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13 Cards in this Set
- Front
- Back
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what are si/sx of dyspepsia?
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1. Upper abd pain
2. early satiety 3. postprandial abd bloating or distention 4. n/v, often exacerbated by eating |
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what are d/dx of dyspepsia?
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1. peptic ulcer
2. GERD 3. CA 4. gastroparesis 5. malabsorption 6. intestinal parasite 7. drugs (NSAIDs) |
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what is tx for dyspepsia?
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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 |
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what are good meds for dyspepsia?
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1. H2 blockers
2. antacids 3. proton pump inhibitors |
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antibiotics for what bacteria are NOT indicated for nonulcer dyspepsia?
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H. PYLORI!!!!!!!
NO abx for non-ulcer dyspepsia!!!!! |
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what are causes of GERD?
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1. obesity
2. relaxed lower esophageal sphincter 3. esophageal dysmotility 4. hiatal hernia |
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what are si/sx of GERD?
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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 |
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what are atypical si/sx sometimes seen with GERD?
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1. asthma
2. chronic cough/laryngitis 3. atypical chest pain |
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what is dx for GERD?
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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 |
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what is tx for GERD?
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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 |
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sequelae of GERD?
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1. barrett's esophagus from chronic GERD--metaplasia from squamous to columnar epithelia in lower esophagus
2. peptic stricture--gradual solid food dysphagia |
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what is barrett's esophagus?
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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 |
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what is peptic stricutre?
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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 |
