Term
| What is the most common cause of chronic dyspepsia? |
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Definition
| Functional dyspepsia is the most common cause; up to 2/3 of pts have no obvious organic cause for their symptoms after evaluation. |
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Term
| What is teh study of choice to dx gastroduodenal ulcers, erosive eophagitis, and upper gi malignancy? |
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Definition
| The study of choice is upper endoscopy. |
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Term
| What are the 5 "alarm" features w/new-onset of dyspepsia in pt over 55? |
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Definition
| The 5 alarm features are: weight loss, dypshagia, recurrent vomiting, bleeding, anemia. |
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Term
| What does a noninvasive test for H. pylori (urea breath, fecal Ag, Ig serology) prove? |
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Definition
| A negative test in pts not taking NSAIDS exludes peptic ulcer dz. |
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Term
| Do most pts w/dyspepsia have severe, constant, or mild, intermittent symptoms? |
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Definition
| Most pts have mild intermittent symptoms that respond to reassurance and lifestyle changes. |
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Term
What imaging is ordered for:
A. severe abdominal pain, B. gastric outled obstruction, C. SI obstruction, D. gastroparesis, E. pancreaticobiliary dz, and F. CNS causes of n/v? |
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Definition
| Order A. flat and upright abdominal xray. B. upper endoscopy. C. CT. D. nuclear scintigraphic studies or C-octanoic A. breath test. E. LFTs, amylase, lipase. F. CT/MRI. |
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Term
| Are most causes of acute vomiting severe or mild? |
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Definition
| Most causes are mild, self-limited, and require no specific tx. |
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Term
| What are a few meds for post-op n/v? |
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Definition
dexamethasone or droperidol are useful.
you could also use a corticosteroid like dexamethasone. |
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Term
| What are a few meds used for chemo n/v? |
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Definition
Use a serotonin 5-ht3 antagonist like odansetron.
a corticosteroid like dexamethasone can enhance it's efficacity.
For highly emetic chemo agents add NK-antagonist like aprepitant.
THC is available as dronabinol. |
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Term
| Can what pH imbalance can be caused by singultus? |
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Definition
| This can cause respiratory alkalosis. |
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Term
| What evaluations should be perfomred for persistent hiccups? |
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Definition
| Eval should include detailed neuro exam, serum creatinine, liver chemistry, and cxr. |
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Term
| What drug is most commonly used to tx singultus? |
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Definition
| Chlorpromazine 25-50 mg po or im is most commonly used. |
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