Stomach & Duodenal Diseases Flashcards Preview

GI > Stomach & Duodenal Diseases > Flashcards

Flashcards in Stomach & Duodenal Diseases Deck (84)
Loading flashcards...
1

Diseases of the Stomach & Duodenum

Gastritis
PUD
Gastric & duodenal ulcers
H. pylori
Zollinger-Ellison syndrome
Gastroparesis

2

Features of Dyspepsia

Indigestion
Chronic/recurrent pain in upper abdomen
Upper abdominal fullness
Early satiety
Bloating
Belching
Nausea
Heartburn

3

Types of Gastritis

Erosive & hemorrhagic gastritis
Nonerosive, nonspecific gastritis

4

Types of Erosive & Hemorrhagic Gastritis

Stress (medical or surgical illness)
NSAID
Alcoholic
Portal hypertension

5

Types of Nonerosive & Nonspecific Gastritis

H. pylori
Pernicious anemia
Eosinophilic

6

Asymptomatic Gastritis May Have

Anorexia
Epigastric pain
Nausea
Vomiting
Upper GI bleed

7

Upper GI Bleeding from Erosive Gastritis

Melena (dark, sticky feces)
Coffee ground emesis
Blood in NG tube

8

Work up of Erosive Gastritis

CBC
Serum iron
Upper endoscopy

9

Highest Risk for Bleeding in Stress Gastritis

Coagulopathy
Need for mechanical ventilation
Trauma, burns, shock
Sepsis, liver failure, kidney disease
Multi-organ failure
CNS injury

10

Prophylaxis of Stress Gastritis

PPIs are best
H2 Blockers

11

Treatment for GI Bleeding due to Stress Induced Gastritis

PPI bolus followed by continuous infusion
Sucralfate suspension
Endoscopy

12

Red Flags for Gastritis

Severe pain
Weight loss
Vomiting
GI bleeding
Anemia
Refer for Upper Endoscopy

13

Treatment of Gastritis

Trial of PPI for 2-4 weeks
H2 blockers
Refer for endoscopy

14

Pathophysiology of ETOH Gastritis

Alcohol disrupts mucosal barrier
Alcohol & aspirin increase the permeability of gastric mucosal barrier

15

Symptoms of Alcoholic Gastritis

Dyspepsia
Nausea
Emesis
Minor hematemesis

16

Treatment for Alcoholic Gastritis

H2 blockers or PPI
+ sucralfate 2-4 weeks
Decrease ETOH consumption

17

Portal Hypertensive Gastropathy

Congestion of gastric vessels
Chronic GI bleeding

18

Treatment of Portal Hypertensive Gastropathy

Porpranolol or nadolol

19

Nonerosive, nonspecific gastritis

H. pylori
Pernicious anemia
Eosinophilic gastritis

20

H. pylori

Lives beneath gastric mucous layer
Secrete urease & produce ammonia
Causes gastric mucosal inflammation
Increases risk of gastric CA
Fecal-oral spread

21

Risk Factors for H. Pylori

Correlates inversely with SES
Contaminated water supply

22

What can H. pylori lead to over time?

Cellular changes
Duodenal/gastric ulcers
Gastric CA
Low grade B cell gastric lymphoma

23

Testing for H. pylori

Serology
Urea breath test
Stool antigen test
Endoscopy biopsy

24

Treatment for H. pylori

Eradication therapy
2-3 antibiotics + PPI or bismuth

25

Pernicious Anemia Gastritis

Autoantibodies to gastric gland parietal cells and intrinsic factor

26

What causes loss of acid production in pernicious anemia gastritis?

Gastric gland atrophy
Mucosal atrophy

27

What can pernicious anemia gastritis be associated with?

Hashimoto thyroiditis
Addison disease
Graves disease

28

Define Eosinophilic Gastritis

Infiltration of eosinophils into GI tissue

29

Symptoms of Eosinophilic Gastritis

Abdominal pain
N/V
Early satiety
Diarrhea

30

Eosinophilic Gastritis is Associated with

Hx of allergies
Hx or asthma
Hx of atrophy