Small group Upper GI Flashcards
Burning pain, relief with antacids/PPI, lack of exacerbation with exercise:
?
GERD
(possible:
- hiatal hernia w/ reflux
- ulcer
- non GERD esophagitis)
Risk factors for GERD
Smoking, Alcohol,
Obesity
Male
>50
How should PPI be used?
(Omeprazole)
should be taken 30-60 min prior to eating
- since PPIs only act on actively secreting pumps, meals and mornings maximize are optimal
alcohol and tobacco and high fat foods leads to LES ______
LES sphincter relaxation
- cutting back can reduce reflux
Caffeine and coffee consumption may do what to contribute to GERD?
Increase Gastric acid production
If pt has GERD and is symptomatic for 10 years, (long time) what test should you run?
Esophagogastroduodenoscopy (EGD)
Salmon pink: buzz word for?
Barrett Esophagus
Red dots seen on reactive squamous epithelium, think . . .
eosinophilic esophagitis
squamous pearls seen on biopsy of mass
- think?
Squamous cell carcinoma
risk factor for SCC?
same as adeno
- smoking, alcohol
But also
- caustic injury
- achalasia
Where is adenocarcinoma seen vs SCC for GI?
Adeno: by GEJ
- gastric cardia, GEJ, lower eso
SCC: proximal esophagus (midd-upper 1/3)
What is the presence of melena suggestive of?
Source proximal to the ligament of Treitz.
Hb –> broken down to hematin (black)
or
Slow bleeding from small bowel and prox colon –> melena
Most common causes of gastric ulcers?
H.Pylori (65% stomach, 85% duodenal)
NSAIDS
Tobacco
Neoplasm
Ways to test for H. pylori infxn
serum IgG Ab to H. pylori
- identifies exposure, not active infxn
Stool
- antigen to H.Pylori - best but not avail. everywhere
Breath
Urease containing organisms
Is nuclei arranged around basal end more or less malig?
less
