Term
What is the ass symptoms with Achalasia?
What is the BITest&R
What is the MATest&R |
|
Definition
progressive dysphagia for both solids and liquids AT THE SAME TIME <50
Barium esophagram shows 'birds beak'
Manometry shows failure for esophagial sphincter to relax |
|
|
Term
When is upper endoscopy done on Achalasia ?
What is the progressive treamtent? |
|
Definition
if there are risk factors for malignacy, anemia, blood in stools, >6 mo, weight loss
first Pneumatic dilation-
if fails
Botulinum toxin injections
if fails
Sergical sectioning(myotomy) |
|
|
Term
what is the most important clue for Esophageal cancer? others?
What is the diagnostic test |
|
Definition
Dysphagia first for solids and later (progressivly) dysphagia for liquids
Need Endoscopy/Biopsy for dx
Barium might be BITest |
|
|
Term
| What is the treatment for Esophageal cancer? |
|
Definition
Remove, Chemo and radiation
Stent placement is used to open palliation and to improve dsyphagia |
|
|
Term
What clinical sign is ass with diffuse Esophageal spasm and Nutcracker esophagus x2
How can you tell the two apart?
What does Barium studies show at time of spasm |
|
Definition
sudden onset of chest pain that is not related to exertion .
Precipitated by drinking cold liquids
Manometry is the MAT and distinguishing test
Corkscrew appearance |
|
|
Term
What ring is ass with hiatal hernia?
What syndrome is ass with this?
What is the tx |
|
Definition
Schatzki ring
ass with "Steakhouse syndrome" intermittent dysphagia from solid foods
pneumatic dialation |
|
|
Term
what is the ass symptom of Zenker diverticulum?
how is it diagnoses? |
|
Definition
bad smells and bad breath(severe halitosis)
Barium swallow |
|
|
Term
What are the main clinical ass. with Scleroderma dysphaisa?
What is the most common cause of mid epigastric pain?
What is the only way to truley understand the etiology of epigastric pain |
|
Definition
Dysphasia + GERD
Non Ulcer dyspepsia
endoscopy |
|
|
Term
What is the are 4 indications of GERD?
how is GERD diagnosed |
|
Definition
sore throat, bad taste, hoarseness, cough
mostly with history
if unsure do a 24hr pH monitoring |
|
|
Term
What are the indicatons for endoscopy in GERD? x4
What is the treatment?
for persistent symptoms or erosive esophagitis
if not responding? |
|
Definition
Sign of obstruction, weight loss, anemia, heme positve stool, more than 5-10 years
mild to intermittent- liquid antacids or H2 blookers
PPI's
Nissen fundoplication- wrapping the stomach around the lower esophageal sphincter
local heat or radiation of LES causes scarring |
|
|
Term
What is the progression from GERD to barrets esophagus to Cancer histologically?
What is the Managment of Barrets esophagus |
|
Definition
Squamous to Metastatic columnar to Adenocarcinoma
PPI's and rescope every 2-3 years |
|
|
Term
What is the managment of low grade and High grade dysplasia
in the lower esophagus ? |
|
Definition
lo:PPIs and rescope every 6-12months
hi: Ablation with endoscopy
photodynamic therapy, radiofrequency ablation, endoscopic mucosal resection |
|
|
Term
What is the Ass S&S with gastritis?x2
What is the Dx test?
What other really important tests should be done? |
|
Definition
Bleeding without pain (with epigastric pain if severe)
NSAIDS or alcoholism is a clue
--------------------
endoscopy
H. pylori testing |
|
|
Term
| What is the treatment for gastritis? |
|
Definition
PPIs and H2 blockers
sucralfate and liquid antacids not as effective (nearly always the wrong answer) |
|
|
Term
What is the most accurate test for H. Pylori
What is a inexpincive/ easy test
What are the indications for stress ulcer prophylaxis? |
|
Definition
Endoscopy biopys
Serology
Mechanical vent, burns, head trauma, coagulopathy |
|
|
Term
What is the first and second most common causes of PUD?
What is the MAT?
What is the Treatment? |
|
Definition
H. Pylori, NSAIDs
Upper endoscopy
PPIs in over 95% of cases but will recur if H. pylori is eradicated |
|
|
Term
what is the best initial treatment of H. pylori?
not responding? |
|
Definition
PPIs +clarithromycin and amoxicillin
if not responding
Metronidazole and tetracycline
adding bismuth may aid in resolution |
|
|
Term
what is Non-Ulcer dyspepsia?
what is the empirical Next best step? |
|
Definition
epigastric pain that has no identified etiology? only dx via endoscopy?
------------
<45 empirical tx, PPI, if s&s do not reslove do endoscopy
--------------
45-55- unclear
--------------
>55 endoscopy |
|
|
Term
what are the characteristics of ulcers that can cause Zollinger Ellison syndrome? x4
once endoscopy confirms ulcer what is th MATests? |
|
Definition
large, recurrent, distal, multiple
High gastrin levels/acidity
despite high gastric acid output, despite injecting secretin |
|
|
Term
| what is the treatment for Gastroma? |
|
Definition
surgery
if unresectable lifelong PPIs |
|
|
Term
what is the ass S&S of Diabetic Gastroparesis?
What is the Next best step after clinical diagnosis? |
|
Definition
Chronic abd discomfort "bloating, and constupation in diabetic
no need to test
Erythromycin and metoclopromide increases gastro Intestinal motility |
|
|
Term
What is the most accurate test and results for Hemochromoatosis?
When is this NOT used?
What is the treatment for hemochromotosis |
|
Definition
liver biopsy showing increased iron
abnormal MRI and abnormal genetic test = hemochromotosis (does not need biopsy)
phlebotomy |
|
|
Term
What is the BITest for Wilson's disease?
MATest?
Treatment? |
|
Definition
slit lamp examination for Kayser-Fleischer rings
MATest: looking at an abnormally increased amnt of copper excretion
tx: Penicillamine
additional(zinc, trientine) |
|
|
Term
what is the antibody for autoimmune hepatitis?
what is the MATest?
what is the tx? |
|
Definition
anti smooth muscle antibodies
liver biopsy
prednisone and or azathioprime |
|
|
Term
| Name some PPI's and their Brand name. x2 |
|
Definition
Omeprazole (Prilosec)
Ianoprozole (Prevacid) |
|
|
