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28 Cards in this Set

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which cells secrete pepsinogen?
Chief cells of the stomach
where does Gastrin come from?
from G cells in the antrum and from the pancreas
where are secretin & cholecystokinin secreted from?
The intestines
what are some signs of gastritis?
Hematemesis, bloody nasogastric aspirate
Abdominal tenderness
Bloating
Emesis
what is the gold standard test for gastritis?
Endoscopy
What's the definition of PUD
Break in the duodenal or gastric mucosa extending through the musularis mucosae
what is Zollinger-Ellison (ZE) Syndrome and what causes it
considered a form of PUD and is caused by gastrin-releasing islet cell tumors (gastrinomas)
which 2 substances participate in the pathogenesis of PUD?
gastric acid and Pepsin
the symptoms of which peptic ulcer are relieved by food?
Duodenal Ulcer; Gastric ulcers symptoms are worsened by food
what causes PUD?
H. Pylory #1 cause
NSAIDs #2 cause
Name some systemic diseases that make you prone to PUD
COPD, Renal failure, Liver cirrhosis

These patients should be started on H2 blockers
how is H.Pylori diagnosed?
Upper endoscopy
Serological tests
Fecal Antigen Assay
Urea Breath test
what is considered the gold standard diagnostic test for H.Pylori?
Histologic identification of the organisms
When would you suspect ZE syndrome?
Multiple or recurring duodenal ulcers
Ulcers associated with diarrhea
Elevated serum gastrin levels
#1 cause of occult blood loss
Neoplasms
Adult anemia is secondary to GI bleeding until proven otherwise

GI bleeding is secondary to cancer until proven otherwise
Adult anemia is secondary to GI bleeding until proven otherwise

GI bleeding is secondary to cancer until proven otherwise
T/F Upper GI bleed is 4x more common than lower GI bleed
TRUE
Name some causes of upper GI bleed
PUD
Portal HTN
Mallory Weiss
Vascular abn
Gastric Neoplasms
Name some causes of lower GI bleed in pts under 50 y/o
Infectious colitis
Anorectal ds
Inflammatory bowel ds
Name some causes of lower GI bleed in pts over 50 y/o
Diverticulosis
Vascular ectasias
Malignancy
ischemia
which labs should you order if you suspect GI bleed?
CBC
PT/PTT
Electrolytes/BUN/creatinine
Blood Type and Cross match
CXR/ AXR
which test should you perform in all patients >40-45 yo c/ + guiaic or Fe+ deficiency anemia
Colonoscopy
how do you manage Upper GI bleeds
administer Octeotride to decrease portal HTN until source can be ID’d by endoscopy
what type of bleed would you see with hemorrhoidal bleeding
intermitent minor hematochezia
What is the function of Secretin?
stimulates the secretion of bicarbonate from the liver, pancreas, and duodenal Brunner's glands in order to buffer the incoming protons of the acidic chyme.
What is the function of gastrin?
stimulates secretion of gastric acid by the parietal cells of the stomach
Name some examples of H2 blockers
cimetidine (Tagamet)
ranitidine (Zantac)
famotidine (Pepcid)
nizatidine (Axid, Tazac)
Name examples of PPIs
Omeprazole- Prilosec
Esomeprazole- Nexium
Lanzoprazole- Prevacid
Pantoprazole- Protonix
Rabeprazole- Rabecid