Term
|
Definition
| emesis of bright red (large bleed) or coffee ground vomit |
|
|
Term
|
Definition
|
|
Term
| what are 3 suprious causes of GI bleeding |
|
Definition
food: jello, kool aid, tomato, beet, cranberries
amoxicillin
nasopharyngeal source |
|
|
Term
| how can you determine if a bleed is a true bleed (3) |
|
Definition
NG tube and gastric lavage
gastro-occult
hemoccult |
|
|
Term
| how does a NG tuve and gastric lavage work |
|
Definition
| put NG tuve into stomach, wash it out, and aspirate to see if there is a bleed |
|
|
Term
| how does a hemoccult work |
|
Definition
sees if there is blood in the stool to determine presence of a bleed
testing abilities are limited in emesis |
|
|
Term
| what is the best way to determine location of a bleed, why |
|
Definition
endoscopy
old contrast radiology method does not identify mucosal bleeds |
|
|
Term
| define mallory weiss tear |
|
Definition
| spontaneous tear at gastro-esophageal junction after forced emesis |
|
|
Term
| how does a parent normally explain the symptoms of a mallory weiss tear |
|
Definition
| the vomiting was initially normal yellow and now is full of blood |
|
|
Term
| what are three locations of a mallory weiss tear and their frequencies |
|
Definition
usually extend into gastric side causing most bleeding
20% extend into esophagus
20% have multiple tears |
|
|
Term
| how is a mallory weiss tear treated (3) |
|
Definition
self limited in kids
anti-emetics
stomach decompression |
|
|
Term
| what are three ways to treat a mallory weiss tear if no other methods work |
|
Definition
electrocoagulation
surgery
fel foam embolization of lt gastric artery |
|
|
Term
| what are two other ways to say GERD |
|
Definition
reflux esophagitis
acid reflux |
|
|
Term
|
Definition
|
|
Term
| what are two complications or associations with GERD |
|
Definition
progression to major hemorrhage
hiatial hernia |
|
|
Term
| what is the major acid barrier to GERD |
|
Definition
|
|
Term
|
Definition
| 3-4 CM long smooth muscle with intrinsic and extrinsic pressure and tonic contraction |
|
|
Term
| what causes the extrinsic pressure on the LES (4) |
|
Definition
crus of diaphragm
intra abdominal location
integrity of phreno-esophageal ligament
maintience of acute angle of His |
|
|
Term
| what mechanism causes GERD |
|
Definition
| decrease in LES pressure allows acid into esophagus |
|
|
Term
| what are 4 foods that decreases LES pressure |
|
Definition
| fat, chocolate, ethanol, peppermint |
|
|
Term
| what are 6 GI signalers that decrease LES |
|
Definition
secretin
CCK
glucagon
somatostatin
GIP
VIP |
|
|
Term
| what are 4 hormones or neurotransmitters that decrease LES |
|
Definition
progesterone
prostaglandins
serotonin
dopamine |
|
|
Term
| what are 3 drugs that decrease LES |
|
Definition
morphine
diazepam
barbituates |
|
|
Term
| if stimulated (or antagonized) what receptors would decrease LES (3) |
|
Definition
a antagonist
B agonist
cholinergic antagonist |
|
|
Term
| if stimulated (or antagonized) what receptors would increase LES (3) |
|
Definition
a agonist
B antagonist
cholinergic agonist |
|
|
Term
|
Definition
|
|
Term
| what drugs increase LES (4) |
|
Definition
antacids
metoclopramide
domperidone
cisapride |
|
|
Term
| what substances naturally made in the body increase LES 95) |
|
Definition
gastrin
motilin
substance P
prostaglandin
histamine |
|
|
Term
| why is GERD worse at night (5) |
|
Definition
during sleep there is less LES tone
you are layind down so gravity isnt helping
you are at rest and digest mode
dry swallow stops so peristalsis pushing acid down stops
less saliva production so less alkaline buffer |
|
|
Term
| what are the symptoms of GERD dependent on |
|
Definition
| extent of esophageal and mucosal injury |
|
|
Term
| what two things can increase GERD symptoms |
|
Definition
acid reflux
potency of refluxate |
|
|
Term
| what are 5 complications of GERD |
|
Definition
erosive esophagitis
sentineal fold
barrett's esophagus
reflux stricture
hiatial hernia |
|
|
Term
| what is barrett's esophagus, how is it identified |
|
Definition
pre-cancerous metaplasia of lower esophageal mucosa with tongue like projections
has goblet and columnar cells (abnormal) |
|
|
Term
| how is GERD diagnosed, what are the first two and last two steps |
|
Definition
barium swallow first
esophageal pH studies second
endoscopy
manometry |
|
|
Term
| what is the treatment for GERD (5) |
|
Definition
antacids
H2 receptor antagonist
protein pump inhibitor
pro-kinetic agent
carafate |
|
|
Term
| define erosive gastropathy |
|
Definition
| subepithelial hemorrhage or erosion |
|
|
Term
| what is erosive gastropathy associated with |
|
Definition
|
|
Term
| what are 5 causes of erosive gastropathy |
|
Definition
NSAIDS
stress; burns, sepsis
prophylactic acid supression in ICU
alcohol
H. pylori |
|
|
Term
| how can you tell if someone has NSAID erosive gastropathytis |
|
Definition
| flea bitten appearance on endoscopy |
|
|
Term
| how can you tell if someone has H. pylori erosive gastropathy (4) |
|
Definition
pink nodules
prominent gastric rugae
shows on gemisa stain
gram negative pleonprphhic comma shaped rods in lumen |
|
|
Term
| how is erosive gastropathy diagnosed |
|
Definition
|
|
Term
| how is erosive gastropathy treated (6) |
|
Definition
pin point etiology
anti-helobacter
acid supression: antacid, H2 receptor antagonist, proton pump inhibitor
rare: volume expanders, electrocoagulation |
|
|
Term
| whais a esophageal varices or portal gastropathy |
|
Definition
|
|
Term
| what causes esophageal varices (2) |
|
Definition
chronic liver disease
cystic fibrosis |
|
|
Term
| what are 4 signs of esophageal varices |
|
Definition
splenomeagly
acetes
abnormal LFT
portal gastropathy looks red with spider webs on endoscopy |
|
|
Term
| how is esophageal varices treaed (7) |
|
Definition
volume resuscitation: prompt
vasopressin
somatostatin
TIPS
surgical porto caval shunt
liver transplant
viscereal scleropathy |
|
|
Term
| what is visceral scleropathy |
|
Definition
| injecting sclerosing agent to induce fibrosis to stop bleeding |
|
|
Term
| gastric and duodenal ulcers: who gets it, what are two causes |
|
Definition
rare in childhood
H. pylori, hypergastrinemia |
|
|
Term
| how are gastric and duodenal ulcers treated (6) |
|
Definition
stop bleed: thermocoagulation, epinepherine
acid supression: proton pump inhibitor, H2 receptor antagonist
carafate: promote healing
anti-helobacter |
|
|
