GERD

Question 1

___ is a condition or histiological alteration resulting in reflux.

Answer 1

GERD

Question 2

___ ___ is inflammation of esophagus secondary to reflux.

Answer 2

Reflux esophagitis

Question 3

What are the 4 aggressive factors in GERD?

Answer 3

acid, pepsin, bile acids, and pancreatic enzymes

Question 4

What is the hallmark sign of GERD?

Answer 4

heartburn

Question 5

Heartburn can be aggravated by ___.

Answer 5

weight

Question 6

Other signs of GERD besides heartburn include:

Answer 6

regurgitation, dysphagia, bleeding, chest pain

Question 7

Aims of tx for GERD include: increase ___ pressure, improve ___ emptying, decrease ___ and ___.

Answer 7

LES, gastric, acidity, volume

Question 8

Phase 1 tx for GERD includes:

Answer 8

elevate bed, change diet, stop smoking, avoid certain meds, antacids or gaviscon, OTC H2’s

Question 9

Phase 2a tx for GERD includes:

Answer 9

H2’s, prokinetic agents, bethanechol, sucralfate

Question 10

Phase 2b tx for GERD includes:

Answer 10

Hi-dose H2’s, PPI

Question 11

Phase 3 tx for GERD includes:

Answer 11

antireflux laparoscopic surgery (Nissen fundoplication)

Question 12

Alginic Acid (aka ___) is an antacid that ___ acid and creates a ___ that floats on top of ___ secretions to provide a mucosal barrier on the ___.

Answer 12

Gaviscon, neutralizes, foam, acid, esophagus

Question 13

___ are the mainstay therapy for GERD. Superior to ___.

Answer 13

H2-RA’s, antacids

Question 14

With GERD, you want continuous acid ___.

Answer 14

suppression

Question 15

Bethanechol is a ___ agent that increases ___ tone for GERD. Do not want to use in ___, ___ or ___.

Answer 15

cholinergic, LES, PUD, astha, COPD (b/c you use anticholinergics to tx COPD)

Question 16

___ is a prokinetic agent that increases ___ tone and gastric ___. Is a ___ antagonist, so don’t give to pt’s w/___.

Answer 16

Metoclopramide, LES, emptying, dopamine, PD

Question 17

Metoclopramide has extrapyramidal s/e, including ___ ___ and ___.

Answer 17

tardive dyskinesia, dystonia’s

Question 18

Tx for mild GERD:
moderate GERD:
Refractory/severe GERD:

Answer 18

lifestyle changes, antacid or low dose H2
H2-RA’s or PPI
PPI is best option

Question 19

May have to switch to ___ if higher doses of H2’s not effective.

Answer 19

PPI

Question 20

Tx for GERD is ___, whereas it is short-term therapy for ___.

Answer 20

prolonged, PUD

Question 21

Dosing for GERD is ___, whereas it can be ___ for PUD.

Answer 21

BID, dly

Question 22

Acetylcholine stimulates ___ production, so do not want to give ___ in PUD, only for use in GERD.

Answer 22

acid, Bethanechol

Question 23

___ needs to be monitored closely for toxicity.

Answer 23

Metoclopramide (Reglan)