Lecture 2 - Stomach Disorders Flashcards
What are 3 vestibular disorders which may be causes of nausea or vomiting?
- Labyrinthitis
- Meniere syndrome
- Motion sickness
What are 3 causes of Gastroparesis that may be associated with N/V?
- Diabetes
- Postviral
- Postvagotomy
The use of what reduces the risk of stress-related gastric bleeding?
What reduces the incidence?
- Use of enteral nutrition reduces risk of stress-related bleeding
- Use of H2 blocker or PPI reduce incidence
Which meds are indicated as causes of Hemorrhagic Gastritis?
Aspirin and other NSAIDs
Alcohol is a risk factor for what type of Gastropathy?
Portal HTN gastropathy
Portal HTN gastropathy is correlated with the severity of what?
Severity of portal HTN and underlying liver disease
Treatment of portal HTN gastropathy with what reduces the incidence of recurrent acute bleeding?
Propranolol or Nadolol
Pts with portal HTN gastropathy who fail propranolol therapy may be successfully treated with what?
Portal decompression
What is the most common clinical manifestation of erosive gastritis?
How about in a patient receiving nasogastric suction?
- Upper GI bleed which presents as hematemesis, “coffee ground” emesis
- Bloody aspirate in pt receiving nasogastric suction
- Melena
How is the diagnosis of erosive gastritis made?
What is usually seen?
Inflammation?
- Upper endoscopy
- Superficial lesions, varying in size and #, which may be focal or diffuse
- There is usually NO significant inflammation on histo exam
What is the recommended treatment for erosive gastritis?
Removal of offending agent and maintenance of O2 and blood volume as required
Hourly oral administration of what drugs can be used for prevention of stress ulcers in critically ill patients?
Liquid antacids, sucralfate, or IV PPI
Type A gastritis is the type found where in the stomach?
Fundic type (predominantly the body)
Type A gastritis is caused by?
Autoimmune mechanism
What are some of the common findings with Type A gastrities (i.e., gastrin and H+ levels)?
- Achlorhydria –> pronounced hypergastrinemia –> hyperplasia of gastric ECL cells
- May lead to the development of carcinoid tumors
- Decreased IF –> Pernicious Anemia
Type A gastritis (autoimmune type) is associated with what types of cancer?
- Gastric Adenocarcinoma
- Carcinoid tumors
Type B Gastritis is also know as what type?
Predominantly affects which part of th stomach?
- H. pylori gastritis
- Antral predominant disease
The eradication of H. pylroi for chronic gastritis is recommended in what 2 instances?
- MALT lymphoma
- PUD
A small # of patients with Menetrier Disease have shown dramatic improvement after the administration of which drug?
Cetuximab, an Ab that binds EGFR
By definition, ulcers extend through the ___________ (layer) and are usually over _____mm in diameter
By definition, ulcers extend through the muscularis mucosae and are usually over 5 mm in diameter
PUD results when which factors overwhelm “defensive” factors involved in mucosal resistance?
Gastric acid or pepsin
What is the typical patient description of the epigastric pain associated with PUD?
Gnawing, dull, aching, or “hunger-like”
Most patients with PUD have symptomatic periods lasting up to several weeks with intervals of months to years in which they are pain free, a concept known as?
Periodicity
Does recovered nasogastric lavage fluid that is negative for blood exclude active bleeding from a duodenal ulcer?
NO
Strains of H. pyloripositive for which virulence factor significantly increase the risk for an ulcer?
Cag-A positive
Successful eradication of H. pylori can be confirmed with what tests?
How long after antibiotic therapy and PPI treatment should you wait to run these tests?
- Urea breath test
- Fecal antigen test
- Endoscopy w/ biopsy
- At least 4 weeks after completing Ab tx and 1-2 weeks after PPI’s