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  1. Complications of GERD
    • Esophagitis
    • Esophageal strictures
    • Ulcers, hemorrhage
    • Barrett's esophagus --> adenocarcinoma
  2. Classic presentation of PUD
    • Chronic, intermittent epigastric pain, often relieved¬† by antacids or milk
    • Occult blood, n/v may also be seen
    • Gastric ulcers are exacerbated by eating; duodenal ulcers are relieved by eating
  3. What type of peptic ulcer is more likely to be related to H. pylori?
    Duodenal (gastric=NSAIDs)
  4. Major complication of PUD
  5. Chronic, recurrent ulcers, refractory to tx
    Measure serum gastrin to r/o ZE
  6. Triple therapy
    • PPI
    • Clariththromycin
    • Amoxicillin
  7. Weakness, dizziness, sweating, n/v after eating in a patient after surgery for PUD
    Think about dumping syndrome--a complication of the Billroth procedure
  8. Common causes of an upper GI bleed
    • Gastritis
    • Esophagitis
    • Varices
    • PUD
  9. Common causes of a lower GI bleed
    • Diverticulosis
    • Colitis
    • IBD
    • Vascular ectasia
    • Hemorrhoids
    • Cancer
  10. Management of a px with a GI bleed
    • Stabilize
    • NG tube--if there's blood, it's an upper bleed
    • Endoscopy (upper or lower, depending on symptoms and NG aspirate) to identify the lesion
  11. Correction of a GI bleed
    • Angiography, to ID source of bleeding and embolize vessel
    • Surgery for severe, resistant bleeds
  12. Complications of diverticulitis
    • Abscess
    • Fistula formation
    • LBO
    • Sepsis
  13. LLQ pain + fever + diarrhea + neutrophila: what is the condition, and how is it managed?
    • Think about diverticulitis
    • Can use CT to dx and r/o complications (e.g. abscess, fistula)
    • If there are no complications, tx with abx (fluoroquinolones) and bowel rest
    • If there are complications, tx surgically

    After the px recovers, do colonoscopy to r/o colon cancer (can look like diverticulitis clinically and on CT)
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step II
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