Kim Shared "E5" - 25 Picmonics

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E5

Achalasia
Pathophysiology
Failure to Relax Lower Esophageal Sphincter
Malignancies
Chagas Disease
Loss of Auerbach Plexus
Symptoms
Dysphagia to Solids & Liquids
Diagnosis
Barium Swallow
Bird's Beak Appearance
Manometry
Risk Factors
Increased Risk Squamous Cell Carcinoma
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2 mins
Mallory-Weiss
Characteristics
Bleeding From Tears in Mucosa
Forceful Vomiting
Alcoholism
Eating Disorders (Bulimia)
Painful Hematemesis
Diagnosis
Endoscopy
Management
Observation
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2 mins
Boerhaave Syndrome
Pathophysiology
Esophageal Rupture
Increased Esophageal Pressure while Vomiting
Lower 1/3 of Esophagus
Signs and Symptoms
Chest Pain
Odynophagia
Subcutaneous Emphysema
Management
Shock
Surgical Emergency
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2 mins
Esophageal Varices
Pathophysiology
Dilated Submucosal Veins in Lower Esophagus
Most common cause of death Cirrhosis
Pathophysiology Causes
Portal Hypertension
Esophageal Branches Left Gastric Vein
Signs/Symptoms
Painless Hematemesis
Risk Factor
Rupture
Asymptomatic
Portal Hypertension
Azygos Vein
Melena
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Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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2 mins
Barrett's Esophagus
Histological findings
Metaplasia in Lower Esophagus
Columnar Epithelium
Associated Pathologies
Gastroesophageal Reflux Disease (GERD)
Esophagitis
Esophageal Ulcers
Increased Risk of Esophageal Adenocarcinoma
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1 min
Tracheoesophageal Fistula (TEF)
Cause
Esophageal Atresia
Ends in Blind Pouch
Assessment
Coughing
Choking
Cyanosis
Drooling
Considerations
NPO
Surgical Emergency
Aspiration Pneumonia
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2 mins
Zenker Diverticulum
Pathophysiology
False Diverticulum
Junction of Pharynx and Esophagus
Inferior Pharyngeal Constrictor
Symptoms
Dysphagia
Regurgitation of Undigested Food
Halitosis
Diagnosis
Barium Swallow
Treatment
Surgical Repair
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2 mins
Peutz-Jeghers Syndrome
Mechanism and Characteristics
Symptomatic Age: 10-30 Years
LKB1/STK11 Gene Mutation
Autosomal Dominant
Signs and Symptoms
Benign GI Hamartomatous Polyps
Mucocutaneous Hyperpigmentation
Positive Family History
Increased Risk of Colorectal Carcinoma
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1 min
Plummer-Vinson Syndrome
Triad of Symptoms
Dysphagia
Esophageal Webs
Glossitis
Iron Deficiency Anemia
Association
Squamous Cell Cancer of Esophagus
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1 min
Esophageal Carcinoma (Adenocarcinoma vs. Squamous Cell Carcinoma)
Esophageal Adenocarcinoma
Most Common Subtype in America
Barrett's Esophagus
Obesity (Adenocarcinoma RR)
Smoking (Adenocarcinoma RR)
Esophageal Squamous Cell Carcinoma
Alcohol and Tobacco (MCC for SCC)
Very Hot Tea (SCC)
Achalasia
Esophageal Webs
Esophageal Injury/Lye Ingestion
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Acute Gastritis
Erosive
Disruption of Mucosal Barrier
Caused by Stress
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Alcohol
Uremia
Burns
Curling's Ulcer
Brain Injury
Cushing Ulcer
Increase H+ Production
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1 min
Chronic Gastritis
Type A
Type A
Fundus and Body
Autoimmune
Autoantibodies to Parietal Cells
Pernicious Anemia
Achlorhydria
Type B
Type B
Most Common Type
Helicobacter pylori
Antrum
Increased Risk of MALT Lymphoma
Associations
HIV/AIDS
Crohn's Disease
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3 mins
Helicobacter Pylori
Characteristics
Gram-Negative
Bacilli
Curved
Polar Flagellum
Catalase-Positive
Oxidase-Positive
Disease
Gastric and Duodenal Ulcers
Ammonia
Alkaline Environment
Gastric Adenocarcinoma
MALT lymphoma
Diagnosis
Serology IgG antibody
Stool Antigen
Urease Positive Breath Test
Biopsy
Treatment
2 ABX and PPI
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2 mins
Helicobacter pylori Associations
Gastritis
Peptic Ulcer Disease
Stomach Cancer
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50 secs
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
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1 min
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
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2 mins
Stomach Cancer
Adenocarcinoma
Intestinal Type
Intestinal Type
Smoked Foods Containing Nitrosamines
Achlorhydria
Type A Blood
Helicobacter pylori
Diffuse Type
Diffuse Type
Signet Ring Cells
Linitis Plastica (Leather Bottle Stomach)
Assessment
Acanthosis Nigricans
Left Supraclavicular Lymph Node
Virchow's Node
Subcutaneous Periumbilical Mets
Sister Mary Joseph's Nodule
Complications
Bilateral mets to ovaries
Krukenberg's tumor
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3 mins
Krukenberg Tumor
Non-germ Cell Tumor
Lymphatic Spread to Ovaries
Metastasis
GI Malignancy
Mucin-secreting Signet Cell
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34 secs
Gastrointestinal Stromal Tumor (GIST)
Cajal cells
Occurs at peak age of 60
Mutation in tyrosine kinase KIT
Mutation in PDGRFA
Spindle cell type
Anemia
Surgical resection
Imatinib
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