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32 Cards in this Set
- Front
- Back
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alarm symptoms |
dysphagia, bleeding, prolonged duration of sx, family hx of GI neoplasms, weight loss |
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transfer dysphagia |
difficult to bring food from mouth to esophagus; choke & cough; neuromuscular |
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transport dysphagia |
hard to bring food from upper esophagus to stomach - "food sticks" |
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mechanical causes of dysphagia |
intrinsic (infl., webs/rings, strictures, neoplasm) and extrinsic (osteophytes/spurs, lymphadenopathy, vascular) |
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causes of odynophagia |
ulceration, trauma, infectious esophagitis, pill-induced |
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GERD |
symptomatic reflux, MC in affluent communities, incr. in obese population |
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GERD pathophysiology |
frequency of transient relaxations of the LES (TRLES), poor clearance, hiatal hernia, low LES pressure, delayed gastric emptying, incr. acid |
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GERD symptoms - esophageal |
heart burn, regurg., chest pain, dysphagia/odynophagia |
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extraesophageal symptoms - GERD |
nocturnal cough, sore throat, hoarseness, exacerbated asthma, globus sensation |
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Rx GERD |
lifestyle mod (weight loss), proton pump inhibitors (prilosec), fundoplication |
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Barrett's esophagus |
intestinal metaplasia caused by chronic reflux; small risk of esophageal adenoCA (<0.5%/year) |
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Diagnosis of Barrett's esophagus |
biopsy: presence of intestinal metaplasia in tubular esophagus (columnar epithelium w/ goblet cells) endoscopic changes in epithelium |
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squamous cell carcinoma of esophagus - RF |
EtOH, tobacco, achalasia, Lye stricture |
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Achalasia |
loss of neurons in myenteric plexus & vagal nuclei -> dilated and fluid-filled esophagus; get worsening dysphagia, weight loss, chest pain |
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Diagnosis of achalasia |
poor relaxation of LES, aperistalsis, bird-beak appearance |
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Achalasia |
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Achalasia Rx |
pneumatic dilation, Heller myotomy, Botulinum toxin |
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Eosinophilic esophagitis |
eosinophils in mucosa; dysphagia (strictures) & chest pain; young males; poor PPI response; Rx = high dose PPI, fluticasone inhaler |
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Infectious esophagitis |
Candida albicans, Herpes simplex, Cytomegalovirus; present w/ odynophagia in immunosuppressed patients |
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Pill-induced esophagitis |
ABs, NSAIDs, bisphosphonates, KCl, quinidine, ferrous sulfate |
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symptoms of gastric disorders |
N/V, upper abd. pain, burning & discomfort, belching/bloating |
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Dyspepsia |
group of upper GI symptoms = epigastric fullness, postprandial pain, belching, bloating, nausea; often a functional disorder |
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Peptic ulcer disease MCCs |
H. pylori, ASA/NSAIDs, smoking |
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PUD management |
acid suppression (PPI), H. pylori eradication, stop smoking, avoid ASA/NSAIDs, surgery |
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H. pylori conditions |
gastritis, PUD, non-ulcer dyspepsia, gastric cancer, MALT lymphoma |
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Mucosa-associated Lymphoid Tissue (MALT) Lymphoma |
low-grade B-cell lymphoma; H. pylori inf -> inflammatory response; cure w/ H. pylori treatment |
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H. pylori infection pathogenesis |
chronic active gastritis -> atrophic gastritis -> metaplasia -> dysplasia -> carcinoma |
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Dx H. Pylori infection |
urea breath test, stool exam, biopsy, culture |
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Medication-induced gastropathy |
NSAIDs; Rx = stop NSAID, co-administer PGE analogue (misoprostol) or PPI, use of COX-2 selective NSAIDs |
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gastroparesis |
delayed gastric emptying w/o gastric outlet obstruction; causes = DM, idiopathic, post-surgical; vagus nerve neuropathy; F>M |
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gastroparesis Dx |
gastric emptying scintigraphy |
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gastroparesis Rx |
diet (small frequent meals), antiemetics, prokinetics, surgery |
