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P&T Block 3 Pulm & GI > SG Stomach > Flashcards

Flashcards in SG Stomach Deck (21):
1

How does food change a gastric vs duodenal ulcer pain?

Duodenal gets better with food
Stomach gets worse

2

2 color options for hematemasis

Red
Coffee grounds: not actively bleeding

3

3 color options for stool if bleeding

Brown - occult
Black with red hue - melena
Red = hematochezia

4

What might look like melena - other things that could be confused for melena?

Digestion of:
- Peptobismol
- Dark leafy greens
- Iron supplements

5

Familial things that cause duodenal ulcers

H.pylori
Zollinger Ellison

6

Why would a patient with GI ulcers have orthostatic HTN?

B/c bleeding - large volume losses

7

What is Hct?

% of blood that is solid cells

8

What happens is a pt you think is bleeding has normal Hct?

Pt is losing blood and volume at same rate
Aka both plasma and blood cells
= ACUTE bleed
Chronic bleed would show decreased Hct
Will only see the fall in Hct acutely after you resuscitate with fluids (increase volume w/ blood cells)

9

Why are you worried if INR is high during a GU bleed?

B/c pt can't stop their own bleed
Maybe:
- Used all clotting factors (more severe bleed, varice)
- Liver disease so not making the clotting factors

10

How would epi help stop a bleed

Inject epinephrine - constrict surrounding vessels

11

Why would a pt with ulcer have peritonits

Perforate through stomach
Contents leak into peritoneal cavity
Dx: pneumoperitonitis on XR

12

Ulcers do 3 things:

Bleed
Perforate
Obstruct

13

3 ways stomach handles acid

Mucin
Epithelial turnover
Thin layer protective bicarb over epithelium

14

Do ZE pts get diarrhea?

Yes:
- Malabsoption
- Pouring acid from stomach out into SI so the SI isn't as basic as it needs to be to activate pancreatic enzymes

15

3 stimuli to parietal cells to increase acid secretion

Gastrin (G cells)
ACh (vagus)
Histamine (ECL cells)

16

3 reasons you might have high gastrin for no reason

ZE
You're on a PPI
Lost parietal cell fxn due to AI gastritis

17

Secretin test - what is it testing for

ZE pts
Give sectrin - gastrin levels go up

18

What is MEN 1

ZE combo cancer
= Multiple endocrine neoplasia type 1 = adenoma in:
Pancreas - ZE
Parathyroid - hyperCa
Pituitary

19

Fe deficiency levels of:
Ferratin
Transferratin

Low ferratin
High trans = is the carrier, goes up because wants to grab anything it can

20

Causes of elevated gastric pH

AI gastritis - Ab vs parietal cells
Antacids, PPI, H2 blockers

21

3 reasons for B12 def

Pancreatic def
Crohn's - lose terminal ilium
AI gastritis