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CD 3305 > Gastro #2 > Flashcards

Gastro #2 Flashcards

(54 cards)

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1
Q

Etiology of gastritis (4)

A

H. Plylori
Alcohol
Aspirin
Food

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2
Q

Peptic Ulcer disease

A

Damage to the gastric or duodenal mucosa cause by imapired mucosal defense and/or increased acidic gastric contents

Defects superficial to the muscularis mucosa are EROSIONS and do not cause scarring

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3
Q

Where do we see defects in Peptic Ulcer Disease (2)

A

Stomach (gastric ulcers)

Duodenum (duodenal Ulcers)

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4
Q

Most common cause of duodenal ulcer vs gastric ulcer (peptic ulcer disease)

A

duodenal- h. pylori

Gastic- NSAIDs

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5
Q

does alcohol cause ulcers

A

Alcohol impairs healing but doesnt cause ulcers

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6
Q

PUD facts in red for clincal features

A

70% of peptic ulcers are asymptomatic

5-7% of lower GI bleeds are from an upper GI source

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7
Q

Clinical Features of Duodenal Ulcers

A

epigastric pain (may be localized to tip of xiphoid or radiating to t5-t8)

Burning

Develops 1-3h after meals (food intake actually relieves pain)

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8
Q

Gastric Ulcers symptoms

A

more atypical symptoms

biopsy required to exclude malignancy! (duodenal rarely malignant)

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9
Q

gastric vs peptic ulcer - meals

A

gastric ulcer will feel WORSE, while duodenal ulcer pain will be relieved while eating

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10
Q

most accurate test for PUD, and what else do we need to do

A

Endoscopy with biopsy

Zollinger-ellison syndrome needs to be ruled out with serum gastrin levels in cases of GERD and PUD that are refractory to medical management.

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11
Q

Zollinger-Ellison (ZE) Syndrome (Gastrinoma)

A

tumor of pacnreas or duodenum causes increase production of gastin

leads to ulcers, may see steathorrhea (excess fat in feces).

usually part of multiple endocrine neoplasm (MEN1) syndrome which includes pancreatic, pituitary, and parathyroid tumours

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12
Q

Zollinger-Ellison syndrome is assocaited with Multiple Endocrine Neoplasm (MEN1) syndrome - what is this related to

A

3 P’s= pancreatic, putuitary and parathyroid tumors

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13
Q

why do we need to scope suspected peptic ulcer disease in people above 45

A

to exclude gastric cancer

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14
Q

Whats H.Pylori’s shape and stuff as it relates to Peptic Ulcertaion + route of infection

A

gram-negative flagellated rod

most commonly acquried by fecal-oral route

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15
Q

H pylori is found in what % of canadians

A

20%

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16
Q

Gold standard invasive test for H pylori

A

Endoscopic biopsy

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17
Q

NSAIDS mc cause what

A

Gastric mucosal petechia, erosions and ulcers

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18
Q

NSAID ulcers usually present w these symptoms

A

Bleeding, perforation and obstruction

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19
Q

definition and loc of stress induced ulceration

A

ulceration or erosion in the upper GI tract of ill pts
-lesions mc in the fundus of stomach

Unclear etiology

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20
Q

Complication of Duodenal ulcertaion - perforated ulcer and symptoms

A

surgical emergency

sudden pain w/ acute abdomen: rigid, diffuse guarding

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21
Q

Duodenal ulceration - posterior penetration (investigation + symptom)

A

elevated amylase/lipase if penetration into pancreas

constant mid-epigastric pain burrowing into back

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22
Q

Duodenal ulcertaion - hemorrhage, what happens?

