stomach, duodenum, GI bleeds Flashcards
(20 cards)
hematochezia
bright red blood, typically from lower GI bleed
acute labs ordered for GI bleeding may not have an accurate….
Hct
50% of all upper GI bleeds are from?
peptic ulcer disease, majority of which are from H. Pylori or NSAIDs
PUD tx
intravascular fluid resuscitation, IV PPI, urgent/emergent endoscopy
which type of hemorrhoid is painful?
prolapsed internal, needs to be fixed within 24-48 hours
where is meckel’s diverticulum usually located?
within 100 cm of ileocecal valve
what med to use for prevention of variceal re-bleed?
propranolol
( ) inhibit prostaglandin, bicarbonate, and mucus production
NSAIDs
best test for H. Pylori is….
other options include….
upper endoscopy w/biopsy
breath test, stool sample
triple therapy for H. Pylori
PPI (continue 8 weeks after tx)
Clarithromycin or Metronidazole
Amoxicillin or Metronidazole if not used
whats meds need to be d/c before an H. Pylori stool/breath test?
PPI
Bismuth subsalicylate
antibiotics
Alcoholic, intense episode of emesis, now with UGI bleeding.
mallory weiss syndrome
gastroparesis
- stomach takes longer to empty
- common with diabetics
- Pts says they used to eat a lot and then they get early satiety
how to dx gastroparesis
gastric emptying scan
signs of gastric adenomacarcinoma
- palpable enlarged stomach
- enlarged virchows lymph nodes
- hepatomegaly
primary cause of gastric cancer
H. Pylori
how does PUD present?
- epigastric pain, may bore into back
- bleeding
how do duodenal ulcers present?
- these can bleed
- relief gained from OTC meds and eating
Zollinger-Ellison Syndrome
-endocrine tumor disorder, direct result of gastrinoma
Suspect in patients with multiple peptic ulcers, recurrent ulcer disease, duodenal or jejunal ulcers, family history of MEN1
Diarrhea or steatorrhea
how to dx Zollinger-Ellison
Fasting serum gastrin concentration >1000 pg/ml (normal is <110)
Pts on PPIs will have high levels of gastrin, so they have to come off this to test
