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Med Surg III Exam 3 > Esophogeal/Stomach Disorders > Flashcards

Esophogeal/Stomach Disorders Flashcards

1
Q

What causes proximal dysphagia?

A

Neurological deficits from stroke, can lead to aspiration pneumonia

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2
Q

What causes distal dysphagia?

A

Obstructive: Inflammation, tumor, Achalasia

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3
Q

What is achalasia?

A

The smooth muscle fibers in esophagus cannot relax, so sphincter cannot open/close at proper times

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4
Q

Distal dysphagia can also mimic what condition?

A

Angina

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5
Q

S/S of GERD

A 
Heartburn
Reflux
Dysphagia
Painful Swallowing
Chest pain (esp supine)
Coughing, asthma, wheezing
Sore throat
Hoarseness
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6
Q

How is GERD Diagnosed?

A

History
Endoscopy
Barium Radiography
Presence of H. Pylori bacteria

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7
Q

How is GERD treated?

A

Eat small, frequent meals
Acid-suppressing medications
Surgery

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8
Q

What are PT implications for GERD?

A

Have pt lay on RIGHT side to let gastric juices flow, avoid supine position immediately after eating.

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9
Q

What is barrett’s esophagus?

A

Damage of the esophageal lining by the stomach acid; damaged lining is replaced by one similar to the that in the stomach

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10
Q

What are S/S of Barrett’s esophagus?

A 
Dysphagia
Esophagitis
Ulceration
Bleeding
Adenocarcinoma
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11
Q

How do you treat Barrett’s Esophagus?

A

Control GERD
Endoscopic ablation therapy
Proton pump inhibition to control acid secretion

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12
Q

What are esophageal varices?

A

Abnormally large, swollen/distended veins in the lower part of the esophagus.

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13
Q

How do you treat esophageal varices?

A
  • If they bleed, hemorrhage will stop on its own
  • Prophylactic treatment
  • Stent to reduce pressure (between hepatic and portal vein)
  • Liver transplant
  • AVOID ACTIVITES INCREASING INTRA-ABDOMINAL PRESSURE
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14
Q

What is a hiatal hernia?

A

Stomach pushes through the hiatus (opening in the diaphragm) when the cardiac sphincter becomes enlarged.

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15
Q

Etiology of hiatal hernia

A

Weakening of the diaphragm OR enlargement of the hiatus. Can be congenital (born with weak diaphragm) or acquired (trauma, aging, surgery, activities that increase intra-abdominal pressure)

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16
Q

What are the risk factors for a hiatal hernia?

A

> 50 years old, obesity, smoking

17
Q

what are the s/s of a hiatal hernia?

A

heart burn, chest pain, reflux, belching, nausea

18
Q

How are hiatal hernias diagnosed?

A

Ultrasonography, barium swallow, endoscopy

19
Q

How are hiatal hernias treated?

A

Antacids, elevate the head of the bed

20
Q

PT Implications for hiatal hernias

A

Avoid lying supine, avoid anything that increases intra-abdominal pressure

21
Q

What is a peptic ulcer?

A

A break in the protective mucosal lining that exposes the submucosal areas to gastric secretions

22
Q

What are some problems involved with chronic peptic ulcers?

A

Muscular layer of stomach is damaged and replaced with scar tissue, blood vessels can be damaged and hemorrhage

23
Q

What are the different types of peptic ulcers? (3)

A

Gastric
Duodenal
Esophageal

24
Q

Etiology/risk factors of peptic ulcers

A 
H. Pylori Infection (90% of time)
Long term NSAID use
Tobacco/alcohol
Physiologic changes
Genetics
Gastrinoma
Systemic mastocytosis
Malignant tumors
25
Q

S/S peptic ulcer

A 
Epigastric pain
Midline pain in T/S
Melena
Nausea
Vomitting blood
Loss of appetite --> weight loss
Bleeding
Symptoms occur 3-4 days to weeks, subside, then reappear months later
26
Q

Complications of peptic ulcer

A

Hemorrhage
Perforation
Obstruction
Unremitting pain

27
Q

How are peptic ulcers diagnosed?

A 
s/s and history
Upper GI x-ray
blood or breath test
stool antigen test
Gastroscopy
28
Q

Prevention and treatment of peptic ulcers

A 
Avoid prolonged Nsaids
Antimicrobials
Acid blockers
Cabbage
Coffee
Exercise
Surgery
29
Q

Prognosis of peptic ulcers:

A

GU: heal in 3 months
DU and GU: chronic w/ remissions and exacerbations
- Massive hemorrhage or perforation may cause mortality
- Curing H pylori usually cures disease

Med Surg III Exam 3 (8 decks)

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