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Flashcards in GI - Stomach Deck (28)
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0
Q

Functional dyspepsia?

A

Symptoms as described for dyspepsia persisting for at least 12 weeks without evidence of an ulcer

1
Q

Dyspepsia? Associated with?

A

Pain associated with fullness early satiety bloating or nausea.

2
Q

Gastroesophageal reflux typically occurs when? Worsens with?

A

After meals. Recumbency.

3
Q

Biliary colic caused by? Location of pain? Precipitated by? Lasts for?

A

Gallstones. Right upper quadrant. Precipitated by meals, especially fatty foods. Last 30 to 60 minutes with spontaneous resolution

4
Q

Irritable bowel syndrome suggested by what symptoms?

A
  1. Chronic dysmotility symptoms (up loading, cramping)
  2. Relieves with defecation
  3. no weight loss or bleeding
5
Q

Duodenal ulcers caused pain how long after meals? Relieved by?

A

2 to 5 hours after a meal. Food or antacids.

6
Q

If food worsens gastric pain - think?

A

Gastric ulcer

7
Q

Gastric cancer can present with dysphasia if? Persistent vomiting if? Early satiety it?

A

In the cardiac region of the stomach. Blocking the pyloric channel. Mass effect or infiltration of the stomach wall.

8
Q

When should patients undergo endoscopy for dyspepsia?

A
  1. Older than 45 years who present with new onset dyspepsia
  2. Patients with alarm symptoms (weight-loss, recurrent vomiting, dysphasia, bleeding, anemia)
  3. Symptoms have failed to respond to empiric therapy
9
Q

In younger patients with no alarm features - strategy for dyspepsia?

A

Urea breath test or H. pylori antibody test

10
Q

Problem with H. pylori antibody test?

A

Will remain positive for life even after successful treatment

11
Q

Cancers associated with H. pylori?

A

Gastric carcinoma and gastric MALT lymphoma

12
Q

Treatment for H. pylori?

A

Clarithromycin, amoxicillin and a PPI

13
Q

Major cause of duodenal and gastric ulcers not caused by H. pylori? Mech?

A

NSAIDs. Inhibit prostaglandin synthesis resulting in reduced secretion of mucus and bicarb and decreased mucosal bloodflow

14
Q

Condition that should be suspected if pt with ulcers is H. pylori negative and does not use NSAIDs? Diagnosed with?

A

Zollinger-Ellison syndrome. Serum gastrin levels greater than 1000

15
Q

Free perforation into the abdominal cavity may cause?

A

Hemorrhage with severe onset of pain and development of Peritonitis

16
Q

Indications for surgical intervention?

A

Perforation and obstruction

17
Q

Symptoms of gastric outlet obstruction?

A

Persistent vomiting and weight loss with +/-

abdominal distention

18
Q

Gastritis? Presents as? Common causes?

A

Information/erosion of the gastric lighting; bleeding without pain

#Alcohol
#NSAIDs
#H pylori
#Portal hypertension
#Stress (trauma, burns, sepsis, uremia)
19
Q

Atrophic gastritis is associated with which vitamin deficiency?

A

B12

20
Q

Test to diagnose erosive gastritis?

A
#Endoscopy to diagnose
#H pylori testing
21
Q

H pylori testing options?

A
#endoscopic biopsy – most accurate/invasive
#Serology – negative test excludes infection but lacks specificity (current versus old infection?)
#Urea breath testing – positive only in activity fiction
# stool antigen – positive only in active infection
22
Q

When to give stress ulcer prophylaxis?

A
#Mechanical ventilation 
#head trauma
#burns
#Coagulopathy
23
Q

Role of alcohol and tobacco in PUD?

A

Delay healing of ulcers (do not cause ulcers)

24
Q

Risk of cancer into duodenal PUD? Gastric PUD?

A

No risk

4%

25
Q

Patient with H. pylori gastritis treated with triple therapy. How to evaluate if treatment worked?

Treatment failure usually from?

A

Breath test or stool antigen

Alcohol, NSAIDs, smoking, medication noncompliance

26
Q

Patient with confirmed gastrinoma. CT/MRI negative for metastases. Next step?

A

Somatostatin receptor scintigraphy (nuclear octreotide scan) + endoscopic ultrasound to further exclude metastases

(Gastrinoma associated with increased number of somatostatin receptors)

27
Q

Treatment for diabetic gastroparesis?

A

Erythromycin and metoclopramide

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