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Flashcards in Gastro - Online MedEd - misc gastric Deck (16)
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1
Q

Gastroparesis - what is it?

A

Gastric paralysis

Stomach fails to empty

2
Q

Causes of gastroparesis

A

Idiopathic

Diabetes

3
Q

Presentation of gastroparesis

A

Delayed gastric emptying: chronic N/V, abdominal pain especially with eating
-Diabetic - peripheral neuropathy, but diabetic gastroparesis is peripheral neuropathy of vagus nerve!

4
Q

Diabetic neuropathy

A

Nerves to feet are longer than nerves to stomach

So in order for diabetic gastroparesis to occur –> must have damage to feet already

5
Q

Diagnosis of gastroparesis

A

Rule out PUD, cancers, gastric outlet obstruction
Scope negative –> go to next step, scope cannot make definitive diagnosis of gastroparesis, but might still see food in someone who has fasted
Definitive diagnosis: emptying study

6
Q

What is emptying study

A

Radiotracer with scrambled eggs
Picture at 0, 2, 4 hours
>60% at 2 hours, >10% at 4 hours = this is positive test
-Must be off opiates, off anticholinergics and have good blood glucose control

7
Q

Treatment of gastroparesis

A

Avoid opiates, avoid anticholinergics, maintain good blood glucose control

  • Best agent: pro kinetic agents - metachlopramide (for stable disease, PO), arithromycin (acute flare, IV), domperidone (cardiac side effects)
  • Low fiber and small volume meals
8
Q

Diabetic gastroparesis - brittle diabetics - what is there picture?

A

Really high sugars preprandially and really low post prandially
Challenging to control blood sugars

9
Q

Cyclic vomiting syndrome - what is it?

A

Linked to THC

This is not a withdrawal/dependent thing

10
Q

Presentation of cyclic vomiting

A

Habitual MJ
MJ multiple times/day
Cyclical vomiting x weeks - when get symptoms, MJ makes them feel better

11
Q

Diagnosis of cyclic vomiting

A

Clinical dx
Likely do EGD and biopsy to rule out other causes
Might even get emptying study

12
Q

Treatment of cyclic vomiting

A

Stop MJ
Metochlopramide
Azithryomycin
Control N/V - ondansetron

13
Q

Gastric carcinoma - what is it?

A

Increased incidence in east Asia

Linked to nitrites - preservatives, diet related

14
Q

Gastric carcinoma - presentation

A

Early satiety - taking up space
Unintentional weight loss
Gastric outlet obstruction
*Usually late

15
Q

Gastric carcinoma - dx

A

EGD and biopsy (sigma ring cells)

PET scan/Pan scan CT for staging (90% are already spread)

16
Q

Treatment of gastric carcinoma

A

Resection, chemo