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1. 4th year > Upper GI (stomach and oesophagus) > Flashcards

Upper GI (stomach and oesophagus) Flashcards

(74 cards)

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1
Q

describe the dysphagia associated with motility issues

A

intermittent
both solids and liquids from outset
non-progressive

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2
Q

what are the features of systemic sclerosis

A 
calcinosis
Raynauds
oEsophageal dysmotility
sclerodactyly
telangiectasia 
(CREST)
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3
Q

oesophageal dysmotility + blurred vision / ptosis

A

myasthenia gravis

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4
Q

1st line Ix for dysphagia

A

OGD

+ FBC

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5
Q

Ix required if consideration for fundoplication

A

ambulatory oesophageal pH and manometry studies

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6
Q

tx benign oesophageal stricture

A

dilation and high dose PPI

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7
Q

triad of plummer vinson

A

oesophageal webs + glossitis + iron deficiency anaemia

in post-menopausal wmoen

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8
Q

tx of plummer vinson

A

dilation and iron supplement

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9
Q

virus associated with SCC of oesophagus

A

HPV

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10
Q

cancer of lower 1/3 oesophagus

A

adenocarcinoma

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11
Q

ix oesophageal cancer

A

OGD + biopsy

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12
Q

initial staging in oesophageal cancer

A

CTCAP

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13
Q

staging in oesophageal cancer if localised disease seen on CTCAP

A

EUS +/- FNA

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14
Q

staging in oesophageal cancer if metastasis/not localised seen on CTCAP

A

PET CT

or laparoscopy to detect peritoneal disease

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15
Q

tx localised SCC oesophageal cancer

A

radical chemo/radio

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16
Q

best treatment of oesophageal cancer

A

surgery - endoscopic resection or oesophagectomy (stage 2 and above)

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17
Q

diagnositic test achalasia

A

oesophageal manometry

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18
Q

barium swallow of achalasia

A

birds beak

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19
Q

pharmacological tx achalasia

A

nitrates or CCB

Botox - if not suitable for surgery

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20
Q

1st line surgical tx of achalasia

A

endoscopic balloon dilation

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21
Q

definitive surgical tx of achalasia if recurrent or persistent symptoms

A

hellers cardiomyotomy + lifelong PPI

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22
Q

CXR/barium swallow of Diffuse oesophageal spasms

A

corkscrew appearance/nut cracker

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23
Q

1st line ix for Diffuse oesophageal spasms

A

OGD

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24
Q

young male
atopic
OGD - mucosal furrows
schatzi rings

A

eosinophilic oesophagitis

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25
retrosternal discomfort made worse with eating/lying down | odynophagia
GORD
26
ix of GORD
usually trial of treatment before OGD unless red flags ``` > 55 symptoms > 4 weeks weight loss dysphagia persistent symptoms despite treatment ```
27
lifestyle advice for GORD
o Diet change, weight loss, reduce alcohol and smoking. o Small, regular, meals, avoid eating before going to bed. o Elevate the end of the bed review meds
28
tx GORD in patients who have not had OGD
PPI for 1 months
29
tx GORD in patients who have oesophagitis on OGD
full dose PPI 1-2 months - if this works then low dose - if not then double dose for 1 month
30
tx GORD in patients who do not have oesophagitis on GORD
full dose PPI 1 month | - if no response then H2 receptor blocker (ranitidine)
31
Risk of PPI
risk of osteoporosis
32
what is red velvety oesophageal mucosa on OGD
barretts
33
how often should patients with oesophageal metaplasia but not dysplasia get endoscopy
3-5 years
34
tx oesophageal dysplasia (barretts)
endoscopic mucosal resection + RFA
35
most sensitive investigation for hiatus hernia
barium swallow
36
1st line ix for hiatus hernia
OGD
37
tx hiatus hernia
nissen fundoplication
38
2 tests for H pylori
urea (carbon 13) breath test or H pylori stool antigen (primary care)
39
how long do PPI and antibiotics need to be stopped before H pulori test
ppi - 2 weeks | abx - 4 weeks
40
how long should PPI be stopped before OGD
2 weeks
41
what is used for repeat H pylori testing
breath test
42
do you do a repeat H pylori test if symptoms resolve
no
43
1st line ix for dyspepsia
H pylori or OGD
44
1st line tx of dyspepsia
medication review lifestyle advice antacid /alginate
45
tx for dyspepsia after lifestyle/medication if not needing OGD
full dose PPI for 1 month and / or test and treat for H pylori
46
what is the treatment for H pylori - normal and pen all
amoxicillin + clarithromycin + omeprazole 1 week | pen al - clarithromycin + metronidazole + omeprazole
47
ulcers that are sore when hungry
duodenal - more common
48
ulcers that are more sore when eating
gastric
49
ix peptic ulcer
H pylori
50
tx peptic ulcer H pylori +ve
H pylori eradication
51
tx peptic ulcer H pylori negative
PPI for 4 weeks
52
ix possible perforated peptic ulcer
erect CXR
53
what is a zollinger ellison syndrome and when it is seen
MEN1 tumour of pancreas/duodenum produces gastrin leading to treatment resistant dyspepsia and steatorrhoea
54
ix for ZE syndrome
high fasting gastrin | MRI
55
what gastric cancer has the highest associated with H pylori
adenocarcinoma
56
adenocarcinoma on histology
signet ring
57
2 nodes seen in gastric cancer
virchows | sister mary joseph (periumbilical)
58
diagnostic ix for gastric cancer
OGD + biopsy
59
staging gastric cancer
CTCAP
60
tx gastric cancer in proximal 1/3 stomach
total gastrectomy
61
tx gastric cancer in distal 2/3 stomach
subtotal gastrectomy
62
what is the mainstay treatment of gastric cancer
surgery +/- chemo
63
tx functional dyspepsia
lifestyle | PPI PRN or lowest possible dose
64
dx gastropareisis
gastric scintigraphy
65
tx gastropareisis
prokinetic- domperidone, metoclopramide | anti emetic - prochlorperazine, ondansentron
66
stool if upper GI bleed will appear like what
black sticky smelly tar like tool
67
blood marker that might indicate upper GI bleed
High urea out of proportion of creatinine
68
treatment variceal bleed
FTKAB - FFP - vitamin K - terlipressin - antibiotic prophylaxis - ciprofloxacin - endoscopic band ligation
69
uncontrolled variceal haemorrhage
senstaken-blakemore tube
70
last line variceal bleed
TIPS
71
drug to reduce risk of further variceal bleed
propranolol
72
tx upper GI bleed due to peptic ulcer/gastritis
IV PPI infusion - given after OGD, not in acute phase, if evidence of non-variceal bleeding endoscopic treatment on ulcer - adrenaline, thermal ablation, clipping
73
what should all patients with severe upper GI be offered
OGD immediately after resus, within 24 hours
74
general treatment of upper GI bleed
IV access, fluid resus, ABCDE FFP - if low fibrinogen levels or high PT prothrombin complex and vit K to warfarin patients actively bleeding

1. 4th year (23 decks)

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