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Flashcards in MTB Gastro Deck (37):
1

pain while swallowing.

Odynophagia

2

Alarm symptoms indicating endoscopy include:

• Weight loss
• Blood in stool
• Anemia

3

Achalasia diagnostic finding

Barium esophagram will show a "bird's beak"

4

Achalasia treatment

Pneumatic dilation
Botulinum toxin injection

5

Esophageal Spasm presentation

sudden onset of chest pain that is not related to exertion. Therefore, at first it is impossible to distinguish them from some form of atypical coronary artery spasm or unstable angina.

6

Zenker is

an outpocketing of the posterior pharyngeal constrictor muscles. There is dysphagia, halitosis, and regurgitation offood particles. Some patients suffer from aspiration pneumonia when the contents of the diverticulum end up in the lung.

7

Mallory-Weiss tear presents with

upper gastrointestinal bleeding after prolonged or severe vomiting or retching. Repeated retching is followed by hematemesis of bright red blood, or by black stool.

8

GORD presentation

The patient also complains of sore throat, bad taste in the mouth (metallic), hoarseness, or cough.

9

GORD treatment

All patients should:
• Lose weight if obese.
• Avoid alcohol,nicotine,caffeine,chocolate,and peppermint.
•Avoid eating at night before sleep (within 3hours of bedtime).
• Elevate head of bed 6 to 8inches.
PPis.

10

Stress ulcer prophylaxis Is Indicated In:

• Mechanical ventilation
• Burns
• Head trauma
• Coagulopathy

11

Less common causes of peptic ulcers are:

• Burns
• Head trauma
• Crohn disease
• Gastriccancer
• Gastrinoma(Zollinger-Ellisonsyndrome)

12

"best initial therapy" of H, pylori is

a PPI combined with clarithromycin and amoxicillin.

13

Gastrinoma aka

Gastrinoma (Zollinger-Ellison Syndrome)

14

Diabetic Gastroparesis

Look for a diabetic patient with chronic abdominal discomfort, "bloating," and constipation. There is also anorexia, nausea, vomiting, and early satiety.

15

Variceal bleeding, look for

• Vomiting blood+/- black stool
• Spiderangiomataandcaputmedusa
• Splenomegaly
• Palmar erythema
• Asterixis

16

Chronic pancreatitis diagnostic finding

AXR calcification
Abdo CT calcification

17

Carcinoid syndrome

• Flushing
• Wheezing
• Cardiac abnormalities of the right side of the heart

18

The pain of IBS is:

IBS is not associated with weight loss.
• Relieved by a bowel movement
• Less at night
• Relieved by a change in bowel habit such as diarrhea

19

Crohn disease

skip lesions
transmural glanulomas
fistula and abscess
masses and obstruction
perianal disease

20

Ulcerative colitis

curable by surgery
entirely mucosal
no fistula, no abscess
no obstruction
no perineal disease

21

Acute epigastric pain + tenderness + nausea/vomiting = pancreatitis

Acute pancreatitis

22

All forms of chronic liver disease can produce:

• Ascites
•, Coagulopathy (all clotting factors except VIII are made in liver)
• Asterixis and encephalopathy
• Hypoalbuminemia and edema
• Spider angiomata and palmar erythema
• Portal hypertension leading to varices
• Thrombocytopenia from splenic sequestration
• Renal insufficiency (hepatorenal syndrome)
• Hepatopulmonary syndrome

23

Treat PBC with

ursodeoxycholic acid.

24

Nonalcoholic Steatohepatitis (NASH) or Nonalcoholic Fatty liver Disease

This disorder is associated with:
• Obesity
• Diabetes
• Hyperlipidemia
• Corticosteroiduse

25

The single word progressive (or "from solids to liquids") is the most important
clue to the diagnosis of

esophageal cancer.

26

Plummer-Vinson syndrome is associated with

iron deficiency anemia and can rarely transform into squamous cell cancer.

27

GERD is the answer when you see

"epigastric burning pain radiating up into the chest."

28

Testing for H.pyroli

Endoscopic biopsy
Serology
Urea C13 or C14 breath testing
H. pylori stool antigen

29

There is no way to diagnose PUD without

endoscopy or barium studies.
Radiologic testing such as an upper GI series can detect ulcers, but cannot detect the presence of either cancer or H. pylori.

30

If there is no response to DU therapy with PPis, clarithromycin, and amoxi- cillin, the first thought should be

antibiotic resistance of the organism.
C13 urea breathing test

31

All forms of fat malabsorption present with

deficiency of fat-soluble vitamins such as vitamins A, D, E, and K.
Fat malabsorption frequently presents with weight loss.

32

ANCA and ASCA results in IBD

ANCA only positive in UC
ASCA positive in Crohn

33

Colonoscopy and barium enema are dangerous in

acute diverticulitis because of increased risk of perforation. Infection weakens the colonic wall.

34

Diverticulitis Abx

Ciprofloxacin combined with metronidazole
cover the E. coli and anaerobes

35

MRCP is diagnostic; ERCP is for

therapy.

36

Early PSC can look just like PBC. Look for:

• Pruritus
• Elevated alkalinephosphatase and GGTPas well as elevated bilirubin level
Early PSC can look just like PBC. The bilirubin level can be normal in early disease.

37

Look for the combination ofliver disease and emphysema (COPD) in a young patient (under 40) who is a nonsmoker.

Alpha !-Antitrypsin Deficiency