Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations III GI (Cholley) > Esophagus & stomach > Flashcards

Esophagus & stomach Flashcards

1
Q

What causes esophagitis?

A

Candida

CMV, HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the presentation of esophagitis?

A

Odynophagia or dysphagia**

Fever, lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you dx esophagitis?

A

Endoscopy

Definitive = cytology/culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you treat esophagitis?

A

Candida: Fluconazole or ketoconazole

HSV: Acyclovir

CMV: IV ganciclovir or foscarnet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the presentation of medical induced esophagitis?

A

Severe retrosternal CP

Odynophagia, dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does corrosive esophagitis (due to ingestion of causative agent) present?

A

Ulceration, necrosis, perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are complications of corrosive esophagitis?

A

Fibrosis
Stricture
Increased risk of SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does neurogenic esophageal dysmotility present?

A

Trouble swallowing liquids & solids

Can lead to aspiration pneumo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does Zenker’s diverticulum (an esophageal dysmotility) present?

A

Pouch in posterior hypopharynx above UES

Undigested food & liquid is regurgitated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does esophageal stenosis (an esophageal dysmotility) present?

A

Webs, rings, malignancy

Trouble swallowing solids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the presentation of Schatzki’s ring?

A

Occurs at GE junction

Dysphagia to solids

+/- impaction of bolus

Abrupt sub-sternal discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are esophageal webs?

A

Mucosal fold protrudes into lumen

Intermittent dysphagia to solids

Sx seen in iron deficiency & middle-aged women (plummer vinson syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe achalasia

A

Decreased peristalsis, ineffective relaxation of LES

Dysphagia to solids & liquids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe esophageal spasm

A

Dysphagia or intermittent CP

+/- a/w eating, drinking cold liquids

Can mimic MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe scleroderma of the LES

A

Decreased sphincter tone & peristalsis –> reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you dx achalasia?

A

Parrot beak on esophagram

Dilated esophagus tapering to distal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you dx diffuse esophageal spasm?

A

Barium esophagram: corkscrew

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you treat esophageal spasm?

A

SM relaxants

NTG before meals & bed
Isosorbide before meals
Nifedipine before meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is an ADE of SM relaxants?

A

Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does “CREST” stand for in scleroderma?

A 
Calcinosis
Raynauds 
Esophageal dysmotility 
Sclerodactyly 
Telangiectasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you dx dysphagia in general?

A

Barium swallow

Endoscopy: to DIRECTLY see abnormalities & bx

Esophageal manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you treat esophageal dysmotility?

A

Strictures: if benign –> dilation, if CA –> resect

Diverticula, achalasia, stenonis: endoscopic dilation, resection, myotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe: Mallory-Weiss Tear

A

Causes 10% of upper GIB

Linear tear in esophageal mucosa

Usually at GE junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pathophys behind Mallory-Weiss tears?

A

Occurs w/ forceful vomiting/retching

Leads to hematemesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are RFs of Mallory-Weiss tears?

A

Alcohol

Hyperemesis gravidarum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How do you dx Mallory-Weiss tears?

A

Endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How do you treat Mallory-Weiss tears?

A

Epi injection to stop bleeding

Thermal coagulation

Surgery if severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What causes esophageal varices?

A

Portal HTN from cirrhosis due to alcohol abuse or chronic hepatitis

Budd-Chiari syndrome (thrombosis of portal vein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are RFs of esophageal varices?

A

NSAIDs exarcerbate bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do esophageal varices present?

A

Painless upper GI bleed

If large bleed –> hypovolemic shock, orthostasis

Usually asx until they bleed & become life-threatening!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How do you dx esophageal varices?

A

Endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How do you treat esophageal varices?

A

Hemodynamic support

Emergent EGD: Band ligation, sclerotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you prevent esophageal varices in pts w/ cirrhosis?

A

B-blockers
No alcohol
Band ligation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What causes GERD?

A

Abnormality of LES

Prolonged exposure to gastric acid

Abx, bisphosphonates, iron, NSAIDs, anticholinergics, CCBs, narcotics, benzos

35
Q

How does GERD present?

A

Heartburn = MC sx

  • worse after meals, lying down, bending over, or in PM
  • some relief w/ antacids
  • regurgitation, dysphagia

Hoarseness, halitosis, cough, hiccups, sore throat, laryngitis, nausea, CP

36
Q

What are the “ALARM Sx” of GERD, which indicate a different dx?

A 
Anemia
Loss of weight
Anorexia
Recent onset 
Melena or hematemesis 
Swallowing difficulty
37
Q

How do you dx GERD?

A

Clinically!
Trial of PPI x 4-8wks

Consider endoscopy to confirm

38
Q

What diagnostic procedures can you use for more severe GERD?

A

Barium swallow

Esophageal manometry

Ambulatory 24hr pH monitor (gold standard for surgical planning)

39
Q

How do you treat GERD?

A

Lifestyle modification

H2 blockers: only relieve sx

PPIs prior to eating: heals mucosa (meds end in “prazole or prozole”)

40
Q

How do you treat GERD if refractive to PPI therapy?

A

Nissen fundoplication

41
Q

What are complications of GERD?

A 
Aspiration pneumo
Acid laryngitis 
Asthma
Strictures
Barrett esophagus & adenocarcinoma
42
Q

Describe Barret esophagus

A

Replacement of squamous epithelium w/ columnar epithelium

A/w adenocarcinoma

43
Q

What is the most frequent benign tumor of the esophagus & how does it present?

