Notes in upper gi

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Published	09/08/2024	GERD is present when the patient reports symptoms impacting {{c1::quality of life}} or there is {{c2::mucosal injury}} in the esophagus due to acid ex…
Published	09/08/2024	GERD three Dominate Mechanisms:1. {{c1::Transient lower esophageal sphincter relaxations (tLESRs)}}2. {{c2::Hypotensive or incompetent lower esophagea…
Published	09/08/2024	risk factors of GERD are: 5{{c1::•Obesity •Smoking •Alcohol •Caffeine •Pregnancy}}
Published	09/08/2024	–Symptoms of GERD  {{c1::•Heartburn → Substernal burning or pain and Typically post prandially •Regurgitation -> brings food back up •Water b…
Published	09/08/2024	GERD diagnosis:•Can be made on {{c1::clinical reasoning}} and {{c2::subjective information}} alone •Objective testing –usually reserved for patients w…
Published	09/08/2024	GASTRITIS can be caused by {{c1::infection (h. pylori)}} or {{c2::inflammation (substance use like NSAIDs or immunologic) }}
Published	09/08/2024	{{c2::GASTRITIS}} symptoms:{{c1::•Epigastric pain •Nausea •vomitingbloating diarrhea}}
Published	09/08/2024	Gastritis is diagnosed with an {{c1::EGD with biopsies }}
Published	09/08/2024	peptic ulcers are defects in the {{c1::mucosal lining}} of the {{c3::stomach}} or {{c2::duodenum}}
Published	09/08/2024	•Risk factors of {{c2::PUD }} •{{c1::NSAID use •Alcohol •Smoking •H pylori }}
Published	09/08/2024	the epigastric pain of PUD is characterized as: •“{{c1::gnawing}},” “{{c1::dull}},” “{{c1::empty}},” or “{{c1::hunger-like}}.” •Can radiate to {{c2::R…
Published	09/08/2024	–Gastric Ulcer symptoms:  •Eating can {{c1::exacerbate pain}} -> bc you are making more acid •{{c4::Nausea}}, {{c3::anorexia}}, {{c2::+/- wei…
Published	09/08/2024	–{{c2::Duodenal}} Ulcer symptoms:  •Eating {{c1::alleviates}} pain, can return 2-4 hours after meal -> bc it buffers the acid
Published	09/08/2024	–Alarm Signs and Symptoms of PUD:  •{{c1::Melena, hematemesis, Heme + stools, unexplained Anemia}} •Persistent {{c2::Vomiting}}, Early {{c2::Sati…
Published	09/08/2024	Approximately {{c1::70}} percent of peptic ulcers are asymptomatic
Published	09/08/2024	H. pylori releases {{c1::urease}} to help break down more CO2 and ammonium to make a buffer around themselves to make it less acidic around themselves…
Published	09/08/2024	•Diagnosistics for H. Pylori:  –{{c1::Breath test}} –{{c2::Stool antigen test}} –{{c3::Biopsy}} –{{c4::Serology -> antibodies }}
Published	09/08/2024	PUD is diagnosed with an {{c1::EGD }}
Published	09/08/2024	{{c1::Sucralfate}} (med) is typically used to treat duodenal ulcerations or refractory gastric ulcers
Published	09/08/2024	For PUD, you must treat the ulcer AND the cause/risk factors –Stop/discuss {{c1::NSAID use}} –{{c1::Smoking cessation}} –{{c1::Alcohol use}} –Treat {…
Published	09/08/2024	{{c3::•Boerhaave Syndrome}} -> EMERGENCY •symptoms: {{c1::Chest pain and Shortness of Breath}} •Ruptured {{c2::transmural laceration}} of the dis…
Published	09/08/2024	The tears in Mallory-Weiss syndrome are caused by a rapid increase in {{c1::intraabdominal}} pressure (ex. retching, vomiting)
Published	09/08/2024	Mallory-Weiss syndrome presents with {{c1::hematemesis}} that can be painful
Published	09/08/2024	{{c2::Mallory-Weiss}} syndrome is a linear {{c1::mucosal}} laceration at the gastroesophageal (GE) junction
Published	09/08/2024	ZOLLINGER ELLISON SYNDROME (ZE SYNDROME) :•Defined as hypersecretion of {{c1::gastrin}} by a {{c2::duodenal}} or Cneuroendocrine tumor known as a…
Published	09/08/2024	{{c2::ZOLLINGER ELLISON SYNDROME}}:symptoms:{{c1::GERD, abd pain, diarrhea}}
Published	09/08/2024	•Suspect {{c1::ZE}} if patient has multiple or refractory peptic/duodenal ulcers, small bowl ulcerations, or PUD with diarrhea
