UW revision gastroparesis/gerd

Question 1

gastroparesis. Table. Causes? 5

Answer 1

DM (autonomic neuropathy)
Medications (opioids, anticholinergic drugs)
Traumatic/postsurgical injury (ie vagus nerve injury)
Neurologic (multiple sclerosis, spinal abdominal injury)
Idiopathic/postviral

Question 2

gastroparesis. Table. CP?

Answer 2

Nausea, vomiting, epigastric pain
Early satiety, bloating, weight loss
labile glucose (DM)
Epigastric distension and succussion splash

Question 3

gastroparesis. Table. Diagnosis? 2

Answer 3

Exclude obstruction: upper endo +/- CT or MR enterography

Assess motility: nuclear gastric-emptying study

Question 4

gastroparesis. Table. treatment? 3

Answer 4

Frequent small meals (low fat, soluble fiber only)

Promotility drugs (metoclopramide, erythromycin)

Gastric electrical stimulation and/or jejunal feeding tube (refractory symptoms)

Question 5

gastroparesis. Buvo eating disorder table, bet jos i BS neikeliau, gal bus prie psicho.

Answer 5

.

Question 6

Dyspepsia table. Symptoms? 3

Answer 6

epigastric pain or burning
postprandial fullness, early satiety, bloating
>= 1 months

Question 7

Dyspepsia table. Etiology? 4

Answer 7

Functional/idiopathic (75 proc.)
Malignancy (gastric, esophageal)
Peptic ulcer (Hpylori, NSAIDs)
Drug induced (nsaids, bisphosphonates)

Question 8

Dyspepsia table. work up. low malignancy risk?

Answer 8

age <60 and no alarm symptoms
DO: testing and Tx for H pylori

Question 9

Dyspepsia table. work up. high malignancy risk?

Answer 9

age >60 or alarm symptoms
DO: gastroenterology referral/upper endoscopy

Question 10

Dyspepsia table. Tx?2

Answer 10

treatment of underlying cause
trial of PPI if no cause found

Question 11

Dyspepsia. why nocturnal pain?

Answer 11

due to circadian rhythm of gastric acid secretion

Question 11

GERD. complications? dysphagia?

Answer 11

GERD –> mechanical obstruction (difficulty swallowing solids, but not liquids) = esophageal stricture, esophageal adenocarcinoma.

Question 12

GERD. complications = esophageal stricture. imaging what shows?

Answer 12

symetric, concentric narrowing in the distal esophagus

Question 13

GERD. complications = esophageal carcinoma. imaging what shows?

Answer 13

asymetrical and irregular narrowing of the distal esophagus

Question 14

Also in other Q was GERD complication = esophageal ulcer. caused by acidic erosions. CP = odynophagia and IDA

Answer 14

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