[DSA Week 1] N/V Epigastric abdominal pain, Dyspepsia, Heartburn, Hematemesis (McGowan) Flashcards

1
Q

Define:

Retching

Regurgitation

Rumination

A

Retching = Labored rhythmic respiratory activity that precedes emesis

Regurgitation = Gentle expulsion of gastric contents in the absence of nausea and abdominal diaphragmatic muscular contraction

Rumination = Regurgitation, rechewing and reswallowing of food from the stomach

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2
Q

What is gastroparesis?

A

Slowing of the gastric emptying

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3
Q

What are the symptoms associated with gastroparesis?

A

Intermittent waxing and waning

Early satiety

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4
Q

Define:

Paralytic ileus

A

Obstruction of the intestine due to paralysis of the intestinal muscles

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5
Q

What are the common findings on physical exam and in the hx of an acute paralytic ileus pt?

A

N/V, distention

Decreased or absent bowel sounds

Commonly seen in hospitalized pts

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6
Q

Define:

Dyspepsia

A

Indigestion

“A condition characterized by upper abdominal symptoms that may include pain/discomfort, bloating, feeling of fullness w/ very little food, heartburn, loss of appetite”

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7
Q

Define:

Pyrosis

A

Heartburn

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8
Q

What are the two primary causes of gastritis?

A

H. pylori

Autoimmune

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9
Q

State where H. pylori vs Autoimmune gastritis are located

A

H. pylori = Antrum

Autoimmune = Body

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10
Q

Antral type chronic gastritis is HIGHLY associated with?

A

MALT lymphoma

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11
Q

State which type of ulcer is:

Relieved by food

and

Food averse

A

Relieved by food = Duodenal ulcer

Food averse = Gastric ulcer

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12
Q

Which type of ulcer is worse 1-3 hours AFTER meals?

A

Duodenal ulcer

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13
Q

Which type of ulcer is worse by food within 30 min of eating?

A

Gastric ulcer

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14
Q

When can perforated viscus occur?

A

When any hallow organ (esophagus, stomach, intestine, uterus, bladder) perforates

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15
Q

What are the terms for air trapped:

Below the diaphragm

Above the diaphragm

A

Below the diaphragm = Pneumoperitoneum

Above the diaphragm = Pneumomediastinum

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16
Q

What is a curling ulcer?

A

Peptic ulcer in a patient with extensive burns

17
Q

What is a cushing ulcer?

A

Peptic ulcer occuring from severe head (brain) inury or with other lesions of the CNS

18
Q

H. pylori is

Gram (+)/(-)?

A

Gram negative

19
Q

Following a completion of H.Pylori eradication thearpy, what do you need to do?

A

Need to confirm successful eradication

Urea breath test

Fecal antigen test

Endoscopy w/ biopsy

20
Q

What is the unique histology associated w/ gastric adenocarcinoma?

A

Signet-ring cells

21
Q

What are the two forms of cholelithiasis? (gallstones)

A

Cholesterol = Cholesterol monohydrate

Pigment stones = Calcium bilirubinate

22
Q

What is the best diagnostic test for cholelithiasis?

A

Ultrasound

23
Q

Where are stones typically impacted with calculous acute cholecystitis?

A

Cystic duct

24
Q

What is the etiology of acute pancreatitis?

A

Biliary tract gallstones greater than 5mm

Heavy alcohol use

25
Q

What are two major PE findings that are indicative of pancreatitis?

A

Cullen

or

Grey turner sign

26
Q

What are the criteria used to assess the severity of pancreatitis?

A

Ranson criteria

APACHE II

27
Q

What is key to the management of acute pancreatitis?

A

LOTS of fluid resuscitation

28
Q

Define:

Hematemesis

Melena

Hematochezia

A

Hematemesis = vomit bright red blood or “coffee grounds”

Melena = develops after little as 50-100mL blood loss in most cases

Hematochezia = bright red blood per rectum

29
Q

What is your initial step when managing an acute upper gastrointestinal bleed?

A

Assessment of the hemodynamic status

30
Q

How do you stabilize an acute upper gastrointestinal bleed?

A

Two large bore “18-gauge or larger” IV lines

31
Q

1 unit of PRBC’s raises the HBG by ????

A

1 unit of PRBC’s raises the HBG by 1g/dl

32
Q

What is the treatment for esophageal varices?

A

Emergent upper endoscopy w/ variceal banding

33
Q

Describe the hematemesis of hemorrhagic gastropathy/gastritis

A

Coffee ground emesis

34
Q

Where is zollinger ellison syndrome frequently found?

A

Duodenum

35
Q

What is the confirmatory test for ZE?

A

Serum (fasting) gastrin

>1000ng/L

36
Q

What is the treatment for ZE?

A

PPI

37
Q

What is menetrier disease characterized by?

A

Giant thickened gastric folds involving predominantly the body of the stomach

Chronic protein loss

38
Q

What is the etiology of mallory weiss tear?

A

Superficial/non-transmural tear

39
Q
A