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PHAR 123 > Upper GI > Flashcards

Upper GI Flashcards

1
Q

Who is most likely to experience esophagitis?

A

Immunocompromised pt;
HIV/AIDS pts
Cancer therapeutics
immunodeficiency disorders

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2
Q

What is the most common irritation/ inflammation in GI?

A

GERD

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3
Q

Are swallowing disorders espophagitis?

A

No; Lack of neuromuscular coordination of the voluntary or involuntary muscles associated with swallowing

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4
Q

What is the feeling of somethings tuck in the throat?

A

Globus

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5
Q

Where does the esophagus meet the stomach?

A

Lower esophageal sphincter

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6
Q

What can occur when esophagus is constantly inflammed/ exposed to the stomach acid?

A

Metaplasia

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7
Q

T or F GERD can mimic a heart attack chest pain

A

True

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8
Q

What is the risk of Barret’s esophagus? What is it?

A

15%
Metaplasia pre-cancerous and must be monitored as its a higher risk of esophageal cancer

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9
Q

What are some non-pharmacological treatments of GERD?

A

Weight loss, extra pillow for sleep, earlier supper, avoiding trigger foods

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10
Q

What medications can be used to reduce acid for GERD treatment?

A

H2 receptor antagonists, PPI’s
Antacids can cause rebound acidiity but still a good choice to try

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11
Q

How do the H2 receptors work to treat GERD? What are drug names?

A

Bind H2 receptor reducing H/K ATPase activity
used to treat GERD and peptic ulcers, duration is not as long as PPI’s
Drugs: Rantidine, Famotidine, Cimetidine, Nizatidine

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12
Q

How do PPI’s work to treat GERD? what are the drug names?

A

Bind to H/K ATPase of the gastric parietal cell, preventing acid secretion
Used to treat GERD, peptic ulcers, pylori-related ulcers, duodenal ulcers, and Zolliner-Ellison disorder
Drugs: Pantoprazole, Omeprazole, Rabeprazole, Estomeprazole, Lansoprazole, Dexlansoprazole

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13
Q

What do pareiral cells do?

A

Secrete acid into stomach

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14
Q

What do ECL cells do?

A

Secrete histamine and peptide homrones

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15
Q

What is Gastritis?

A

Inflammation of the stomach can be Acute or Chronic

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16
Q

What can cause Gastritis?

A

infection (h. pylori)
Irritation from food
Medications such as NSAIDs, antibiotics
alcohol as direct irritant
atrophy via old age
major stress
autoimmune

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17
Q

What is the number one reason for hospitalization due to GI bleeding?

A

Chronic NSAID use

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18
Q

What are some signs and symptoms of Gastritis?

A

Pain
bloating
burning sensation
heavy stomach
belching and flatulence
Nausea and Vomitting
loss of apetite
weigth loss (chronic)
blood in vomit or stool
coffee-ground emesis
Melena (tar stool)

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19
Q

How do you manage H pylori infections associated with gastric ulcers?

A

Triple antibiotic therapy + PPI is typical

20
Q

T or F. H2 antagonists should be used for gastritis from irritations (foods)

A

False; H2 antagonists and antacids should be avoided

21
Q

What are the 3 parts of treatment for gastric ulcers?

A

1-2 antibiotics (amox, tetra, clarithromycin, metronidazole) depending on sensitivity and allergies
Bismuth can be added
H2 antagonist or PPI for 2-3 weeks

22
Q

When is surgery done for gastric ulcers?

A

Only if perforated or nonhealing

23
Q

What are risk factors for gastric cancer?

A

infections (h pylori, EBV)
Genetic factors
prior stomach surgery/ radiation exposure
smoking
alcohol
high salt diet
overweight

24
Q

What is the most commonly seen gastric cancer type?

A

Adenocarcinomas

25
Q

WHat is the treatment for gastric cancer?

A

SUrgery in early stages, radiation and chemo for later stages

26
Q

What are early symptoms of gastric cancer? What symptoms arise as it progresses?

A

early symptoms are vague and similar to gastric ulcers, but systemic symptoms like fatigue and weight loss and anemia can develop. Lymph node involvement vomitting, pain, abdominal blaoting, fullness, and blockage may occur

27
Q

what are the 3 parts of the pancreas?

A

head
body
tail

28
Q

What is the exocrine function of the pancreas?

A

produce bicarbonate and digestive enzymes such as lipase, amylase, and protease to break down fats, carbs, and proteins

29
Q

Where does pancreatic fluid enter the duodenum through?

A

papilla (major and minor) which is near the common bile duct

30
Q

Why is pancreatic cancer of the head so problematic?

A

can impinge on the ducts and duodenum leading to digestive problems

31
Q

What is acute pancreatitis?

A

Acinar cell injury and duct obstruction resulting in inappropriate extracellular leakage of activated digestive enzymes and thus autodigestion of pancreatic and extra-pancreatic tissues

32
Q

T or F Pancreatitis is a minor disease with little severity?

A

False; ranges from miled to fatal, can have hemorrhagic pancreastitis with massive necrosis

33
Q

What does necrosis of acinar cells lead to?

A

Inflammation which releases oxygen free radicals that damage tissue leading to patches of necrotic adipocytes that cause fibrosis upon healing

34
Q

What are symptoms of acute pancreatitis?

A

Severe epigastric pain radiating to upper back, nausea, vomiting

35
Q

What are signs of acute pancreatitis?

A

elevated serum amylase and lipase, going into shock or collapsing

36
Q

What is the management for acute pancreatitis?

A

pain management
avoiding alcohol
supportive care

37
Q

What complications can occur with acute pancreatitis?

A

repeated incidences can cause chronic pancreatitis and fibrosis
In some cases necrotic pancreas becomes infected with intestinal bacteria greatly increasing risk of death

38
Q

What is the main cause of chronic pancreatitis?

A

Alcoholism (80%)

39
Q

What are some presentations of chronic pancreatitis?

A

poor digestion
pain upon eating
greasy/smelly stools
malnutrition
recurrent or persistent epigastric pain

40
Q

What is saponification?

A

areas of fat necrosis becoming calcified

41
Q

how does alcohol lead to obstruction of ducts?

A

alcohol acts as a secretagogue stimulating secretion but, these extra proteins can clog up the pancreatic ducts

42
Q

What enzyme supplement is given when pancreatic function declines?

A

pancreatin

43
Q

what is the mortality rate of chronic pancreatitis patients per year? over 20 years?

A

3-4%/year
25% by 20 years

44
Q

What can occur in chronic pancreatitis patients that can have fatal complications?

A

Acute pancreatitis episodes

45
Q

Compare and contrast Acute vs Chronic pancreatitis.

A

Acute occurs suddenly and goes away within a few days vs Chronic developing over many years does not go away andleaves permanet injury or scarring to pancreas

Acute may involve a short hospital stay to heal pancreas vs chronic have a good outlook if they follow management plan

Acute most cases are mild and pancreas returns to normal vs chronic calcification can appear on a CT scan; damage can be seen even when flare up is not occuring

PHAR 123 (18 decks)

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