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25 Cards in this Set
- Front
- Back
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Etiologies of achalasia
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Chagas Dz, lack of peristalsis in esophageal body, non-relaxation of LES
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Presentation of achalasia
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dysphagia
chest pain heartburn regurgitation |
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Complications of achalasia
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malnutrition
pulmonary SCC |
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Presentation of achalasia on barium swallow
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bird beak: smooth, symmetric narrowing at distal esophagus
dilated esophagus Maybe debris at proximal end |
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MoA of Botox for achalasia
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blocks presynaptic ACh release
(for 6 mo) |
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Txs for achalasia
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pneumatic dilation (have to put on chronic PPI)
esophageal myotomy (longitudinal slice to dilate) |
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Repetitive, simulataneous, abnormally long contractions of esophagus in response to swallows;
Presentation? |
esophageal spasm
Chest pain, dysphagia |
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Classic appearance of esophageal spasm
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corkscrew esophagus
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Tx for esophageal spasm
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smooth muscle antagonists
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Characterized by weakened peristalsis
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ineffective esophageal motility
(can be seen in association w/ reflex dz) |
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Pathophys of scleroderma (systemic sclerosis)
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diffuse fibrosis, inflammation, and vasculopathy
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Scleroderma presentation
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sclerodactyly: tightening and thickening of skin/fingers
tightening of skin around mouth Raynaud's phenomenon Calcinosis Renal crisis pHTN GI myopathy throughout GI tract |
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Scleroderma GI effects
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collagen replaces muscle,
-dec LES resting pressure -dec peristalsis -gastric stasis (N/V) -impaired motility in SI (bloating, nausea) -Impaired motility (constipation) |
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Acute N/V, think what?
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infection, toxin, obstruction, trauma, pregnancy
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Chronic N/V, think what?
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motility disorder, toxic (meds), endocrine, other chronic GI dz, chronic obstruction
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Lack of gastric motility or emptying in absence of obstruction
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gastroparesis
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Etiologies of gastroparesis
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diabetes, scleroderma, drugs, idiopathic
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Symptoms of gastroparesis
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N/V
bloating epigastric pain weight loss |
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Dx for gastroparesis
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upper endoscopy (r/o phys obstruction)
gastric emptying study |
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Management of gastroparesis
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dietary changes
prokinetic agents surgery neurostimulators |
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3 main types of bowel obstruction
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intrinsic, extrinsic, H-I-V (hernia, intussusception, volvulus)
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2 main types of volvulus
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sigmoid (points to LLQ), cecal (points to RLQ)
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What can cause intussusception in pediatrics?
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infections, maybe rotavirus vaccination
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Intussusception's appearance looking into lumen
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"target sign"
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Management of bowel obstruction
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decompression (NG tube)
assessment of etiology ultimate therapy based on underlying etiology |
