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Coexisting Disease/Comprehensive Exam - PPT Questions > GI System > Flashcards

GI System Flashcards

1
Q

What position is esophagogastroduodenoscopy performed most frequently?

A

left lateral decubitus

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2
Q

What are the respiratory complications of EGD?

A

desaturation, airway obstruction, laryngosapsm, aspiration

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3
Q

What is a major concern with colonoscopy?

A

Bowel prep – > high risk of dehydration

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4
Q

A barium contrast study can be used to demonstrate ___, ___,___, ___, and ____

A

esophageal reflux, hiatal hernia, ulcerations, erosions, strictures

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5
Q

What are the most common symptoms of esophageal diseae?

A

dysphagia, heart burn ,and regurgitation

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6
Q

____ is a symptom referring to difficulty swallowing.

A

dysphagia

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7
Q

Oropharyngeal dysphagia is commonly seen after what type of surgery?

A

Head and neck

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8
Q

What conditions are associated with oropharyngeal dysphagia?

A

stroke and Parkinson’s

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9
Q

Dysphagia only for solid foods indicates what kind of disorder?

A

Structural

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10
Q

Dysphagia for both liquids and solids indicates what kind of disorder?

A

motility

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11
Q

_____ is a symptom described as burning or discomfort behind the sternum, possilby readiating to the neck.

A

heartburn

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12
Q

_____ refers to the effortless return of gastric contents into the pharynx without hte nausea or retching that would be experienced with vomiting.

A

Regurgitation

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13
Q

What is odynophagia?

A

Pain with swallowing

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14
Q

What is Achalaisa?

A

A NM disorder consisting of esophageal outflow obstruction caused by inadequate relaxation of the LES and a dilated hypomotile esophagus

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15
Q

What are the s/s of achalasia?

A

dysphagia w/ both liquids and solids, regurgitation, heratburn, and chest pain

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16
Q

What disease is associated with an increased risk of esophageal cancer?

A

Achalasia

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17
Q

What is a common complication of achalasia?

A

pulmonary aspiration

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18
Q

How is achalasia diagnosed?

A

By esophagram

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19
Q

A “birds beak” appearance is associated with waht?

A

Achalasia

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20
Q

T/F: Treatment for achalasia relieves the obsturction and corrects the peristaltic deficiency of the esophagus.

A

False - all treatments are palliative. They relieve the obstruction but cannot correct the peristaltic deficiency of the esophagus

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21
Q

What two medications can be used ot try to relax the LES with Achalasia?

A

Nitrates and CCB

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22
Q

What are invasive treatments for Achalasia?

A

Endoscopic botulinum toxin injection, pneumatic dilation, lap Heller myotomy, per oral endoscopic myotomy

23
Q

Are those with achalasia considered full stomachs?

A

Yes

24
Q

In what disease does the dilated esophagus retain food for many days?

A

Achalasia - therefore the duration of fasting is meaningless

25
Q

In what patient population does distal esophageal spasm typically occur?

A

eldelry patients

26
Q

What causes distal esophageal spasm?

A

ANS dysfunction

27
Q

What does an esophagram show in a patient with distal esophageal spasm?

A

Corkscrew or rosary bead esophagus

28
Q

pain produced by distal esophageal spasm can sometimes mimic _____

A

angina pectoris

29
Q

What medications reduce pain associated with distal esophageal spasm?

A

Nitroglycerin, Traxodone and Imipramine (both antidepressants), and Sildenafil (phosphodiesterase inhibitor)

30
Q

What are esophgeal diverticular?

A

Outpouching of the wall of hte esophagus

31
Q

What location does Zenker’s diverticulum occur?
pharyngoesophageal, mideosphageal, or epiphrenic?

A

Pharyngoesophageal

32
Q

What S/S occur with small-medium sized Zenker’s diverticula?

A

asymptomatic

33
Q

_____ appears in a natural zone of weakness in the posterior hypopharyngeal wall and can cause significant bad breath from retention of food.

A

Zenker’s diverticulum

34
Q

T/F: Zenker’s diverticular can comrpess the esophagus.

A

True - if they become large and filled with fluid… this leads to dysphagia

35
Q

How is anesthesia induced in esophageal diverticula?

A

Head-up position WITHOUT cricoid pressure
(b/c cricoiod pressure reducing the risk of aspiration during RSI is doubtful in this case)

36
Q

T/F: An NGT is used to decompress esophagus and abomdne after induction in esophageal diverticula?

A

False - insertion of a NGT is avoided b/c it can perf the diverticulum

37
Q

A _____ is a herniation of part of the stomach into the thoracic cvity through the _______ in the diaphragm.

A

hiatal hernia; esophageal hiatus

38
Q

How does esophageal cancer present?

A

With progressive dysphagis to solid food and weight loss

39
Q

What are post-op complications of esophagectomy

A

ARDS, anastomotic leaks, dumping syndrome, esophageal stricture

40
Q

What risk persists for life after esophagectomy?

A

Significant risk of aspiration

41
Q

What are the most common S/S of GERD?

A

heratburn and regurgitaiton

42
Q

What are natural antireflux mechanisms? (3)

A
  1. LES
  2. crural diaphragm
  3. anatomic location of the GE junction below the diaphgramatic hiatus
43
Q

At rest, the ___ exerts a high pressure that prevents gastric contents from entering esophagus.

A

LES

44
Q

What is the average resting tone of the LES in patients wtihout GERD?

A

29 mmHg

45
Q

What is the average resting tone of the LES in patients with GERD?

A

13 mmHg

46
Q

What are 3 common physiologic causes of GERD?

A
  1. transient LES relaxation
  2. LES hypotension
  3. anatomic distortion of the GE junction
47
Q

What is therapy for GERD?

A

lifestyle modificaiton

48
Q

What foods should be avoided with GERD?

A

Ones that reduce LES tone (fatty & fried, alcohol, peppermint, chocolate) and acidic foods (citrus and tomato)

49
Q

Which is more effective for GERD to inhibit gastric acid secretion: PPI or H2 blockers?

A

PPI

50
Q

What is a surgical option for severe GERD?

A

Nissen fundoplication

51
Q

Cimetidine effect begins in _____

A

1-1.5 hours

52
Q

What are the MOA of cimetidine and ranitidine?

A

decrease gastric acid secretion and increase gastric pH

53
Q

What isthe DOA of cimetidine?

A

3 hour

54
Q

Is ranitidine or cimetidine more potent?

A

Ranitdine

Coexisting Disease/Comprehensive Exam - PPT Questions (6 decks)

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