upper Gi Flashcards
what questions will you ask in Hx for Dysphagia
acuity of onset
duration of symptoms
what substances cause it
location of disturbance
drooling/coming out nose
Red flags for Dysphagia
acute focal neuro deficit
drooling
inability to swallow anything.
weight loss
imagining for dysphagia
barium swallow with solid bolus
chiroman for dysphagia
rule out red flags
co-manage
what is achalasia
neurogenic motility disorder where lower esophageal sphincter doesn’t relax
what cells are lost in achalasia and what causes it
mycenteric cells can be caused by chagas - protozoan parasite
achalsia mc in what age
+ 3 symptoms
20-60 years
dysphagia LIQUIDS + SOLIDS
33% nocturnal vomit
chest pain - weight loss
Oesophageal Diverticula
out pouching of mucosa through the muscular wall of the oesophagus
how does Oesophageal Diverticula presennt
vomit with forward flexion or lying down.
chronic halitosis
Mallory- Weiss Syndrome & how is it caused
= non- penetrating laceration (small tear) of the distal oesophagus
vomiting, coughing, hiccups
pregnancy and alcoholics
Boorhave’s Syndrome
= complete rupture of the oesophagus
MC in distal esophagus L side
Boorhave’s Syndrome presentation and chiroman
chest + abdo pain
violent vomiting
refer out
diagnosed by plain film - mediastinal air, pleural effusion
risk factors for esophageal cancer include
smoking
alcohol
HPV
lye
squamous cell carcinoma hallmarks
US, ASIA, SOUTH AFRICA
blacks
men
strong link to alcohol
adenocarcinoma hallmarks and what is it linked to
whites
linked with barrets esophagus
Esophaheal cancer hallmarks
asymptomatic in early days until lumen narrows starts from solid to liquid
chest pain radiating into back
vocal cord ↓
diagnosis and chiroman for esophageal
cancer
endoscopy if suspected + biopsy
check and adjust tolerance
what is GERD
acid reflux from stomach due to LES not closing
how will GERD present what will patient feel
chest burn
can travel to neck, jaw
what makes GERD worse
positional
diet - fatty/spicy/meds/fast eaters
complications of GERD
Esophagitis, pneumonia, barretts, ulcer
how will you DDX GERD from HD
GERD has no relation to physical activity
MC type of Hiatus hernia and its symptom
sliding they have GERD
possible causes of gastritis
NSAIDS, alcohol, infection viral (erosive)
infection (H pylori) non - MC in blacks, Spanish, Asian
what is peptic ulcer & what causes it
erosion of stomach lining due to ↓ mucosa
stomach - gastric
duodenum- duodenal
caused my helicobacter pylori and NSAIDS
hallmarks for Gastric ulcer
non consistent pain
eating can ↑ pain
hallmarks for duodenal ulcer
consistent pain
eating ↓ pain
pain mid morning and wakes up at night
happens 2 hours post meal
MC complication for peptic ulcer
bleeding - in stools
melena
when perforation occurs due to complication of peptic ulcer what will the patient present as
sudden intense pain
pt lies still doesnt want to move
pain on palpation + no bowel sounds
refer tf out
stomach cancer is MC in who and has a strong relationship with what
japan, chile, iceland - linked with h pylori
what are the symptoms of acute pancreatitis
Starts in lower abdomen before localising to upper
radiates from abdo to back 50%
sitting up & leaning forward palliative
during an abdo exam for acute pan what will you see
grey turner - ecchymosis of flanks
cullens - ecchy of umbilical
distended upper abdo
what labs will you order for acute pan
amalyse and lipase
symptoms for CHRONIC PAN
episodic abdo pain
pain in epigastric lasts for hours to days
steatorrhea
diagnosis for Chronic pan
#2
CT is gold standard
amylase and lipase is normal due to damage
