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2: ECOS III Exam 1 > 12: Epigastric Complaint > Flashcards

12: Epigastric Complaint Flashcards

1
Q

Defensive products/structures in the stomach vs ones that cause GERD

A

Defensive: LES, UES, peristalsis, saliva, bicarb, mucus

Cause GERD: acid, pepsin, bile acids, trypsin

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2
Q

Possible progression of GERD: five conditions

A
  1. GERD
  2. Reflux esophagitis
  3. Esophageal stricture
  4. Barrett’s esophagus
  5. Esophageal adenocarcinoma
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3
Q

Barrett’s esophagus pathology

A

Columnar cells of the stomach creep up and replace squamous epithelial cells of the esophagus

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4
Q

Most common complication of PUD

A

Bleeding

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5
Q

Risk factors associated with poor outcome for PUD bleeding

A

Age >60, NSAIDs, multi-organ failure, pulmonary complications, malignancy

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6
Q

What causes gastric outlet obstruction

A

Peri-ulcer edema near the pylorus

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7
Q

First line quadruple treatment for H pylori infection**

A
  1. PPI
  2. Bismuth
  3. Tetracycline
  4. Metronidazole
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8
Q

First line clarithromycin triple therapy for H pylori**

A
  1. PPI
  2. Clarithromycin
  3. Amoxicillin or metronidazole
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9
Q

How does gastric scintigraphy work?

A

Consume radioactive eggs -> take images of the stomach at 0, 30, 60, and 120 minutes

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10
Q

Metoclopramide MOA

A

D2 receptor antagonist - stimulates Ach in the GI tract to enhance motility + increase LES tone

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11
Q

Erythromycin: type of Abx

A

Macrolide

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12
Q

9 Causes of acute pancreatitis

A
  1. Gallstones (40% of cases)
  2. Alcohol (30% of cases)
  3. Hypertriglyceridemia
  4. Genetic causes
  5. Drugs
  6. Autoimmune causes
  7. ERCP
  8. Trauma
  9. Infection
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13
Q

MRCP stands for?

A

Magnetic resonance cholangiopancreatography

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14
Q

What is MRCP used for?

A

Pancreatic ducts, biliary tree

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15
Q

EUS: endoscopic US: functions

A
  1. Evaluate biliary tree, panc ducts, panc cysts, masses

2. Can biopsy and perform ERCP

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16
Q

Diagnosis of Pancreatitis requires 2/3 of which three things?**

A
  1. Abd pain consistent with panc
  2. Lipase or amylase 3x ULN
  3. CT/MRI consistent with panc
17
Q

Seven factors that predict a negative outcome with pancreatitis

A
  1. Age >60 yrs
  2. Obesity
  3. Long term EtOH
  4. Elevated BUN/Cr
  5. Hemoconcentration
  6. Elevated CRP
  7. Elevated scoring system (APACHE II)
18
Q

Four ways to help prevent pancreatitis

A
  1. Remove gallbladder
  2. EtOH cessation
  3. Manage high triglycerides
  4. Review med list
19
Q

Acute Coronary syndrome presentation

A

CP esp with exertion, pressure on chest, nausea

20
Q

What is ACS (acute coronary syndrome)?

A

Acute blockage of blood flow to heart

2: ECOS III Exam 1 (17 decks)

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