Flashcards in GI - dysphagia Deck (12)
How does solids/liquids help in DDx of dysphagia?
Solids = mechanical obstruction
Solids + liquids = motility dysfunction
Px of GORD
- heartburn, acid regurgitation
- positional cough (e.g. nocturnal cough)
- waterbrash (increased salivary secretion due to acid at the back of throat)
- altered taste sensation
- morning nausea
- laryingitis/hoarse voice
Distance from mouth to upper & lower esophageal sphincters (E.g. when doing endoscope)
UES (upper esophageal sphincter) at 22cm
LES (lower esophageal sphincter) at 40cm
What is hiatus hernia? What are the common types?
Part of stomach being above the diaphragm
- sliding hernia: part of stomach up through diaphragm along esophagus. Commonest type
- paraesophageal hernia: hernia of stomach next to esophagus through diaphragm. It may compress esophagus from the side
Diet advice for GORD
- low fat diet
- low cigarette
- low caffeine
- eat earlier to avoid nocturnal reflux
- not excessive anticholinergic drugs (TCA) + ventolin
How can you confirm the eradication of H. pylori? When can you get false negatives & false positives?
Check eradication 6 weeks post with faecal H. pylori antigen test or with H2 breath test
False negatives: due to PPIs
False positives: urease still present during 2-4 weeks post eradication of H. pylori
What classes are Zantac & Somac?
Zantac: H2 receptor blocker for GORD
Somac: Pantoprazole (PPI) for GORD
What (2) medications can give you oesophageal ulceration?
Slow K+ & doxycycline
(2) findings in Pathology of peptic esophagitis
-long lamina propria papillae
-Smooth muscle hypertrophy
What defines a Z line in the stomach/esophagus?
Where Columnar epithelium joins sqamous epithelium. Z line may be in the esophagus in cases of Barrett's esophagus or hiatus hernia
Significance of presence of Goblet cells in esophagus
Intestinal metaplasia within the Barrett's mucosa
Goblet cells are NOT present in esophagus or stomach. Only present in duodenum/small intestine.