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A

gastroduodenal artery involvement

23
Q

duodenal ulceration - gastric outlet obstruction major sign

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A

succussion splash (splashing noise heard with stethoscope over the stomach when patient is shaken)

24
Q

gastric polyps - removal facts (size that should be removed)

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A

all polyps > 1cm should be removed for biopsy

25
types of gastric poylps (4)
1. fundic gland poylp 2. Hyperplastic poylps 3. Adenomatous poylps 4. Multiple poylps are sus for familial polyposis syndrome
26
Epidemiology of gastric carcinoma (age, gender, risks)
95% gastric adenocarcinoma m:f 3:2 50-60years old
27
5 signs of gastric carcinoma
Virchows node- enlarged left supraclavicular node Blumbers shelf- Mass in the rectouterine pouch Krukenbergs tumor- Metastasis to ovary Sister mary josephs nodule- Periumbilical lesion Irish nodes- Left axillary node
28
Gastroparesis- def and symptoms
due to neuropathy (of vagus n) caused by uncontrolled diabetes mellitus affecting the motility of stomach and beyond ss- post prandial epigastric pain, bloating, vomiting
29
condiitons celic is associated with
Sjogrens, thyroid disease, T1DM
30
most common clinical feature of celiac??
iron deficiency anemia (pallor and fatigue)
31
celiac clinical features that arent anemia
improves with gluten free diet dermatitis herptiformis (pruritic papules and vesicles on elbows, knees, buttocks, neck, scalp)
32
investigations for serological
serum anti-tTG iGa (anti tissue transglutaminase) Antiendomesial antibodies small b owel mucosal (mostly duodenum) biopsy is DIAGNOSITIC
33
2 major types of IBD
chrons and ulcerative colitis
34
chrons disease definition
Chronic transmural inflammatory disorder potentially affecting the entire gut from mouth to perianal region "gum to bum"
35
chron's disease pathology terms to know + loc
ileum + ascneding colon cobblestone appearence granulomas Young age, perianal disease, and need for corticosteroids have been associated with poor prognosis
36
clinical features of chron's
Recurrent episodes of abdominal cramps, non-bloody diarrhea (KEY), and weight loss
37
Ulceritive Colitis def
Inflammatory disease affecting colonic mucosa anywhere from rectum (always involved) to cecum confined to mucosa, confined from colon to rectum risk is less in smokers?
38
hallmark symptom of lcerative colitis
rectal bleeding though it starts as non bloody diarrhea, then progresses
39
common complications with ulverative colitis
greater risk of colorectal cancer toxic megacolon (colon diameter > 6cm on)
40
histology - chrons vs ulcerative colitis
chrons has skip lesions and granulomas UC only mucosal, no skip lesions or granumolas
41
complications of chrons vs UC
CHRONS- strictures, fistuales, perianal disease vs US- toxic megacolon
42
IBS def
A disorder of chronic pain that is relieved by a bowel movement idiopathic, diagnosis of exclusion
43
Rome IV criteria for diagnosing IBS
Recurrent abdominal pain for more than 6 mo, of at least 1/d/wk in the last 3 mo, associated with 2 or more of the following: 1. Related to defecation 2. Associated with a change in frequency of stool 3. Associated with a change in form (appearance) of stool Symptom onset at least 6 mo before diagnosis and criteria present during the last 3 mo
44
appendicits clinical features
Abdominal pain (classic pattern: pain initially periumbilical; constant, dull, poorly localized, then well localized pain over McBurney's point) Flexed knee and hip in severe pain
45
more clinical features of appendicitis
mcburney's sign, rovsing's sign, psoas sign, obturator sign
46
appendicitis lab test for women
beta-hCG to rule out ectopic pregnancy
47
Hereditary Non-Polyposis Colorectal Cancer - LYNCH Syndrome (HNPCC) - but why
utosomal dominant inheritance | Mutation in a DNA mismatch repair gene
48
MC risk factor for colorectal carcinoma
Inflammaotry bowel disease
49
clinical picture of colorectal cancer
aften asymp weakness and anemia weight loss
50
imvestigastions for colorectal cancer
colonoscopy | staging
51
screening for colorectal cancer at 50-59 and 60-74
50-59= either gFOBT or FIT, q2 year or flexible sigmoidoscopy q10 60-74= either gFOBT, fecal immunochemical testing q2 or flexible sigmoidoscopy q10year
52
Diverticular disease def
abnormal outpoiching from wall of hallow organ 65% by age 85
53
Clinical features of diverticular disease
Episodic left lower quadrent pain
54
Dyspepsia def
predominant epigastric pain/buring lasting at least one month one or more of following symptoms: - Postprandial fullness - early satiation - epigartric pain or burning

CD 3305 (15 decks)

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