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Knowledge Rehab > Upper GI Complaints > Flashcards

Upper GI Complaints Flashcards

1
Q

effortless return of esophageal or gastric contents to pharynx

A

regurgitation

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2
Q

failure to relax the LES

A

achalasia

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3
Q

pain w/ swallowing

A

odynophagia

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4
Q

____ epithelium is in the esophagus, _____ epithelium in the gastric area.

A

Squamous

columnar

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5
Q

Striated muscle is seen in (upper/lower) portion of esophagus.

A

upper

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6
Q

Smooth muscle is seen in (upper/lower) portion of esophagus.

A

lower

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7
Q

Oropharyngeal or esophageal dysphagia?

Difficulty initiating swallowing

A

Oropharyngeal

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8
Q

Oropharyngeal or esophageal dysphagia?

suprasternal notch or substernally

A

Esophageal

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9
Q

Oropharyngeal or esophageal dysphagia?

Onset after few seconds

A

Esophageal

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10
Q

Oropharyngeal or esophageal dysphagia?

Worse with liquids

A

Oropharyngeal

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11
Q

Oropharyngeal or esophageal dysphagia?

Worse with solids

A

Esophageal due to mechanical obstruction

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12
Q

Oropharyngeal or esophageal dysphagia?

Symptoms about the same with solids and liquids

A

Esophageal due motility disorder

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13
Q

Oropharyngeal or esophageal dysphagia?

Caused by poor dentition, reduced saliva production, or neuromuscular disorders, structural lesions.

A

Oropharyngeal

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14
Q

Oropharyngeal or esophageal dysphagia?

Caused by esophagitis, mechanical obstruction or motility disorder (achalasia, scleroderma)

A

Esophageal

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15
Q

Oropharyngeal or esophageal dysphagia?

Choking or nasal regurgitation

A

Oropharyngeal

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16
Q 
Which of the following is used to diagnosis oropharyngeal dysphagia?
A. Upper endoscopy
B. Barium radiography
C. Videofluroscopy
D. Esophageal manometry
A

B, C
Also Nasopharyngeal laryngoscopy for oropharyngeal

The others are used for esophageal dysphagia.

17
Q

Difficulty swallowing

A

dysphasia

18
Q

Name the two causes of odynophagia

A 
Infectious esophagitis (Herpes, CMV)
Pill esophagitis
19
Q 
Which of the following is TRUE about achlasia?
A. Male predominance
B. Young age 
C. Dysphagia for liquids
D. Slow progressive
A

D

A. No gender predominance
B. Middle age
C. Dysphagia for solids and liquids

20
Q 
All of the following are ways to diagnosis achlasia EXCEPT:
A. Barium study
B. Upper endoscopy
C. Videofluroscopy
D. Esophageal manometry
A

C

All the others are the same techniques used for esophageal dysphagia.

21
Q

1st line diagnosis of GERD if confident in diagnosis

A

Therapeutic trial w/ acid suppressing medication

22
Q

T/F: Absence of reflux esophagitis upon endoscopy excludes diagnosis of GERD.

A

False. GERD can manifest solely as symptoms.

23
Q

Ambulatory pH monitoring for GERD indicated for _____

A

o Atypical symptoms and negative endoscopy

o Symptoms refractory to standard therapy

24
Q

All of the following are alarm symptoms of dyspepsia EXCEPT:
A. Early satiety, dysphagia
B. Nausea/vomiting
C. Hematemesis, anemia, occult blood in stool, melena
D. Unintentional weight loss
E. Onset > 45 y/o

A

B

25
Q

T/F: Majority of pts w/ cancer or significant ulcers initially present w/ alarm symptoms.

A

False. Majority do NOT present with alarm symptoms

26
Q 
Which of the following is FALSE on peptic ulcer disease?
A. Worse at night
B. Stomach pain worsen by food
C. Nausea/vomiting
D. Relief more common w/ duodenal ulcer
A

B. Stomach pain reduced by food

27
Q

T/F: ~90% of pts w/ PUD that are not using NSAIDs are infected w/ H. pylori

A

True

28
Q

Malignancy associated w/ H. pylori (2)

A 
Gastric adenocarcinoma
MALT lymphoma (mucosa-associated lymphoid tissue)
29
Q 
All of the following are used to diagnosis current peptic ulcer EXCEPT:
A. Urease breath test
B. Stool antigen 
C. Serology (IgG anti-HP antibody)
D. Gastric biopsy with EGD
A

C. Does NOT distinguish b/w past and present infection. Remains positive long after eradication.

30
Q

1st line treatment of PUD

A

PPI + 2 antibiotics x 2 weeks

Confirm eradications via urea breath test or stool antigen

31
Q 
Which of the following is NOT a risk factor of PUD?
A. Smoking
B. Acetaminophen (Tylenol)
C. Old age 
D. History of PUD
A

B. Acetaminophen is NOT a NSAID

32
Q

T/F: The main pathophysiology of PUD is direct damage to epithelial cells.

A

False. Not an important component of pathophysiology. Mainly due to inhibition of cyclooxygenase

33
Q

Zollinger-Ellison Syndrome =

A

Gastrin-producing neuroendocrine tumor

34
Q

Which of the following is NOT a symptom of gastroparesis?
A. Postpardial bloating
B. Early satiety
C. Delayed vomiting partially digested contents
D. Refractory GERD
E. Watery diarrhea

A

E

35
Q 
Which of the following is NOT a cause of gastroparesis?
A. Diabetic gastropathy
B. Nerve damage
C. Post viral gastroenteritis
D. Scleroderma
E. Medication use
A

E

36
Q

Succussion splash is seen in ____

A

gastroparesis

= sloshing sound from stomach

37
Q

Treatment for gastroparesis include ____

A

Promotility agents: Erythromycin (motilin antagonist) but rapidly diminishing response to successive doses

Metoclopramide but not really used due to SE of dyskinesia

38
Q

Name the disease:

Trachealization, furrowing, strictures, diffuse narrowing, eosinophilic abscesses

A

Eosinophilic Esophagitis

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