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Gastro General


heartburn: DDx GERD (regurg, dysphagia), PUD/ gastritis (epigastric pain, n/v, bloating), gallstones (colicky RUQ), panc (severe constant mid-abd)
PUD: H pylori dx testing rapid urease (s/s 90/98); if neg, do histo stain; sero test (stays pos); fecal Ag (can use to test of cure); urea breath test
fever, high WBC, LLQ pain; poss painless rectal bleed = acute diverticular dz
abd pain assoc w/bowel dysfn, often relieved by BM = IBS
Biliary dz: dx test u/s is definitive for GS; u/s or HIDA for cholecystitis; xray/CT for porcelain; u/s or ERCP for choledocho
Common causes of gastritis NSAIDs, EtOH, stress, portal HTN
Diarrhea >3/day or 200 mL; osmotic vs secretory; dx: fecal WBC, occult blood, flex sig/bx, upper GI
GERD: pathophys, s/s low LES/high intra abd pressure; burning epigastric pain, recurs despite food; cough, hoarse, dysphagia
Barrett esophagus physio low stomach pH changes esoph squamous cells to adenomatous cells
GERD: dx tests, tx EGD, barium (inc upper GI; sens < EGD), manometry; tx avoid trigger foods; H2 or PPI
PUD: tx triple tx: PPI or H2 + clarithro + amox or flagyl x 7-14 days
diverticular dz DDx colon ca, appy, IBD, IBS, ischemic colitis, UTI, PID
IBS DDX dietary (lactose); celiac dz (wt loss); IBD, colon ca (wt loss, anemia)
biliary dz RFs 4Fs, hispanic, rapid wt loss, insulin resistance/ CHO intake, high TG, IBD
biliary dz labs WBCs in GS/choledocho; ALT/AST, alk phos, bili; poss amylase
Causes of upper GI bleed PUD, MW tear, AVM, esophageal varices
Diarrhea: inflam vs non-inflammatory agents inflam: cMV, E histo, EHEC, C diff, SSC; non-inflam: noro, rota, giardia, crypto, SA, B cereus, vibrio cholera
Diarrhea: Abx for: Shigella, cholera, ETEC, C diff; No Abx for salmo, campy, EHEC, Yersinia
Oral Rehydration Solution: 3.5 g NaCl, 2.5 g Na HCO3, 1.5 g KCl, 20 g glucose, in 1L water
Meds associated with constipation NSAIDs, opiates, anticholinergics (TCAs, phenothiazine, antihistamine), CCBs, clonidine, iron
Meds associated with diarrhea Antacids with Mg. Abx (clind, Sulfa, broad-spectrum). Colchicine. Reglan. Prostaglandins. Anti-neoplastics.
Created by: Abarnard