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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?

A

12 weeks

24
Q

how long is PPI therapy used for duodenal ulcers?

A

4 to 8 weeks

25
Q

3 Prophylactic treatment for patients with hx of peptic ulcers

A

Misoprostol (to prevent ulcers when using NSAIDs)
Sucralfate (take 1 hr before meals)
PPI

26
Q

4 complications of PUD

A

obstruction, GI bleed, Ulcer perforation, Penetration/ fistulization

27
Q

diabetes is associate with which condition related to the stomach?

A

gastroparesis

28
Q

Delayed gastric emptying/altered motility associated with many diseases is referred to as what?

A

gastroparesis

29
Q

what is the clinical presentation of Gastroparesis?

A

nausea, early satiety, bloating, weight loss, abdominal pain

30
Q

Scintigraphic gastric emptying study is used for what?

A

Gastroparesis diagnosis

31
Q

Gastroparesis diet modification

A

smaller meals, avoid carbonation

32
Q

Gastroparesis medications

A

pro kinetic medication, cisapride and metoclopramide

33
Q

incidence of Hiatal/Diaphragmatic Hernia increases with

A

age

34
Q

Hiatal/Diaphragmatic Hernia clinical presentation

A

many asymptomatic, but may present with GERD or chest discomfort

35
Q

Hiatal/Diaphragmatic Hernia is diagnosed how?

A

with a barium esophagogram and endoscopy

36
Q

what are the treatment options for Hiatal/Diaphragmatic Hernia

A

acid reduction and surgical repair

37
Q

a Hiatal/Diaphragmatic Hernia is a protrusion of what through the diagram via the esophageal hiatus?

A

the stomach

38
Q

a Gastrinoma secretes what?

A

gastrin, this cause hypergastrinemia which causes PUD (1%)

39
Q

most common location of a Gastrinoma?

A

the duodenum

40
Q

Gastrinoma is also called

A

Zollinger-Ellison syndrome

41
Q

1/3 of Gastrinomas are a part of what MEN I, what does this stand for?

A

multiple endocrine neoplasia I, therefore screen those positive for Gastrinomas for MEN1

42
Q

clinical presentation of Gastrinomas

A

Abdominal pain, diarrhea, GI bleed

43
Q

fasting serum gastrin level positive for gastrinomas will be above

A

150 pg/mL

44
Q

during a secretin test used to confirm ZES gastrin levels will rise by

A

over 200

45
Q

treatment options for Gastrinomas

A

PPI and surgery to remove tumor

46
Q

Gastric adenocarcinoma

age population and risk factors

A

almost never occurs before 40

risk factors smoking, H pylori infection, genetic facotrs

47
Q

Gastric adenocarcinoma clinical presentation

A

dyepsia, weight loss, anemia, GI bleeding
Abdominal mass
Signs of metastatic spread (vchhow node and sister Mary Joesph node)

48
Q

a Sister Mary Joseph nodule is what?

A

an umbilical nodule, which is a sign of metazoic spread in gastric adenocarcinomas

49
Q

a Virchow node is what?

A

a left supraclavicular lymphadenopathy, which is a sign of metazoic spread in gastric adenocarcinomas

50
Q

when to do an endoscopy for possible gastric adenocarcinomas

A

any patient over 40 years old with dyspepsia who is unresponsive to therapy

51
Q

most common lab finding on CBC for gastric adenocarcinomas

A

Iron deficiency anemia is most common lab finding

52
Q

gastric adenocarcinomas treatment options

A

surgery +/- chemo and radiation

53
Q

2 types of Gastric lymphoma

A

1) MALT mucosa associated lymphoid tissue

2) Diffuse large B cell lymphoma

54
Q

what increases risk of gastric lymphoma

A

k is 6-fold higher if positive for H. pylori infection

F3E3 (11 decks)

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