upper GIT Flashcards

1
Q

how is LOS opened in stage 1 -pharyngeal phase of swallowing

A

vasovagal reflex- receptive relaxation reflex

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2
Q

peristaltic wave pressure

A

40mmHg

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3
Q

LOS resting pressure

A

20mmHg

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4
Q

pressureof LOS during receptive relaxation

A

under 5mmHg

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5
Q

what is motility and it’s measurement

A

The co-ordination of contraction and dilation of the muscles of the GI tract.​
pressure measurement (manometry)

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6
Q

how is motility mediated

A

Mediated by inhibitory noncholinergic nonadrenergic (NCNA) neurons of myenteric plexus, these inhibit the contraction of oesophagus muscle

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7
Q

difference between regurgitation and reflux

A

regurg
return of oesophageal contents from above an obstruction

reflux
passive return of gastroduodenal contents to the mouth

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8
Q

hypermotility -achalasia what is it due to and cause

A

loss of gangion cells in aurebach’s myeteric plexus in LOS wall

primary=unknown
secondary- disease like chagas’ disease/oesophagitis

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9
Q

treatment for hypomotility (scleroderma)

A

1.remove obstruction
2.prokinetics (ie. cisapride)- improves force of peristalsis

once peristaltic failure occurs-usually irreversible

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10
Q

disordered coordination- corkscrew oesophagus
treatment

A

pneumatic dilation but not as effective

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11
Q

disordered coordination- corkscrew oesophagus
diagnosis and pressure

A

barium swallow
400-500nnHg

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12
Q

disordered coordination- corkscrew oesophagus- symptoms and what happens to the circular muscle

A

dysphagia and chest pain
hypertrophy of circular muscle

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13
Q

3 pathological cause of narrowing of oesophagus and what it cause

A

cancer
FB
Physiological dysfunction

oesophageal perforation

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14
Q

boerhaave’s cause and it’s weak point

A

Sudden ↑ in intra-oesophageal pressure with negative intra thoracic pressure
Vomiting against a closed glottis

Left posterolateral aspect of the distal oesophagus

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15
Q

FB - example and issue it cause

A

batteries- cause electrical burns in mucosa

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16
Q

what force need to cause trauma to neck and thorax for trauma/perforation

A

neck- penetrating
thorax-blunt

17
Q

investigations for oesophageal perforation

A

CXR
CT
Swallow (gastrograffin)
OGD

18
Q

oesophageal perforation primary management

A

surgical emergency

1.NBM/ IV fluids/ Broad spectrum A/Bs & Antifungals

ITU

Bloods (including G&S)
Tertiary referral centre

19
Q

oesophageal perforation definitive management

A
  1. conservative management- cover with metal stent
  2. operative management-
    primary repair//esophagectomy
20
Q

cause of sliding hernias and what it is

A

phrenoesophageal ligament weak

gastro-oesophageal junction slides up

21
Q

GORD treatment

A

lifestyle change
PPI
dilatation peptic strictures
laparoscopic Nissen’s fundoplication

22
Q

what does
Cardia & Pyloric Region
Body & Fundus
Antrum
produce

A

Cardia & Pyloric Region: Mucus only

Body & Fundus: Mucus, HCl, pepsinogen

Antrum: Gastrin

23
Q

what is Erosive & haemorrhagic gastritis

A

Acute ulcer – gastric bleeding & perforation
cause-NSAID/traume

23
Q

types of gastritis

A

Erosive & haemorrhagic gastritis
Nonerosive, chronic active gastritis
Atrophic (fundal gland) gastritis
reactive gastritis

24
what is Nonerosive, chronic active gastritis
Antrum Helicobacter pylori - Triple Rx (amoxicillin, clarithromycin, pantoprazole) for 7-14days
25
what is Atrophic (fundal gland) gastritis
Fundus Autoantibodies target parietal cells and it's products Parietal cells atrophy ↓acid & IF secretion
26
mechanism for repairing epithelial defects
1. migration (of adjacent epithelial cells) 2. gap closed by cell growth 3. acute wound healing -BM detroyed-
27
ulcer treatment
primary med: PPI/H2 blocker triple Rx 7-14 d 12 weeks later: check serum gastrin/OGD 2. surg
28
treatment for ruptured peptic ulcer
laparoscopic omental patch
29
scan for biliary tree (ie cystic duct)
MRCP=magnetic resonance cholangio pancreatography