GI 3 Flashcards
Why more likely to surgical repair paraesophageal hiatal than sliding hiatal hernia?
B/c risk of incarceration/strangulation
Type A gastritis is what?
AUTOIMMUNE against parietal cells, NEED TO GIVE B12
Type B gastritis tx?
PPI, clarithro with amoxi for H pylori
Duodenal ulcer almost diagnostic of what?
H PYLORI
Gastric ulcer hurts when?
shortly after eating
Gastric ulcer kinds? Think if burn or intracranial?
So what is common in burn unit?
Curling (hot iron burn)
Cushing (pressure is crushing)
Give ulcer prophylaxis! Basically give them if people in stressful hospitilaztion
What do you do if no response to antacid treatment?
DO SERUM GASTRIN INVESTIGATION
What is zollinger ellison syndrome?
H and P?
from GASTRIN producing tumor
Located in duodenum or pancreas
Ulcers not responding
Lab:
Fasting gastrin level
Secretin stimulation test
What is secretin stimulation test?
For ZE syndrome
CAUSES INCREASE IN GASTRIN RELEASE IN ZOLLINGER ELLISON
ZE tx?
PPI h2 blocker, octreotide if PPI needs help
NEEDS RESECTION
Look out for MEN1
GAstric cancer, always biopsy around ulcer!
Oh ok
What is Virchow’s node? What is sister mary joseph node?
KNOW THIS
Virchow is L supraclavicular
Periumbilical node is sister mary joseph
For gastric cancers!!
Gastric cancer marker?
CEA
Stomach cancer surgerY?
If lower third, partial gastrectomy.
If first 2/3, remove the entire thing
Branching rods are what?
Actinomyces
Antiendosomysial?
Antibodies in celiac (along with antiTGA)
Tx of refractory celiac?
Steroids
Tropical sprue can present years after leaving tropics.
History? Labs? Tx?
It looks like celiacs but no antibodies
Has megaloblastic anemia
Tx: folic acid (think get rid of megaloblastic anemia and improve it)
Tetracycline helps it too for some reason or sulfas
Whipple disesase dx and tx?
History of white person with diarrhea, wasting, STEATORRHEA (OF COURSE FATTY B/c IT IS FOAMY MACROPHAGE), arthrtalgia…
Biopsy of jejunum is foamy macrophage
Ceftriaxone and BACTRIM for longt ime
D xylose?
test carb absorption (pancreatic insufficiency won’t effect)
Sedan stain?
For fat in stool
Tests of shit for pancreatic insufficiency?
abnormal sedan (fat) Normal d xylose (sugar absorbed normally)
Bloody bacteria or fever or lasting five days?
CONSIDER bacteria or protozoan or parasite
Inflam diarrhea think what?
IBD
Osmotic diarrhea, think what?
Celiac or tropical sprue and much more or things not obsorbed
Fatty diarrhea think what?
Pancreatic insufficiency or whipple disease
Osmotic gap of diarrhea: if less than 50 it is what? If more than 125 it is what? Formula?
KNOW!!!
Secretory less than 50, osmotic more than 125 is osmotic (duh)
290 - 2(Na+K)
Secretory diarrhea causes?
Lots of them, but consider infection, IBS, laxative
