Brainscape's Knowledge GenomeTM

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


See full index

GI > Stomach & Duodenal Diseases > Flashcards

Stomach & Duodenal Diseases Flashcards

1
Q

Diseases of the Stomach & Duodenum

A 
Gastritis
PUD
Gastric & duodenal ulcers
H. pylori
Zollinger-Ellison syndrome
Gastroparesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Features of Dyspepsia

A 
Indigestion
Chronic/recurrent pain in upper abdomen
Upper abdominal fullness
Early satiety
Bloating
Belching
Nausea
Heartburn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of Gastritis

A

Erosive & hemorrhagic gastritis

Nonerosive, nonspecific gastritis

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

Types of Erosive & Hemorrhagic Gastritis

A

Stress (medical or surgical illness)
NSAID
Alcoholic
Portal hypertension

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

Types of Nonerosive & Nonspecific Gastritis

A

H. pylori
Pernicious anemia
Eosinophilic

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

Asymptomatic Gastritis May Have

A 
Anorexia
Epigastric pain
Nausea
Vomiting
Upper GI bleed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Upper GI Bleeding from Erosive Gastritis

A

Melena (dark, sticky feces)
Coffee ground emesis
Blood in NG tube

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

Work up of Erosive Gastritis

A

CBC
Serum iron
Upper endoscopy

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

Highest Risk for Bleeding in Stress Gastritis

A 
Coagulopathy
Need for mechanical ventilation
Trauma, burns, shock
Sepsis, liver failure, kidney disease
Multi-organ failure
CNS injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prophylaxis of Stress Gastritis

A

PPIs are best

H2 Blockers

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

Treatment for GI Bleeding due to Stress Induced Gastritis

A

PPI bolus followed by continuous infusion
Sucralfate suspension
Endoscopy

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

Red Flags for Gastritis

A 
Severe pain
Weight loss
Vomiting
GI bleeding
Anemia
Refer for Upper Endoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of Gastritis

A

Trial of PPI for 2-4 weeks
H2 blockers
Refer for endoscopy

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

Pathophysiology of ETOH Gastritis

A

Alcohol disrupts mucosal barrier

Alcohol & aspirin increase the permeability of gastric mucosal barrier

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

Symptoms of Alcoholic Gastritis

A

Dyspepsia
Nausea
Emesis
Minor hematemesis

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

Treatment for Alcoholic Gastritis

A

H2 blockers or PPI
+ sucralfate 2-4 weeks
Decrease ETOH consumption

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

Portal Hypertensive Gastropathy

A

Congestion of gastric vessels

Chronic GI bleeding

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

Treatment of Portal Hypertensive Gastropathy

A

Porpranolol or nadolol

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

Nonerosive, nonspecific gastritis

A

H. pylori
Pernicious anemia
Eosinophilic gastritis

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

H. pylori

A 
Lives beneath gastric mucous layer
Secrete urease & produce ammonia
Causes gastric mucosal inflammation
Increases risk of gastric CA
Fecal-oral spread
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risk Factors for H. Pylori

A

Correlates inversely with SES

Contaminated water supply

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

What can H. pylori lead to over time?

A

Cellular changes
Duodenal/gastric ulcers
Gastric CA
Low grade B cell gastric lymphoma

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

Testing for H. pylori

A

Serology
Urea breath test
Stool antigen test
Endoscopy biopsy

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

Treatment for H. pylori

A

Eradication therapy

2-3 antibiotics + PPI or bismuth

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

Pernicious Anemia Gastritis

A

Autoantibodies to gastric gland parietal cells and intrinsic factor

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

What causes loss of acid production in pernicious anemia gastritis?

A

Gastric gland atrophy

Mucosal atrophy

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

What can pernicious anemia gastritis be associated with?

