Stomach Flashcards
Diagnostic criteria for Zollinger-Ellison Syndrome (2)
fasting gastrin > 1000
pH < 2
Gastrin increase w/ secretin stimulation for ZES
> 120
Antibodies positive in celiac (2)
anti-tTG IgA
EMA
Follow-up testing for celiac (2)
total IgA for IgA deficiency
repeat anti-tTG IgA after 6-12 months gluten free
Biopsy findings for celiac
villous atrophy
Route through the stomach
cardia - fungus - body - antrum
Fundus function
gas storage
Body of stomach function
food digestion
Antrum function
churning
Key regulators/stimulators of gastric acid (3)
1) gastrin
2) histamine - released from enterochromaffin-like cells
3) acetylcholine - released by vagal stimulation
Tests for H. pylori diagnosis (3)
urea breath
stool antigen
biopsy via EGD
Common supplementation needed post-gastrectomy (3)
vitamin B12
iron
calcium
Testing for H. pylori eradication (2)
1) urea breath test
2) or stool antigen after 4 wks
Gastric emptying study parameters (3)
<60% at 2 hrs
<10% at 4 hours
half-life > 90 minutes
Treatment of severe cases of salmonella
ciprofloxacin 500 mg BID for 5-7 days
Most common location of gastric ulcer
antrum
Pain timing of gastric vs duodenal ulcer
gastric: soon after eating
duodenal: 2-5 hrs later, usually relieved by food
Acid exposure time on ambulatory pH monitoring for GERD
> 4.2% of 24 hrs
Diagnosis of carcinoid syndrome
elevated 24-hr urinary 5-HIAA
Ulcer pain that improves w/ food
duodenal
Ulcer pain that worsens w/ food
gastric
Screening required following carcinoid diagnosis
cardiac valvulopathy
Most common location of NSAID-induced ulcer
stomach
Most common location of H. pylori-induced ulcer
duodenum
Dor fundoplication wrap degree and position
180 degrees, anterior
Toupet fundoplication wrap degree and position
270 degrees, posterior
Nissen fundoplication wrap degree and position
360 degrees, complete wrap
Best fundoplication if esophageal motility issues
Toupet
Best fundoplication for dysphagia risk
Dor
Most effective fundoplication for reflux control
Nissen
