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13 Cards in this Set

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what are si/sx of dyspepsia?
1. Upper abd pain
2. early satiety
3. postprandial abd bloating or distention
4. n/v, often exacerbated by eating
what are d/dx of dyspepsia?
1. peptic ulcer
2. GERD
3. CA
4. gastroparesis
5. malabsorption
6. intestinal parasite
7. drugs (NSAIDs)
what is tx for dyspepsia?
1. empiric for 4 wk, if sx not relieved, try endoscopy
2. avoid caffeine, alcohol, cigarettes, NSAIDS,
3. eat fequent small meals
4. reduce stress
5. maintain ideal body wt
6. elevate head of bed
what are good meds for dyspepsia?
1. H2 blockers
2. antacids
3. proton pump inhibitors
antibiotics for what bacteria are NOT indicated for nonulcer dyspepsia?
H. PYLORI!!!!!!!
NO abx for non-ulcer dyspepsia!!!!!
what are causes of GERD?
1. obesity
2. relaxed lower esophageal sphincter
3. esophageal dysmotility
4. hiatal hernia
what are si/sx of GERD?
1. hearburn occuring 30-60 min postprandial and upon reclining usually relieved by antacid self-admin
2. dyspepsia
3. postprandial burning sensation in espohagus
4. regurgitation of gastirc contents into the mouth
5. cough
6. hoarseness
7. globus sensation
what are atypical si/sx sometimes seen with GERD?
1. asthma
2. chronic cough/laryngitis
3. atypical chest pain
what is dx for GERD?
1. upper endoscopy may reveal tissue damage but may be normal in 50% of cases
2. can confirm with ambulatory pH monitoring
3. clinical dx
what is tx for GERD?
1. lifestyle modifications
2. H2-receptor antagonists--aim to d/c in 8-12 wks
3. promotility agents may be comparable to H2 antagonists
4. proton pump inhibitors--reserve for refracotry dz, sx often return upon d/c
5. surgical fundoplication--relieves sx in 90% of pts
sequelae of GERD?
1. barrett's esophagus from chronic GERD--metaplasia from squamous to columnar epithelia in lower esophagus
2. peptic stricture--gradual solid food dysphagia
what is barrett's esophagus?
1. metaplasia from squamous to columnar in lower esophagus from chronic GERD
2. requires close surveillance c/ endoscopy and aggresstive tx as 10% progress to adenocarcinoma
what is peptic stricutre?
1. results in gradual solid food dysphagia often with concurrent improvement of heartburn sx
2. endoscopy establishes dx
3. requires aggressive proton pump inhibitor tx and surgical opening if unresponisive