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Gastrointestinal > Stomach Disorders > Flashcards

Stomach Disorders Flashcards

1
Q

What is gastritis?

A

superficial inflammation/irritation of the stomach with mucosal injury

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2
Q

What is gastropathy?

A

Mucosal injury without evidence of inflammation

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3
Q

What is the pathologic causes of gastritis?

A

imbalance between aggressive (increased) and protective (decreased) mechanisms of gastric mucosa.

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4
Q

What are the most common causes of gastritis?

A
  1. H. pylori (most common!)
  2. NSAIDs/ASA (2nd most common)
  3. Acute stress (ICU pts)
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5
Q

What are the clinical manifestations of gastritis?

A

Patients are most commonly asymptomatic
If symptomatic —-> upper GI bleed (hematemesis, melena)
Epigastric pain, N/V

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6
Q

What is the diagnostic test of choice for gastritis?

A

Endoscopy and H.pylori testing

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7
Q

What is the management for H.pylori + gastritis or PUD?

A

CAP —> clarithromycin, amoxicillin, and a PPI

metronidazole if allergic to PCN

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8
Q

_____ ulcers are 4x more common than ______ ulcers.

A

Duodenal ulcers

Gastric ulcers

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9
Q

Gastric ulcers are more common in the ______.

A

elderly

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10
Q

What are the most common causes of peptic ulcers?

A
  1. H. pylori
  2. NSAIDs
  3. Zollinger Ellision syndrome
  4. ETOH
  5. smoking
  6. stress
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11
Q

Why do NSAIDs cause peptic ulcers?

A

because they inhibit prostaglandins, which are mucosal protective factors

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12
Q

How does a duodenal ulcer typically present?

A

Dyspepsia that is worse 2-5 hours AFTER meals and is better with meals and/or antacids

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13
Q

How does a gastric ulcer typically present?

A

Dyspepsia that is WORSE with meals (especially 1-2 hours after meals). Patients typically have weight loss b/c don’t want to eat.

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14
Q

What is the MOST common cause of an upper GI bleed?

A

Peptic ulcer disease!!!!

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15
Q

What is the gold standard diagnostic test for diagnosing PUD?

A

Endoscopy with biopsy (r/o malignancy especially with GU)

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16
Q

What are considered the “alarming” symptoms of PUD to suggest cancer?

A
  1. > 50 years
  2. dyspepsia
  3. hx of GU
  4. anorexia/weight loss
  5. anemia
  6. dysphagia
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17
Q

What is the gold standard diagnostic test for diagnosing H. pylori?

A

Endoscopy with biopsy and rapid urease test

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18
Q

When if the urea breath test utilized?

A

Testing for H. pylori if endoscopy can’t be done

Also used to confirm eradication after therapy**

19
Q

H. pylori converts urea to _____.

A

carbon dioxide

20
Q

Which test can be utilized to confirm eradication of H. pylori after therapy?

A
  1. Urea breath test

2. H. pylori stool antigen (HpSA)**

21
Q

What is Zollinger-Ellison syndrome?

A

A gastrinoma (gastrin secreting tumor resulting in gastric acid hyper secretion leading to PUD)

22
Q

What are the clinical manifestations of Zollinger-Ellison syndrome?

A
  1. multiple peptic ulcers that are refractory to tx

2. diarrhea

23
Q

What are the best screening tests for Zollinger-Ellison syndrome?

A
  1. Fasting gastrin level —-> will be elevated

2. Secretin test —-> increase gastrin release (gastrin normally inhibited by secretin)

24
Q

What is the management of Zollinger-Ellision syndrome?

A

Local —> surgical resection

Metastatic —> PPIs, surgical resection if involves liver

25
Q

What is pyloric stenosis?

A

hypertrophy and hyperplasia of the muscular layers of the pylorus causing a functional outlet obstruction

26
Q

Pyloric stenosis most commonly presents when in life?

A

95% present in 1st 3-12 weeks of life (rare after 3 months)

27
Q

What are the clinical manifestations of pyloric stenosis?

A
  1. NONbilious vomiting/regurgitation that is projectile after feeding**
  2. signs of dehydration and malnutrition
  3. may have jaundice and metabolic alkalosis
28
Q

An infant with pyloric stenosis will most likely have what on physical exam?

A

“olive-shaped” nontender mobile hard pylorus** (palpated especially after infant has vomited)

29
Q

What diagnostics are ordered for pyloric stenosis?

A
  1. Ultrasound*** —> elongation/thickening of pylorus

2. Upper GI contrast study (not done 1st to prevent radiation) —> string sign

30
Q

What is the management of pyloric stenosis?

A

pyloromyotomy and rehydration

31
Q

What is the most common gastric carcinoma?

A

Adenocarcinoma (90% worldwide)

32
Q

What is the most important risk factor of gastric carcinoma?

A

H. pylori!!!

33
Q

Gastric carcinoma is most commonly occurs in ____.

A

males > 40 years

34
Q

What are the clinical manifestation of gastric carcinoma?

A
  1. indigestion
  2. weight loss
  3. early satiety
  4. abdominal pain/fullness
  5. often have iron deficiency anemia
35
Q

What are 3 signs of metastasis of gastric carcinoma?

A
  1. Virchow’s node —> supraclavicular lymph node
  2. Sister Mary Joseph’s node —> umbilical lymph node
  3. Irish sign —> left axillary lymph node
36
Q

What is linitis plastica?

A

diffuse thickening of stomach wall due to cancer (worse type of gastric cancer)

37
Q

What is the management of gastric carcinoma?

A

gastrectomy, radiation, and chemotherapy

poor prognosis

38
Q

What is pyloric stenosis?

A

hypertrophy and hyperplasia of the muscular layers of the pylorus causing functional outlet obstruction

39
Q

What is the most common epidemiology of pyloric stenosis?

A

1st 3-12 weeks of life (rare after 3 months)

40
Q

What are the clinical manifestations of pyloric stenosis?

A

NONbilious vomiting/regurgitation projectile
emesis after eating
signs of dehydration and malnutrition
metabolic alkalosis

41
Q

What will be seen of physical exam with an infant with pyloric stenosis?

A

“olive-shaped” nontender mobile mas 1-2 cm in diameter

Felt especially AFTER infant has vomited

42
Q

What are the most common diagnostic studies performed for pyloric stenosis and what will they show?

A

Ultrasound**– elongation/thickening of the pylorus
Upper GI contrast study– string sign (delayed gastric emptying)

Upper GI not done first to prevent radiation

43
Q

What is the management of pyloric stenosis?

A

Pyloromyotomy and rehydration

Is incision through the tense muscle so it can loosen so the food in the stomach can move into the small intestine

Gastrointestinal (8 decks)

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