Gi- Last Lecture For Test 1

Front 1

what is the most likely cause of peptic ulcers?

Back 1

h.pylori

Front 2

what is the most common presentation of upper GI bleeding?

Back 2

hematemesis or melena

Front 3

where does the stomach get its blood supply from?

Back 3

the celiac artery

Front 4

which nerve stimulates the stomach?

Back 4

vagas nerve

Front 5

what type of cells make up the cardia and antrum?

Back 5

mucous cells

Front 6

what are some etiologies of acute upper GI bleeds?

Back 6

peptic ulcer diseases, portal HTN, mallory-weiss tears, vascular anomolies,

Front 7

which pharmacologic pain management option should you avoid in patients c cardiac disease because of its possible association with increased risk for MI?

Back 7

COX-2 inhibitors

Front 8

morphine, hydromorphone, oxycodone and fentanyl are what classification of pain meds?

Back 8

opioid. used for severe pain. sometimes in conjunction with NSAID's.

Front 9

dilated submucosal veins that develop in patients with underlying portal HTN and may result in serious upper GI bleeding

Back 9

esophageal varices

Front 10

what is the most common cause of portal HTN?

Back 10

cirrhosis

Front 11

a disease which affects all organs of the body, but most lethally the liver and the brain. it is a two-phase illness because it is almost always associated with a previous viral infection, such as influenza, cold, or chicken pox. MC in children. associated w the use of ASA

Back 11

Reye's Syndrome

Front 12

what are some side effects of ASA?

Back 12

gastrointestinal irritation and bleeding, allergy, associated w/ Reye's syndrome, bleeding in general.

Front 13

a Score used to assess the prognosis of chronic liver disease, mainly cirrhosis. Although it was originally used to predict mortality during surgery, it is now used to determine the prognosis, as well as the required strength of treatment and the necessity of liver transplantation.

Back 13

Child-Pugh score

Front 14

what are the 3 phases of neural/hormonal influence on gastric function?

Back 14

Cephalic
Gastric
Intestinal

Front 15

what are the 3 basic types of gastritis

Back 15

acute (erosive/hemorrhagic)
non-erosive
special forms

Front 16

what is the most common symptom of acute gastritis?

Back 16

nondiscript epigastric descomfort

Front 17

what is the only gastritis that cannot be treated with H2 blockers or sucralfate?

Back 17

if p has Portal HTN gastritis. use BB instead.

Front 18

h.pylori causes 80% of this infectious disease and therefore R/O pernicious anemia?

Back 18

Infectious gastritis

Front 19

this type of chronic gastritis usually affects the body and antrum and sometimes promotes Peptic ulcer disease?

Back 19

infectious gastritis

Front 20

this type of chronic gastritis usually spares the antrum and affects the pariental cells. specific to the body and fundus. there is a lack of intrinsic factor produced, decrease in acid production?

Back 20

autoimmune gastritis

Front 21

what are some examples of Granulomatous Gastritis?

Back 21

-TB
-syphilis
-fungal
-sarciod
-crohn's

Front 22

mild epigstric discomfort, occasional N/V, HA, excessive salivation, flatus are symptoms of ?

Back 22

acute gastritis

Front 23

what are some common findings that indicate gastritis?

Back 23

hematemesis, bloody NG aspirate, abdominal tenderness, bloating, emesis

Front 24

what is the gold standard lab test to order if gastritis is suspected?

Back 24

endoscopy c biopsy

Front 25

what is the TX for gastritis (and also duodenal ulcers)

Back 25

remove irritant
treat for H pylori
antacids & H2 blockers
no smoke/drink

Front 26

a break in the duodenal or gastric mucosa that extends through the muscularis mucosae, are usually 5mm-1cm?

Back 26

Peptic Ulcer Disease

Front 27

what are the top 3 MC types of PUD?

Back 27

duodenal
gastric
ZE syndrome

Front 28

gastric and duodenal ulcers tend to recur in the same location? T/F

Back 28

true.

Front 29

this is typically relieved by food, increases acid production in the stomah and H.pylori is the number one cause?

Back 29

duodenal ulcer

Front 30

this condition is worsened by eating or by the use of NSAIDS; normal or decreased acid production and decreased mucosal resistance?

Back 30

gastric ulcer

Front 31

where are most duodenal ulcers located?

Back 31

in the duodenal bulb. ulcers distal to the duodenal bulb should raise suspicion for ZE syndrome

Front 32

which is more common, duodenal or gastric ulcer?

Back 32

Duodenal. 5 times more common!

Front 33

where are gastric ulcers commonly located?

Back 33

lesser curvature. malignancies more likely at greater curvature.

Front 34

what is the 2nd MC etiology of PUD?

Back 34

NSAID's

Front 35

how do NSAID's cause PUD?

Back 35

they inhibit prostaglandins which normally timulate production of mucous secretions & bicarb

Front 36

what are some examples of hypersecretion states that have been known to cause PUD?

Back 36

ZE-syndrome, MEN-1 (multiple endocrine Neoplasia)and systemic mastocytosis.

Front 37

what are some common disease processes associated with PUD?

Back 37

cirrhosis, renal failure, pulmonary ds and any P that have a systemic dz are prone to ulcers.
Treat Prophylactically c H2 blockers

Front 38

what is the number one symptom of PUD?

Back 38

epigastric pain, then N/V.

Front 39

what are some Lab tests that may help with the DX of PUD?

Back 39

upper GI endoscopy c/ biopsy, amylase/lipase, electrolytes, serum gastrin level if ZE is suspected

Front 40

how is H. pylori infection dx?

Back 40

serological tests that measure H.pylori IgG, FECAL ANTIGEN ASSAY, Urea Breath test

Front 41

how is H.pylori infection in PUD diagnosed?

Back 41

upper endoscopy "EGD"

Front 42

what are some general examples of pharmacological therapy that can be used to inhibit acid?

Back 42

H2 blockers
Antactids
PPI's
Anticholinergics
Prostaglandins
Augmentation protection

Front 43

what are some common side effects of H2 blockers

Back 43

-hypermagnesemia
-aluminum (causes phosphate depletion & osteoporosis)
-Sodium overload in chf
-hypercalcium causing milk alkali syndrome
-Inhibits absorption of antibiotics, digoxin, warfarin

Front 44

what are the side effects of the anticholinergics?

Back 44

Reduce acid by 50%
Hot as a Hare
Blind as a Bat
Dry as a bone
Red as a beet
Mad as a hatter

Front 45

which PUD therapy should not be used during pregnancy?

Back 45

prostaglandins

Front 46

what are the TX regimens used for H.pylori eradication?

Back 46

10-14 days ABX
+
H2 blocker/pepto/PPI

Front 47

what are some of the ABX used to treat H.pylori?

Back 47

amoxicillin
tetracycline (not in children <12)
metronidazole
clarithromycin

Front 48

what are the two main reasons for H.pylori TX failure?

Back 48

ABX resistance
patient noncompliance

Front 49

what is the second most common cancer worldwide?

Back 49

gastric cancer

Front 50

a tumor of the pancreas that secretes gastrin~ gastrinoma

Back 50

Zollinger-Ellison Syndrome

Front 51

a tumor of the pancreas that secretes gastrin~ gastrinoma

Back 51

Zollinger-Ellison Syndrome

Front 52

a tumor of the pancreas that secretes gastrin~ gastrinoma

Back 52

Zollinger-Ellison Syndrome