SECRETS GI - Stomach

Question 1

duodenal vs gastric ulcers

Answer 1

gastric = pain with meals –> weight loss due to food avoidance

duodenal = pain 1-3 h after meals

Question 2

PUD causes

Answer 2

h. pylori

NSAIDs

Question 3

NSAIDs –> PUD

Answer 3

NSAIDs inhibit PGs that normally protect gastric mucosa by increasing mucus and bicarb production & stimulating local vasodilation (adequate perfusion)

Question 4

Misoprostal

Answer 4

PGE1 analog
decrease gastric acid secretion
increase mucus and bicarb secretion

Question 5

COX-2 inhibitors ADR

Answer 5

prothrombotic

exacerbate HTN

Question 6

upper vs lower GI bleed

Answer 6

upper = melena or hematemesis

ligament of treitz

lower = hematochezia

Question 7

PUD hemorrhage locations & blood supply

Answer 7

posterior duodenum - gastroduodenal artery

lesser curvature - gastric artery

Question 8

gastric carcinoma risk factors

Answer 8

chronic gastritis

h. pylori

Question 9

gastric carcinoma mets

Answer 9

left supraclavicular node (Virchow)

bilateral to ovaries (krukenberg) - signet ring cells

Question 10

h pylori dx

Answer 10

urease breath test

Question 11

multiple duodenal ulcers or ulcers in jejunum

Answer 11

zollinger-ellison syndrome

Question 12

zollinger-ellison syndrome

Answer 12

due to gastrin-secreting tumor or gastrinoma –> excessive secretion of acid

markedly elevated gastrin level

Question 13

triple therapy

Answer 13

2 antibioties + PPI/H2 blocker

Question 14

PUD tx

Answer 14

PPI
H2 blocker
anticholinergic (atropine)
mucosal protective agent (misoprostol)
antacids

Question 15

acute gastritis risk factors

Answer 15

alcohol, NSAIDs

Question 16

acute gastritis pathology

Answer 16

punctate erosions in antrum

diffuse inflammation of gastric mucosa

Question 17

autoimmune gastritis

Answer 17

affects parietal cells

inhibit production of IF (pernicious anemia) and HCl (achlorhydria)