Upper GI Complaints Flashcards
effortless return of esophageal or gastric contents to pharynx
regurgitation
failure to relax the LES
achalasia
pain w/ swallowing
odynophagia
____ epithelium is in the esophagus, _____ epithelium in the gastric area.
Squamous
columnar
Striated muscle is seen in (upper/lower) portion of esophagus.
upper
Smooth muscle is seen in (upper/lower) portion of esophagus.
lower
Oropharyngeal or esophageal dysphagia?
Difficulty initiating swallowing
Oropharyngeal
Oropharyngeal or esophageal dysphagia?
suprasternal notch or substernally
Esophageal
Oropharyngeal or esophageal dysphagia?
Onset after few seconds
Esophageal
Oropharyngeal or esophageal dysphagia?
Worse with liquids
Oropharyngeal
Oropharyngeal or esophageal dysphagia?
Worse with solids
Esophageal due to mechanical obstruction
Oropharyngeal or esophageal dysphagia?
Symptoms about the same with solids and liquids
Esophageal due motility disorder
Oropharyngeal or esophageal dysphagia?
Caused by poor dentition, reduced saliva production, or neuromuscular disorders, structural lesions.
Oropharyngeal
Oropharyngeal or esophageal dysphagia?
Caused by esophagitis, mechanical obstruction or motility disorder (achalasia, scleroderma)
Esophageal
Oropharyngeal or esophageal dysphagia?
Choking or nasal regurgitation
Oropharyngeal
Which of the following is used to diagnosis oropharyngeal dysphagia? A. Upper endoscopy B. Barium radiography C. Videofluroscopy D. Esophageal manometry
B, C
Also Nasopharyngeal laryngoscopy for oropharyngeal
The others are used for esophageal dysphagia.
Difficulty swallowing
dysphasia
Name the two causes of odynophagia
Infectious esophagitis (Herpes, CMV) Pill esophagitis
Which of the following is TRUE about achlasia? A. Male predominance B. Young age C. Dysphagia for liquids D. Slow progressive
D
A. No gender predominance
B. Middle age
C. Dysphagia for solids and liquids
All of the following are ways to diagnosis achlasia EXCEPT: A. Barium study B. Upper endoscopy C. Videofluroscopy D. Esophageal manometry
C
All the others are the same techniques used for esophageal dysphagia.
1st line diagnosis of GERD if confident in diagnosis
Therapeutic trial w/ acid suppressing medication
T/F: Absence of reflux esophagitis upon endoscopy excludes diagnosis of GERD.
False. GERD can manifest solely as symptoms.
Ambulatory pH monitoring for GERD indicated for _____
o Atypical symptoms and negative endoscopy
o Symptoms refractory to standard therapy
All of the following are alarm symptoms of dyspepsia EXCEPT:
A. Early satiety, dysphagia
B. Nausea/vomiting
C. Hematemesis, anemia, occult blood in stool, melena
D. Unintentional weight loss
E. Onset > 45 y/o
B
T/F: Majority of pts w/ cancer or significant ulcers initially present w/ alarm symptoms.
False. Majority do NOT present with alarm symptoms
Which of the following is FALSE on peptic ulcer disease? A. Worse at night B. Stomach pain worsen by food C. Nausea/vomiting D. Relief more common w/ duodenal ulcer
B. Stomach pain reduced by food
T/F: ~90% of pts w/ PUD that are not using NSAIDs are infected w/ H. pylori
True
Malignancy associated w/ H. pylori (2)
Gastric adenocarcinoma MALT lymphoma (mucosa-associated lymphoid tissue)
All of the following are used to diagnosis current peptic ulcer EXCEPT: A. Urease breath test B. Stool antigen C. Serology (IgG anti-HP antibody) D. Gastric biopsy with EGD
C. Does NOT distinguish b/w past and present infection. Remains positive long after eradication.
1st line treatment of PUD
PPI + 2 antibiotics x 2 weeks
Confirm eradications via urea breath test or stool antigen
Which of the following is NOT a risk factor of PUD? A. Smoking B. Acetaminophen (Tylenol) C. Old age D. History of PUD
B. Acetaminophen is NOT a NSAID
T/F: The main pathophysiology of PUD is direct damage to epithelial cells.
False. Not an important component of pathophysiology. Mainly due to inhibition of cyclooxygenase
Zollinger-Ellison Syndrome =
Gastrin-producing neuroendocrine tumor
Which of the following is NOT a symptom of gastroparesis?
A. Postpardial bloating
B. Early satiety
C. Delayed vomiting partially digested contents
D. Refractory GERD
E. Watery diarrhea
E
Which of the following is NOT a cause of gastroparesis? A. Diabetic gastropathy B. Nerve damage C. Post viral gastroenteritis D. Scleroderma E. Medication use
E
Succussion splash is seen in ____
gastroparesis
= sloshing sound from stomach
Treatment for gastroparesis include ____
Promotility agents: Erythromycin (motilin antagonist) but rapidly diminishing response to successive doses
Metoclopramide but not really used due to SE of dyskinesia
Name the disease:
Trachealization, furrowing, strictures, diffuse narrowing, eosinophilic abscesses
Eosinophilic Esophagitis
