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GI - 2 > Dyspepsia and Heartburn > Flashcards

Dyspepsia and Heartburn Flashcards

1
Q

4 DDX considerations for Dyspepsia and Heartburn?

A

GERD
Acute/Chronic Gastritis
PUD

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2
Q

4 DDX considerations for Dyspepsia and Heartburn?

A

GERD
Acute/Chronic Gastritis
PUD

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3
Q

Dyspepsia

A

Indigestion

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4
Q

With GERD, what allows the stomach acid to reflux?

A

LES

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5
Q

List some risk factors for GERD

A

Obesity/pregnancy
Alcohol, caffeine
Smoking
Fat-rich diet

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6
Q

Important history items with GERD

A

Heartburn after meals or upon reclining

Bad taste in the mouth and epigastric pain

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7
Q

What is an atypical symptom with GERD?

A

Chronic cough

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8
Q

Alarm features of GERD

A

Constant/severe pain
Dysphagia/odynophagia
Weight loss, vomiting, blood in stool

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9
Q

Alarm features of GERD

A

Constant/severe pain
Dysphagia/odynophagia
Weight loss, vomiting, blood in stool

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10
Q

Alarm features of GERD need further evaluation. What other presentation of GERD needs further evaluation?

A

> 60 years old with persistent symptoms despite treatment

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11
Q

GERD diagnosis is ____

A

Clinical

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12
Q

GERD treatment is ____ if no alarm features

A

Empiric

- Acid suppression and lifestyle modifications

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13
Q

Complications with GERD?

A

Barrett’s Esophagus that can transition into an Esophageal Adenocarcinoma

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14
Q

Gastritis

A

Stomach inflammation

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15
Q

List some etiologies of Acute Gastritis

A

Alcohol, medication, H. Pylori, stress, allergies

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16
Q

Symptoms of Acute Gastritis?

A

Dyspepsia and Abdominal pain

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17
Q

2 types of Chronic Gastritis

A

Type A

Type B

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18
Q

What causes Type A Chronic Gastritis?

A

Autoimmune - antibodies to parietal cells or intrinsic factor

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19
Q

Where does Type A Chronic Gastritis occur?

A

Fundus of stomach

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20
Q

Type A Chronic Gastritis has loss of?

A

Rugal folds

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21
Q

Diagnostic measures for Type A Chronic Gastritis

A

Antibodies to Parietal cells/Intrinsic factor
CBC with B12 levels
EGD with biopsy

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22
Q

Treatment for Type A Chronic Gastritis

A

Parenteral B12 supplementation

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23
Q

Possible complications of Type A Chronic Gastritis?

A

Pernicious (megaloblastic) anemia
INCREASED risk of Gastric Adenocarcinoma
Carcinoid tumors

24
Q

What causes Type B Chronic Gastritis?

A

Helicobacter Pylori

25
Where does Type B Chronic Gastritis occur?
Antrum of stomach
26
Diagnostic measures of Type B Chronic Gastritis
Detection of H. Pylori; EGD with biopsy
27
Treatment for Type B Chronic Gastritis
Eradication of H. Pylori will treat PUD and MALToma
28
Possible complications for Type B Chronic Gastritis?
MALToma Increased risk for Gastric Adenocarcinoma Decreased B12
29
Describe H. Pylori
Gram (-) spiral rod with flagella that produces urease
30
What does H. Pylori produce?
Urease
31
Where does H. Pylori colonize?
Gastric antrum mucosa
32
90% of patients with H. Pylori are?
ASYMPTOMATIC
33
What toxin will be (+) with H. Pylori that increases your risk of ulcer and gastric cancer?
Cag - A positive toxin
34
How do you treat MALToma?
Eradicate H. Pylori
35
4 tests for detection of H. Pylori?
Fecal antigen test Urea breath test IgA antibody test EGD with biopsy
36
Etiology of PUD?
H. Pylori | NSAIDs
37
What makes PUD worse?
Coffee, alcohol, stress
38
With PUD, you should exclude?
GU malignancy
39
2 types of ulcers with PUD?
GU - gastric ulcer | DU - duodenal bulb ulcer
40
Etiology of GUs?
H. Pylori, smoking, corticosteroids, NSAIDs
41
Symptoms of GUs?
Asymptomatic | BURNING epigastric pain within 30 minutes of eating and symptoms worsen ==> food aversion
42
BURNING epigastric pain within 30 minutes of eating is seen with?
GU
43
Food aversion due to pain is seen with?
GU
44
GUs can cause food aversion to due to pain, which means the patient may experience weight ___
Loss
45
Etiology of DUs?
Almost always H. Pylori!
46
Symptoms of DUs?
Asymptomatic Gnawing epigastric pain 1-3 hours after eating ** often NOCTURNAL and relieved by food
47
When do symptoms of DUs occur?
Nocturnal
48
What can relieve the symptoms of DUs?
Eating food
49
DUs can cause patients to eat food to relieve the pain, which means the patient may experience weight ___
Gain
50
Perforated Viscus
Free air in mediastinum or under diaphragm
51
Perforated Viscus diagnosis and treatment
Free air in mediastinum or under diaphragm - CT or Plain X-ray - Emergent surgery
52
List some risk factors for Gastric Adenocarcinomas
Smoked fish, meats, pickled veggies | Chronic gastritis, H. pylori, ulcers
53
Unique physical exam findings with Gastric Adenocarcinomas?
Virchow's node Leser-trelat sign Sister Mary Joseph Nodule
54
What cells will be seen with Gastric Adenocarcinomas on EGD?
Signet ring cells
55
What cells will be seen with Gastric Adenocarcinomas on EGD?
Signet ring cells

GI - 2 (61 decks)

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