Gastroesophageal Reflux Flashcards
1
Q
Complications due to GERD
A
- Esophagitis,
- stricture,
- perforation,
- cancer,
- Barrett’s esophagus,
- bleeding
- ulcers
1
Q
What is gastroesophageal reflux?
A
Gastric juices irritate the mucosal lining of the esophagus
2
Q
Risk factors
A
- Hiatal hernia,
- pregnancy,
- obesity,
- caffeine, alcohol, chocolate, and nicotine
3
Q
GERD in infants
A
Predominantly a benign physiologic factor
4
Q
GERD age stats
A
- 7-8 months: resolves spontaneously
- 18 months: symptom free
- 4 years: 1/3 have persistent symptoms
5
Q
Rare cases of GERD in infants
A
- 5-10% have serious strictures, pneumonia, and upper airway infections
6
Q
Adult symptoms
A
- heartburn,
- nausea,
- vomiting,
- sore throat,
- hoarseness,
- difficulty swallowing,
- coughing,
- wheezing,
- middle back pain,
- belching,
- acidic taste in mouth
7
Q
Pediatric symptoms
A
- Burping,
- spitting up,
- slow growth,
- refusing food,
- inconsolable crying,
- respiratory problems,
- iron deficiency,
- breath holding spells,
- bad breath
8
Q
Patient interviews
A
- Hiatal hernia
- Duration of symptoms
- past surgeries
- diagnosis of chronic illness eg. diabetes
- difficulty swallowing
- previous tests
9
Q
Infant Prep
A
- NPO 3 hours
10
Q
Infant RP prep
A
- RP: 99m-Tc sulfur colloid
- Dose: 3.7-37 MBq (0.1-1 mCi)
- 5 uCi/ml of milk
- Oral or NG tube
- Half of milk is mixed with RP
- Infant finishes meal with the non-radioactive milk
- Done @ normal meal times
11
Q
Imaging Parameters
A
- supine and posterior
- chest and upper abdomen in FOV
- Dynamic images
- LEAP
- 64 x 64
- 5-10 sec/frame
- 30 minutes
- begins at feeding
- Post meal image 1 min static at 1 and 2 hrs, ant and post
- Delayed images 4, 6, and 12 hours
12
Q
Adult patient prep
A
- NPO 6 hours
13
Q
Adult RP prep
A
- 99m-Tc sulfur colloid
- 11.1 MBq
- Mix in 150 mL orange juice and 0.1 HCl in 150 mL
14
Q
GERD results
A
- Percent of gastric counts the reflux into the esophagus
- CINE study
- GER is seen as a spike of activity from the stomach into esophagus
