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Clin Med II > GI Drugs Take 1 > Flashcards

GI Drugs Take 1 Flashcards

1
Q

what kinds of drugs that can mess with LES function (ie lower the tone)?

A

anti-cholinergic

anti-muscerinic

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2
Q

what is the vicious cycle of GERD/

A

esophageal damage causes reduced esophageal peristalsis causes compromised integrity of LES causes more gastric contents and more esophageal erosion

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3
Q

how do H2RAs work?

A

blocks H2 receptor in the stomach and it blocks acid production (75-80% acid reduction)

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4
Q

how much acid reduction do PPis give you?

A

85-90%, shuts down acid production

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5
Q

what are pro-ulcerative substances?

A 
gastric acid (inc. by histamine, gastrin, ACh)
Pepsin (proteolytic enzyme)
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6
Q

what are protective gastric substances?

A

gastric mucus
bicarb
prostaglandins (increases mucous and bicarb and mediates gastric repair)

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7
Q

what do you do when a pt isn’t getting relief from a PPI?

A

try a different one

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8
Q

where does non-hodgkins lymphoma typically go to?

A

stomach cancer

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9
Q

what deficiency can duodenal resection cause?

A

folate
iron
Ca

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10
Q

what deficiency can terminal ileum cause?

A

B12

bile salts

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11
Q

what deficiency can extensive SB resection cause?

A

diarrhea
weight loss
electrolyte nutrient malabsorption

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12
Q

what is an ileus?

A

a functional gut problem

neurogenic failure or loss of peristalsis in the absence of mechanical obstruction

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13
Q

what is the MCC of ileus?

A

post operative

other causes could be peritoneal inflammation or extreme illness

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14
Q

how does an ileus present?

A

mild abd pain (diffuse)
N/V
distention
hypoactive or absent BS

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15
Q

why is the pelvic MRI good for colorectal cancer?

A

it can tell you if there is presacral nerve involvement

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16
Q

what is the rectal coil?

A

enhances images that are taken in the area

-it is large! it doesn’t feel good!

17
Q

who is most commonly affected by constipation?

A

women and elderly

18
Q

what is the MCC of constipation?

A

inadequate fiber and fluid intake

poor bowel habits

19
Q

what is functional constipation?

A 
normal transit (35 hrs) but have trouble pushing it out
idiopathic, eating problems
20
Q

what is slow transit?

A

takes more than 3 dys to have a BM

21
Q

what is evacuation disorder?

A

functional outlet obstruction

paradoxical contraction of anal sphincter and/or pelvic floor

22
Q

what is ROME criteria?

A

helps to define functional constipation

  • > 3mo of sxs
  • onset >6 mo
  • > 2 of (straining, hard stools, incomplete evacuation, anorectal blockage, manual maneuvers, t have IBS
23
Q

what is a common secondary cause of constipation?

A

medications

24
Q

when would you suspect obstructing colonic lesion?

A

new onset sxs

25
Q

what are alarm sxs for constipation pt?

A 
bleeding
wt loss
anemia
heme (+)
family hx of colon cancer
26
Q

how do you assess ppls stool?

A

bristol stool form scale
(type 1-type 7)
type 8 is mucous like, bubbly, foul

27
Q

what is a rectocele?

A

vaginal wall or bladder is protruding into rectum

28
Q

what is a SITZ mark study?

A

ingest capsule w radio plaque markers,

f/up imaging to evaluate for pattern of retained markers

29
Q

what is anorectal manometry?

A

measures function of the anal sphincter

30
Q

when might you need to get a subtotal colectomy in a constipation pt?

A

colonic inertia

nothing works

31
Q

what is an internal hemorrhoid?

A

supepithelial vascular cushion protects seal of anus

-arise from rectal artery and veins

32
Q

what is an external hemorrhoid?

A

arise from inferior hemorroidal veins (below dentate line)

-squamous epithelium

33
Q

when is an US the test of choice?

A

gyn complaint

RUQ pain

Clin Med II (23 decks)

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