gastroesophageal reflux Flashcards
gastroesophageal reflux
- freq
- et
common GI problem (50%)
neuromuscular et
GER patho
reflux via lowr esophageal sphincter
-gastric contents->esoph->esophagitis
complication/problem from GER
growth problems
GER tx
mostly self limiting (may need PPI or H2RA)
- modify feeding (small meals, thicken, positon)
- fundoplication
Hirschsprung disease
- incidence
- et
1/5000
-RET gene mutation on chr 10 (it codes for the proteins involved in cell signalling (neural tissue))
Hirschprung disease patho
possible complic
area of colon lack parastympathetic ganglia->no peristalsis (localized)->accum of contents->colon distension->abdm distension
-risk of perforation and peritonitis
intussesception is
usually occurs where
intestine invaginates into adjoining part
usually at ileocecal valve. (the ileum enters the cecum)
incidence of intussusception
1-4/1000 births
patho of intussusception
invagination->obstr->inflm->edema (into the lumen)->edema->ischemia
possible complic of intussusception
necrosis
perforation
peritonitis
all possibl
tx of intussuscpetion
- hydrostatic reduction (using a contrast medium that is water soluble and air pressure
- some require sx
influenza is
acute viral infection in URT
-seasonal
how is the flu divided
TYpes A B C
A is most prevalent (and the cause of outbreaks)
flu incubation
1-4 days
who is susceptible to the flu
elderly
young (defenses arent fully established)
health care workers
chronically ill
influenza patho
viral injury to epith cells in URT
- inflm and tissue damage
- if it extends to LRT can cause bronchial and alveolar damage
flu complic
2’ bacterial infection??
bronchitis or pneumonia??
mnfts of influenza
cough (good for expectorating mucus. 140-160km/hr)
- fever
- lethargy, myalgia
tx of flu
immunization prohylaxis prevent spread -symptomatic eg pain meds limit infect to URT -antivirals?? Amantadine (1st generation antiviral. Antivirals have a narrow window that they can be taken in within 24-48hrs)
immuniation for flu
what is the challenge
usually giving an attenuated vaccine in which an Ag from virus is inactivated and given in small quantity.
problem is predicting which strain will ome next. It doesnt always match the strain. Vaccines for flu always contain multiple strains
how does amantadine work
inhibits uncoating. it is best for a and b strains
relenza
inhibits replication and prevents release of…
Pneumonia aka pneumonitis
inflm of alveoli and bronchioles
infectious and noninfectious forms (eg from bact/viruses can classify based on et and on location)
et of pneumonia
usuall bact (oppotunitic infection often from during flu)
- viruses
- fungi
- aspiration
- noxious fumes
pahto of pneumonia
impaired pulmonary defenes (such as the mucociliary blanket)
-agent enters resp tract and proceeds to lungs
-inflm->pulm edema->impaired gas exchange
(youll have systemic hypoxi, hypercapnea)
what is atypical and typical pneumonia
typical is bact (this will be in the alveolar space)
atypical is viral (this will be in the cels)
how are lobar and bronchopneumonia different
lobar is restricted to a lobe
broncho is diffuesed. There are many areas of consolidation that contain exudate, inflm debris, bact, host defence cells
