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33 Cards in this Set
- Front
- Back
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achalasia dx
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young nonsmoker, both solids and liquids, regurgitation and heart burn that does not respond to PPI
initial: barium swallow, have to do EGD to r/o CA most accurate: esophageal manometer |
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achalasia tx
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initial: pneumatic dilation or surgical myotomy
botulinum toxin if they refuse surgery or dilation |
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esophageal CA dx
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solids first, liquids later (progressive)
> 50 yo smoker and/or drinker endoscopy can do barium swallow |
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esophageal Ca tx
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i. Esophagectomy, chemo for advanced with 5 fu
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rings and webs
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schatzkis ring and peptic stricture - pneumatic dilation
treatment - dilation and acid suppression |
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zenker's diverticulum
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dysphagia with bad breath
dx. barium swallow tx surgical resection |
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diffuse esophageal spasm
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dx chest pain, intermittent dysphagia
manometery tx. CCB and nitrates |
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scleroderma
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incompetant LES, poor peristalsis, GERD
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esophagitis
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dx. odynophagia
hiv -ve do endoscophy hiv +ve fluconazole |
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GERD
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mettalic taste, sore throate, hoarseness, chough, wheezing, heartburn, asthma
PPI can be diagnositic and therapeutic 24 hr ph monitor EGD if alarm signals, failure to respond to ppi, |
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barrett's tx
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barretts - ppi and repeat endo in 2-3 yrs
low grade dysplasia = PPI and repeat endo in 3-6 mo high grade - resection, ablation, or distal esophagectomy |
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non-ulcer dyspepsia
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belching, fullness, discomfort dx of exclusion |
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peptic ulcer disease
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H. Pylori
Nsaids trauma, burns, intubation, crohn/s ZES |
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ZES dx
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dx high gastrin and high gastric acid output
EUS somatostatin scan secretin stimulation ( will have no change in gastrin level) |
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ZES tx
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local - resection
metastatic - lifelong ppi |
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dysphagia |
liquids and solids - motility intermittent solid - lower esophogeal ring progressive solid - stricture or malignancy |
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Schatzki's ring |
Intermittent solid food dysphagia tx. dilation +- PPI |
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eosinophillic esophagitis |
-solid food dysphagia -young males -history of allergies, asthma -EGD with ringed esophogus > 15 EOS/hpf tx. PPI and ingested steroid |
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GERD alarm symtoms |
N/V blood in stool weight loss anorexia IDA dysphagia/odynophagia |
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what med gives false negative H pylori |
PPI |
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ZE syndrome |
diarrhea + esophagitis dx. elevated serum gastrin, somatostatin receptor scintography and EUS |
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boerhaave's syndrome |
triad of forceful vomiting, chest pain, and subc emphysema rapid pleural effusion on left side dx. constrast esophogram |
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acute hepatitis B |
malaise, rash, hot joint pain with swelling, lymphadenopathy, uritcaaerial lesions, jaudice |
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oropharyngeal dysphagia |
often seen after neurological injury dx. barium swallow promptly to prevent aspiration |
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peritoneal dialysis perotonitis |
dx. abd pain and nausea, fluid with > 100wbc or > 50 % PMNs confirmed with cx tx intraperitoneal vanc and cefepime |
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Corrosive ingestion |
1. EGD steroid not recommended |
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common non-pancreatic caucses of lipase elevation |
renal insufficiency, DKA, intestinal obstruction or ileus |
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SBO |
crampy periumbilical abdominal pain, vomiting |
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how many H pylori test to rule out |
2 |
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volvulus tx |
1. sigmoidoscopy with rectal tube 2. surgery |
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Mallory Weiss tear |
EGD |
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PPIs impair intestinal absorption of ? |
Magnesium |
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tyhphilitis (neutropenic enterocolitis) |
-pts with hematologic malignancies -due to chemo + neutropenia -10-14 days after chemo -N/V, RLQ abd pain, watery or bloody diarrhea -CT scan -broad spectrum abx |
