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1. Internal Medicine I > 4. Disorders of esophagus and GI > Flashcards

4. Disorders of esophagus and GI Flashcards

(60 cards)

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1
Q

What are the symptoms of esophageal diseases?

A

The symptoms of esophageal diseases include :
- epigastric pyrosis,
- heartburn,
- regurgitation,
- dysphagia,
- odynophagia
- NCCP

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2
Q

What are the examination methods for esophageal diseases?

A

The examination methods for esophageal diseases include
- laboratory parameters,
- barium swallow,
- upper GI endoscopy,
- examinations of motility-manometry
- impedance

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3
Q

What are the symptoms of hiatal hernia?

A

No symptoms / dysphagia / NCCP

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4
Q

What are the different types of esophageal diverticula?

A

The different types of esophageal diverticula are
- hypopharyngeal (Zenker),
- epiphrenic
- midesophageal

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5
Q

What are the symptoms of large esophageal diverticula?

A

Large esophageal diverticula can cause dysphagia, regurgitation, cough, halitosis

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6
Q

What are the main patogenetical factors of GERD?

A

Dysphunction of LES + decreased esophageal clearence + prolonged gastric emptying.

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7
Q

What are the aggressive factors of GERD?

A

Gastric acid, pepsin, (+ bile acids, tripsin in duodenogastric reflux)

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8
Q

What are the symptoms of GERD?

A
  • Heartburn,
  • acid regurgitation,
  • NCCP,
  • Dysphagia, odynophagia,
  • Coughing, hoarseness,
  • dyspnea.
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9
Q

What are the extraoesophageal symptoms of GERD?

A
  • Persistent couhing,
  • pharyngeal dysphagia,
  • throat pain,
  • recurrent pneumonia
  • caries
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10
Q

What are the complications of GERD?

A

Stenosis, ulcer, bleeding, Barrett’s oesophagus, adenocarcinoma.

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11
Q

What are the clinical phenotypes of GERD?

A
  • NERD (non erosive reflux disease) (+++)
  • ERD, (++)
  • barrett oesophagus (+)
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12
Q

What is the treatment for GERD?

A
  • Lifestyle changes,
  • surgical laparoscopy,
  • PPIs (omeprazole, panteprazole)
  • H2 blockers
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13
Q

What is Barrett’s esophagus?

A

It is a condition where the lining of the esophagus changes and becomes similar to the lining of the intestine (salmon pink in endoscopy)

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14
Q

What are the risk factors for Barrett’s esophagus?

A
  • Long history of GERD,
  • age over 50,
  • male gender,
  • Caucasian race,
  • obesity,
  • positive family history.
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15
Q

What is the treatment for Barrett’s esophagus?

A
  • Esophagectomy,
  • EMR
  • ESD
  • RFA.
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16
Q

What is eosinophilic esophagitis?

A

Allergen-driven inflammation of the esophagus, mostly affecting young male patients with atopic diseases such as asthma, food allergy, rhinitis.

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17
Q

What are the symptoms of eosinophilic esophagitis in children, young adults, and the elderly?

A
  • Children may experience nausea, abdominal pain, and eating difficulties,
  • young adults may experience dysphagia and food impaction,
  • the elderly may experience regurgitation and heartburn.
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18
Q

How is eosinophilic esophagitis diagnosed?

A

Diagnosis is based on histological examination of upper and lower esophageal biopsies after initial treatment with PPIs.

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19
Q

What are some treatments for EE?

A
  • Remove allergen from diet
  • Topical corticosteroids
  • leukotriene antagonists
  • esophageal dilation
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20
Q

What are some motility disorders that can affect the esophagus?

A
  • Cricopharyngeal disorder,
  • diffuse esophageal spasm,
  • hypo/hypercontractile esophagus (also known as “nutcracker”)
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21
Q

What are some symptoms and diagnostic methods for esophageal motility disorders?

A
  • Symptoms can include dysphagia and chest pain,
  • diagnostic methods can include radiography and manometry.
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22
Q

What is achalasia?

A

Achalasia is a condition where there is an inability of the LES to relax, leading to dysphagia, chest pain, passive regurgitation of undigested food, and aspiration.

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23
Q

What are some treatment options for achalasia?

A
  • ISDN to decrease LES pressure,
  • nifedipine to relax the LES,
  • botulinum toxin to inhibit Ach release,
  • dilation
  • Myotomy
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24
Q

What are the common infective diseases of the esophagus?

