GI brief Flashcards
Describe the first step in the management of a patient with hematemesis.
Establish an IV line and administer normal saline.
If pt needs blood: hametestmessis
packed RBCs.
What is the investigation of choice for hematemesis?
Upper GI endoscopy.
What is the diagnosis for an infant with persistent non-bilious vomiting starting at 2-6 weeks, marked dehydration, and weight loss?
Congenital hypertrophic pyloric stenosis (CHPS).
Inv of choice of CHPS:
US.
What is the treatment of CHPS?
First correct dehydration and electrolyte imbalance, then consider surgery.
- Vomiting at 2-6 Ws+ marked dehydration, bad general condition:
CHPS.
- Vomiting at 2-6 Ws+ NO dehydration, good general condition:
GERD.
Describe the presentation of a patient with acquired pyloric stenosis.
Long-standing history of peptic ulcer disease, recurrent vomiting occurring 1 hour after a meal, and a succussion splash on physical exam.
What is the first most common cause of peptic ulcer disease (PUD)?
H. pylori infection.
What is the second most common cause of PUD?
Smoking (other causes include stress, alcohol, NSAIDs).
Inv of choice of PUD:
upper GI endoscopy (biopsy only from gastric cancer).
What is the regimen for eradicating H. pylori?
Amoxicillin, clarithromycin, proton pump inhibitor (PPI).
Why is metronidazole removed from the regimen for H. pylori eradication?
Due to bacterial resistance.
What is the follow-up test after treatment for H. pylori infection?
Urea breath test.
What is the best advice for a patient with PUD?
Stop smoking.
TTT of Pt with PUD develops hematemesis:
1st step: IV line& normal saline. If need blood: packed RBCs.
Then: endoscopy& injection of adrenaline or heat probe if visible bleeding.
Describe the first step in the treatment of a patient with PUD who develops hematemesis.
Establish an IV line, administer normal saline, and consider packed red blood cells if needed. Then proceed to endoscopy and consider injection of adrenaline or heat probe if visible bleeding.
Pt with PUD develops severe abdominal pain referred to back:
perforation.
What is the first step investigation in suspected perforation in a patient with PUD?
Perform an erect x-ray to check for air under the diaphragm.
TTT of perforation:
resuscitation 1st & then surgery.
What are the symptoms of early dumping syndrome?
Nausea, abdominal pain, fullness, diarrhea, and flushing within 1 hour after a meal. mainly due to hypovelemia
What are the symptoms of late dumping syndrome?
Symptoms occurring 1-3 hours after eating, mainly due to hypoglycemia.
What is the treatment for dumping syndrome?
Diet modification, including light frequent meals with decreased carbohydrate content.