Upper Gi

Front 1

fecal smelling emesis indicates:

Back 1

intestinal obstruction below level of pylorus

Front 2

bile in emesis indicates:

Back 2

possible intestinal obstruction; possible bile reflux gastritis

Front 3

partially digested food in emesis indicates:

Back 3

gastric outlet syndrome;
delay in gastric emptying

Front 4

coffee-ground emesis indicates:

Back 4

gastric bleed (HCL acid mixed with blood - dark, curdled)

Front 5

bright red emesis indicates:

Back 5

esophageal varices (liver cirrhosis); mallory-weiss tears; gastric or duodenal ulcer; neoplasm

Front 6

Clinical manifestations of Upper GI bleeding include:

Back 6

hematemesis (coffee-ground or bright red blood); melena (black tarry stools); occult blood (need lab test)

Front 7

Drugs that cause upper GI bleeding:

Back 7

NSAIDS; Salicylates; Corticosteroids

Front 8

what drugs are contraindicated in upper GI bleeding?

Back 8

anticholinergics

Front 9

Anti-emetic drugs include:

Back 9

anticholinergics (scopalamine); antihistamines (promethazine); phenothiazines (thorazine, compazine); buytophenones (droperidol); metocolpramide (Reglan)

Front 10

contraindications of Reglan

Back 10

hyperactive bowel sounds and loose stools - this drug increases gastric emptying

Front 11

what is pyrosis?

Back 11

"heartburn". Burning sensation from zyphoid to throat and jaw.

Front 12

what is dyspepsia?

Back 12

Pain or discomfort centered in upper abdomen, midline, between zyphoid and umbillicus.

Front 13

clinical manifestations of GERD

Back 13

dyspepsia, pyrosis, hypersalivation; noncardiac chest pain; respiratory symptoms (wheezing, coughing, dyspnea, hoarseness, sore throat, lump in throat, choking); food regurgitation; gastrci symptoms (early satiety, postmeal bloating, n/v);

Front 14

Complications of GERD

Back 14

Esophagitis; Barrett's esophagus (precancerous lesions); Respiratory (bronchospasm, larygospasm, cricopharyngeal spasm); dental erosion

Front 15

What drug is used in Diagnosis of GERD?

Back 15

High-dose proton pump inhibitor treatment will reduce symptoms

Front 16

dehydration due to vomiting: what is initial fluid of choice for rehydration by mouth?

Back 16

water! 5 - 15 mL q 15 - 20 minutes

Front 17

what is best way to check for fluid status?

Back 17

daily weight (normal fluctualtion is 1 lb per day)

Front 18

Predisposing factors involved in development of GERD

Back 18

incompetent LES; hiatal hernia; impaired esophageal motility (delayed espohageal clearance); delayed gastric emptying.

Front 19

biological irritants in the production of GERD

Back 19

HCL acid; gastric enzyme Pepsin; intestinal enzyme Trypsin; bile salts: all corrosive to esophageal lining

Front 20

diet and lifestyle factors that contribute to GERD

Back 20

tobacco products; caffeine, chocolate, peppermint, drugs (anticholinergics) lower LES pressure; obesity;

Front 21

What are hiatal hernias?

Back 21

Hiatal hernias occur when the stomach squeezes through the hiatus in the diaphragm meant for the esophagus.

Front 22

Name the 2 types of hiatal hernias and describe differences.

Back 22

Sliding Hiatal hernia: the stomach and LES comes up thru the hiatus.

Paraesophageal hernia: the stomach bulges thru the hiatus next to the esophagus