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16 Cards in this Set
- Front
- Back
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Treatment of a patient who is under the age of 50 Has progressive dysphagia to both solids and liquids at the same time Does not drink alcohol or smoke cigarrettes |
This achalasia TX; 1. Pneumatic dilation 2. Botulinum toxin injection (every 3-6 months) 3. Surgical sectioning or myotomy |
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Treatment of a patient with the following: 50 or older progressive dysphagia (first solids, then liquids) Association with prolonged alcohol and tobacco use More than 5-10 years of GERD symptoms |
This is most likely esophageal cancer 1. Surgical resection 2. chemo and radiation post resection 3. Stent placement for lesions that cannot be resected and more for palliative care |
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How to distinguish the 2 forms of esophageal spasm |
Both present with sudden onset of chest pain EKG and stress test will be normal Esophagram and endoscopy will be normal Manometry will differentiate the two Diffuse esophageal spasm nutcracker esophagus |
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Schatzki ring |
From acid reflux and associated with hiatal hernia Scarring or tightening of the distal esophagus intermittent dysphagia TX: pneumatic dilation |
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Epigastric pain diagnosis |
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TX of GERD |
lose weight if obese avoid alcohol, nicotine, caffeine, chocolate, and peppermint avoid eating at night before sleep elevate head 6-8 inches PPI Nissen fundoplication, endocinch, heat or radiation. |
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Causes of gastritis |
Alcohol NSAIDs Helicobacter Pylori Portal hypertension Stress (burns, trauma, sepsis, and MOF) |
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Treatment of PUD and why |
Most common cause is H. Pylori (2nd NSAID) PPI and (clarithromycin and amoxicillin) (metronidazole and tetracycline) |
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Non-ulcer dyspepsia |
Epigastric pain with normal endoscopy |
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Gastrinoma DX |
1. High gastrin levels off antisecretory therapy with high gastric acidity 2. High gastrin levels despite a high gastric acid output Persistent high gastrin levels despite injecting secretin |
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TX for diabetic gastroparesis |
Erythromycin and metoclopromide |
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Treatment of antibiotic associated diarrhea |
Metronidazole not effective then switch to oral vancomycin or fidaxomicin |
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How to differentiate chronic pancreatitis and gluten sensitive enteropathy |
Iron deficiency - iron needs an intact bowel wall to be absorbed - pancreatic enzymes do not play a role in iron absorption |
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Test for celiac disease |
Anti-tissue transglutaminase Antiendomysial antibody IgA antigliadin antibody |
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Treatment for IBD |
Mesalamine steroids -> azathioprine and 6-mercaptopurine to wean off steroids |
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Treatment for diverticulitis |
Ciprofloxacin combined with metronidazole |
