Upper GI

Question 1

Upper GI organs

Answer 1

Esophagus, stomach, beginning of small intestine

Question 2

2 categories of UGI probs

Answer 2

esophagus problems and influx disorders

Question 3

How does dysphagia begin?

Answer 3

With solids, then moves to liquids

Question 4

Mechanical causes of dysphagia

Answer 4

Structural probs like tumor, diverticula, stenosis and strictures

Question 5

Neuromuscular causes of dysphagia

Answer 5

CVA, achalasia (LES doesn’t open well)

Question 6

Can ppl recover from dysphagia

Answer 6

Yes, even with trach/intubation

Question 7

GERD

Answer 7

LES does not close well so lower stomach gastric contents does not go back up
- lack of strength or inc ab pressure

Question 8

Triggers for GERD

Answer 8

very acidic - fatty, spicy, tomato, citrus, caffeine, lots of alc, smoking, sleep pattern, obesity, pregnancy, pharmacologic agents

Question 9

GERD CM

Answer 9

burning feel (pyrosis), dyspepsia, regurgitating, dysphagia, chest pain, pulmonary symptoms, mouth problems (gingivitis, sore throat, laryngitis), earache

Question 10

Complications of GERD

Answer 10

Ulcers, scars, strictures, Barrett’s esophagus

Question 11

Barrett’s esophagus

Answer 11

Develop abnormal metaplastic cells (premalignant)
- 3x risk of developing adenocarcinoma

Question 12

Treatment for Barrett’s eso

Answer 12

No great tx; prevention bc very low survival

Question 13

Hiatal hernia

Answer 13

defect in the diaphragm that lets part of the stomach pass into the thorax

Question 14

Sliding hernia

Answer 14

small hernia that leaves the peritoneum intact
- no tx

Question 15

Paraesophageal hernia

Answer 15

Part of the stomach pushes through the diaphragm and stays there permanently; can protrude into the chest if peritoneum is thin

Question 16

Can there be mixed type hiatal hernia

Answer 16

Yes

Question 17

Causes of hiatal hernia

Answer 17

Age related, injury or damage may weaken diaphragm muscle, excess pressure on muscle and/or stomach (cough, vom, BM strain), obesity, smoking

Question 18

CM of hiatal hernia

Answer 18

Belching, dysphagia, chest or epi pain or asymptomatic

Question 19

CM that only goes with paraeso hernia

Answer 19

GERD

Question 20

Tx for hiatal hernias

Answer 20

CONSERVATIVE
- small frequent meals
- sit up after eating
- avoid tight clothes and abdominal supports
- wt control
- antacids for GERD/esophagitis
Surgery as last resort

Question 21

Gastritis

Answer 21

Inflammation of the stomach

Question 22

Acute gastritis

Answer 22

Temporary inflammation, no intestine function
- lasts 2-10d

Question 23

Chronic gastritis

Answer 23

Progressive inflammation from H. pylori or autoimmune (parietal cells attacked)
- lasts weeks to years

Question 24

Acute gastritis is r/t…

Answer 24

Drugs, alcohol and irritating substances, NSAIDs, infectious agents like H. pylori

Question 25

Complications of chronic gastritis

Answer 25

PUD, bloating, anemia, gastric cancer

Question 26

H. pylori

Answer 26

Gram - spirobacteria - needs acid - overgrowth causes chronic gastritis, PUD, stomach cancer - asymptomatic at first - transmitted with fluids or food and water

Question 27

CM of gastritis

Answer 27

Burning, vomiting, anorexia, postprandial discomfort (after eating), gas, hematemesis

Question 28

Acute gastroenteritis

Answer 28

Inflammation of the stomach and small intestine - viral (Norovirus or rotovirus) - bacterial (E. coli, Salmonella, campylobacter) - parasitic infx - lasts 1-3 days up to 10 days

Question 29

CM of acute gastroenteritis

Answer 29

diarrhea (bloody if bacterial), abdominal pain, N/V, fever, malaise

Question 30

BIG risk for acute gastroenteritis

Answer 30

FVD

Question 31

Tx for acute gastroenteritis

Answer 31

Usually let it play out

Question 32

Locations of ulcers

Answer 32

eso, stomach (gastric), or duodenum (peptic ulcer)

Question 33

What causes PUD

Answer 33

Often after exposure to acid and H. pylori, injury causing substances (NSAIDs), alcoholic

Question 34

What can worsen PUD

Answer 34

NSAIDs, smoking, pepsin

Question 35

Protective factors for PUD

Answer 35

Mucus, bicarb, BF, prostaglandins

Question 36

Does the body try to balance factors for PUD

Answer 36

YES

Question 37

Risk factors for PUD

Answer 37

family, stress (not a cause), SMOKING

Question 38

Why does stress worsen PUD

Answer 38

Increases gastric acid secretion

Question 39

NSAIDs-induced PUD

Answer 39

lose protective prostaglandin layer when you take NSAIDs

Question 40

Risk fx for NSAID-induced PUD

Answer 40

Older, higher and more freq doses, take chronic steroids, anticoags, PUD hx, serious system diagnosis, H. pylori

Question 41

Patho of PUD

Answer 41

Damage mucosa -->histamine secreted-->inc acid and pepsid secretions-->further damage-->vasodilation which bring WBCs to the area and edema-->damaged BVs can cause bleeding

Question 42

Duodenal ulcers

Answer 42

- more common - any age, often early adulthood - often from NSAIDs

Question 43

Gastric ulcers

Answer 43

- 50-70Y - bc inc use of NSAIDs, stomach, anticoags - more like to have serious systemic illnesses

Question 44

CM of PUD

Answer 44

none or N/V, anorexia, wt loss, bleeds - burning pain in the middle of the ab when stomach is empty

Question 45

CM for gastric PUD

Answer 45

burning, cramping, gas-like, epigastrum, back - 1-2h post eating

Question 46

Duodenal CM

Answer 46

Same as gastric but 2-4h post eating

Question 47

Complications of PUD

Answer 47

- Hemorrhage - stomach and int pretty vascular - Obstruction - Perforation and peritonitis