Upper GI

Question 1

what are the 3 common causes of dysphagia?

Answer 1

Mechanical obstruction, neuromuscular (ex: stroke), and people that have been intubated / trachs

Question 2

List the common triggers for GERD:

Answer 2

• fatty foods
• spicy foods
• tomato based foods
• citrus
• caffeine
  -large amounts of ETOH
• cigs
• sleep position
• obesity
• pregnancy
• some drugs

Question 3

what is dyspepsia?

Answer 3

Basically like indigestion - burning, bloating/gassy, nauseous

Question 4

What are the mouth manifestations of GERD?

Answer 4

tooth decay, gingivitis, bad breath

Question 5

True or false - GERD can manifest as an ear ache.

Answer 5

True

Question 6

What are 3 pulmonary manifestations of GERD?

Answer 6

Chronic cough, worsening asthma, recurrent pneumonias

Question 7

What is Barrett esophagus?

Answer 7

Development of abnormal metaplastic tissue in the esophagus. Places the patient at an increased risk of developing adenocarcinoma (cancer) of the esophagus. Overall survival rate is low. Monitor the patient for progression of this.

Question 8

What is another name for a Type I hiatal hernia?

Answer 8

sliding hernia

Question 9

What is another name for a Type II hiatal hernia?

Answer 9

paraesophageal hernia

Question 10

What education can the nurse give to a patient with a hiatal hernia to help control symptoms?

Answer 10

small, frequent meals
avoid laying down after eating
avoid tight clothing
avoid abdominal supports
weight control if obese
antacids (GERD and esophagitis)

Question 11

Where is the inflammation at with acute and chronic gastritis?

Answer 11

in the stomach lining

Question 12

Where is the inflammation for gastroenteritis?

Answer 12

stomach lining and small intenstines

Question 13

What are the 3 common causes of acute gastritis?

Answer 13

NSAIDS, ETOH, H. pylori

Question 14

What are the 4 complications of chronic gastritis?

Answer 14

PUD, bleeding ulcers, anemia, gastric cancer

Question 15

What are the 2 common causes of chronic gastritis?

Answer 15

H. pylori
Autoimmune attack of parietal cells

Question 16

What type of environment is best for H. pylori?

Answer 16

acidic

Question 17

How can H. pylori be transmitted?

Answer 17

Saliva, fecal matter, vomit, contaminated food or water

Question 18

What are the 3 common causes of gastroenteritis?

Answer 18

viral infections (norovirus and rotavirus), bacterial infections (e. coli, salmonella, campylobacter), parasitic infections

Question 19

Normal duration for gastroenteritis?

Answer 19

1-3 days, can last 10

Question 20

What is the primary complication from gastroenteritis?

Answer 20

FVD

Question 21

What are the common causes of PUD?

Answer 21

H. pylori, NSAIDs, ASA, ETOH, increased secretion of acid, smoking, family hx, stress (exacerbates NOT cause)

Question 22

What is the patho behind PUD?

Answer 22

Mucosa is damaged causing histamine to be released. When histamine is released it increases the acid and pepsin secretion causing more irritation and damage to the lining. It also destroys blood vessels which explains why some patients may have bleeding.

Question 23

What is the most common location of PUD and when?

Answer 23

duodenum, early adult hood

Question 24

Why are older adults more at risk for gastric ulcers?

Answer 24

More use of NSAIDS, ASA, steroids, anticoags. Also generally more comorbidities.

Question 25

Some patients with PUD may have burning pain in the middle of their stomach, when is this typically the worse?

Answer 25

When they have an empty stomach (nothing to protect the lining)

Question 26

What is the typical onset of pain related to gastric ulcers?

Answer 26

1-2 hours after eating

Question 27

What is the typical onset of pain related to duodenal ulcers?

Answer 27

2-4 hours after eating

Question 28

What are the 3 major complications from PUD?

Answer 28

hemorrhage obstruction perforation and peritonitis

Question 29

What factors are considered "aggressive" in relation to developing PUD?

Answer 29

H. pylori NSAIDS acid and pepsin smoking

Question 30

What factors are considered "defensive" factors in relation to developing PUD?

Answer 30

mucus bicarbonate blood flow prostaglandins

Question 31

What is GERD?

Answer 31

The lower esophageal sphincter not closing properly and allowing stomach contents to come back up. The stomach contents are highly acidic and cause irritation and inflammation in the esophagus.

Question 32

What are the symptoms of GERD?

Answer 32

heartburn (pyrosis) dyspepsia regurgitation chest pain (referred pain) dysphagia

Question 33

What are common complications from GERD?

Answer 33

ulceration scarring strictures barrett esophagus

Question 34

What is a hiatal hernia?

Answer 34

a defect in the diaphragm that allows part of the stomach to pass into the thorax

Question 35

Which type of hernia usually is small and doesn't need treatment?

Answer 35

type I / sliding hernia

Question 36

What are the risk factors for hiatal hernias?

Answer 36

older age injury or other damage that may weaken the diaphragm repeatedly putting too much pressure on the abdominal muscles (severe coughing, vomiting, constipation / straining) obesity smoking (nicotine weakens abdominal muscles)

Question 37

What are the common manifestations for a hiatal hernia?

Answer 37

can be asymptomatic belching dysphagia chest / epigastric pain

Question 38

Can a hiatal hernia and GERD coexist?

Answer 38

yes

Question 39

What is duration difference between acute and chronic gastritis?

Answer 39

acute - 2-10 days chronic - weeks - years

Question 40

What are the clinical manifestations of acute and chronic gastritis?

Answer 40

vomiting stomach burning upset stomach anorexia N/V postprandial discomfort gas hematemesis tarry stools anemia

Question 41

What are the clinical manifestations of acute gastroenteritis?

Answer 41

watery diarrhea (may be bloody) abdominal pain N/V fever malaise

Question 42

What are the risk factors for acute gastroenteritis?

Answer 42

older age higher doses of NSAIDS (more frequent doses) history of PUD use of corticosteroids and anticoagulants long term autoimmune disease H. pylori

Question 43

What are the clinical manifestations of PUD?

Answer 43

sometimes none - especially if they aren't bleeding N/V anorexia weight loss bleeding burning pain