Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

clin med > gi 4.2 > Flashcards

gi 4.2 Flashcards

1
Q

Boerhaave syndrome

sx

A

Pain in neck, chest, throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Boerhaave syndrome

pe

A

SQ emphysema on PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Boerhaave syndrome

dx

A

XR- free air

Contrast esophagram/ CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Boerhaave syndrome

trmt

A

None bc they die fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Esophageal varices?

A

Dilated veins from portal venous HTN
In pts with cirrhosis
Can cause upper GI bleeding
BAD…worse than other bleeding areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Esophageal varices

trmt

A

Do periodic endoscopy is cirrhosis to evaluate

Treat before bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Esophageal varices

risk of bleeding

A

Size
Red whale markings on endoscopy
Severity of liver disease
Active ETOH abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

GERD?

A

Stomach contents go into esophagus and cause sx or complications
Mild amt is normal
Very common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

GERD types

A

Erosive esophagitis- visible break in distal esophagus with ot without sx
Non Erosive esophagitis- GERD sx without visible injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

GERD causes

A 
Sphincter dysfunction
Transient: eating too much, vasovagal reflex, meds
Chronic: weak LES valve
Hiatal hernia
Abnormal esophageal peristalsis
Delayed gastric emptying
Pregnancy or obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

GERD risks

A

Pregnancy, obesity, smoking, ETOH, no chocolate, caffeine, peppermint, fatty foods, NSAIDS, CCB- vasodilators such as nifedipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

GERD sx

A 
Heartburn substernal burning
Worse with meals, bending, lying down
Regurg
Sx last 30-60 min
May have chronic cough, ST, CP, sleep issues, chronic laryngitis/hoarseness
Water brash
Sx does not = severity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

GERD dx

A

Usually normal exam and labs
Upper endoscopy- only if rex flag sx, Barrett’s screen, abnormal imaging
Response to PPI or antisecretory drugs does not confirm dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

GERD pt education

A

Small meals
No acidic foods: tomato, citrus, coffee, spicy
Avoid foods that cause reflux: ETOH, peppermint, fatty, caffeine
Stop smoking
Lose weight
Don’t lie down for 3 hrs after eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

mild/occasional GERD sx trmt

A

Lifestyle modifications
H2 blocker- inhibit stomach acid secretion
Ends in -idine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

frequent GERD sx trmt

A

PPI once a day

Ends in -azole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

long term GERD trmt

A

If you try meds and it works DC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

GERD referral

A

Red flag sx
Barrett
Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

do this in GERD if sx persist with ppi

A

Order upper endoscopy to looks for tissue damage, PUD, complications such as strictures, Barrett, adenocarcinoma, reflux esophagitis
Could also be functional dyspepsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Red flag sx

A 
Weight loss/anorexia
Persistent vomiting
Constant or severe pain
Dysphagia or odynophagia
hematemesis/melena/fobt
New onset over age 55
Organomegaly or abdominal mass
Choking
CP
Longstanding sx
FH GI GA
Unexplained iron def anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hiatal hernia?

A

LES and stomach move above diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Common in severe/erosive esophagitis and Barretts

A

Hiatal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Dyspepsia

?

A

fullness, belching, early satiety, heartburn, discomfort, NV

Usually young, many GI complaints, psychosocial stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dyspepsia

