Term
| 2 main categories of gastritis: |
|
Definition
1. erosive and hemorrhagic
2. nonerosive, nonspecific |
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Term
| which gastritis category involves upper gI bleed? |
|
Definition
|
|
Term
| 2 signs of upper GI bleed: |
|
Definition
|
|
Term
|
Definition
1. Usually asx
2. anorexia
3. epigastric pain
4. N/V |
|
|
Term
| most common casues of erosive gastritis: |
|
Definition
1. drugs (NSAIDs)
2. EtOH
3. Stress due to severe illness |
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|
Term
| dx for erosive gastritis: |
|
Definition
|
|
Term
| tx for erosive gastritis: |
|
Definition
1. stop offending agent
2. acid supression |
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|
Term
| nonerosive gastritis is mainly caused by: |
|
Definition
| H. pylori causing mucosal inflammation |
|
|
Term
|
Definition
1. 2 abx
2. proton pump inhibitor |
|
|
Term
| enodoscopy eval on nonerosive gastritis will reveal: |
|
Definition
|
|
Term
|
Definition
1. LES incompetent
2. hiatal hernia
3. elevated acid level
4. delayed gasric emptying |
|
|
Term
|
Definition
1. heartburn 30-60 min after meal
2. regurge of gastric contents into mouth
3. dysphagia due to scar tissue (1/3 of pts) |
|
|
Term
| 5 atypical findings in GERD: |
|
Definition
1. asthma sx
2. chronic cough
3. chronic laryngitis
4. sore throat
5. non cardiac CP |
|
|
Term
| what is the prefered study for dysphagia? |
|
Definition
|
|
Term
|
Definition
| squamous cells in wsophagus are replaced by metaplastic collumnar epithelium. looks like orange gastric type cells upon endoscopy. may progress to adenocarcinoma in 0.5% of cases |
|
|
Term
| tx of peptic esophageal stricture: |
|
Definition
| mechanical dilation of stricture |
|
|
Term
| Tx for mild, intermittent sx of GERD: |
|
Definition
| antacids or H2 antagonists |
|
|
Term
| Tx for moderate sx of GERD: |
|
Definition
| H2 antagonist BID or PPI QD |
|
|
Term
| Tx for severe sx & erosive dz of GERD: |
|
Definition
|
|
Term
| A break in the gastric or duodenal mucosa through the muscularis and usually >5mm |
|
Definition
|
|
Term
| pt presents w nonspecific epigastric pain; gnawing, dull, aching or hunger-like: |
|
Definition
|
|
Term
| 3 causes for Peptic Ulcers: |
|
Definition
1. H. Pylori (most common)
2. NSAIDs (long term use - 10-20% rate of gastric & 2-5% rate of duodenal ulcers.
3. Acid hypersecretory states |
|
|
Term
| test of choice for peptic ulcers: |
|
Definition
|
|
Term
| what woul suggest ulcer penetration? |
|
Definition
|
|
Term
|
Definition
1. abx & PPI for H. pylori
2. stop NSAIDs & PPI
3. refractory ulcers PPI maybe surgery |
|
|
Term
| 4 complications in peptic ulcers: |
|
Definition
1. GI bleed
2. Ulcer perforation
3. Ulcer penetration
4. Gastric outlet obstruction |
|
|
Term
| Zollinger-Ellison Syndrome: |
|
Definition
| Gastrin serctreting tumor that results in increased HCl. |
|
|
Term
| Epidemiology of Zollinger-Ellison Syndrome (Gastrinomas): |
|
Definition
1. Less than 1% of peptic ulcers
2. of the Gastrinomas 2/3 are malignant and 1/3 have already metastisized |
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|
Term
| 45yo latino Male presents with nonspecific epigastric pain, GERD, anorexia and diarrhea, endoscopy shows ulcers negative for H. pylori and unresponsive to tx: |
|
Definition
|
|
Term
| of the gastric neoplasms which require removal: |
|
Definition
adenomatous polyps
adenocarcinoma and lymphoma |
|
|
Term
| name 4 gastric neoplasms and malignancies: |
|
Definition
| 1. epithelial polyps (benign) 2. Fundic gland polyps (benign) 3. adenomatous polyps (premalignant) 4. adenocarcinoma and lymphoma (malignant) |
|
|
Term
|
Definition
1. usually silent until late
2. dyspepsia
3. vague epigastric pain
4. anorexia
5. early satiety
6. weight loss
7. may have hematemesis/melena |
|
|
Term
|
Definition
1. barium
2. endoscopy
3. CT (ck for metast)
4. Endoscopic ultrasound (depth of tumor and lymph nodal mets) |
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|
Term
| chronic H. pylori infections is a large risk for: |
|
Definition
|
|
Term
| tx for localized gastric tumor: |
|
Definition
|
|
Term
| tx for local invasion of gastric CA: |
|
Definition
| resection with radiation &/or chemo |
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|
Term
| tx for mets of gastric CA: |
|
Definition
| resection, radiation, chemo for Paliative measure only |
|
|
Term
| epidemiology of esophageal neoplasms: |
|
Definition
|
|
Term
| 2 types of esophageal neoplasms: |
|
Definition
1. squamous cell (EtOH/smoking)
2. Adenocarcinoma (Barret's metaplasia) |
|
|
Term
| what condition is assoc w adenocarcinoma with unknown origin? |
|
Definition
|
|
Term
|
Definition
1. (90%)dysphagia of solids
2. weight loss
3. anemia of chronic dz |
|
|
Term
|
Definition
1. barium
2. upper endoscopy
3. lab; anemia
4. CT (evidence of mets)
5. enodscopic ultrasound (measure depth of tumor and lymph nodal mets) |
|
|
Term
| overall 5yr survival rate of Esophageal CA: |
|
Definition
|
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