Upper GI Flashcards
Meds that worsen GERD
tetracycline
bisphosp
NSAID
CCB, anticholinergic, BB
GERD clinical sx
MC heartburn worse after meals; regurgitation, dysphagia
GERD dx
H&P, endoscopy for epithelial damage
*>45 yo, endoscopy
Important test to do to distinguish GERD from something else
EKG (atypical MI)
GERD tx
antacid, H2 blocker
*PPI if unresponsive to H2 blocker
large deep ulcers in esophagus - what infection?
CMV
multiple shallow ulcers in esphagous?
HSV
infectious esophagitis clinical sx
dysphagia, odynophagia
What is Zencker diverticulum?
outpouched posterior hypopharynx
What is achalasia?
Smooth muscle of esophagus fails to relax, food stuck
Characteristic imaging finding of achalasia?
parrot beak on barium swallow
Type of Ca that arises from Barretts?
adenocarcinoma (squamos > columnar)
Why would you want to avoid BB, benzos, CCB, nitrate in pt w/ GERD?
Lower sphincter tone
Progressive dysphagia + wt loss - what dx are you thinking
esophageal Ca
Tx for a Mallory Weiss tear
Most self resolve but endoscopic thermal coag if not’ avoid PPI until bleeding stops
What is Budd-Chiari?
hepatic vein thrombosis
Budd Chiari clinical manifestation
ascites, hptomegaly
Budd Chiari etiology
hypercoag state (polycythemia, HCC,
Budd Chiari tx
Drain ascites, anticoagulate/thrombolyse
Budd Chiari labs
LFT high initially w/ low albumin, become more normal as the liver scars…
MC cause of cirrhosis in US?
Hep C and ASH
What’s “cardiac cirrhosis”?
R heart failure/cor pulmonale; causes chronic hepatic congestion
What are Mallory bodies ?
Damaged intermediate filaments seen in stetohepatitis?
MC micronodular cirrhosis
MC macronodular cirrhosis
micro - EtOH
macro - viral hepatitis
Dx of viral hepatitis?
Bx w/ mononuclear protal infiltrate, HC necrosis, progressive fibrosis
Hepatitis etiologies
Viral>autoimmune>drug>metabolic dz
What Vitamin can cause chronic liver dz?
Vitamin A
Ground glass hepatocytes are associated w/ what dz?
Hep B
Lymphoid aggregates and fatty changes in the liver are associated with what?
Hep C
Eisinophil + plasma cell in liver associated w what?
drug toxicity hep