A
  • Candidiasis,
  • viral infections (HSV, CMV, VZV),
  • bacterial infections (caused by bacteria of physiological flora, Mycobacterium, syphilis, diphteria, Nocardia),
  • parasitic infections (Chagas disease).
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25
What are the symptoms of esophagitis?
- Asymptomatic, - odynophagia, dysphagia, - nausea/vomiting, - haematemesis.
26
What are the complications of esophagitis?
- Stenosis, - bleeding, - perforation.
27
What is the treatment for candidiasis esophagitis?
Oral or intravenous imidazol or amphotericin B.
28
What is the treatment for viral esophagitis?
Antiviral therapy such as acyclovir, gancyclovir, or foscarnet
29
What is Boerhaave syndrome?
A rare but life-threatening condition that occurs when there is a tear in the esophagus, usually caused by forceful vomiting, caustic ingestion, or iatrogenic injury.
30
What are the symptoms of Boerhaave syndrome?
- Chest pain - odynophagia, - dyspnea, - cyanosis, - subcutaneous emphysema, - mediastinal crepitation, - shock.
31
What is the treatment for Boerhaave syndrome?
Conservative treatment such as carentia, intravenous fluids, and antibiotics, or surgery.
32
What is Mallory-Weiss syndrome?
It is a consequence of retching or forced vomiting that causes a tear of the mucosa at the esophagogastric transition
33
What are the different types of functional diseases that can affect the stomach?
- Globus pharyngeus, - rumination, - functional heartburn, - functional chest pain, - functional dysphagia.
34
What are the ROME criteria used for?
They are used to diagnose functional diseases that affect the gastrointestinal tract.
35
What are the different etiologies of gastritis?
Infection, autoimmune, and systemic diseases.
36
What is the most common cause of acute gastritis?
H. Pylori
37
What are the different types of chronic gastritis?
- Autoimmune atrophic gastritis -type A - H. Pylori gastritis - type B
38
What is are the symptoms of acute gastritis?
Asymptomatic or with symptoms such as epigastric pain, nausea, vomiting, and fever.
39
What are the symptoms of chronic gastritis?
Asymptomatic.
40
What is the gold standard for diagnosing Helicobacter pylori infection?
Histology (with a sensitivity of 90-95% and specificity of 95-98%)
41
What is the purpose of the urease test for diagnosing Helicobacter pylori infection?
It is a quick and simple test used to detect the presence of urease enzyme produced by H.Pylori
42
What are less invasive methods for diagnosing H.Pylori infection?
- IgA - PCR of stool, gingiva, gastric juice
43
What is the purpose of the UBT test for diagnosing Helicobacter pylori infection?
It is used to monitor the success of eradication of H.Pylori
44
HP eradication method 1
PPI+ bismuth subsalicylate + metronidazole + tetracycline
45
HP eradication method 2
PPI+ clarithromycin + amoxicillin or metronidazole
46
What is gastropathy?
It refers to changes in the gastric mucosa without inflammation
47
What are the types of gastropathy?
- Haemorrhagic - Vascular - Hypertrophic (thickening of folds)
48
What is the difference in prevalence between duodenal and gastric ulcers?
Duodenal ulcers are more common than gastric ulcers, with a male to female ratio of 3.5:1, while gastric ulcers have a 1:1 ratio and are more common in the elderly.
49
What are some factors that contribute to the development of ulcers?
- Gastric acid hypersecretion, - nervous system dysfunction - Genetic factors - Environmental factors - H pylori
50
What are the symptoms of ulcers?
Abdominal pain, nausea, and vomiting are common symptoms of ulcers.
51
What are the common symptoms of gastroparesis?
Abdominal pain, nausea, vomiting, early satiety, epigastric pain, discomfort, and loss of weight.
52
What is the treatment for peptic ulcer disease?
- Proton pump inhibitors - Eradication of H.Pylori - H2R antagonists - Sucralfat (protects)
53
What is gastroparesis?
Altered gastric emptying lasting more than 3 months without mechanical obstruction.
54
What are the causes of gastroparesis?
- Idiopathic, - diabetes mellitus - postoperative complications
55
What is the treatment for gastroparesis?
- Diet, - medication (prokinetics, erythromycin, metoclopramide, antiemetic drugs), - electric stimulation of the stomach, - surgical interventions
56
What are some epidemiological characteristics of intestinal gastric cancer?
It is more common in males, older age groups, and high-risk areas, and is likely linked to environmental factors.
57
What are some epidemiological characteristics of diffuse / infiltrative gastric cancer?
- It is equally frequent in both sexes, more common in younger age groups, and has a worse prognosis.
58
What are the symptoms of gastric cancer?
- weight loss, - abdominal pain (epigastric, vague, mild in early stages, more severe and constant as the disease progresses), - dysphagia (pseudoachalasia), - nausea, - early satiety, - occult GI bleeding.
59
What are the metastatic sites of gastric cancer?
- liver - peritoneum, - lymph nodes (ovary, CNS, bones)
60
What are the treatment options for gastric cancer?
Treatment options for gastric cancer include surgery, chemotherapy, and radiation therapy.

1. Internal Medicine I (20 decks)

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