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Z GI
Stomach Digestion
Characteristics
Chief Cells Secrete Pepsinogen
Pepsinogen Turned to Pepsin By H+
Protein Breakdown Begins
Mucous Cells Secrete Mucus and Bicarbonate
G Cells Secrete Gastrin
Gastrin Stimulates Parietal Cell HCl Release
Parietal Cells Secrete Intrinsic Factor
2 mins
Liver tissue architecture
Apical surface of hepatocytes faces bile canaliculi. Basolateral surface faces sinusoids. Kupffer cells, which are specialized macrophages, form the lining of these sinusoids (black arrows in A ; yellow arrow shows hepatic venule).
Hepatic stellate (Ito) cells in space of Disse store vitamin A (when quiescent) and produce extracellular matrix (when activated).
Zone I—periportal zone: Affected 1st by viral hepatitis Ingested toxins (eg, cocaine)
Zone II—intermediate zone: Yellow fever
Zone III—pericentral vein (centrilobular) zone: Affected 1st by ischemia Contains cytochrome P-450 system Most sensitive to metabolic toxins Site of alcoholic hepatitis
liver disease severity checked by albumin, bilirubin and PT time
Tracheoesophageal Fistula (TEF)
Cause
Esophageal Atresia
Ends in Blind Pouch
Assessment
Coughing
Choking
Cyanosis
Drooling
Considerations
NPO
Surgical Emergency
Aspiration Pneumonia
2 mins
Salivary Gland Tumors
Pleomorphic adenoma
Painless mobile mass
Most common benign salivary gland tumor
Composed of chondromyxoid storm and epithelium
Recurs if incompletely excised or ruptured intraoperatively
Mucoepidermoid carcinoma
Painless and slow-growing
Mucinous and squamous component
Malignant tumor
Warthin tumor
Benign cystic tumor with germinal centers
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
2 mins
Mallory-Weiss
Characteristics
Bleeding From Tears in Mucosa
Forceful Vomiting
Alcoholism
Eating Disorders (Bulimia)
Painful Hematemesis
Diagnosis
Endoscopy
Management
Observation
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
2 mins
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
2 mins
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
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
1 min
Hypertrophic Pyloric Stenosis (HPS) Assessment
Mechanism
Hypertrophied Pylorus
Risk Factor
Macrolide Use
Assessment
3-6 Weeks of Age
Projectile Vomiting After Feeding
No Pain or Discomfort
Weight Loss
Dehydration
Hungry Baby
Olive Mass
2 mins
Hypertrophic Pyloric Stenosis (HPS) Interventions
Treatment
Pyloromyotomy
Preoperative Care
Stabilize Fluid and Electrolyte Balance
Nasogastric Tube
Monitor Feeding
Postoperative Care
Start Formula or Breastfeeding Within 24 Hours
Feedings Every 4-6 hours
Full Feeding Within 2 days
2 mins
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
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
3 mins
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
NSAIDs
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
2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
1 min
Zollinger-Ellison Syndrome Disease
Pathophysiology
Gastrin-Secreting Tumor
Increased Gastric Acid
Recurrent Peptic Ulcers
MEN Type 1
Symptoms
Abdominal Pain
Heartburn (Pyrosis)
Diarrhea
3 mins
Zollinger-Ellison Syndrome Diagnosis and Treatment
Diagnosis
Gastrin > 1000 pg/mL
Positive Secretin Stimulation Test
Treatment
High-Dose PPI
Octreotide
Surgical Resection
3 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
3 mins
Meckel's Diverticulum
Pathophysiology
True Diverticulum
Vitelline Duct
Yolk Stalk
Contain Ectopic Tissue
Pancreatic And Gastric Mucosa
Signs and Symptoms
Hemorrhage
Intussusceptions
Volvulus
Diagnosis
2 Feet From Ileocecal Valve
2 Inches Long
2% Population
First 2 Years Of Life
Pertechnetate T99
2 mins
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