Stomach Flashcards
Patient presents w sx of recurrent heartburn and a positive response to acid-suppression drugs. Dx?
GERD
Alarm sx of GERD
Dysphagia
Gi bleeding
Weight loss
What are DDx that can cause GERD alarm sx?
Stricture
Adenocarcinoma
What are extraesophageal sx of GERD?
Pharyngitis Ear pain Gingivitis Chronic cough asthma, aspiration pneumonia
What is the gold standard for id’ing reflux?
Esophageal pH monitoring
Treatment for GERD
Lifestyle changes and drug therapy
Common causes of gastritis
Helicobacter pylori
AutoImmune gastritis
Bile
NSAIDs
Endoscopy shows erosions and petechial hemorrhages. What is the Tx?
Dx: Helicobacter pylori
Tx: Abx, PPi or H2 antagonist, stop using NSAIDs
H2 receptor antagonists for H pylori tx
Famotidine
Cimetidine
PPis for H pylori tx
Omeprazole
Lansoprazole
You feel a lymph node in the left supra-clavicular region. Patient is cachetic. What now?
Dx: Neoplasm of Virchow’s node
Procedure: Endoscopy w biopsy
Tx: Surgery w resection, chemo, radiation
You feel a node involvement in the periumbilical area. You feel enlarged liver. What now?
Dx: Neoplasm of Saint Mary Joseph’s node
Procedure: Upper endoscopy w biopsy
Tx: Surgery w resection, chemo, radiation
Most common causes of Peptic Ulcer Disease PUD
H pylori and NSAIDs
Uncommon cause of PUD
Gastrinoma tumor (Zollinger-Ellison syndrome)
Presents w sx of burning, epigastric pain that is worse on empty stomach or at night. (+) epigastric TTP. What do you order to confirm Zollinger-Ellison syndrome?
Procedure: Endoscopy w biopsy
Labs: Serum Gastrin will be elevated w Z-E syndrome
Patient feels better after eating. Where is the ulcer likely located?
Duodenum
Patient c/o gastric pain at night. Where is the ulcer likely located?
Duodenum
Triple Therapy treatment for H pylori
PPI BID
Amoxicillin 1g BID plus Metronidazole 500 BID
or
Amoxicillin 1g BID plus clarithromycin 500 BID
Most common cause of upper Gi bleeding
Peptic ulcer disease (PUD)
