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30 Cards in this Set
- Front
- Back
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pyrosis
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heartburn
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dyspepsia
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epigastric discomfort or pain
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odynophagia
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painful swallowing
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3 objectives in treating GERD
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-relieving symptoms
-healing mucosa -preventing complications |
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Most common symptoms of reflux (3)
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dyspepsia
pyrosis regurgitation |
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The most accurate test for GERD
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24 hour pH study
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Bernstein test
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used to differentiate cardiac from non-cardiac chest pain
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Nuclear scintiscan
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best for gastric emptying studies
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First step in treatment for reflux
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behavior modification
-wt loss -avoid alcohol, tomatoes, peppermint licorice, caffiene (all lower LES pressure) -elevation of head of bed -quit smoking -avoid food/drink 2 hrs. before bedtime |
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Drug therapy for GERD
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H2 blockers
PPI's Motility agents |
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The most accurate test for GERD
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24 hour pH study
|
|
|
Bernstein test
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used to differentiate cardiac from non-cardiac chest pain
|
|
|
Nuclear scintiscan
|
best for gastric emptying studies
|
|
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First step in treatment for reflux
|
behavior modification
-wt loss -avoid alcohol, tomatoes, peppermint licorice, caffiene (all lower LES pressure) -elevation of head of bed -quit smoking -avoid food/drink 2 hrs. before bedtime |
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Drug therapy for GERD
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H2 blockers
PPI's Motility agents |
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Surgical intervention for debilitating GERD (ex. severe esophagitis, aspiration pneumonia, etc)
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Laparoscopic Nissen Fundoplication
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Complications of reflux...
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stricture, ulcer, barrett's esophagus, aspiration, UGI bleeding
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Examples of motility agents
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bethanecol (Urecholine)
metroclopramide (Reglan) -these also strengthen LES pressure |
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Medical tx for acute variceal bleed
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-support for shock (hypovolemic)
PRBC's, albumin,IV hydration -correction of coagulopathy FFP -Octreotide (drug of choice for control of bleeding) -IV PPI -banding when stable |
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Side effects of Octreotide (2)
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Bradycardia
Seizures |
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2 most common indications of an esophageal tumor...
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dysphagia
odynophagia |
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Most esophageal tumors are what type...
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squamous cell carcinomas
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Survival rate for esophageal tumors is only 3%. Treatment is therefore palliative. The goal is to ....
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restore normal swallowing.
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What might be placed if palliative surgery and therapies are unsuccessful for esophageal tumors...
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gastrostomy tube
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Diverticulum associated with a dysfunctioning UES...
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Zenkers
-(dx'd by barium swallow) |
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Patients with a Zenkers diverticulum present with...(3)
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-cervical dysphagia
-halitosis -aspiration pneumonia |
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Tx for Zenkers diverticulum...
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usually left untreated..
if necessary, surgical tx is diverticulectomy |
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Epiphrenic diverticula are usually located directly above the LES and are characterized by what symptom....
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regurgitation of massive amounts fluids.... usually at night when lying down.
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Surgical tx. of epiphrenic diverticula....
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removal and long myotomy.
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The bigger the burger the better the burger the burgers are bigger at ....
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Burger King.
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