TBL Abdominal Pain- Melissa Flashcards
What are lifestyle modifications that can help gerd symptoms?
Smaller meals and weight loss, avoid rich foods smoking cessation, don’t lay down after eating…
Potential long term consequences of GERD?
Barrett’s esophagus and adenocarcinoma
Where does squamous cell ca of the esophagus arise?
Most commonly in the middle 1/3
What is in a differential diagnosis doe a patent with dysphasia?
Zeneker’s, tumor, esophageal web, achalasia, esophageal stricture–sooo many things.
What are some risk factors for squamous cell ca od the esophagus?
smoking, ETOH, nitrates, achalasia
When can an upper GI bleed cause frank blood in stool? What might you see on PE?
if the bleed is really BIG!!! High volume bleeds can cause bright red blood from the rectum; patient may be short of breath from loss of blood and low O2 carrying capacity (anemia)
What causes the string sign on imaging? Why does this happen?
CHRONS–thickening of the colonic wall will cause obstruction and narrowing of the lumen for contrast to flow through
Which type of polyp has the highest risk of transforming into cancer? Which have virtually zero risk?
Villous adenomas! Remember hyper plastic have virtually ZERO risk for transformation
Why do cancers located in the cecum present differently than in the sigmoid?
“Can’t see ‘em in the cecum!”
They hide in the little pouch and fill the sac and present later!!
What are some good questions to ask when working up constipation?
- based on age, ask about a colonoscopy
- hypothyroid sx? (weight changes, energy…)
- ask about meds and compliance
- ask about Fe supplements and Al antacids
- always ask about diet and water intake
- stool caliber + blood in stool
What is initial management in most patients with constipation?
diet, H2O intake, lifestyle mod…
