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22 Cards in this Set
- Front
- Back
63 y/o pt pesents to you with symptoms of GERD for several years. He has lost 15 pounds has trouble swalling. Labs show anemia. What do you do?
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refer to gastroenerologist, act immediately!!!
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23y/o pt presents with recent onset of GERD. He reports that his symptoms are intermittent usually after eating cetain foods and responds to OTC therapy. What do you do?
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give PPI for 2-3 mo and watch
if he continues to have s/s then refer |
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Which is worse--Barrets
Long segment or Short segment? Why |
Long segment-related to adenocarcinoma & more complications
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What is the most important factor in determining risk for esophageal CA.
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DYSPLASIA
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Pt presents for evaluation of GERD. Bx shows no dysplasia? What do you do?
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if no dysplasia-low risk for CA, follow endoscopically 1-2 yrs
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Pt presents for evaluation of GERD. Bx shows high grade dysplasia/carcinoma in situ? What do you do?
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need to adress this right away- sx or photodynamic, or laser ablative tx—MUST REMOVE!!!
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What type of CA is Barrets __________ (adenocarcinoma or SSC)
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adenocarcinoma NOT SSC
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How is H pylori related to Barrets?
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Hpylori not or inversely related to Barrets!!
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what is the most important mechanism in GERD
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TLESR
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What is TLESR?
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transient lower esophagelal sphincter relaxation
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TRANSIENT LES RELAXATION is characterized by 3 things.
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INDEPENDENT OF SWALLOWING
NOT ACCOMPANIED BY PERISTALSIS PERSIST LONGER THAN NORMAL SWALLOW INDUCED LES RELAXATION |
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TLESR associated w/ complictions complications of like _________ & _________
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strictures & erosions
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H-pylori infection is assoc w/ these 4 things
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chronic superficial gastritis, duodenal and gastric ulcer, MALT lymphoma, and adenocarcinoma
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What lab test should you do after you tx pts w/ H pylori—
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Stool related H-pylori Ag
to make sure you eradicated the bug |
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What does Stool related H-pylori test tell us?
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tells whether you have active infxn
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What does the blood H-pylori tell us
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tells who has been exposed NOT who has active infxn
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Pt presnts with gastric ulcers. What do you do? Why?
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Must biopsy! Gastric CA looks many times like gastric ulcers.Follow with US or FNA until it is gone!
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Pt presnts with duodenal ulcers. What do you do?
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don't worry as much duodenal ulcers are usually benign
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what is the most important mechanism in GERD
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TLESR
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What is TLESR?
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transient lower esophagelal sphincter relaxation
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TRANSIENT LES RELAXATION is characterized by 3 things.
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INDEPENDENT OF SWALLOWING
NOT ACCOMPANIED BY PERISTALSIS PERSIST LONGER THAN NORMAL SWALLOW INDUCED LES RELAXATION |
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TLESR associated w/ complictions complications of like _________ & _________
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strictures & erosions
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