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33 Cards in this Set
- Front
- Back
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what is the musculature in the proximal stomach responsible for?
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allowing volume expansion
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what is the musculature in the distal stomach responsible for?
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high amplitude peristalsis
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what is dyspepsia?
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acute, chronic, or recurrent pain/discomfort in the upper abdomen
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what are 6 causes of dyspepsia?
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overeating/eating too quickly
high-fat stress too much alcohol or coffee NSAIDs antibiotics |
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what are 3 types of gastritis?
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erosive/hemorrhagic
nonerosive specific types |
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what are 3 of the most common causes of erosive gastritis?
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NSAIDs, alcohol
stress-related musosal changes portal htn |
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what is the main presenting sign of erosive gastritis?
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GI bleeding (although because it is superficial it is rarely life threatening)
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what is the most sensitive diagnostic method of erosive gastritis?
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endoscopy
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how do NSAIDs cause indirect damage?
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active hepatic metabolites and decreased synthesis of mucosal prostaglandins
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when should you perform an endoscopy on NSAID users? (4)
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severe pain
weight loss vomiting bleeding/anemia |
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what types of injuries can NSAIDs cause? (3)
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subepithelial hemorrhages
erosions ulcerations |
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what happens when blood flow is reduced to the mucosa? (2)
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protective mechanisms are altered
cytokines and free radicals are released |
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what happens when mucosal resistance to acid back-diffusion is reduced?
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it results in erosions that may progress to ulcerations and bleeding
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what are 2 of the most important risk factors for stress-related gastric damage?
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coagulopathy
respiratory failure |
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who should receive propylaxis for stress-related gastric damage?
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coagulopathies
respiratory failure CNS trauma major surgery PUD multiorgan failure |
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what are 3 prophylactic strategies to prevent GI bleeding?
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acid neutralization
mucosal protection (sucralfate) inhibition of gastric acid secretion (H2RAs) |
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what will lower portal pressure and thus reduce the incidence of acute bleeding? (2)
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propranolol or nadalol
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what is peptic ulcer disease?
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mucosal defects of the GI mucosa of the stomach or duodenum
it arises when the normal mucosal defensive factors are impaired or are overwhelmed by aggressive luminal factors |
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who is PUD more common in? (2)
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smokers
those on NSAIDs |
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what are 3 main causes of PUD?
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NSAIDs
H pylori ZES |
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what is the study of choice for PUD?
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upper endoscopy
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what is zollinger ellison syndrome?
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gastric acid hypersecretion
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what are 2 main signs of ZES?
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peptic ulcers
diarrhea/steatorrhea |
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how do you diagnose ZES?
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fasting gastrin levels
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what fasting gastrin level is diagnostic of ZES?
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>150 (median is 500-700)
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what is gastroparesis?
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intermittent signs of gastric obstruction in the absence of any mechanical lesions
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what is a common cause of gastroparesis?
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diabetes
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how do you diagnose gastroparesis?
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plain films should demonstrate the dilation of the stomach (and maybe the esophagus)
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how do you treat an acute exacerbation of gastroparesis?
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nasogastric suction and IV fluids
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how should you treat gastroparesis in diabetes?
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maintain glucose below 200
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what should be avoided in gastroparesis?
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agents that slow gastric emptying
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what are 4 symptoms of early dumping syndrome?
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epigastric fullness and pain
nausea and vomiting early satiety vasomotor symptoms (flushing, palpitations, diaphoresis) |
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what should lead to a strong clinical suggestion of acute gastric volvulus? (3)
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sudden, severe pain
persistent retching producing scant vomitus inability to pass an NG tube |
