum, severe trauma or burns

24
Q

What are Cushing’s ulcers?

A

Gastric, duodenal, esophageal due to intracranial processes and vagal stimulation

25
What does H. pylori cause?
Decreased acid Gastrin levels increased Antral (pylorus) location and may progress to multifocal atrophic gastritis
26
What are virulence factors from H. pylori?
Flagella Urease: ammonia generated from urea increasing tissue pH Adhesins Toxins (CagA)
27
What are the types of chronic gastritis?
Autoimmune | H. pylori
28
What are the key clinical features of autoimmune gastritis?
``` Abs against parietal cells Pernicious anemia (parietal cells cannot produce IF) Body and fundus affected not the antrum Achlorhydria Hypergastrinemia ```