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GI 3 Gastric Cond

Gastric Conditions

QuestionAnswer
What imaging study is used to diagnose a DVT? compressive venous US
A pt who visited the southwest US presents with fever, malaise, cough, and night sweats. What is the dx and treatment? Coccidio. Tx is fluconazole
What diarrheal illness is assoc'd with picnics/mayo? Staph aureus
Post-prandial GI discomfort including nausea, vomiting, diarrhea, cramps, diaphoresis, palpitations and flushing after a partial gastrectomy. Dx? Dumping syndrome
Which deficiencies can occur after a partial gastrectomy for recurrent PUD? B12, iron, and/or calcium
How do the sx of gastric ulcer differ from the sx of duodenal ulcer in terms of timing and association of pain with eating? Duodenal: pain is initially improved with eating, then occurs 2-3h after. Gastric: pain is worsened by eating and occurs immediately after; may include n/v.
What is the next step in the mgmt of a pt with recurrent duodenal ulcers seen on at least 2 EGDs? Serum gastrin level (suspect Z-E syndrome)
What is the most effective tx of a duodenal ulcer not due to ZE syndrome? Triple therapy for H pylori
What are the qualifications for surgical candidates for bariatric surgery? Anyone with BMI of 40+ or BMI 35+ with comorbid conditions (DM, OSA, cardiomyopathy 2/2 obesity, severe joint dz)
An EGD with biopsy in a 65yo man reveals gastric cancer. What is the next step in the mgmt? CT abd/pelvis for staging
What is the tx for gastric cancer? Distal 1/3 of stomach: subtotal gastrectomy Middle or upper 1/3 stomach: total gastrectomy Adj chemo and radiation
You suspect your pt has gastric cancer. During the physical exam you palpate in two places for enlarged lymph nodes assoc'd with this disease. Where will you palpate, and what are the names of these enlarged nodes? L supraclavicular fossa= Virchow's nodes. Periumbilical region= Sister Mary Joseph's nodes
A female pt has a known duodenal ulcer that has been refractory to high dose PPI therapy. What two tests may dx her disease? Gastrin level and secretin stim test (normally inhibits gastrin secretion, but not in Z-E syndrome)
What is an unwelcome "male" side effect of cimetidine? Gynecomastia and impotence. Wah wah lol
Which antiemetic can cause dystonia? What is the tx? Metoclopramide. Tx is diphenhydramine or benztropine.
What is the difference between a sliding hernia and paraesophageal hernia? Which one has the more severe complication? Sliding is when both the GE j'n and stomach get displaced; complication is GERD which is mild compared to paraesophageal. Paraesophageal is when stomach protrudes thru the diaphragm leaving the GE j'n behind; it's more severe b/c it can cause ischemia.
Dx test for hiatal hernia? Barium swallow
H pylori is involved in the pathology in most ____ ulcers and almost all ____ ulcers. Gastric. Duodenal.
What drug must be stopped prior to getting gastrin levels? PPI
Marker for gastric cancer? CEA
Created by: sarah3148