Brainscape's Knowledge GenomeTM

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


See full index

GI > stomach disorders > Flashcards

stomach disorders Flashcards

PUD, tumor, gastritis, diverticulitis, pyloric stenosis

1
Q

what causes type A gastritis

involves what part of stomach

A

autoimmune disorders(pernicious anemia) and other non infectious factors

involves the body of the stomach

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

H pylori present in what ulcers

A

70% duodenal

up to 90% of peptic ulcers

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

relief with food, recurring in 2-4 hrs

A

PUD

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

epigastric pain turning to a radiating and constant pain

A

think perf or penetration from a PUD

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

meds for good mucosal defense

A

misoprotol, sulcralfate

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

H pylori eradication

A

combo therapy for 2-3 weeks:

1) PPI with [clarithomycin and amoxicillin] or [clarithomycin and addition of metronidazole] or
2) bismuth subsalicylate plus tetracycline, metronidazole, and PPI

prophylactic tx with misoprostol or a PPI: hx of ulcer who require a daily NSAID, hx of bleed, need for chr steroids or anticoagulants, signficant co morbidities

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

h pylori shape

implicated in what cases

A

gram neg, spiral shaped bacillus

almost all non NSAID induced GI mucosal inflammation

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

h pylori causes what

A

type B gastritis; involves the antrum and body of stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

h pylori associated with what 3 diseases

why is in the stomach

A

it tolerates the acidity of the stomach;

peptic ulcer, gastric adenocarcinoma, and gastric lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

NSAIDs and the stomach lining

A

it can cause gastric injury by diminishing local prostaglandin production in the stomach and duodenum.

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

.other causes of gastritis

A

alcohol, stress from CNS, burns, sepsis

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

.common indicators of gastritis

A

dyspepsia and abdominal pain n/v

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

dx tests for h pylori

2 for sure tests

2 maybe tests

A

initial: endoscopy with bx

urea breath test;

fecal antigen testing or serology is also helpful

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

nausea and feeling of excessive fullness after meals

A

delayed gastric emptying

tx: prokinetic meds

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

prokinetic meds

A

cisapride, metoclopramide

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

NSAID induced GI mucosal inflammation implicates what usually

A

h pylori

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

H pylori involves what part of the stomach

A

antrum and body which is type B gastritis

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

.gastric vs duodenal ulcers assoc with malignancy?

A

gastric

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

.gnawing or burning abdominal pain that often radiates to the back

A

PUD

also think ZES

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

.difference with pain between a duodenal ulcer and a gastric ulcer

A

duodenal pain improves with food. gastric worsens with food

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

.what is the most common cause of non hemorrhagic GI bleeds

A

PUD

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

.best test for PUD and why

A

upper endoscopy b/c its more sensitive and definitive

differeniates gastritis from ulcer disease;

all gastric ulcers need repeat endoscopy to document healing

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

.tx for PUD (h pylori +)

A

pepto with tetracycline, metronidazole, and PPI x 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

.PUD related to ZES?

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

.what is PUD

A

any ulcer of the upper digestive system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

h pylori found in what percentage of cancer pts

gender?

A

80%

male 3:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

.common cause of PUD

whats good about this

A

H pylori

the disease can be erradicated with treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

.gastric ulcers and h pylori: association with gastric malignancy

A

although most patients with h pylori or a gastric ulcer will not get gastric cancer, almost all pts with gastric cancer have had h pylori or a gastric ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

.common cause of non hemorrhagic GI bleeds

A

PUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

.melena

A

PUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

dyspepsia symptoms

A

belching

bloating

distention

heartburn

think PUD, may have nausea and bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

.disadvantage of PUD tests:

barium radiography,

serum antibody test

stoot antigen testing,

urea breath test

A

barium radiography: cheap but less sensitive, 30% false neg rate

serum antibody test: highly sensitive but cannot be used to confirm cure

stoot antigen testing and urea breath test: s and s but not accurate for 4 weeks after completion of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

how much of gastrinomas are part of multiple endocrine neoplasia(autosomal dominant condition)

A

one third

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what fasting gastrin level indicates hypergastrinemia

A

> 150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

.what test diagnoses ZES

what tests to localize the tumor

A

secretin: givin 2 units, gastrin levels will increase by more than 200

endoscopy, CT, MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

.tx of ZES

A

PPI or sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

.what gender is gastrin adenocarcinoma twice as common in

age

incidence

A

males

usually over 40 y/o

common cancer worldwide but less common in US

38
Q

.gastrin adenocarcinoma strongly associated with what

what decreases risk

A

h pylori

asa, nsaids, wine, lots of fruits/veg

39
Q

progressive dysphagia vs postprandial vomiting in terms on gastrin adenocarcinoma

A

progressive means the neoplasm is impinging on esophagus and postprandial means its near the pylorus

40
Q

metastatic spread of gastrin adenocarcinoma

A

left supraclavicular lymphnode(virchows node) and umbiliical node(sister mary joseph node)

41
Q

common finding in gastrin adenocarcinoma

other tests

A

iron def anemia

liver enzymes may be elevated with hepatic metastases

endoscopy with cytology should be done a pt with 40 years of age with dyspepsia who is unresponsive to therapy

do CT after to determine the extent of the disease

42
Q

what is the common extra-nodal site for non hodgekins lymphoma

A

stomach

43
Q

what is the risk of gastric lymphoma if H pylori is present

A

6 fold!

44
Q

.what is ZES

results in what

% of cases of PUD from this

A

gastrin secreting tumor resulting in excessive acid production; causes hypergastrinemia

results in refractory PUD

1% of cases of PUD are caused by ZES

45
Q

most gastrinomas found where

A

in pancreas and duodenum;

but may be found anywhere or may metastasize

46
Q

.presentation of ZES

A

similar to PUD and maybe…

abdominal pain may have secretory diarrhea that improves with H2 blockers or PPI

occult or frank bleeding, causing anemia

47
Q

presentation of gastric adenocarcinoma

A

dyspepsia and weight loss associated with anemia and occult GI bleeding

progressive dysphagia may be caused by a neoplasm impinging on the esophagus

postprandial vomiting may be caused by a neoplasm near the pylorus

48
Q

advantage of early diagnosis of gastric adenocarcinoma

A

80% cure rate;

if the muscularis propria is involved, the cure rate is 50%

but is there is lymphatic spread, the cure rate is 10%

49
Q

progressive dysphagia or postprandial vomiting

A

think gastric adenocarcinoma

dyspepsia and weight loss associated with anemia and occult GI bleeding

progressive dysphagia may be caused by a neoplasm impinging on the esophagus

postprandial vomiting may be caused by a neoplasm near the pylorus

50
Q

tx of gastric adenocarcinoma

A

curative or palliative resection of tumor

chemo or radiation may provide some palliative benefit

51
Q

.carcinoid tumors in stomach location

A

55% occur in GI tract, 30% in lungs

rarely occur in response to hypergastrinemia and are generally benign and self limited

52
Q

gastric lymphomas incidence

risk

sx

dx

tx

A

less than 2% of gastric malignancies

risk is greater by 6 fold if h pylori present

sx same as gastric adenocarcinoma

dx: findings differ than adenocarcinoma only in the pathology of the lesion
tx: resection with or w/out radiation or chemo

53
Q

stomach the most common extranodal site for what

A

non hodgkin’s lymphoma

54
Q

discuss type A and type B in chronic gastritis

A

type A(10%) occurs in fundus and d/t autoantibodies to parietal cells. causes pernicious anemia and assoc with other autoimmune disorders and increased risk of gastric adenocarcinoma and carcinoid tumors

type b(90%) occurs in antrum and may be caused by NSAIDs or h pylori infection. often asymptomatic, but assoc with increased risk of PUD and gastric cancer.

55
Q

why is type A gastritis assoc with pernicious anemia

A

due to lack of intrinsic factor necessary for the absorption of vitamin B12

56
Q

stress ulcers and burn injuries

A

curling ulcers;

associated with traumatic brain injury

57
Q

h pylori antibodies after an infection

A

they stay positive even when cleared;

use the urea breath test or a repeat stool antigen as a test of cure

58
Q

.risk factors for gastric cancer (3)

A

diet high in nitrates and salt; low in fresh vegetables

h pylori colonization (90%)

chronic gastritis

59
Q

.what to do if you suspect a perforation with PUD

A

get a KUB upright to evaluate diaphram and CT abdomen

60
Q

.how to remember ulcer pain after a meal

A

after a meal, pain from a GASTRIC ulcer is GREATER

whereas DUODENAL pain DECREASES

61
Q

misoprostol

A

can help pts with PUD who require NSAID therapy

62
Q

1) hypercalcemia (MEN type 1)
2) epigastric pain(peptic ulcer)
3) diarrhea (due to mucosal damage and pancreatic enzyme inactivation leading to malabsorption)

A

3 key things about ZES

63
Q

.constipation definition

A

under 2 BM a week

64
Q

.MOA of bulk forming laxatives

A

psyllium

absorbs water and increases fecal mass

65
Q

.MOA Of stimulant laxatives

A

bisacodyl, senna

increases acetycholine-regulated GI motility and alters electrolyte transport in the mucosa

66
Q

.what is hirschsprung’s ds

A

outlet delay

67
Q

.most common cause of acute lower GI bleeding(painless hematochezia)

A

diverticulosis

68
Q

.diverticulosis most common location

A

left colon usually in incidence.

right colon most common location for bleeding.

69
Q

.diverticulosis test if colonoscopy does not visualize bleeding

A

radionuclide imaging followed up by a arteriography

70
Q

.diverticulosis tx

A

most cases stop spontaneously;
resuscitation with fluids

71
Q

.diverticulosis s/s

A

usually asymptomatic; lower GI bleeding, hematochezia, painless

72
Q

.diverticulitis most common area

age

A

sigmoid due to high intraluminal pressure.

> 40

73
Q

.diverticulitis s/s

A

LLQ pain, N/V, low fever. poss tender mass

74
Q

.diverticulitis tx

A

uncomplicated: antibx(flagly + either cipro or levoquin) 7-10 days. clear liquid diet.

alternative: bactrim plus flagyl

75
Q

.diverticulitis dx

A

CT initial imaging. labs: leukocytosis

76
Q

.which pud ulcer is more common

A

duodenal

77
Q

.hallmark of PUD

A

dyspepsia(burning, gnawing, epigastric pain)

78
Q

.increase damaging factors in ___ ulcers

A

duodenal

79
Q

.decreased protective mechanisms with ___ ulcers

A

gastric

80
Q

.most common in the antrum of the stomach

A

gastric

81
Q

.ages of pts with duodenal and gastric ulcers

A

duodenal younger (30-55)

gastric older (55-70)

82
Q

.upper endoscopy shows thick, edematous erosions <0.5

A

gastritis

83
Q

.location of autoimmune metaplastic atrophic gastritis

A

gastric fundus and body

84
Q

.severe recurrent multiple or refractory ulcers + diarrhea

A

suspect ZES

85
Q

.carcinoid syndrome

A

periodic diarrhea, flushing, tachycardia, bronchoconstriction, and hemodynamic instability

86
Q

.pyloric stenosis common at what age

what med is a r/f

A

first 3-12 weeks of life

emycin within the 1st 2 weeks of life

87
Q

.pyloric stenosis located where

sx?

A

right of epigastrium

nonbilious projectile vomiting hallmark

88
Q

.pyloric stenosis dx

A

abd u/s initial test of choice

upper GI series shows string sign or railroad sign

89
Q

.labs from vomiting

A

hypokalemia and hypochloremic metabolic alkalosis

90
Q

.upper GI series shows string sign or railroad sign

A

pyloric stenosis

GI (14 decks)

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