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GI Clinical focus > Stomach 1 > Flashcards

Stomach 1 Flashcards

1
Q

Resolution rate of post viral Gastroparesis?

A

80% after one year

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2
Q

Medications that induce gastroparesis?

A

GAsTrOParesis

GLP1 agonists
Pramlintide (amylin agonists)
Opioids, Anticholinergic’s, TCAs

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3
Q

Medical conditions associated with gastroparesis?

A

Hypothyroid, hyperparathyroid
Addison’s
Scleroderma
Parkinson’s

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4
Q

Gastroparesis levels based on emptying study?

A

Mild 11-20%
Moderate 21-35
Severe 36-50%
Very severe >50%

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5
Q

Gastroparesis drug that should generally be continued only for two weeks? Why?

A

Erythromycin; tachyphylaxis

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6
Q

Role of TCAs in gastroparesis?

A

Not effective

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7
Q

Role of intra-pyloric injection of Botox in gastroparesis?

A

Generally not recommended

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8
Q

ROME IV diagnostic criteria for cyclic vomiting syndrome?

A
  • Stereotypical episodes (acute onset, duration less than one week)
  • 3+ episodes in the prior year
  • absence of vomiting between episodes
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9
Q

Supportive criteria for cyclic vomiting syndrome?

A

Personal or family history of migraines

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10
Q

Prophylactic therapy for cyclic vomiting syndrome?

A

Propranolol
Amitriptyline
Keppra
Zonisamide

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11
Q

Rumination syndrome?

Supportive criteria?

A

Persistent regurgitation of undigested food (a few minutes after eating) without retching

No nausea; non-acidic regurgitation

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12
Q

Treatment of rumination syndrome?

A

Behavioral therapy (optimizing postprandial diaphragmatic breathing)

Baclofen TID

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13
Q

Medication induced causes of dyspepsia?

A

NSAIDs/colchicine, iron, narcotics, acarbose

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14
Q

Rome criteria for functional dyspepsia?

A
  • 1+ of :bothersome postprandial fullness, early satiety, epigastric pain, epigastric burning
  • no evidence of structural disease
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15
Q

Subtypes of functional dyspepsia?

A

Post prandial distress syndrome (postprandial fullness and early satiety)

Epigastric pain syndrome (not relieved by defecation, Meal unrelated)

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16
Q

Herbal medications for functional dyspepsia?

A

Iberogast
Artichoke leaf extract
Peppermint oil
Carraway oil

17
Q

Acotiamide - Mechanism of action?

A

Gastroprokinetic agent; acetylcholinesterase inhibitor

18
Q

Classes of treatments for functional dyspepsia? (7)

A

Herbal medications
SSRIs (not better than placebo)
TCAs

Acotiamide (works in Japan)

GABA agents

Buspirone

Mirtazapine

19
Q

Mechanism of the breath test for H pylori?

How long must a patient be off PPI?

A
  1. Baseline breath sample
  2. Drink solution with carbon labeled urea
  3. If h pylori present, urea converted into CO2, absorbed into the blood, and excreted in the lungs

2 weeks

20
Q

H. pylori biopsy and stool antigen – sensitivity decreased if?(3)

Effect of G.I. bleeding on breath test and stool antigen tests?

A

PPI, antibiotics, bismuth

Reduces sensitivity of breath test; causes false positives on stool antigen

21
Q

Difference between C13 and C14 urea breath test?

Do not give latter to?

A

C 13 non-reactive
C 14 low radiation

Pregnant patients

22
Q

In order to use clarithromycin for H pylori, must ensure?

A
  • No patient history of prior macrolide exposure

- Clarithromycin resistance under 15%

23
Q

Disease characterized by hypertrophic gastric folds? Symptoms? Difference in adults and children?

A

Ménétrier’s disease

Abdominal pain, anemia, peripheral edema

Adults - insidious onset and progressive
Children – sudden onset, resolves spontaneously

24
Q

Ménétrier’s disease - Molecular pathogenesis?

Endoscopically, usually has sparing of? In order to diagnose, need?

A

Enhanced RTK-EGFR signaling

Antrum; deep biopsies or snare resections

25
Q

Ménétrier’s disease - histology (4)?

A

-foveolar Hyperplasia
-tortuosity and dilation of the glands
– smooth muscle hyperplasia
– decreased parietal cells

26
Q

Elevated gastrin -differential if appropriate secretion?

A 
Appropriate - 
—acid suppressive medications
—atrophic gastritis (autoimmune, pernicious anemia, H pylori)
— chronic renal failure
— vegotomy without antrectomy
27
Q

Elevated gastrin -differential if inappropriate secretion?

A 
Inappropriate 
—Zollinger Ellison
—Retained antrum syndrome
— antral predominant H pylori infection
—GOO
—Small bowel resection
28
Q

Retained antrum syndrome?

A

Small segment of the antrum is retained after Billroth 2;

Exposure to alkaline pancreatic secretions increases acid secretion

29
Q

Gastrin levels over thousand are mostly associated with?

A

ZES and chronic atrophic gastritis

30
Q

Diagnosis of the ZES if gastrin is NOT above 10xULN?

A

Gastrin increases over 120 pg/ml after secretin test

GI Clinical focus (20 decks)

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