A

Leiomyoma

Usually asx
May cause dysphagia

44
Q

How do you dx leiomyomas?

A

Discovered incidentally

45
Q

How do you treat leiomyomas?

A

Excision

46
Q

What are characteristics of SCC?

A

Mid esophagus
Smokers, Etoh users
Asians, African Americans

47
Q

What are characteristics of adenocarcinomas?

A 
Distal 1/3 of esophagus
MC type in US
Smokers
Chronic reflex
Obesity 
Caucasian males
48
Q

What are RFs of esophageal CA?

A

Smoking
Chronic alcohol - SCC
Caustic agents
HPV

49
Q

How does esophageal CA present?

A

Progressive dysphagia w/ solid foods

Wt loss, heartburn, vomiting, regurg, aspiration, hoarseness

50
Q

How do you dx esophageal CA?

A

Barium esophagogram (best initial test): apple core lesion

Endoscopy w/ bx (definitive dx)

51
Q

How do you stage esophageal CA?

A

CT chest/abd

Endoscopic U/S w/ FNA bx of LNs

PET-CT

+/- bronchoscopy

52
Q

How do you treat esophageal CA?

A

Resection

Radiation, chemo

53
Q

Where does esophageal CA tend to metastasize?

A

Stomach & colon

54
Q

What causes gastritis?

A 
Autoimmune d/o 
NSAIDS = #1 
H. pylori = #2 
Stress
Alcohol
55
Q

How does gastritis present?

A

Dyspepsia

Abd pain

56
Q

How do you dx gastritis?

A

Endoscopy w/ bx

Urea breath test

Stool antigen (H.pylori)

Serology for H.pylori (IgA or IgM vs. IgG)

57
Q

How do you treat gastritis?

A

If NSAID induced –> PPI –> endoscopy

If H. pylori –> tx x 14 days

58
Q

Tx for H.pylori: What meds do you use if you are concerned for macrolide resistance?

A

Bismuth + tetracycline + Metronidazole + PPI

59
Q

What is gastritis a/w?

A

PUD
Gastric adenocarcinoma
B cell gastric lymphoma

60
Q

What causes PUD?

A

Break in mucosa from injury, NSAIDs, stress, alcohol

H. pylori = #1

61
Q

What is the presentation of PUD?

A

Abd pain (burning, gnawing, may radiate to back)

Dyspepsia: belching, bloating, distention, heartburn, regurg

62
Q

What is the difference btwn gastric & duodenal ulcers?

A

Gastric: worsens after eating

Duodenal: improves after eating

63
Q

How do you dx PUD?

A

Endoscopy*

Barium swallow

H. pylori testing

64
Q

How do you treat PUD?

A

If H.pylori: tx x 2-4wks

Gastric: PPI x 12 wks

Duodenal: PPI x 4-8wks

65
Q

What can you use for prophylactic tx for pts w/ hx of ulcers?

A

Misoprostol
Sucralfate 1 hr before meals
PPI

66
Q

What are complications of PUD?

A

Obstruction (due to scars)
GI bleed
Ulcer perforation
Penetration/fistulizaton

67
Q

What causes gastroparesis (delayed gastric emptying/motility)?

A

Idiopathic
DM
Diseases of SM
Neuro dysfunction

68
Q

What is the presentation of gastroparesis?

A

Nausea

Excessive fullness after meals

Bloating, wt loss, abd pain

69
Q

How do you dx gastroparesis?

A

Endoscopy

Scintigraphic gastric emptying

70
Q

How do you treat gastroparesis?

A

Smaller meals

Prokinetic meds: cisapride, metoclopramid

71
Q

How do hiatal/diaphragmatic hernias present?

A

Asx
GERD
Chest discomfort

72
Q

How do you dx hiatal/diaphragmatic hernias?

A

Barium esophagogram

Endoscopy

73
Q

How do you treat hiatal/diaphragmatic hernias?

A

Acid reduction

Surgical repair

74
Q

What are characteristics of a gastrinoma?

A

Gastrin secreting tumor –> hypergastrinemia –> PUD

AKA Zollinger-Ellison syndrome

75
Q

How do gastrinomas present?

A

Abd pain, diarrhea, GI bleed

76
Q

How do you dx gastrinomas?

A

Fasting serum gastrin > 150

Secretin test (confirms): Gastrin rises > 200

Endoscopy/CT/MRI

77
Q

How do you treat gastrinomas?

A

PPI
Removal of tumor
Screen for MEN1

78
Q

What are RFs of gastric adenocarcinomas?

A

Smoking
H. pylori
Genetic

79
Q

How do adenocarcinomas present?

A

Dyspepsia, wt loss, GIB, anemia

Abd mass

Signs of metastasis: Virchow node, sister Mary Joseph nodule

80
Q

How do you dx adenocarcinomas?

A

Endoscopy
CBC: iron deficiency
CT

81
Q

How do you treat adenocarcinomas?

A

Surgery +/- chemo & radiation

82
Q

What are the 2 types of gastric lymphoma?

A

MALT

B cell lymphoma

83
Q

What increases risk of gastric lymphoma?

A

H.pylori increases 6-fold

Foundations III GI (Cholley) (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions