GI Disease- Ward Flashcards
alcohol abuse increases risk of what three cancers?
esophageal, colorectal, liver
Most digestive diseaseses (blank) with age.
Except, what occurs in infants?
Young and middle aged adults?
What do women get more than men?
increase
gastroenteritis, appendicitis
Hemorrhoids, IBD, chronic liver disease
non ulcer dyspepsia and IBS
What is sjorgrens syndrome?
autoimmne disease that attacks tears and saliva
-dry mouth and dry eyes
What is the birds beak sign indicative of?
What are the characteristics of this?
What is the tx?
Is there a cure?
achalasia
- intra esophageal pressure
- failure of relaxation of LES
Nifedipine, endoscopic balloon dilation, laparascopic myotomy, peroral endoscopic myotomy and botulinum toxin
NOpe cuz none of them fix the loss of enteric nerves or ICC
Whats the best tx for achalasia?
-laparascopic myotomy
What is this:
esophageal squamos epithelium is replaced by metaplastic columnar epithelium w/ goblet cells and paneth cells
barretts esophagus
What is this:
in-situ squamos carcinoma displays full thickness replacement of the epithelium with severely dysplastic cells. BM is intact w/ no evidence of invasion into the LP
Squamos cell carcinoma
How do you test for GERD and baretts esophagus?
Manometry-pH probe, upper endoscopy, biopsies
barium swallow x ray
What is average age of barretts esophagus? What gender? What is a risk factor? prognosis? tx?
- 55
- male (2X)
- GERD
- can progress to cancer where survival is less than 1 year
- benzimidazoles (PPI) block the final step of H/K ATPase in parietal cell. Aspirin and NSAIDs thought to prevent esophageal cancer in pnts with Barrett’s esophagus
What is this:
A gastrointestinal motility disorder of the stomach.
Characterized by delayed emptying of food from the stomach into the small bowel in the absence of mechanical obstruction.
gastroparesis
What are these associated with: Alcohol. Anticholinergic drugs. Calcium channel blockers. Dopamine agonists. Histamine (H2) receptor antagonists. Nicotine. Proton Pump Inhibitors
Gastroparesis
How do you identify gastroparesis?
- endoscopy (for bezoars)
- US distinguishers gall bladder from gastroparesis
- scintigraphy (egg meal)
- smart pill (cant have GI problems)
- paracetamol/acetaminophen testing
- octanoic acid breath test
What drugs stimulate gastric emptying?
antiemetic
gastroprokinetic
metoclopramide
Hydrogen breath test?
Urea breath test?
Octanoic acid breath test?
lactose intolerance
H. pylori
Gastroporesis
What can lead to gastroparesis?
- DM
- Autonomic neuropathy
- Myopathy
- Viral infections
- Abnormalities interstitial cells of Cajal
- Nitric oxide synthase
How do you treat gastroparesis?
optimize glycemic control avoid exacerbating factors dietary mod prokinetics intrapyloric botox enteral nutrition gastric pacing surgery
What is metoclopramide and what does it do?
dopamine antagonist-> increases tone and gastric contractions (only FDA approve)
What is erythromycin?
motilin receptor agonist, stimulates migrating motor complex
What is cisapride?
serotonin stimulation
2 places you get PUD? Where is more common and what do you get a bigger risk of?
stomach and duodenum
duodenal -> risk of malignancy
What is this:
Episodes of projectile, nonbilious vomiting.
Present any time in the first weeks to months of life and often gets progressively worse.
olive shaped mass. Lots of projectile vomiting. Hypokalemic, hypochloremic, metabolic alkalosis
Pyloric stenosis
What is this:
The intestinal walls are hypomotile. The condition resembles a true obstruction, but no such blockage exists. Abdominal pain, vomiting, diarrhea, constipation, malabsorption of nutrients, weight loss and/or failure to thrive, enlargement of various parts of the small intestine or bowel also occur.
How do you treat?
Intestinal pseudoobstruction
surgical removal
Secondary intestinal pseudoobstruction may be caused by (blank x 3)
scleroderma, muscular dystrophy, MS
What causes gall stones?
too much cholesterol
too much bilirubin
not enough bile salts