Published	09/08/2024	•Diagnosis of ZE: –Elevated fasting serum {{c1::gastrin}} level – suspicious if level is {{c2::10x}} the upper limit of normal
Published	09/08/2024	BARRETT’S ESOPHAGUS: The replacement of {{c1::stratified squamous}} cells with {{c2::metaplastic columnar}} cells secondary to chronic GERD. &nbs…
Published	09/08/2024	•Barrett’s itself is {{c1::asymptomatic}} •It is typically identified on {{c2::EGD with biopsy}} for GERD or anemia
Published	09/08/2024	•Risk factors  of {{c2::Barrett's }} –{{c1::Chronic GERD, hiatal hernia, over 50 years of age, elevated BMI}}
Published	09/08/2024	metaplasia ({{c1::benign}} process)
Published	09/08/2024	BARRETT’S ESOPHAGUS:  •Still low chance but have 30x increased risk over the general population for development of {{c1::esophageal adenocarcinom…
Published	09/08/2024	•Goals of Barretts-manage {{c1::risk factors}} of GERDsurveillance ({{c2::EGD with biopsies}})  greatly improves outcomes) → Early detection of d…
Published	09/08/2024	•Dysphagia is defined as a sensation of difficulty with {{c1::swallowing.  }}
Published	09/08/2024	{{c1::Oropharyngeal}} dysphagia is difficulty with the initiation of swallowing -> back throat
Published	09/08/2024	–{{c1::Esophageal}} dysphagia is the sensation of food getting stuck in the esophagus -> chest
Published	09/08/2024	•{{c1::Odynophagia}} is defined as pain with swallowing
Published	09/08/2024	–{{c1::Dysphonia}} -> change in voice
Published	09/08/2024	DIAGNOSTIC TESTING FOR DYSPHAGIA: •{{c1::BARIUM SWALLOW}} ->1st line to find where the narrowing is so you don’t poke a hole where you don’t w…
Published	09/08/2024	{{c1::ACHALASIA}}: Thought to be secondary to previous viral infection
Published	09/08/2024	{{c2::Achalasia}} is characterized by disordered esophageal motility due to inability to relax the {{c1::lower}} esophag…
Published	09/08/2024	Does achalasia present with dysphagia for solids or liquids? {{c1::Both solids and liquids :)}}
Published	09/08/2024	Achalasia is characterized by {{c1::high}} LES pressure on esophageal manometry
Published	09/08/2024	Achalasia is characterized by uncoordinated or absent {{c1::peristalsis}} in the esophagus
Published	09/08/2024	{{c2::Achalasia}} is characterized by the "{{c1::Bird's beak}}" sign on barium swallow
Published	09/08/2024	Achalasia may be treated with {{c1::botulinum toxin}} injections
Published	09/08/2024	ACHALASIA will have {{c1::no change}} in symptoms with antacid medications
Published	09/08/2024	ACHALASIA is diagnosed with a {{c1::monometry}} or {{c2::barium upper GI }}
Published	09/08/2024	{{c2::Heller Myotomy}} → surgery → gold standard for achalasia main SE is {{c1::GERD  }}
Published	09/08/2024	ESOPHAGITIS: •Inflammation of the esophagus –symtpoms: {{c1::Odynophagia, dysphagia, chest pain}} •Causes –{{c2::Reflux}} –{{c2::Infectious}}: C…
Published	09/08/2024	esophagitis caused by candida is treated with {{c1::antifungals}} like flucnazole or hystatin
Published	09/08/2024	esophagitis caused by CMV and HSV is treated with {{c1::antibiotics }}
Published	09/08/2024	esophagitis is diagnosed with an {{c2::EGD }}
Published	09/08/2024	RISK FACTORS of esophagitis are {{c1::immunocompromised }}
Published	09/08/2024	symptoms of {{c1::esophageal cancer}}: –Dysphagia to solid food that progresses to liquids –Weight loss –Fatigue/anemia –Regurgitation of und…
Published	09/08/2024	ESOPHAGEAL SQUAMOUS CELL CARCINOMA: •Typically located in the {{c1::midportion}} of the esophagus •Early disease can be detected with {{c2::Lugol…
Published	09/08/2024	ESOPHAGEAL ADENOCARCINOMA: •Typically located near the {{c1::GE junction}} -> because of GERD •Typically associated with {{c2::esophagus}} •M…
Published	09/08/2024	ESOPHAGEAL CANCER TREATMENTS:Clinical staging with {{c4::Endoscopic ultrasound}} and {{c5::CT scan}}.  •Stage I tumor •Recommend {{c1::surgi…
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