A

Hashimoto thyroiditis
Addison disease
Graves disease

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

Define Eosinophilic Gastritis

A

Infiltration of eosinophils into GI tissue

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

Symptoms of Eosinophilic Gastritis

A

Abdominal pain
N/V
Early satiety
Diarrhea

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

Eosinophilic Gastritis is Associated with

A

Hx of allergies
Hx or asthma
Hx of atrophy

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

Diagnosis of Eosinophilic Gastritis

A

Biopsy

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

Treatment of Eosinophilic Gastritis

A

Elimination diet

Steroids

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

Define PUD

A

Break in gastric or duodenal mucosa which can be caused by too much acid or pepsin
>5 mm & extend through muscular mucosae

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

Where are gastric ulcers most common?

A

Antrum

35
Q

Most common ages for duodenal ulcers?

A

30-55

36
Q

Most common ages in gastric ulcers

A

55-70

37
Q

PUD is most common in

A

Smokers

NSAID users

38
Q

Etiology of PUD

A

NSAIDs
Chronic H. pylori infection
Hypersecretory states

39
Q

What are the hypsecretory states that can cause PUD?

A 
Zollinger-Ellison syndrome
Systemic mastocystosis
CMV
Crohn's disease
Lymphoma
Alendronate (Fosomax)
Chronic medical illness
Idiopathic
40
Q

Clinic Presentation of PUD

A 
Dyspepsia
Pain in epigastric area
Pain may be relieved with food or antacids (return 2-4 hours alter)
Nocturnal pain
Periodicity
Nausea & anorexia
GI bleeding
41
Q

Work Up of PUD

A 
CBC
FOBT/FIT
Upper endoscopy
Abdominal CT
Biopsy
42
Q

Treatment for PUD

A 
PPIs
H2 blockers
Bismuth
Misoprostol (Cytotec)
Antacids
43
Q

How do H2 blockers help with PUD

A

Inhibit nocturnal acid secretion

44
Q

Which H2 blocker should we avoid?

A

Cimetidine

45
Q

Medical Treatment of PUD

A

Smoking decreases ulcer healing & increases recurrence rates
Moderate ETOH is okay
Balanced Diet

46
Q

Goals of Therapy for H. pylori Associated Ulcers

A

Relieve symptoms
Promote ulcer healing
Eradicate infection

47
Q

Treatment after Triple or Quadruple Therapy for PUD

A

Small ulcer: no further treatment

Large/complicated ulcer: PPI fo 6 weeks

48
Q

When should we retest for H. pylori?

A

> 4 weeks post antibiotics

>2 weeks post PPI

49
Q

Medical Treatment of NSAID Induced Ulcers

A

Stop offending agent

H2 blockers or PPIs

50
Q

Prevention after NSAID Ulcer Healing

A

Long term PPI
Prescribe NSAID at lowest dose
Cox-2 inhibitors if no CV risks

51
Q

Risk Factors for NSAID Uler Related Complications

A 
>60 years
Hx of PUD or complications
ASA or other anti-platelet therapy
Oral steroids
Serious underlying medical illness
52
Q

Zollinger-Ellison Syndrome

A

Gastrin secreting gut neuroendocrine tumor

53
Q

Sites of Primary Gastrin Tumors

A

Pancreas 25%
Duodenal wall 45%
Lymph nodes 5-15%
Unknown

54
Q

Clinical Presentation of Gastrin Tumors

A 
Dyspepsia
Peptic ulcers in duodenum usually
No isolated gastric ulcers
Diarrhea
Steatorrhea
Weight loss
55
Q

When should you check fasting gastrin levels?

A 
Large ulcers > 2 cm
Ulcers distal to duodenal bulb
Multiple duodenal ulcers
Frequently recurrent ulcers
Ulcers with diarrhea
Ulcers + hypercalcemia
Ulcers + negative NSAID use + negate H. pylori
56
Q

Imaging for Gastrin Tumors

A

CT/MRI to evaluate for hepatic mets & primary lesions
SPECT SRS
Endoscopic ultrasound

57
Q

Treatment of Metastatic Disease in Gastrin Tumors

A

PPIs

Check for hepatic mets

58
Q

Treatment for Localized Disease in Gastrin Tumors

A

Resection before hepatic mets occur

59
Q

Define Gastroparesis

A

Delayed gastric emptying in the absence of a mechanical obstruction

60
Q

Gastroparesis Usually Secondary to

A

DM
Post surgical
Idiopathic

61
Q

Etiologies of Gastroparesis

A

Viral
Medications
Neurologic disease
Autoimmune

62
Q

Diabetic Gastroparesis

A

Chronic hyperglycemia can lead to neuropathy
Autonomic dysfunction
Abnormal intrinsic nervous system

63
Q

Viral Gastroparesis

A 
Norwalk
Rotavirus
Sudden onset
Symptoms improve in a year
CMV, EBV & VZV may lead to severe long term symptoms
64
Q

Medications that can Delay Gastric Emptying

A 
Oxycodone
Clonidine
TCAs
CCB
Dopamine agonists
Muscarinic cholinergic receptor antagonists
Ocreotide
Phenothiazines
Cyclosporine
GLP-1 agonists & Amylin analongues
65
Q

Examples of Muscarinic Cholinergic Receptor Antagonists that can Cause Gastroparesis

A

Scopolamine

Atropine

66
Q

Ocreotide

A

Treat acromegaly

Diarrhea associated with certain tumors

67
Q

Examples of Phenothiazines that can Cause Gastroparesis

A

Antipsychotics

Antiemetics

68
Q

Reasons for Postsurgical Gastroparesis

A 
Injury to vagus nerve
Gastrectomy
Fundoplication
Lung/heart transplant
Vatical sclerotherapy
Botox injections
69
Q

Neurologic Disease Causes for Gastroparesis

A 
MS
Brainstem stroke or tumor
DM neuropathy
Amyloid neuropathy
AIDS
DM
Parkinson's
70
Q

Autoimmune Gastroparesis

A

Idiopathic or part of a paraneoplastic syndrome

71
Q

Other Types of Gastroparesis

A

Mesenteric ischemia

Scleroderma

72
Q

Gastroparesis Symptoms

A

N/V
Early satiety
Bloating
Upper abdominal pain

73
Q

PE for Gastroparesis

A

Epigastric tenderness
Abdominal distension
Signs of underlying disorder

74
Q

Workup of Gastroparesis

A

Upper endoscopy
CT eneterography
MRI
Assessment of gastric motility

75
Q

Scintigraphic Gastric Emptying

A

Nuclear med study
Overnight fast
Breakfast of eggs & toast with dash of isotope
Imaging at interval up to 4 hours to determine degree of gastric emptying

76
Q

Further Workup to Determine Etiology of Gastroparesis

A 
Hemoglobin
Fasting glucose
Serum total protein
Albumin
TSH
ANA
HbA1C
77
Q

Treatment of Gastroparesis

A 
Dietary modifications
Hydration
Vitamin supplementation
Optimize glycemic control
Prokinetics
78
Q

Dietary Modifications in Gastroparesis

A

Small/frequent meals
Low Fat
Avoid insoluble fiber, ETOH, carbonated drinks, tobacco

79
Q

Examples of Prokinetics

A

Metaclopramide (Reglan)

Macrolide antibiotics

80
Q

Metoclopramide (Reglan)

A

Use prior to eating

12 week prescriptions with 2 week holiday

81
Q

SE & Drug Interactions of Metoclopramide (Reglan) can lead to

A

Irreversible tardive dyskinesia

82
Q

Erythromycin

A

Induces gastric contraction
Stimulates fundic contractility
No longer than 4 weeks at a time

83
Q

Antiemetics

A

Use for persistent N/V

84
Q

Refractory Cases of Gastroparesis

A

Surgical treatment
G-tube
J-tube

GI (20 decks)

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