GI Flashcards
Weight loss, anemia, Heme-positive stool
Next best test
Endoscopy
Recent travel to south america and new onset dysphagia
Chagas
Achalasia Tests
first?
best?
Barium esophagram
“Bird’s beak”
Best? manometry
Achalasia Tx:
Pneumatic dilation
botulinum
Heller Myotomy
50 y o, dysphagia, alcohol and tobacco use, >5 yr GERD
Esophageal Cancers
I think Esophageal cancer what test do I order?
Endoscopy
No tissue no issues
Tx for esophageal cancer?
Surgical resection
Chemo/radiation adjuvant therapy
Suddent onset chest pain, not related to exertion. EKG and stress r/o Cardiac origins
Dx?
Best initial test?
Accurate Test?
Diffuse Esophageal spasm
Esophagram
Manometry
Tx for DES
Nitrates
Calcium channel blockers
Difficulty swallowing
+ HIV
CD4 count
Tx: fluconazole Doesn't resolve? Endoscopy with biopsy HSV small vesicles Tx: acyclovir CMV large vesicles Tx: ganciclovir and foscarnet
Schatzki Ring
Steak house syndrome
tx: pneumatic dilation
Plummer vinson syndrome Triad
- Dysphagia
- Iron Def.
- Glossitis
Test: barium esophagram
Tx: Iron def.
Zenker’s
True lumen involving all three layers person wake s up with snacks and halitosis tx. with surgery
Calcinosis Raynauds Esophageal webs Sclerodactyl Telangiectasia
Scleroderma
hemoptysis after drinking
Mallory weiss tear
only in the muscosal layers
Dx: endoscopy tx with epinephrine injections if bleeding doesn’t resolve
Hemoptysis after drinking + crepitus
Surgical emergency
the pt has a esophageal rupture aka Boerhaave Syndrome
Right Upper Quadrant
Cholelithiasis
Biliary Colic
Cholangitis
Perforated duodenal ulcer
Left Upper Quadrant
Splenic rupture
IBD
Right lower Quadrant pain
Ectopic pregnancy Ovarian torsion cecal volvulus cecal diverticulitis Appendicitis
Left Lower Quadrant pain
sigmoid volvulus
sigmoid divierticulitis
ovarian torsion
Ectopic pregnancy
Midepigastric pain
Pancreatitis
Aortic rupture
duodenal ulcer
epigastric plus Pain worse with food
gastric ulcer
Epigastric plus pain better with food
duodenal ulcer
epigastric pain + weight loss
cancer, gastric ulcer
Epigastric Pain +tender
pancreatitis
epigastric pain _ Bad taste, cough, horseness
GERD
epigastric pain + nothing
non-ulcer dyspepsia
Epigastric Pain Tx:
PPI
H2 Blocker
Liquid antacids
Misoprostol (used in NSAID gastric damage)
Heartburn, metallic taste, cough
Dx:
test?
GERD
24 hr. pH monitoring