acute causes

A

Eating too fast, much, high fat, high stress, too much caffeine or ETOH, meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Dyspepsia | chronic causes
``` Functional dyspepsia (MCC), GERD, PUD, H pylori infection Cancer, chronic pancreatitis, biliary disease, gastroparesis ```
26
Dyspepsia | sx
Epigastric pain/indigestion | Burning, early satiety, postprandial pain, bloating, NV
27
Dyspepsia | dx
FOBT H. Pylori Serum- less accurate, not great, does not distinguish between active and old disease Breath/fecal Ag is best CBC, BMP, LFT, TSH in old ppl Endoscopy: red flag sx, new sx, high risk, no response to therapy in 4-8 wks or relapse after DC meds
28
Dyspepsia | trmt
PPI for 4 wks | Functional dyspepsia: poor response to meds, reassurance, antidepressants, metoclopramide (imp. Gastric emptying)
29
gastritis types
``` Erosive and hemorrhagic gastropathy Nonerosive nonspecific H pylori gastritis Pernicious anemia gastritis Other Infections Eosinophilic Note: gastropathy is tissue damage without inflammation ```
30
Erosive /hemorrhagic gastropathy | typical pt
Typical pt: alcoholic, critically ill, or NSAID user
31
Erosive /hemorrhagic gastropathy | causes
Alcohol, severe medical stress, nsaids
32
Erosive/ hemorrhagic gastropathy | sx
Usually Asymptomatic | Epigastric pain, NV, hematemesis
33
Erosive/ hemorrhagic gastropathy | dx
Egd - shows superficial hemorrhage and erosion not inflammation
34
Erosive/ hemorrhagic gastropathy | trmt
Based on cause Stress: PPI NSAIDS: 2-4 wks PPI Alcohol: H2 blocker, PPI, sucralfate
35
Nonerosive/nonspecific gastritis | causes
H pylori- spiral gram - rod that lives under the gastric mucosal layer and causes inflammation
36
Nonerosive/nonspecific gastritis | transmission
Person to person | Most ppl asymptomatic
37
Nonerosive/nonspecific gastritis | 3 phenotypes
MC causes inflammation but pt is asymptomatic 15% of ppl infected have inc risk for PUD Least common: Destroys acid secreting cells and inc risk of cancer and PUD
38
Who to test for H. Pylori?
Anyone with ulcer Anyone dx with gastric CA or MALT lymphoma Dyspepsia sx with no prior workup Before chronic trmt with NSAID or long term ASA Unexplained iron deficiency
39
How to test for H. Pylori?
Serum- only 80% accurate so not recommended Fecal Ag or urea breath- 95% accurate but harder to get Must be off PPI for 2 wks and ATB for 4 wks Endoscopy with biopsy if bleeding (cant see with endoscopy alone bc bug lives under gastric mucosa)
40
trmt for H pylori
ATB: 2 or 3 ATB together + anti-secretory agents (PPI) BID Clarithromycin BID + Amoxil BID + PPI BID Tetracycline QID + Metronidazole TID + Bismuth subsalicylate BID + PPI BID
41
Nonerosive nonspecific gastritis: Pernicious anemia gastritis?
Autoimmune destruction of gastric parietal cells Dec gastrin Anti intrinsic factor Ab Risk of gastric carcinoma
42
Nonerosive nonspecific gastritis: Pernicious anemia gastritis dx
Endoscopy and biopsy
43
PUD | ?
Break in gastric or duodenal mucosa extending into muscularis mucosa over 5 mm Duodenal ulcer more common in young
44
PUD | risks
NSAID use, smoker | No risk in diet, ETOH, and stress
45
Nonerosive nonspecific gastritis types
H pylori gastritis | Pernicious anemia gastritis
46
Erosive and hemorrhagic gastropathy?
superficial hemorrhage and erosion of gastric mucosa not inflammation
47
whilch ulcer inc pain with eating
gastric
48
which ulcer has noctural pain
duodenal
49
which ulcer is more common
duodenal
50
which ulcer is more common wiith NSAIDS? h pylori?
nsaids- gastric | h pylori- duodenal
51
PUD | sx
Dyspepsia, dull, aching, hunger like, epigastric pain Duodenal ulcers improve after eating but pain reoccurs in 2-4 hrs NSAID ulcers asymptomatic Asymptomatic periods Anorexia and nausea No vomiting or weight loss
52
PUD | dx
Endoscopy and biopsy | If you test while pt is on PPI, you'll get false -
53
Trmt for duodenal/h pylori ulcer
Stop smoking Dont restrict diet Antisecretory agent + H pylori eradication ATB PPI good for short term only
54
Trmt for NSAID/gastric ulcer
Stop smoking Dont restrict diet Stop meds PPI 4-8 wks
55
Zollinger ellison syndrome (quiz bowl) | ?
Neuroendocrine tumor secretes too much gastric acid (gastrinoma)
56
Zollinger ellison syndrome (quiz bowl) | sx
Dyspepsia, diarrhea, weight loss, recurrent PUD
57
Zollinger ellison syndrome (quiz bowl) | dx
Fasting gastrin level- must be off PPI/ H2 blockers
58
Zollinger ellison syndrome (quiz bowl) | trmt
Surgery
59
Low risk: HA, GI upset (gas, constipation, pain), dizziness | Use lowest dose for shortest amt of time
Short term effects of PPI
60
Dec nutrient absorption (B12, Mg, iron, Ca) Inc risk of hip fractures and pneumonia Inc risk of all cause mortality
long term effects of ppi
61
ppis end in
prazole
62
Use PPX ____ in older pts that need to be on NSAIDS
ppi
63
2nd MCC CA death worldwide
Gastric neoplasm/adenocarcinoma
64
NV trmt
Clear liquids Bland foods Antiemetics
65
“Hungry vomiter”
Infantile hypertrophic Pyloric stenosis
66
Gastric neoplasm/adenocarcinoma | two types
Intestinal type gastric CA MC | Diffuse type gastric CA
67
Intestinal type gastric CA MC
Chronic h pylori infection | Common in men over 40
68
Diffuse type gastric CA
``` Men = women Younger pts Less assoc with h pylori Genetic mutation Worse prognosis ```
69
Gastric neoplasm/adenocarcinoma | dx
Endoscopy and biopsy
70
Gastric neoplasm/adenocarcinoma | sx
Dyspepsia Weight loss, anorexia, early satiety Vague epigastric pain

clin med (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions