Flashcards in SG Stomach Deck (21):
How does food change a gastric vs duodenal ulcer pain?
Duodenal gets better with food
Stomach gets worse
2 color options for hematemasis
Coffee grounds: not actively bleeding
3 color options for stool if bleeding
Brown - occult
Black with red hue - melena
Red = hematochezia
What might look like melena - other things that could be confused for melena?
- Dark leafy greens
- Iron supplements
Familial things that cause duodenal ulcers
Why would a patient with GI ulcers have orthostatic HTN?
B/c bleeding - large volume losses
What is Hct?
% of blood that is solid cells
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)
Why are you worried if INR is high during a GU bleed?
B/c pt can't stop their own bleed
- Used all clotting factors (more severe bleed, varice)
- Liver disease so not making the clotting factors
How would epi help stop a bleed
Inject epinephrine - constrict surrounding vessels
Why would a pt with ulcer have peritonits
Perforate through stomach
Contents leak into peritoneal cavity
Dx: pneumoperitonitis on XR
Ulcers do 3 things:
3 ways stomach handles acid
Thin layer protective bicarb over epithelium
Do ZE pts get diarrhea?
- Pouring acid from stomach out into SI so the SI isn't as basic as it needs to be to activate pancreatic enzymes
3 stimuli to parietal cells to increase acid secretion
Gastrin (G cells)
Histamine (ECL cells)
3 reasons you might have high gastrin for no reason
You're on a PPI
Lost parietal cell fxn due to AI gastritis
Secretin test - what is it testing for
Give sectrin - gastrin levels go up
What is MEN 1
ZE combo cancer
= Multiple endocrine neoplasia type 1 = adenoma in:
Pancreas - ZE
Parathyroid - hyperCa
Fe deficiency levels of:
High trans = is the carrier, goes up because wants to grab anything it can
Causes of elevated gastric pH
AI gastritis - Ab vs parietal cells
Antacids, PPI, H2 blockers