Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IP3 exam #2 > Pancreatitis, GERD, Peptic Ulcer Disease > Flashcards

Pancreatitis, GERD, Peptic Ulcer Disease Flashcards

1
Q

Causes of Acute Pancreatitis

A
  • Often due to gallstones or alcohol

- High triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs and Symptoms of Acute Pancreatitis

A
  • Severe abdominal pain
  • Elevations in pancreatic enzymes
  • Self limiting, will often spontaneously resolve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Management of Acute Pancreatitis

A
  • Pain relief
  • Fluid replacement
  • Prevention of complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pain managment in Acute Pancreatitis

A
  • Initially IV then PO
  • Morphine (1st choice)
  • Meperidine (less effective and has active metabolites)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Maintain fluid status in acute pancreatitis

A
  • Normal Saline is preferred

- Hyperglycemia can increase risk of secondary infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Preventing complications in acute pancreatitis

A
  • If diagnosed with acute necrotizing pancreatitis start antibiotics with in 48hrs and continue for 2 weeks
  • DO NOT start antibiotics if not indicated by infection
  • 500mg imipenem/cilastin q8hr
  • Ciprofloxacin and metronidazole (if pt has a penicillin allergy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chronic pancreatitis

A
  • Progressive inflammatory state
  • Functional and structural damage
  • Can go undiagnosed for many years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment goals of Chronic pancreatitis

A
  • Control pain
  • Correct malabsorption
  • Assess need for exogenous insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pain management in Chronic pancreatitis

A
  • Stop alcohol and tobacco use
  • Eat small meals
  • Low fat diet
  • Acid suppressive therapy (AST)
  • NSAIDs, APAP, tramadol
  • Use narcotics if pain persists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Malabsorption correction in Chronic pancreatitis

A
  • Reduce dietary fat <20g/meal

- Supplement with pancreatic enzymes (lipase 30,000 to 90,000 IU per meal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diabetes mellitus in Chronic pancreatitis

A
  • Decrease in insulin production, due to loss of pancreatic function
  • Assess glucose tolerance/need for exogenous insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

GERD Therapy

A

1) Weight loss
2) Antacids
3) Surface agents
4) Histamine blockers
5) PPIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antacids

A
  • Pro: quick onset

- Con: short duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Surface agents

A
  • Sucralfate
  • Safe in pregnancy
  • Promotes healing: forms a gum that protects the stomach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Histamine blockers

A
  • More effective than antacids
  • Pro: Longer duration of action
  • Con: Longer onset, loses effectiveness with subsequent dosing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PPIs

A
  • Most effective for GERD
  • Helps to heal erosive esophagitis
  • Pro: fast onset, long duration
  • Con: Side effects, cost, drug interations
17
Q

Peptic Ulcer Disease

A
  • Ulcers due to
    1) H. pylori
    2) NSAIDs
    3) Stress
18
Q

Gastric Ulcers

A
  • Caused by H. pylori or NSAIDs

- Symptoms worsen with food

19
Q

Duodenal

A
  • Caused by H. pylori or NSAIDs

- Symptoms get better with food

20
Q

Non-variceal bleed

A
  • Erosion of ulcer into an artery

- Can be insidious and fatal

21
Q

Diagnosis of H. pylori

A

a) Breath test or stool antigen test (noninvasive)
b) Endoscopy (invasive)
-Drug interactions with tests
PPIs, bismuth, and antibiotics can interfere with breath and stool test

22
Q

Treatment of H. pylori

A
  • Duration is 14 days

- 3 drug regimen or 4 drug regimen

23
Q

3 drug regimen

A
  • 14 day therapy to treat H. pylori
    1) PPI bid (or esomeprazole 40mg qd)
    2) Clarithromycin 500mg bid
    3) Amoxicillin 1g bid (use metronidazole if PCN allergy)
24
Q

4 drug regimen

A
  • 14 day therapy to treat H. pylori
    1) PPI bid (or esomeprazole 40mg qd)
    2) Subsalicylate 525mg qid
    3) Metronidazole qid
    4) Tetracycline, amoxicillin, or clarithromycin qid
25
Q

Pylera

A
  • Includes; Bismuth, metronidazole, and tetracycline
  • Used in 4 drug regimen
  • Just at PPI
26
Q

NSAID induced ulcers

A
  • High risk with piroxicam and ketorlac
  • Moderate risk with naproxen
  • Lowest risk with ibuprofen and diclofenac
27
Q

Risk factors for NSAID induced ulcers

A
  • Age > 65
  • Previous upper GI bleed
  • Corticosteroid or anticoagulant therapy
  • High dose/ multiple NSAID use
  • Chronic major organ impairment
28
Q

Treatment of NSAID induced ulcer

A
  • STOP NSAID
  • Add PPI
  • H2 blockers are NOT effective for gastric ulcers
29
Q

Stress related mucosal damage (SRMD) bleed

A
  • Cause of lack of O2 in GI tract due to respiratory failure causing mucosal damage
  • Prophylaxis with H2 blocker or PPIs
30
Q

Are PPIs effective in UGIB

A
  • Not effective in UGIB

- Are effective in PUD

31
Q

Why should PPI therapy be stopped

A
  • Adverse effects
  • Increased risk of fall/fracture
  • Increased incidence of C. diff
  • Costs
32
Q

De-escalating acid suppressive therapy for GERD or dyspepsia

A

-Taper after being asymptomatic for at least 3 months

33
Q

De-escalating acid suppressive therapy for PPI use of < 8 weeks

A

-No tapering needed for that short of a duration

34
Q

De-escalating acid suppressive therapy for moderate to high dose PPI

A
  • Reduce dose by 50% per week until at lowest dose of PPI
  • After 1 week at lowest dose, discontinue the PPI
  • If symptoms recur treat with high dose H2 blocker
  • Consider addition of antacids

IP3 exam #2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions