Upper GI

Diagnostics

100

Test which outlines anatomical abnormalities after patient swallows radio opaque solution.

What is Barium Swallow

200

Test is which a patient breathes into a balloon, then swallows lemon flavored liquid, and tests again in 15 minutes.

What is H Pylori urea breath test

300

Test used to directly visualize the esophagus & gastric mucosa

What is EGD esphagogastroduodenoscopy

400

Describe the significance of emesis that is bright red vs coffee ground.

Bright red = active bleeding; Coffee ground = old blood (has been in contact with HCl acid)

500

Test to measure the pressure inside the lower part of the esophagus.

Esophageal manometry

N/V& Hernias

100

This is the first choice for PO fluid when recovering from N/V.

What is water

200

Three non drug therapies for N/V.

*Accupuncture, *Ginger/peppermint oil, *Relaxation exercises, *Mouth care, & *Environment

300

The mechanism of action for Reglan?

Promotility (pro-kinetic). Enhances ACH →↑ gastric emptying

400

What causes a hernia?

* Weakening of abd muscles, * ↑ intraabdominal pressure, (obesity, ascites, tumors, heavy lifting), * Trauma, & * congenital weakness

500

Which type of hernia can be an emergency and why?

Rolling hernia because it can cause strangulation

GERD

100

Describe the etiology of GERD

HCL acid and pepsin reflux into lower esophagus and cause inflammation

200

Three major s/s of GERD:

heartburn, dyspepsia, & hypersalivation

300

This type of drug blocks the release of HCl acid and should be taken 15-30 minutes before the first meal of the day.

Proton pump inhibitors

400

Name six teaching points for care of GERD:

*Lose weight, *Stop smoking & ETOH use, *Avoid milk, *Small/freq meals, *Sleep with HOB ↑, *No tight clothes around waist, & * don't lie down for 2-3 hr p meals

500

Name four complications of GERD

*esophagitis & ulcers, *esophageal strictures, *dysphagia, *Barrett's esophagus, *aspiration, *dental erosion, *cough, * asthma, bronchitis, & pneumonia

Gastritis

100

Most common organism that causes gastritis.

What is H Pylori

200

The diagnosis of acute gastritis is often based on a hx of this behavior.

What is drug & alcohol abuse

300

Why is smoking contraindicated in Gastritis and PUD?

It irritates the mucosa

400

At what time of the day should antacids be taken and why?

Take after meals. If taken on full stomach, last 3-4 hrs; If taken on empty stomach last 20-30 minutes

500

How can autoimmune gastritis cause pernicious anemia?

It kills parietal cells of stomach which prevents release of intrinsic factor → mal-absorption of cobalamin (Vit B 12). Cobalamin is essential for growth or RBC → pericious anemia

PUD

100

Where are peptic ulcers most commonly located?

Duodenum

200

Two medications that commonly cause PUD:

Aspirin & NSAIDS

300

The most common complication of PUD.

Hemorrhage

400

This disease commonly occurs after a major physiologic insult such as trauma.

Stress Related Mucosal Disease

500

What is the most lethal complication of PUD and what are the symptoms?

PERFORATION *Sudden onset, *Severe abdominal pain, *Board like abdominal muscles, *Shallow rapid resp, *Weak rapid pulse, & *N/V