Esophagus, Stomach And Upper Duodenum Flashcards
What is esophagitis?
Infection and inflammation of the esophagitis
Common in I/C patients
Manifested by dysphagia, odynophagia and heartburn
Caused by GERD, infections and medications
What are the infectious causes of esophagitis?
Candida albicans- most common, usually like thrush
CMV-only in I/C patients, onset of symptoms gradual
HSV- abrupt onset
HIV-occurs during primary infection, multiple small thrush like lesions
VZV- skin lesions consistent with chickenpox or shingles
What are the diseases of the stomach and upper duodenum?
Chronic active gastritis
Peptic ulcer disease which covers gastric and duodenal ulcers
Mostly caused by Helicobacter pylori
What are the manifestations of chronic active gastritis?
Often asymptomatic
Pain and discomfort in pit of stomach, in left upper abdomen , radiates from belly to the back
Belching offer temporary or no relief, nausea, vomiting
Bloody or dark sticky, foul smelling fouls in critically ill patients
What are the manifestations of the peptic ulcer disease?
Gnawing or burning pain in the epigastrium
Bleeding that may result in anemia, weakness and fatigue
Hematemesis, melena or hematochezia
What are the difference between gastric and duodenal ulcers?
Gastric- pain is made worse by eating, usually seen in patients 55-65
Duodenal-pain is relieved by eating, usually seen in patients 25-75
What are the virulence factors that cause peptic ulcer?
Corkscrew motility Ph sensing ability Urease VacA and cagA genes Cytokines reduce somatostatin and decrease gastrin levels leading to inflammation
What are the 2 majors groups of viral hepatitis?
Fecal borne: Hepatitis A and E
Blood borne: Hepatitis B, C and D
What are the characteristics of the fecal borne viral hepatitis?
Incidence higher in crowded living areas Manifest with a distaste of cigarettes Children are usually asymptomatic Humans are the only natural hosts Does not cause chronic state HEV mortality rate is 10 times higher than HAV, and a higher mortality in pregnant women
What are the manifestations of the fecal borne viral hepatitis?
Initial symptoms are pain in RUQ, hepatosplenomegaly
Classic symptoms are icterus, jaundice, darkurine,clay colored stools, elevated levels of ALT, AST,bilirubin
What is the interpretation of the serology tests for HAV?
Acute HAV infection—>IgM positive
Previous HAV infection—->IgG positive
What are the characteristics of blood borne viral hepatitis?
Newborns and children are less likely to be symptomatic and more likely to develop chronic hepatitis
Chronic hepatitis is more common in HCV than HBV
Sexual routes more common for HBV
Percutaneous routes more common for HCV
What is the serology test results for acute HBV?
Positive surface antigens (HBsAG)
Positive Anti-HBc IgM
What is the serology test results for the window time in HBV infection?
Window time is time surface antigen and anti-surface antigen is not detected
Positive Anti-HBc IgM
What is the serology test results for early convalescence inHBV?
Positive Anti-HBsAg
Positive Anti-HBc IgG
