Disturbances in Ingestion

Question 1

Relaxation, dysfunction and incompetence of Lower Esophageal Spincter

Answer 1

GERD

Question 2

Laparoscopic surgical intervention to wrap around gastric fundus to the lower area of the esophagus

Answer 2

Nissen and Toupet Fundoplication

Question 3

Examples of Proton pump inhibitors and their MOA

Answer 3

Omeprazole, Lanzoprazole, rabeprazole

To treat hyperacidity to decrease gastric acid .

Question 4

AVOID position for patients with GERD

Answer 4

Supine/Lie

2-3 after meal

Question 5

How many inches is HOB elevated in patients with GERD

Answer 5

4-8

Question 6

Adhere to: increase OFI, high protein, low-fat, non-spicy and non irritating foods. What is this diet indicated for

Answer 6

GERD

Question 7

Diagnostic test for GERD (give 2)

Answer 7

esophageal pH monitoring

Upper GI endoscopy (barium swallow)

Question 8

identify the ff clinical manifestations in patients with GERD: 2B, 2R, 2D in

Answer 8

Bloating, Belching, Reflux, Regurgitation, Dyspepsia,Dysphagia

Question 9

12H-36H ambulatory to evaluate the degree of acid reflux

Answer 9

Esophageal pH monitoring

Question 10

Most common manifestation of GERD

Answer 10

heartburn

Question 11

Give the causative factors of GERD

Answer 11

age, increased intra-abdominal pressure, lifestyle, stomach problems

Question 12

Gaviscon, Aluminum,Magnesium Hydroxide are examples of

Answer 12

Antacids

Question 13

Antihistamine drugs give 2

Answer 13

Ranitidine, Cemetidine

Question 14

stricture or ulceration of esophagus

Answer 14

Esophagitis

Question 15

Explain barret’s esophagus

Answer 15

chronic irritation and long-standing untreated GERD metaplasia, reversible change in cell type (flat to columnar; pink to red) in cell lining of LES, precancerous lesion

Question 16

Cancer common in bulimic patients

Answer 16

esophageal cancer

Question 17

Give examples of prokinetic drugs

Answer 17

Baclofen, Metoclopramide, Cisapride

Question 18

anti reflux barrier

Answer 18

LES

Question 19

correct twisting/torsion of stomach, prevent restriction of blood flow, reduce hernia, increase LES pressure.

Answer 19

Gastropexy

Question 20

Complications of hiatal hernia give 3

Answer 20

GERD, esophagitis , ulceration, bleeding, hemorrhage

Stenosis, obstruction, regurgitation, strangulation, tracheal aspiration

Question 21

Protrusion/enlargement/moving/pushing upward of stomach and gastric mucosa in the lower thoracic cavity or esophageal hiatus

Answer 21

Hiatal hernia

Question 22

most common hernia 90%

Answer 22

esophageal hernia

Question 23

Risk factors for hernia

Answer 23

increased intra-abdominal pressure, structural changes, lifestyle, physical exertion

Question 24

Clinical manifestations: HERNIA

Answer 24

Heartburn
Epigastric pain
Regurgitation
Nocturnal heartburn
Indigestion
After-eat Dysphagia, Belching, fullness

Question 25

Diagnostic tests of hiatal hernia

Answer 25

Barium Swallow-

Question 26

Part of stomach is directly pushed upward or rolled upward through the diaphragm

Answer 26

Diaphragmatic hernia

Question 27

Surgical Management for hernia

Answer 27

Herniotomy (sac excision) Herniorrhaphy (defect closure) Anti-reflux procedure

Question 28

cuts/separate esophageal muscle fibers to relieve stricture, allow food to pass

Answer 28

Esophagomyotomy (Heller myotomy)

Question 29

Pharmacologic management for achalasia

Answer 29

Botulinum toxin | Calcium Channel blocker, Nitrates

Question 30

Patient with achalasia should sleep with head?

Answer 30

elevated

Question 31

ideal consistency of diet for patients with achalasia

Answer 31

liquid, soft diet

Question 32

Confirmatory test for achalasia to check for esophageal pressure

Answer 32

Manometry

Question 33

endoscopic procedure use balloon to stretch the narrowed esophagus (watch out for perforation- fever, abdominal tenderness), very painful (sedation)

Answer 33

Pneumatic dilatation

Question 34

food sticking in lower esophagus

Answer 34

sensation globus

Question 35

2 most common symptom of achalasia

Answer 35

halitosis, sensation globus

Question 36

Patients with achalasia are prone to

Answer 36

aspiration

Question 37

Risk factor of achalasia

Answer 37

idiopathic, age

Question 38

Absent or ineffective peristalsis of the distal esophagus; | Esophagus failed to relax, narrows, strictures, dilates, incomplete relax, obstructs, decrease emptying

Answer 38

Achalasia

Question 39

dilated tortuous esophagus (food and fluid) or megaesophagus (enlargement of lower esophagus)

Answer 39

Advanced stage of achalasia

Question 40

Nursing management for achalasia

Answer 40

teach px to eat slowly