Brainscape's Knowledge GenomeTM

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


See full index

GI 1 > Gastric Dz 3 > Flashcards

Gastric Dz 3 Flashcards

1
Q

what is considered upper GI

A

anything above ligament of trietz (LUQ)

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

etiologies of UGIB

A

PUD
erosions/hemorrhagic gastritis
MW tears

esophageal varicose, gastric carcinoma, other

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

location of the bleed

coffe ground emesis

A

digested in stomach prior to vomiting

slow bleed

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

location of the bleed BRB small amount

A

trauma from retching, minimal bleed

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

location of the bleed BRB large amount

A

pumping blood loss from ulcer

get EGD

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

location of the bleed melena

A

dark tarry stools

proximal to ligament of Treitz

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

location of the bleed hematokhezia

A

colonoscopy

red or maroon blood in stool (due to LGIB)

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

GI bleed assessment physical exam

A

s/s that will indicate location of bleed

look for signs of perforation

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

lab work up GI bleed

A 
CBC
CMP 
PTT
INR 
type and screen

serial H&H

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

signs of hypovolemia

A

mild to mod hypovolemia - resting tachycardia

moderate to sig hypovolemia - orthostatic hypotension

severe hypovolemia - supine HotN

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

potential bleeding sources

UGIB

A

ulcer
varices
MW tear

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

potential bleeding sources

LGIB

A 
diverticula 
AVM 
CA 
rectal source 
IBD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

medications that can cause bleeding

A

NSAIDS, bisphospinate, anti-platelet/anticoagulant, steroids

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

comorbid illnesses in GIB

A

CKD, liver DZ

CAD

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

mallory weiss tear

A

mucus membrane of lower part of esophagus or upper part of stomach that starts to bleed

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

risk factors of mallory weiss tear

A

violent and lengthy bouts of retching, coughing, vomiting, increased abdominal pressure

dry heaves after an alcoholic binge

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

mallory weiss tear presentation

A

hematemesis (smaller amount)

blood stool

epigastric pain

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

mallory weiss tear

diagnosis

A

history and clinical grounds

bleeding has generally stopped w/anti-emetics when pt presents and doesn’t reoccur

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

test of choice in mallory weiss tear

A

EGD - esp if bleeding continues

CBC + serial H& H

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

mallory weiss tear prognosis

A

heals in few days without tx

cirrhosis and coagulopathies make future bleeding more likely to occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pathophysiology of esophageal varices

A

blood from abdominal viscera is backed up due to portal HTN causes formation of collaterals

diversion of obstructed blood to systemic veins and causes them to engorge

22
Q

diseases that cause portal HTN

A

pre hepatic (obstructive thrombus in portal vein, splenomegaly)

intra-hepatic (cirrhosis)

post hepatic (RSHF, hepatic vein outflow, obstruction)

23
Q

esophageal varices and bleeding

A

thin walled varicosities that rupture due to minor trauma and cause massive bleeding

24
Q

symptoms of variceal bleeding

A

copious painless hematemesis (2/2 to decreased liver function)

melena or less likely hematochezia, possible hemodynamic compromise

25
Q

management of variceal

A

surgical EGD to clip off varicele

26
Q

BUN and GI bleed

A

BUN to CR ratio should be used to evaluate

acute upper GI bleed will have elevated BUN to Cr ratio due to large amounts of protein absorbed

HIGHER ratio = SEVERE bleed

27
Q

tx of active UGIB

A

volume resuscitation w/crystalloid or colloid solution

transfuse if nec. HgB goal >9

reverse anticoagluate

PPI infusion or Protonix

octreotide

28
Q

UGIB consult and diagnostics

A

GI consult (keep NPO)

Endoscopy with 24hrs

29
Q

how to evaluate occult GI bleed

A

stool guaiac testing

30
Q

Zollinger-Ellison syndrome

A

gastrin-secreting tumor that stimulates stomach to secrete more acid

GI mucosal ulceration, malabsorption and diarrhea

31
Q

cause of ZES

A

sporadic (MC)

multiple endocrine neoplasia type 1 (MEN1)

32
Q

best single screening test of ZES

A

fasting serum gastrin

then localize via imaging studies

33
Q

gastroparesis

A

delayed gastric emptying without obstruction

early satiety, bloating, n/v, anorexia, malnutrition, weight loss

34
Q

MC cause of gastroparesis

A

DM

neuropathy of autonomic and enteric nerve

35
Q

Test OC gastric emptying

A

gastric emptying study

must be suspected on clinical grounds in right patient population

36
Q

tx of gastroparesis

A

avoid meds that slow gastric emptying (narcotics, anticholinergics, TCA)

encourage liquids and blender food

high fat, high fiber

pro kinetic agents

37
Q

pharmacological agents that can cause n/v

A 
chemotherapy 
analgesics
ABX 
OC 
metformin

HTN meds, seizure meds, Parkinson meds

38
Q

steps in n/v tx

A

identify and tx underlying cause

replace GI fluid and electrolyte losses

provide symptom relief

preventative measures

39
Q 
brand + class
Ondansetron
A

zofran

5HT3 Antagonists

40
Q 
brand + class
aprepitant/fosprepitant
A

Neurokinin R Agonists

Emend

41
Q

dipenhydramine

brand + class

A

benedryl antihistamine

42
Q 
brand + class
hydroxyzine
A

Vistaril

antihistamine

43
Q 
brand + class
Promethazine
A

Phenergan

antihistamine

44
Q 
brand + class
scopolamine
A

transform scop

anti-cholinergic agent

45
Q 
brand + class
procholorperazine
A

compazine

46
Q 
brand + class
chloropromazine
A

thorazine

47
Q

metoclopramide

brand + class

A

reglan

dopamine receptor agent

48
Q 
brand + class
dronabinol
A

Marinol

cannabinoids

49
Q

5HT3 Antagonists

A

best used in chemo agents and post operative n/v

can cause QT prolongation

50
Q

neurokinin receptor agonists

A

chemotherapy induced emesis

prevents delayed and acute emesis

additive therapy in treatment

caution in CKD

51
Q

drug interactions with neuokinin

A

decreased concentration of Warfarin and contraceptives

increased concentrations of benzos

GI 1 (12 decks)

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