Gastric Diseases Flashcards

1
Q

why do you need to check bowel sounds in suspected gastric disease?

A

you need to check for perforations, which are an emergency

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2
Q

Why do NSAIDs cause GI injury?

A

they inhibit prostaglandins thru reversible inhibition of both COX-1 and COX-2 enzymes

prostaglandins are key in GI mucosal protection

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3
Q

What patients taking NSAIDs are more likely to get ulcers?

A

hx of ulcer or GI complications

increasing age

anticoagulant use

corticosteriod use

high doses of NSAIDs

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4
Q

What’s H. Pylori?

A

Gram negative rod

that infects stomach or duodenum and leads to inflammation

produces urease with reacts with urea to form NH4

(Carcinogen!)

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5
Q

Who is at risk for H. Pylori infection?

A

Low socioeconimic status

elderly

minority groups

immigrant populations

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6
Q

How do we test for H. Pylori?

A

gastric biopsy

urea breath test

stool antigen

serology

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7
Q

what’s the treatment for H. Pylori?

A

antibiotics for two weeks and proton pump inhibitor

Anerobe - flagyl

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8
Q

when do you use clips vs. cautery for ulcer repair?

A

clips are for smaller ulcers

cautery for larger

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9
Q

what percentage of duodenal and gastric ulcers are healed by PPIs and in what time frame?

A

duodenal - 90% at 4 weeks

gastric - 90% at 8 weeks

(when given once daily 30 minutes before breakfast)

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10
Q

what is MEN 1 syndrome?

A

tumors of pancreas

tumors of duodenum

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11
Q

what are the most common causes of erosive gastritis

A

Medications (NSAIDs)

Alcohol

Stress

Portal hypertension

Ischemia

Caustic ingestion

Radiation

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12
Q

What are the most common causes of non-erosive gastritis?

A

H. pylori 30-50% has chronic gastritis

pernicious anemia

eosinophilic gastritis

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13
Q

what is gastroparesis?

A

reduced or decreased motility of the stomach

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14
Q

what are the symptoms of gastroparesis?

A

bloating

nausea/vomiting

early satiety

epigastric pain

regurgitation

weight loss

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15
Q

what’s a bezoar?

A

a hunk of undigested food just sitting in the stomach

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16
Q

how do you diagnose gastroparesis?

A

gastric emptying study

EGD

17
Q

how long do you treat H. Pylori patients

A

2 weeks of abx

2 months of PPI

hold off 2 months PPI before testing - best is breath or stool

18
Q
A