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STEP 2 GI > Esophagitis 10-30 (1) > Flashcards

Esophagitis 10-30 (1) Flashcards

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1
Q

esophagitis. causes abbreviation?

A

PIECE

Pill induced, infection, eosinophilic, caustic, GERD

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1
Q

esophagitis. CP?

A

Odynophagia, dysphagia

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2
Q

esophagitis. diagnosis?

A

endoscopy and biopsy

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3
Q

esophagitis. treatment/=?

A

disease specific
Antacid: PPI or H2 blocker

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4
Q

Pill induced. mechanism?

A

Pills getting stuck in esophagus.

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5
Q

Pill induced. what pills?

A

Acid effect of tetracyclines.
Osmotic tissue injury of potassium chloride.
Disrupted normal GI mucosa of NSAIDs.

Also: iron, bisphosphonates - alendronate, risedronate

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6
Q

Pill induced. CP?

A

esophagitis. Usually in the mid-esophagus.

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7
Q

Pill induced. diagnosis?

A

endoscopy and biopsy.

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8
Q

Pill induced. treatment?

A

Remove pill. Give them time to heal. Give antacids.

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9
Q

Pill induced. prevention?

A

Avoid recumbency, take water with the pill.

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10
Q

Infectious. candida? CP and treatment

A

Oral thrush and symptoms of esophagitis; treat as candida - oral flukonazole

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11
Q

Infectiuos. HSV CP and treatment?

A

HSV: Oral lesions and symptoms of esophagitis: treat as HSV.

val or acyclovir.

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12
Q

Infecitous. CMV CP and treatment?

A

CMV: No oral lesion.
val or gancyclovir.

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13
Q

Infectious. HIV CP and treatment?

A

HIV: Opportunistic infection.
treatment HAART.

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14
Q

Infectious in general. CP, diagnosis, treatment?

A

C/P: esophagitis.
Diagnosis: endoscopy and biopsy.
Treatment: depends on the organism.

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15
Q

Eosinohilic. Its ,,allergic reaction”.
Pathogenesis?

A

Chronic, immune-mediated esophageal inflammation

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16
Q

Eosinohilic. clinical presentation?

A

Dysphagia (solid food), inability to tolerate fluids (throwing up) –> can lead to fibrosis and strictures –> progressive dysphagia and food impaction.

chest/epigastric pain
reflux/vomiting
Associated atopy

Cardinal symptoms: drooling, hypersalivation

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17
Q

Eosinohilic. diagnosis?

A

endoscopy and biopsy (>= 15 eos/hpf)

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18
Q

Eosinohilic. what is seen on endoscopy?

A

Linear furrows and circular rings.
Trachealization of the esophagus.

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19
Q

Eosinohilic. treatment?

A

Dietary modification
Trial PPI for 6 weeks
if it fails, +/- topical glucocorticoids (topical tai blet oral aerosolized)

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20
Q

Caustic. etiology?

A

kid - accidentaly
adults - suicide

acid or base

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21
Q

Caustic. CP?

Study These Flashcards
A

hoarse voice/stridor. Stridor –> pending airway collapse –> intubate

drooling, facial burns

22
Q

Caustic. diagnosis?

Study These Flashcards
A

endoscopy and biopsy

23
Q

Caustic. treatment?

Study These Flashcards
A

low severity: liquid diet
High severity: NPO for 72h. Then EGD to see if they can accept food.
NGT and lavage if caught early.

24
Caustic. what NOT to do in treatment?
do not neutralize the pH Never induce emesis
25
GERD. pathophysiology? 3
decr. tone or excessive transient relaxation of LES Anatomic disruption to gastro-eso junction (eg hiatal hernia) incr. risk with obesity, pregnancy, smoking, alcohol intake
26
GERD. CP. typical?
Burning chest pain. Made worse by laying down and spicy food. Better by sitting up and antacids. Regurgitation Odynophagia (often indicates reflux esophagitis
27
GERD. CP atypical? extraesophageal
cough, hoarseness, wheezing, nocturnal asthma
28
GERD. complications? eso ir extraeso
eso - erosive esophagitis, barret esophagus, strictures extraeso - asthma, laryngitis
29
GERD. initial treatment?
Lifestyle (eg weight loss) and dietary changes H2R blocker or PPI
30
GERD. diagnosis. initial?
PPI and lifestyle for 6 month --> gets better
31
GERD. diagnosis. what ligestyle?
avoid chocolate, coffe, smoking
32
GERD. diagnosis. if no response to initial?
no response --> EGD and biopsy
33
GERD. diagnosis. when skip PPI and directly do EGD?
Skip PPI and directly to EGD IF ALARM SYMPTOMS or men age >50 with chronic (>5 years) symptoms or cancer risk factors (tobacco use).
34
GERD. diagnosis. what other 2 methods?
24-hour pH monitoring. Manometry.
35
GERD. treatment. if normal GERD?
PPI
36
GERD. treatment. if normal GERD and more than 2 episodes per week?
Fewer than 2 episodes of symptoms per week --> lifestyle changes (weight loss, head of bed elevation) and histamine 2 receptor antagonists (lamotidine, rantidine
37
GERD. treatment. if normal GERD ans more severe symptoms or esophagitis, laryng involvement?
managed with 8-week course of a PPI
38
GERD. treatment. refractory GERD?
higher dose of PPI.
39
GERD. treatment. persistent GERD
endoscopy or esophageal pH monitoring.
40
GERD. treatment. what application aka technique?
Nissen fundoplication: cannot tolerate PPI or doesn’t want to.
41
GERD. treatment. barrets?
higher dose of PPI; twice a day.
42
GERD. treatment. dysplasia?
local ablative therapy. Radiofrequency ablation, laser, or cryotherapy.
43
GERD. treatment. adenocarcinoma?
stage and resect.
44
GERD. treatment. one of method ,,do surveilance EGD"
.
45
GERD. algorithm. 1. PPI and lifestyle for 6 months: improves vs noimprovement
a. Improves --> GERD: PPI. b. No improvement --> EGD and biopsy.
46
GERD. algorithm. 2. EGD and biopsy: improves vs noimprovement
a. No improvement on PPI and lifestyle. b. Alarm symptoms: nausea and vomiting, anemia, and weight loss.
47
GERD. algorithm. pagal findings ,,gydymas". GERD?
PPI
48
GERD. algorithm. pagal findings ,,gydymas". metaplasia?
high doses PPI
49
GERD. algorithm. pagal findings ,,gydymas". dysplasia?
local ablation plus PPI
50
GERD. algorithm. pagal findings ,,gydymas". adneocarcinoma?
staging, resection, chemo, and radiation.
51
GERD. algorithm. d. Keep doing endoscopies to check for worsening condition.
.
52
Yra algoritmas, atspausdintas
.

STEP 2 GI (37 decks)

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