Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastro > Upper GI conditions > Flashcards

Upper GI conditions Flashcards

1
Q

Causes of upper GI bleed

A

Ulcers
Mallory weiss tear
oesophageal varices
malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Duodenal + gastric ulcer presentation

A

DU = worse at night, more common.
Worse 2-5hrs after meals, alleviated by eating
GU = epigastric pain, N+V, exacerbated by eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Investigations for ?ulcers

A

Endoscopy (OGD) - biopsies sent for histology is diagnostic
CLO urease H pylori test (carbon 13 urea breath test)
Bloods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of ulcers

A

Medical management with PPIs for 6-8 weeks
H pylori eradication if positive = metronidazole + clarithromycin + PPI for 7 days
Surgery for perforation or Zollinger Ellison syndrome
Repeat endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of peptic ulcers

A 
H pylori
NSAIDs
Aspirin 
Alcohol
Steroids
Zollinger-Ellison syndrome -severe peptic ulcer disease, gastric acid hypersecretion + gastrinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Red flags for peptic ulcers

A 
ALARMS
Anaemia
Lost weight
Anorexia
Recent rapid onset
Malaena
Swallowing difficulties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for urgent upper GI endoscopy

A

New onset dysphagia >55 y/o with weight loss + abdo pain/ reflux/ dyspepsia
New onset dyspepsia not responding to PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of acute GI bleed

A

ABCDE
Transfusion with blood, platelets + clotting factors
Variceal bleeding = terlipressin, abx, TIPS
Endoscopy
Varcieal bleeding = endoscopic injection of N-butyl-2-cyanoacrylate
Non variceal bleedong = mechanical method, thermal coagulation or fibrin with adrenaline
High dose PPI therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What scores are used to assess upper GI bleeding?

A

Blatchford at first assessment

Rockall after endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

GI bleeds in pts on NSAIDs, aspirin + clopidogrel

A

Continue low dose aspirin
Stop NSAIDs during acute phase
Discuss risk of clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are upper GI bleeds prevented in acutely unwell pts?

A

H2 antagonist or PPI therapy in pts admitted to critical care
Use oral form if possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is dyspepsia?

A

> 4 weeks of upper abdo pain/ discomfort, heartburn, reflux, N+V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common causes of dyspepsia

A

GORD, peptic ulcers, functional dyspepsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Initial management of dyspepsia

A

Advice on lifestyle
Managing stress, anxiety + depression
Reducing drugs that may cause dyspepsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of persistent (>1 month) dyspepsia

A

PPI for 1 month of H pylori testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What test should be used for H pylori?

A

Carbon 13 urea breath test or stool antigen test

17
Q

When should a pt with dyspepsia be referred for endoscopy?

A

Recurrent symptoms despite management

2nd line eradication of H pylori is unsuccessful

18
Q

What is proven GORD?

A

Oesophagitis (endoscopy determined) or endoscopy negative reflux disease

19
Q

RF for GORD

A

Obesity, trigger foods, smoking, alcohol, coffee, stress
CCB, anticholinergics, theophylline, benzos, nitrates
Pregnancy

20
Q

How common is Barrett’s oesophagus + oesophageal cancer?

A

10-15% of GORD get Barretts

1-10% of these develop adenocarcinoma

21
Q

Management of GORD

A

Lifestyle, sleeping with head of bed raised
Stopping NSAIDs
Full dose PPI for 4 weeks for GORD + 8 weeks for oesophagitis

22
Q

Management of refractory GORD

A

Further 4 weeks PPI

Or add H2 antagonist

23
Q

When should pts with GORD be referred for endoscopy

A

Refractory to treatment, or unexplained

Associated with RF for Barrett’s

24
Q

Complications of peptic ulcers

A

Hemorrhage, perforation, gastric outlet obstruction

25
Q

What is achalasia?

A

Progressive degeneration of ganglion cells in myenteric plexus in esophagus leading to failure of relaxation of esophageal sphincter + loss of peristalsis

26
Q

S+S achalasia

A

Dysphagia + regurg of bland undigested food

Chest pain, heartburn, difficulty burping

27
Q

How is the diagnosis of achalasia made?

A

Manometry - aperistalsis + incomplete LES relaxation
Barium swallow
Endoscopy to exclude malignancy

28
Q

Management of achalasia

A

Mechanical disruption of fibres (pneumatic dilation, myotomy) or reduction in LES pressure (injection of botox, oral nitrates)

29
Q

What are the 2 types of functional dyspepsia?

A

Epigastric pain syndrome
Post-prandial distress syndrome
Can overlap

30
Q

Causes of esophageal perforation

A

Iatrogenic (endoscopic, biopsy, intubation, operative)
Barogenic (trauma, forceful vomiting)
FB ingestion
Carcinoma

31
Q

What is a Mallory-weiss tear?

A

Non-transmural esophageal tear

Due to forceful emesis

32
Q

What is Boerhaeve’s syndrome?

A

Transmural oesophageal perforation

Due to forceful emesis

33
Q

Complications of duodenal ulcer

A

Perforation
Posterior penetration
Hemorrhage
Gastric outlet obstruction

34
Q

What is a kissing ulcer?

A

Combination of perforation + bleeding

35
Q

Signs of metastatic gastric carcinoma

A 
Virchow’s node (left supraclavicular) 
Blumer’s shelf (mass in Pouch of Douglas)
Krukenberg tumor (mets to ovary) 
Sister Mary Joseph node (umbilical mets)
Irish’s node (left axillary node)

Gastro (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions