upper Gi

Question 1

what questions will you ask in Hx for Dysphagia

Answer 1

acuity of onset
duration of symptoms
what substances cause it
location of disturbance
drooling/coming out nose

Question 2

Red flags for Dysphagia

Answer 2

acute focal neuro deficit
drooling
inability to swallow anything.
weight loss

Question 3

imagining for dysphagia

Answer 3

barium swallow with solid bolus

Question 4

chiroman for dysphagia

Answer 4

rule out red flags
co-manage

Question 5

what is achalasia

Answer 5

neurogenic motility disorder where lower esophageal sphincter doesn’t relax

Question 6

what cells are lost in achalasia and what causes it

Answer 6

mycenteric cells can be caused by chagas - protozoan parasite

Question 7

achalsia mc in what age
+ 3 symptoms

Answer 7

20-60 years
dysphagia LIQUIDS + SOLIDS
33% nocturnal vomit
chest pain - weight loss

Question 8

Oesophageal Diverticula

Answer 8

out pouching of mucosa through the muscular wall of the oesophagus

Question 9

how does Oesophageal Diverticula presennt

Answer 9

vomit with forward flexion or lying down.
chronic halitosis

Question 10

Mallory- Weiss Syndrome & how is it caused

Answer 10

= non- penetrating laceration (small tear) of the distal oesophagus

vomiting, coughing, hiccups
pregnancy and alcoholics

Question 11

Boorhave’s Syndrome

Answer 11

= complete rupture of the oesophagus
MC in distal esophagus L side

Question 12

Boorhave’s Syndrome presentation and chiroman

Answer 12

chest + abdo pain
violent vomiting

refer out
diagnosed by plain film - mediastinal air, pleural effusion

Question 13

risk factors for esophageal cancer include

Answer 13

smoking
alcohol
HPV
lye

Question 14

squamous cell carcinoma hallmarks

Answer 14

US, ASIA, SOUTH AFRICA
blacks
men
strong link to alcohol

Question 15

adenocarcinoma hallmarks and what is it linked to

Answer 15

whites
linked with barrets esophagus

Question 16

Esophaheal cancer hallmarks

Answer 16

asymptomatic in early days until lumen narrows starts from solid to liquid
chest pain radiating into back
vocal cord ↓

Question 17

diagnosis and chiroman for esophageal
cancer

Answer 17

endoscopy if suspected + biopsy
check and adjust tolerance

Question 18

what is GERD

Answer 18

acid reflux from stomach due to LES not closing

Question 19

how will GERD present what will patient feel

Answer 19

chest burn
can travel to neck, jaw

Question 20

what makes GERD worse

Answer 20

positional
diet - fatty/spicy/meds/fast eaters

Question 21

complications of GERD

Answer 21

Esophagitis, pneumonia, barretts, ulcer

Question 22

how will you DDX GERD from HD

Answer 22

GERD has no relation to physical activity

Question 23

MC type of Hiatus hernia and its symptom

Answer 23

sliding they have GERD

Question 24

possible causes of gastritis

Answer 24

NSAIDS, alcohol, infection viral (erosive)
infection (H pylori) non - MC in blacks, Spanish, Asian

Question 25

what is peptic ulcer & what causes it

Answer 25

erosion of stomach lining due to ↓ mucosa stomach - gastric duodenum- duodenal caused my helicobacter pylori and NSAIDS

Question 26

hallmarks for Gastric ulcer

Answer 26

non consistent pain eating can ↑ pain

Question 27

hallmarks for duodenal ulcer

Answer 27

consistent pain eating ↓ pain pain mid morning and wakes up at night happens 2 hours post meal

Question 28

MC complication for peptic ulcer

Answer 28

bleeding - in stools melena

Question 29

when perforation occurs due to complication of peptic ulcer what will the patient present as

Answer 29

sudden intense pain pt lies still doesnt want to move pain on palpation + no bowel sounds refer tf out

Question 30

stomach cancer is MC in who and has a strong relationship with what

Answer 30

japan, chile, iceland - linked with h pylori

Question 31

what are the symptoms of acute pancreatitis

Answer 31

Starts in lower abdomen before localising to upper radiates from abdo to back 50% sitting up & leaning forward palliative

Question 32

during an abdo exam for acute pan what will you see

Answer 32

grey turner - ecchymosis of flanks cullens - ecchy of umbilical distended upper abdo

Question 33

what labs will you order for acute pan

Answer 33

amalyse and lipase

Question 34

symptoms for CHRONIC PAN

Answer 34

episodic abdo pain pain in epigastric lasts for hours to days steatorrhea

Question 35

diagnosis for Chronic pan #2

Answer 35

CT is gold standard amylase and lipase is normal due to damage