GI Disorders Flashcards
physiologic reflux
- Occurs after eating
- Is short lived
- Rarely occurs during sleep
pathologic reflux
- Associated with symptoms
- Associated with mucosal injury
- Nocturnal symptoms
3 mechanisms of GERD
- Reduction in LES tone
- Irritation of esophageal mucosa
- Increased gastric acid secretion
GERD worrisome symptoms
New onset ≥ age 60 years
* Evidence of GI bleeding (or IDA)
* Anorexia/weight loss
* Dysphagia/odynophagia
* Vomiting (obstruction)
* GI cancer in FDR
Risk Factors for Barrett’s Esophagus
Duration of GERD >5-10 years
* Age >50 years
* White, male
* Hiatal hernia
* Obesity
* Tobacco use
* Nocturnal reflux
Antacids
tums
increases ph for about 20-30 min
h2 receptor antagonists
cimetidine, ranitidine, famotidine
decreases acid production for 6-12 hours, relief in 60 min
Proton pump inhibitors
omeprazole
reduces gastric acid secretion
relief in 1-3 days
Acute Cholecystitis
- Inflammation of the gallbladder
- Right upper quadrant pain; sometimes epigastric
- Fever
- Develops in about 6-11% of patients who have gallstones
RUQ pain diff diagnosis
cholecystitis
acute hepatitis
epigastric pain diff diagnosis
pancreatitis
gastric etiology
LUQ pain diff diagnosis
Acute MI
pancreatitis
PUD
GERD
gastritis
splenic etiology
lower abdominal pain diff diagnosis
appendicitis
diverticulitis
nephrolithiasis
pyelonephritis
right lower quadrant pain with fever
crohn’s dx
left lower quadrant pain plus fever
diverticulitis
Colorectal CA screening options
FOBT- annually
FIT- annually
FIT DNA- 1-3 yrs
colonoscopy- every 10 yrs
small bowel diarrhea
watery
large volume
cramping
bloating
gas
large bowel diarrhea
frequent
regular
small volume
painful
fever
bloody/mucoid
IBS
- Crampy abdominal pain that varies in location and character
- Diarrhea, constipation, alternating diarrhea and constipation; normal bowel habits alternating with above
- Mucus present in stools
- Other GI symptoms: GERD symptoms, early satiety, nausea, chest pain
Diarrhea Red Flags
- Rectal bleeding
- Nocturnal or progressive abdominal pain
- Weight loss
- Anemia, elevated inflammatory markers, electrolyte disturbances
ALT/AST:
measure integrity of liver
PT/albumin:
measure synthetic activity of liver
Bilirubin, ALP:
measure excretory function of liver
HBsAg
Hep B surface antigen
infected (current or past)
anti-HBs
Hep B surface antibody
immune (vaccine or recovery)
anti-HBc
total hep B core antibody
current or previous infection
IgM anti-HBc
IgM antibody to hep B core antigen
acute hep b
HCV antibody
screening test
detects antibody to HCV: prior treated
HCV-RNA
confirmatory test
tests for presence of virus
pyrosis definition
heartburn
gold standard test for cholecystitis
abdominal US
colorectal screening recommendation starts at age
45
