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Finals

Terms in this set (12)

Most common causes of abd pain
- pancreatitis
- appendicitis
- diverticulitis
- ulcer disease/esophagitis/IBS
- Obstruction
- GYN/renal
Most common GI cause of n/v
- meds
- obstruction
- motor/CNS disorders
- enteric infection
- endocrine diseases
- pregnancy
Most common causes of obstructive jaundice
where symptoms develop due to a narrowed or blocked bile duct or pancreatic duct, preventing the normal drainage of bile from the bloodstream into the intestines.
- Bile duct stones (Choledocholithiasis: gallstones in the bile duct)
- Cholangiocarcinoma (bile duct cancer)
- Cholangitis (inflammation of the bile duct)
- Sclerosing cholangitis (inflammation and scarring of bile duct)
- Ampullary stenosis (ampulla: hepatopancreatic duct)
- Ampullary carcinoma
- Pancreatitis
- Pancreatic tumor
Most common GI causes of diarrhea
Infection, Poorly absorbed sugars, IBD, Microscopic colitis, Celiac, Pancreatic insufficiency, Hyperthyroidism, Ischemia, Endocrine tumor
PPI's for GERD
o PPI effect is > H2, both are better than nothing.
o No major efficacy differences between PPIs
o PPIs don't reduce the reflux, it just changes the pH of the secretions
o Eight-week therapy with standard (once daily) dose PPIs can achieve healing of reflux esophagitis in more than 80% of patients a rate depending on the severity of mucosal lesions
o Long term PPI use is associated with bone loss, B12 and iron absorption impairment, C. difficile colitis**
Most common cause of peptic ulcer disease
H. pylori, aspirin, NSAID use

less common: CMV, HSV, bisphosphonate use, chemo, Plavix, crack, mycophenolate, KCL, duodenal obstruction, ischemia, Crohn's, basophilia in myeloproliferative disease
Pain difference between gastric and duodenal ulcers
Duodenal ulcers relieved by food
gastric ulcers precipitated by food
Epigastric tenderness (right of midline)
Succusion splash
Peritoneal signs; rigid abdomen
Sometimes tachycardic, orthostatic (when complicated)
Peptic ulcer disease
What structure connects the 3rd and 4th part of the duodenum?
Ligament of Treitz
- suspensory muscle landmark that helps differentiate on imaging whether GI bleed is upper or lower
Triple therapy
Triple therapy options:
· Bismuth subsalicylate + flagyl + tetracycline
· Ranitidine bismuth citrate + tetracycline + clarith or flagyl
· Omeprazole + clarith + flagyl or amox
Quad therapy
Quad therapy options:
· Omeprazole + bismuth subsalicylate + flagyl + tetracycline
How long to treat H pylori
· For a documented ulcer, if H. pylori present, treat for H. pylori with triple therapy x 14 days then continue PPI for 4-6 days afterward
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