Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
17 Cards in this Set
- Front
- Back
|
Non ulcer dyspepsia is basically a gray area |
and dx of exclusion |
|
|
it can only be diagnosed by EGD |
but the mgmt is to just start a trial of PPI and track for improvement |
|
|
there is no definitive |
symptomatology for non ulcer dyspepsia |
|
|
when DO you scope for non ulcer dyspepsia? |
if the pt has epigastric pain, non-defining symtoms and they have FAILED a PPI trial then it's worth scoping because you have to rule out gastritis, PUD, etc. |
|
|
what age is EGD definitely not indicated for with just vague epigstric pain/ |
under age 45 |
|
|
AT what age SHOULD any patient with epigastric pain undergo EGD? |
over 55
if it's new onset dyspepsia over age 55 then it's more concerning for cancer bc this is weird |
|
|
so basically age over 55 is yet another |
alarm symptom |
|
|
IF symptoms have not resolved and you ahve confirmed NUD by EGD what is the next step in mgmt? |
you should treat empirically for HP with triple therapy even though the evidence of benefit is limited |
|
|
NUD is basically epigastric pain with |
normal EGD findings |
|
|
how many ulcers are due to Zollinger Ellison syndrome? |
less than 1% |
|
|
features of ulcers taht would suggest a gastrinoma |
large recurrent even after H pylori eradication distal in the duodenum multiple
also associated with diarrhea symptoms from the abnormally high acid and subsequent activation of lipase |
|
|
the confirmatory test for gastrinoma is... |
high gastrin levels even with high gastric acidity (when PPIs are stopped)
there should normally be negative feedback to inhibit gastrin production/release |
|
|
persistently high gastrin despite secretin injection |
high gastrin despite measured high gastric acid output |
|
|
the most accurate test for gsatrinoma is... |
looking at the response to secretin |
|
|
If a patient with a gastrinoma also had hypercalcemia |
you would suspect MEN 1 syndrome |
|
|
the next step after dx of a gastrinoma is to rule out |
metastatic disease with CT/MRI |
|
|
If the CT and MRI are normal then what should you do? |
then you should perform nuclear scintigraphy with somatostatin. |
