Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med GI > Stomach Disorders > Flashcards

Stomach Disorders Flashcards

1
Q

etiology of gastritis

A
  1. erosive

2. non erosive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are causes of erosive gastritis

A

NSAIDS (MC)
ETOH
mental or physical stressors (trauma, post-op)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are causes of non erosive gastritis

A

H pylori (MC)
pernicious anemia
CMV (AIDS)
Candida (DM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is H pylori

A
  • gram neg rod transmitted person to person, infects sub mucosal gastric layer
  • can survive in acidic environments thur high urease activity that converts urea into alkaline ammonia and carbon dioxide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is pernicious anemia

A

autoimmune disorder of fundic glands, B12 absorption deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PE findings in erosive gastritis

A

complaints include anorexia, pain, N/V, hematemesis (coffee ground or bright red), exam may reveal epigastric tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PE findings in non-erosive gastritis

A

nonspecific hx

pt may have nausea and pain for short period then be asymptomatic until ulcer or CA formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DDx of gastritis

A
  • ulcer (w/ or w/o perforation)
  • reflux
  • CA
  • viral GE
  • TAA/AAA
  • biliary/pancreatic dz
  • esophageal rupture
  • gastric volvulus or gastroparesis
  • MI/angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

tx of gastritis

A

specific to causative etiology

  1. stress: prophylaxis or tx with H2 blocker or PPI
  2. NSAID: discontinue, PPI’s more effective than H2’s 2-4wks
  3. Alcoholic: discontinue ETOH, H2, PPI or sucralfate x 2-4wk
  4. H pylori: re test 4 wks after completion of 1 of following
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

triple therapy for gastritis

A

PPI, clarithromycin 500mg, amox or metronidazole 500mg, all BID x 10-14days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

quadruple therapy for gastritis

A

PPI or H2 BID, bismuth QID, metronidazole 250mg QID & tetracycline 500mg QID x 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

examples of H2s

A

cimetdine, famotidine, nizatidine, ranitidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

examples of PPIs

A

pantoprazole, esomeprazole, omeprazole, lansoprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

definition of peptic ulcer dz

A

erosion in gastric or duodenal mucosa >5mm through msucularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

epidemiology of peptic ulcer dz

A

10% lifetime prevalence in adult population
male slightly greater than female
duodenal (30-5yo) 5:1 vs gastric (55-70yo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

etiology of PUD

A

NSAID use, H pylori, smoking - increases acid decresaes bicarb = greatest risk factors

ETOH diet and stress = not causative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hx for PUD

A

epigastric pain abrupt or gradual more common at night
nausea and anorexia
pain may increase with eating
duodenal ulcer pain subsides with eating = returns 2-4hrs postprandial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

w/u of PUD

A

same as gastritis

endoscopy most useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

% of population infected with H pylori

A

30-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

H pylori is transmitted via

A

oral-oral, fecal -oral, gastric-oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

stool quality with H pylori

A

may be loose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what makes eradication of H pylori difficult?

A

smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

w/u for H pylori infection in PUD

A

urea breath test, serum antibody, stool antigen, direct culture

24
Q

what patients would you test for H pylori in PUD

A

active PUD
hx PUD not prev treated
gastric CA
dyspepsia in high prevalence area

25
Q

tx for PUD - PPIs

A
  1. PPI - preferred to H2, gastric ulcers treat 8wks, duodenal x 4wks
26
Q

tx for PUD - H2’s

A

QD at bedtime x 6-8wks

27
Q

tx for PUD - H pylori

A

14d combo therapy (continue PPI or H2 up to 6 wks for ulcer >1cm)

