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F3E3 > Stomach > Flashcards

Stomach Flashcards

1
Q

almost all non- NSAID induced gi mucosal inflammation is cased by what?

A

Helicobacter pylori, a gram-negative bacillus

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2
Q

inflammation of the stomach is refer to as

A

gastritis

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3
Q

how do NSAIDS cause local injury and then gastritis

A

NSAIDs inhibit/ decrease prostaglandin production

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4
Q

common causes of gastritis

A 
autoimmune disorders
Helicobacter pylori
NSAIDs 
Stress 
Alcohol
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5
Q

2 most common presentations of gastritis

A

dyspepsia and abdominal pain

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6
Q

what is the benefit of performing an endoscope with biopsy for suspected gastritis?

A

you can identify gastritis and confirm H. pylori through biopsy

a urea breath test, stool antigen test, and serology for H. pylori also can be used

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7
Q

if gastritis is NSAID induced what is used to treat?

A

a PPI

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8
Q

H. pylori treatment length

A

treat for 14 days, test for eradication post treatment

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9
Q

H. pylori treatment: concern for macrolide resistance

A

Bismuth, tetracyline, metronidazole, PPI

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10
Q

H. pylori treatment: no concern for macrolide resistance, no PCN allergy

A

clarithromycin, amoxicillin, PPI

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11
Q

H. pylori treatment: no concern for macrolide resistance, PCN allergy

A

clarithromycin, metronidazole, PPI

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12
Q

any ulcer if the upper GI system (gastric, duodenal) is referred to as

A

Peptic Ulcer Disease

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13
Q

Peptic Ulcer Disease is associated with

A

gastric cancer

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14
Q

most common cause of Peptic Ulcer Disease?

what are other causes?

A

H, pylori

other causes break in mucosa from injury, NSAIDs, stress, alcohol

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15
Q

a patient comes in with a pain she describes as burning or gnawing that radiates to the back, she notices it is much worse after she eats so she has stopped eating most meals of the day, what do you suspect she has?

A

a gastric ulcer

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16
Q

a patient comes in with a pain he describes as burning or gnawing that radiates to the back, he notices it is somewhat better after he eats so he keeps snacks on him at all times, what do you suspect he has?

A

a duodenal ulcer

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17
Q

Belching, bloating, distention, heartburn, regurgitation related to dyspepsia are common in what condition ?

A

Peptic Ulcer Disease

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18
Q

Indigestion, nausea, heartburn, upper abd fullness, early satiety, bloating, belching related to dyspepsia are common in what condition?

A

gastritis

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19
Q

H. pylori gastritis associated with what 3 conditions?

A

PUD, gastric adenocarcinoma, low-grade B cell gastric lymphoma

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20
Q

is a barium swallow used for PUD?

A

yes it is a diagnostic tool that may be used

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21
Q

what diagnostic tool allows you to differentiates gastritis from ulcer disease

A

endoscopy

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22
Q

PUD treatment

A

avoid triggers
H pylori. for 2-4 weeks
PPI

23
Q

how long is PPI therapy used for gastric ulcers?

24
Q

how long is PPI therapy used for duodenal ulcers?

A

4 to 8 weeks

25
3 Prophylactic treatment for patients with hx of peptic ulcers
Misoprostol (to prevent ulcers when using NSAIDs) Sucralfate (take 1 hr before meals) PPI
26
4 complications of PUD
obstruction, GI bleed, Ulcer perforation, Penetration/ fistulization
27
diabetes is associate with which condition related to the stomach?
gastroparesis
28
Delayed gastric emptying/altered motility associated with many diseases is referred to as what?
gastroparesis
29
what is the clinical presentation of Gastroparesis?
nausea, early satiety, bloating, weight loss, abdominal pain
30
Scintigraphic gastric emptying study is used for what?
Gastroparesis diagnosis
31
Gastroparesis diet modification
smaller meals, avoid carbonation
32
Gastroparesis medications
pro kinetic medication, cisapride and metoclopramide
33
incidence of Hiatal/Diaphragmatic Hernia increases with
age
34
Hiatal/Diaphragmatic Hernia clinical presentation
many asymptomatic, but may present with GERD or chest discomfort
35
Hiatal/Diaphragmatic Hernia is diagnosed how?
with a barium esophagogram and endoscopy
36
what are the treatment options for Hiatal/Diaphragmatic Hernia
acid reduction and surgical repair
37
a Hiatal/Diaphragmatic Hernia is a protrusion of what through the diagram via the esophageal hiatus?
the stomach
38
a Gastrinoma secretes what?
gastrin, this cause hypergastrinemia which causes PUD (1%)
39
most common location of a Gastrinoma?
the duodenum
40
Gastrinoma is also called
Zollinger-Ellison syndrome
41
1/3 of Gastrinomas are a part of what MEN I, what does this stand for?
multiple endocrine neoplasia I, therefore screen those positive for Gastrinomas for MEN1
42
clinical presentation of Gastrinomas
Abdominal pain, diarrhea, GI bleed
43
fasting serum gastrin level positive for gastrinomas will be above
150 pg/mL
44
during a secretin test used to confirm ZES gastrin levels will rise by
over 200
45
treatment options for Gastrinomas
PPI and surgery to remove tumor
46
Gastric adenocarcinoma | age population and risk factors
almost never occurs before 40 | risk factors smoking, H pylori infection, genetic facotrs
47
Gastric adenocarcinoma clinical presentation
dyepsia, weight loss, anemia, GI bleeding Abdominal mass Signs of metastatic spread (vchhow node and sister Mary Joesph node)
48
a Sister Mary Joseph nodule is what?
an umbilical nodule, which is a sign of metazoic spread in gastric adenocarcinomas
49
a Virchow node is what?
a left supraclavicular lymphadenopathy, which is a sign of metazoic spread in gastric adenocarcinomas
50
when to do an endoscopy for possible gastric adenocarcinomas
any patient over 40 years old with dyspepsia who is unresponsive to therapy
51
most common lab finding on CBC for gastric adenocarcinomas
Iron deficiency anemia is most common lab finding
52
gastric adenocarcinomas treatment options
surgery +/- chemo and radiation
53
2 types of Gastric lymphoma
1) MALT mucosa associated lymphoid tissue | 2) Diffuse large B cell lymphoma
54
what increases risk of gastric lymphoma
k is 6-fold higher if positive for H. pylori infection

F3E3 (11 decks)

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