GI - Stomach Flashcards

0
Q

Functional dyspepsia?

A

Symptoms as described for dyspepsia persisting for at least 12 weeks without evidence of an ulcer

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1
Q

Dyspepsia? Associated with?

A

Pain associated with fullness early satiety bloating or nausea.

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2
Q

Gastroesophageal reflux typically occurs when? Worsens with?

A

After meals. Recumbency.

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3
Q

Biliary colic caused by? Location of pain? Precipitated by? Lasts for?

A

Gallstones. Right upper quadrant. Precipitated by meals, especially fatty foods. Last 30 to 60 minutes with spontaneous resolution

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4
Q

Irritable bowel syndrome suggested by what symptoms?

A
  1. Chronic dysmotility symptoms (up loading, cramping)
  2. Relieves with defecation
  3. no weight loss or bleeding
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5
Q

Duodenal ulcers caused pain how long after meals? Relieved by?

A

2 to 5 hours after a meal. Food or antacids.

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6
Q

If food worsens gastric pain - think?

A

Gastric ulcer

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7
Q

Gastric cancer can present with dysphasia if? Persistent vomiting if? Early satiety it?

A

In the cardiac region of the stomach. Blocking the pyloric channel. Mass effect or infiltration of the stomach wall.

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8
Q

When should patients undergo endoscopy for dyspepsia?

A
  1. Older than 45 years who present with new onset dyspepsia
  2. Patients with alarm symptoms (weight-loss, recurrent vomiting, dysphasia, bleeding, anemia)
  3. Symptoms have failed to respond to empiric therapy
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9
Q

In younger patients with no alarm features - strategy for dyspepsia?

A

Urea breath test or H. pylori antibody test

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10
Q

Problem with H. pylori antibody test?

A

Will remain positive for life even after successful treatment

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11
Q

Cancers associated with H. pylori?

A

Gastric carcinoma and gastric MALT lymphoma

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12
Q

Treatment for H. pylori?

A

Clarithromycin, amoxicillin and a PPI

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13
Q

Major cause of duodenal and gastric ulcers not caused by H. pylori? Mech?

A

NSAIDs. Inhibit prostaglandin synthesis resulting in reduced secretion of mucus and bicarb and decreased mucosal bloodflow

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14
Q

Condition that should be suspected if pt with ulcers is H. pylori negative and does not use NSAIDs? Diagnosed with?

A

Zollinger-Ellison syndrome. Serum gastrin levels greater than 1000

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15
Q

Free perforation into the abdominal cavity may cause?

A

Hemorrhage with severe onset of pain and development of Peritonitis

16
Q

Indications for surgical intervention?

A

Perforation and obstruction

17
Q

Symptoms of gastric outlet obstruction?

A

Persistent vomiting and weight loss with +/-

abdominal distention

18
Q

Gastritis? Presents as? Common causes?

A

Information/erosion of the gastric lighting; bleeding without pain

#Alcohol
#NSAIDs
#H pylori
#Portal hypertension
#Stress (trauma, burns, sepsis, uremia)
19
Q

Atrophic gastritis is associated with which vitamin deficiency?

20
Q

Test to diagnose erosive gastritis?

A
#Endoscopy to diagnose
#H pylori testing
21
Q

H pylori testing options?

A
#endoscopic biopsy – most accurate/invasive
#Serology – negative test excludes infection but lacks specificity (current versus old infection?)
#Urea breath testing – positive only in activity fiction
# stool antigen – positive only in active infection
22
Q

When to give stress ulcer prophylaxis?

A
#Mechanical ventilation 
#head trauma
#burns
#Coagulopathy
23
Q

Role of alcohol and tobacco in PUD?

A

Delay healing of ulcers (do not cause ulcers)

24
Risk of cancer into duodenal PUD? Gastric PUD?
No risk 4%
25
Patient with H. pylori gastritis treated with triple therapy. How to evaluate if treatment worked? Treatment failure usually from?
Breath test or stool antigen Alcohol, NSAIDs, smoking, medication noncompliance
26
Patient with confirmed gastrinoma. CT/MRI negative for metastases. Next step?
Somatostatin receptor scintigraphy (nuclear octreotide scan) + endoscopic ultrasound to further exclude metastases (Gastrinoma associated with increased number of somatostatin receptors)
27
Treatment for diabetic gastroparesis?
Erythromycin and metoclopramide