28
Q

adjuncts to tx for PUD

A

bismuth, misoprostol, sucralfate

29
Q

hemostasis tx for PUD

A

endoscopic cautery or surgical clips. IR arterial emoblization

30
Q

complications of PUD

A
  1. perforation: sudden, severe pain with peritonitis, free air on urpight xray or CT
  2. gastric outlet obstruction: edema at pylorus or duodenal bulb (PUD vs CA)
  3. gastric carcinoma: chronic gastritis can lead to CA
31
Q

s/s of gastric outlet obstruction

A

early satiety

vomiting partially digested food, weight loss

32
Q

dx/rx of gastric outlet obstruction

A

NGT to decompress and presence of foul smelling fluid is diagnostic

PPI, electrolyte correction and 24-72 hr endoscopy

33
Q

definition of GERD

A

displacement of acidic stomach contents into the esophagus

34
Q

etiologies of GERD

A
  1. relaxation of esophageal sphincter
  2. hiatal hernias
  3. obesity
  4. diminished esophageal peristalsis
  5. delayed gastric emptying
35
Q

relaxation of LES in GERD

A

via normal vagovagal reflex in response to gastric distention or hypotensive sphincter (idiopathic vs smoking) permits reflux during bearing down or supine position

postprandial acid secretions can form an acid pocket on top of meal contents

36
Q

hiatal hernias & GERD

A

LES is displaced above the diaphragm resulting in LES dysfunction and delayed gastric emptying

37
Q

obesity and GERD

A

external forces increase in the intra abdominal pressure

38
Q

diminsied esophageal peristalsis & GERD

A

slowed clearance distally secondary to underlying pathology

-scleroderma, Sjorgren’s, anticholinergics, radiation

39
Q

delayed gastric emptying & GERD

A

gastroparesis or gastric outlet obstruction

40
Q

hx/pe for GERD

A 
heartburn sensation 30-60min postprandial or when supine
relieved with antacieds
sour/bitter regurg episodes
dysphagia
cough 
laryngitis
sore throat
posterior dental caries
41
Q

ddx of GERD

A 
angina/MI
costochondritis
TAA
pneumomediastinum
PE
42
Q

w/u of GERD

A

most can be diagnosed via H&P and DDX exclusion

endoscopy is usually definitive and can r/o other pathology

43
Q

rx for GERD

A
  1. lifestyle modifications - avoid acidic foods, smoking, ETOH, weight loss, avoid postprandial lying supine x 3hrs, elevate head of bed
  2. H2 blockers for mild or PPI for mod-severe symptoms x 8-12 wks
  3. surgical fundoplication if uncontrolled
  4. recurrence somewhat common with meds or surgery
44
Q

complications of GERD

A

Barrett’s esophagus

strictures

45
Q

definition of Barrett’s esophagus

A

normal esophageal epithelium replaced with columnar

46
Q

etiology of barrett esophagus

A

occurs in up to 10% of pts with chronic GERD

47
Q

complications of barrett’s esophagus

A

up to 0.33%/yr increase in adenocarcinoma formation

48
Q

s/s of Barrett’s esophagus

A

same as GERD

49
Q

endoscopic visualization and biopsy

A

repeat q3-5 yrs

50
Q

rx for Barrett’s esophagus

A

long term GERD control with PPI

aggressive lifestyle modifications

51
Q

definition of gastroparesis

A

decreased or absent gastric motility in the absence of any mechanical lesion

52
Q

etiology of gastroparesis

A 
DM
hypothyroid
post surgical
parkinson's 
MD/MS
idiopathic
53
Q

s/s of gastroparesis

A

intermittent post prandial fullness, nausea, vomiting, pain

54
Q

ddx of gastroparesis

A

SBO, gastric outlet obstruction, gastritis, GERD

55
Q

w/u of gastroparesis

A

upright abd xray may reveal dilated stomch and A/F level

gastric emptying study (nuclear) is definitive, retention of >60% of contents at 2hrs or >10% at 4 hrs

56
Q

rx of gastroparesis

A
  • eat smaller meals low in fiber, milk, and gas forming foods
  • acute exacerbation may require NGT and TPN
  • metoclopramide for acute event or erythromycin for prophylaxis
  • gastric electrical stimulator
57
Q

definition of gastritis

A

irritation of the stomach lining

Clin Med GI (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions