Disorders of the Stomach Flashcards
A patient presents with left supraclavicular lymphadenopathy and an umbilical lymph node. What do you suspect?
Gastric cancer or abdominal cancer (Left supraclavicular lymphadenopathy aka Virchow’s node)
Refers to a palpable nodule bulging into the umbilicus as a result of metastasis of a malignant cancer in the pelvis or abdomen.
Sister Mary Joseph’s node (Umbilical)
Gastrin secreting tumor
Zollinger-Ellison syndrome
H. pylori Triple therapy
Clarithromycin + Amoxicillin + PPI (CAP)
A patient describes abdominal discomfort that improves with meals and gets worse an hour or so later. What do you suspect?
Duodenal ulcer
Projectile vomiting occurs shortly after feeding in an infant < 3 mo old, palpable “olive-like” mass
Pyloric stenosis
The most common cause of GERD
H. pylori infection
What is the gold standard for diagnosis of GERD?
pH monitoring with a intra-esophageal electrode
What surgical procedure is indicated for refractory GERD?
Nissen Fundoplication
What lifestyle change, in addition to smoking cessation, not eating before bedtime, and proper food choices, has the largest effect on GERD symptoms?
weight loss
A patient describes abdominal discomfort that is worse with meals and gets better an hour or so later after eating? What do you suspect?
gastric ulcer
Treatment for gastritis?
Proton pump inhibitor
Treat H. Pylori if present
Remove irritants
What GI cancer is acanthosis nigricans associated with?
stomach cancer
What medications may result in a false-negative urea breath test in a patient with H. pylori?
Proton pump inhibitors
H2 blockers
Bismuth
Antibiotics
What symptoms of GERD may present as a pulmonary disease process?
hoarseness
cough
wheeze
Syndrome with elevated gastrin levels?
Zollinger Ellison
What type of GI ulcer has pain relief with food?
duodenal ulcer
In addition to peptic stricture what is another complication of chronic GERD?
Barrett’s esophagus
What disorder can cause heartburn hoarseness and atypical chest pain?
GERD
A baby presents with vomiting and abdominal exam reveals an olive like mass in the RUQ. What do you suspect?
pyloric stenosis
What exam finding would be possibly seen on radiologic work up for child with pyloric stenosis?
- US for identification shows a Double-track
- Follow up barium studies show String & Shoulder sign
Use of what antibiotic is associated with increased risk of pyloric stenosis?
Clarithromycin (Note: erythromycin is also associated)
What type of hernia can worsen GERD symptoms?
hiatal hernia
What MEN I tumor causes excess gastric acid production?
Zollinger Ellison
A patient describes abdominal discomfort that is worse with meals and gets better an hour or so later after eating? What do you suspect?
gastric ulcer
A patient describes abdominal discomfort that improves with meals and gets worse an hour or so later. What do you suspect?
duodenal ulcer
