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H. pylori associated with what?
peptic ulcer disease
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stress, NPO long term, are pathophys conditions leading to what?
gastritis
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breakdown and inflammation of normal gastric mucosal barrier?
gastritis
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symptoms of esophageal cancer?
- asymptomatic in early stages
- dysphagia
- substernal, epigastric, back pain
- sore throat, hoarseness
- weight loss
- esophageal stenosis
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complications of esophageal CA?
- hemorrhage
- esophageal perf
- esophageal obstruction
- metastasis
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how to diagnose esophageal CA?
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prognosis for esophageal CA?
poor due to late dx
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collaborative care for esoph CA
- endoscopic ablation
- surg interventions
- palliative care
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patient comes back with what after esoph surgeries?
single lumen NG tube to ICWS
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intrinsic factor produced by what?
- parietal cells of stomach
- (loss of intrinsic factor leads to anemia)
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anemia secondary to loss of intrinsic factor >> manifestation of what?
chronic gastritis
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anorexia, N/V & epigastric tenderness >> manifestations of what?
acute gastritis
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first step of care for acute gastritis?
NPO, antiemetics, NGT, IVF. monitor for bleeding.
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which is most effective for gastritis: antacids, H2R blockers, or PPIs?
PPIs (proton pump inhibitors)
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treatment for H. pylori?
need multiple abx usu for several weeks
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erosion of the GI mucosa resulting from digestive action of HCl and pepsin....
peptic ulcer disease
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types of PUD? (four)
acute, chronic, gastric, duodenal
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gastric vs duodenal ulcers?
- gastric - stomach. high epigastric pain. occurs before eating or 30 min - 1 hr after eating
- duodenal - mid-epigastric pain - occurs 2-4 hours AFTER eating (when food is hitting duodenum)
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before diagnosing PUD, what should be ruled out?
CV disease
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hematemesis, melena (black stool), perforation, gastric outlet obstruction... complications of what?
PUD
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eosophageal varices?
dilated submucosal veins in lower third of esophagus. makes person subject to bleeding
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vagotomy?
cutting of the vagus nerve.
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subtotal gastrectomy
removing parts of the stomach
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pyloroplasty?
widening of the opening of the stomach so that food may pass into the small intestine.
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Billroth I surgery?
pylorus removed; stomach reanastamosed to the small intestine
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Billroth II surgery?
- stomach is anastomosed to the jejunum in a side-by-side manner
- common for PUD
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achlorhydria?
deficiency of HCl
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symptoms of stomach CA?
heartburn, epigastric dyscomfort, bloating, poor appetite
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Zollinger-Ellison syndrome?
gastrin secreting tumors
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sources of bleeding via esophagus?
mallory-weiss tear; esophageal varices
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sources of bleedings via stomach/duodenum?
peptic ulcers, medications (NSAIDs, corticosteroids), stress-related mucosal disease
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"large bore" IVs what size?
18 - 20g
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1 unit PRBCs raises what?
1 point of Hgb and 3% hematocrit
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