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Clin Med II - GI Exam > Stomach Disorders > Flashcards

Stomach Disorders Flashcards

1
Q

define gastritis

A

stomach lining irritation

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2
Q

gastritis etiology (2 types)

A
  • erosive

- non-errosive

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3
Q

MC cause of erosive gastritis

A
  • NSAIDs
  • ETOH
  • stress
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4
Q

MC cause of non-errosive gastritis

A

H. pylori

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5
Q

physical exam of erosive gastritis

A
  • anorexia
  • pain
  • n/v
  • hematemesis
  • epigastric tenderness
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6
Q

physical exam of non-erosive gastritis

A
  • asx until ulcer or CA then nausea, pain
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7
Q

gastritis workup

A
  • CBC
  • fecal antigen
  • urea hydrogen test
  • endoscopy w/ bx
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8
Q

When working up gastritis and H. pylori is suspected what must be avoided prior to testing and for how long?

A

PPI x 7-10d or abx x 28d

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9
Q

gastritis tx

A
  • specific to cause
  • stress = H2 or PPI
  • NSAIDs = d/c NSAIDs (duhh), PPI
  • ETOH = d/c ETOH (again, duh); H2, PPI, or sucralfate
  • H. pylori = triple or quadruple abx
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10
Q

define pepticu ulcer disease (PUD)

A

erosion in gastric or duodenal mucosa over 5mm deep into muscularis

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11
Q

PUD epidemiology

A
  • males more than females

- duodenal (35-55 y/o) 5:1 gastric (55-70 y/o)

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12
Q

PUD etiology

A
  • NSAIDs
  • H. pylori
  • smoking
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13
Q

What are NOT PUD etiologies?

A
  • ETOH
  • diet
  • stress
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14
Q

PUD physical exam

A
  • epigastric pain, MC @ night (abrupt = perforation or irritation)
  • nausea
  • anorexia
  • incr. pain w/ eating
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15
Q

ddx PUD with duodenal ulcer

A

duodenal = decr. pain w/ eating, incr. s/p eating x 2-4hr

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16
Q

PUD workup

A
  • same as gastritis

- endoscopy

17
Q

PUD tx

A
  • PPI w/ probiotic
  • H2
  • bismuth, misoprostol, cautery/clips, IR arterial embolization
18
Q

PUD complication

A
  • perforation
  • gastric outlet obstruction
  • gastric carcinoma
19
Q

describe the PUD complication of perforation

A
  • sudden, severe pain w/ peritonitis

- free air on upright XR or CT

20
Q

describe the PUD complication of gastric outlet obstruction

A
  • edema at pylorus or duodenal bulb
  • S+S: early saitiety, regurgitation, wt loss
  • dx: NGT to decompress; will have a “foul smell”
  • tx: PPI, electrolytes, endoscopy x 24-72hr
21
Q

define GERD

A

displacement of acidic stomach contents into esophagus

22
Q

GERD etiology

A
  • relaxation of LES
  • hiatal hernia
  • obesity
  • decr. esophageal peristalsis
  • delayed gastric empty
23
Q

Hx/PE GERD

A
  • “heartburn” w/in 30-60mins of meal or when supine (relieved w/ antacids)
  • sour/bitter taste w/regurgitation
  • dysphagia, cough, sore throat, or laryngitis
  • posterior dental carries
24
Q

GERD workup

A
  • endoscopy
25
Q

GERD tx

A
  • lifestyle modification
  • H2 v. PPI
  • surgical fundoplication
26
Q

GERD complication

A
  • Barrett esophagus

- strictures

27
Q

define Barrett esophagus

A

replacement of normal esophageal epithelium w/ columnar cells

28
Q

Barrett esophagus S+S

A

same as GERD

  • “heartburn” w/in 30-60mins of meal or when supine (relieved w/ antacids)
  • sour/bitter taste w/regurgitation
  • dysphagia, cough, sore throat, or laryngitis
  • posterior dental carries
29
Q

Barrett esophagus complication

A

adinocarcinoma

30
Q

Barrett esophagus treatment

A
  • long term GERD control w/ PPI

- lifestyle modificaton

31
Q

Barrett esophagus dx

A

endoscopic visualization w/ bx (repeat q3-5y)

32
Q

define gastroparesis

A

decrease or no gastric motility w/o mechanical lesion

33
Q

gastroparesis etiology

A
  • MC = DM
  • hypothyroid
  • post-op
  • Parkinson’s
  • MD/MS
  • idopathic
34
Q

gastroparesis S+S

A
  • intermittent postprandial fullness
  • n/v
  • pain
35
Q

gastroparesis workup

A
  • upright XR = mildly dilated stomach + air-fluid level

- gastric emptying study = over 60% retention @ 2hrs, 10% @ 4hrs

36
Q

gastroparesis tx

A
  • sm meals low in fiber, milk, and gas forming foods
  • NGT + TPN
  • metoclopramide = acute
  • erythromycin = prophylaxis
  • gastric electric stimulatior

Clin Med II - GI Exam (14 decks)

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