Itis Case Study Flashcards
Can mimic GERD and is accompanied by solid food dysphagia
Eoinophillic Esophagitis
Associated with systemic allergy and asthma
Eosinophillic esophagitis
Characterized by the pathophysiology of a loos LES, thus allowing reflux into the esophagus
GERD
Decreased LES resting pressure can lead to
GERD
Another cause of GERD can be a
Hiatal Hernia
Impaired esophageal clearance due to impaired peristalsis or salivary bicarbonate can lead to
GERD
Impaired distal esophageal clearance and delayed gastric emptying can also cause
GERD
An H2 blocker used to treat GERD
Ranitidine
What are three ways we can decrease a GI bleed/anemia?
Dietary changes, decrease caffeine, do not eat before bed
Characterized by the replacement of normal squamous epithelium with specialized columnar epithelium
Barret’s esophagus
What percentage of GERD patients develop Barrett Esophagus?
10%
What percentage of Barret Esophagus patients develop dysplasia?
10%
Occurs due to impaired LES pressure, the presence of hiatal hernia, impaired distal esophageal mucosal defense mechanisms and delayed gastric emptying
GERD
Difficulty swallowing
Dysphagia
Painful swallowing
Odynophagia
Placing the hand under the RUQ, the patient is asked in inspire. The patient’s breath is sharply curtailed as the hand encounters the inflamed gall bladder. This describes
Murphy’s sign
Characterized by RUQ pain lasting less than 4 hours following meals
Biliary Colic
When a stone is lodged in the cystic duct, then the stone falls back into the fundus and pain is relieved
Biliary Colic
In Biliary colic, the pain
Radiates
Characterized by constant pain in the RUQ with possible radiation to the shoulder or back
Acute Cholecystitis
Shows signs of inflammation like elevated WBC, and ALT/AST
-also displays positive murphy’s sign
Acute cholecystitis
Mucosal phospholipases hydrolyze luminal lecithins to toxic lysolecithins, and Gall stones form
Acute cholecystitis
In acute cholecystitis, what is the percentage of patients with cystic duct obstruction?
90%
What percentage of acute cholecystitis patients have acalculous cholecystitis?
10%
The gall bladder wall thickens with chronic inlfammation and the gall bladder contractility is poor with
Acute Cholecystitis
Pigment stones, Crohn’s disease, and oral contraceptives are risk factors for
Acute Cholecystitis
Results from chemical irritation and inflammation of the obstructed gallbladder
Acute calculous cholecystitis
Defined as persistent RUQ abdominal pain > 4 hours and associated with nausea and vomiting, fever, radiation of pain to the back and shoulder, leukocytosis, and often mild elevation of LFT’s
Acute Cholecystitis
What is the treatment for acute cholecystitis?
Cholecystectomy
Pancreatic digestive enzymes are synthesized in the inactive (pro enzyme) form, except for
Amylase and lipase
These enzymes are then sequestered in membrane bound zymogen granules in
Acinar cells
Activation of pro-enzymes requires conversion of trypsinogen to trypsin by duodenal
Enterokinase
Trypsin inhibitor that counter-balances trypsin activity
Spink1
Auto-digestion of the pancreas by inappropriately activated pancreatic enzymes
Pancreatitis
Inappropriately activated in pancreatitis, triggering the intrapancreatic cascade of enzyme activation
Trypsin
Pancreatic duct obstruction: gallstones and biliary sludge…enzyme rich fluid in the interstitium…lipase > fat necrosis > inflammatory response > ischemia > ascinar cell injury
Pancreatitis
