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Stephanie Shared "Upper GI System" - 5 Picmonics

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Upper GI System

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
Celiac Disease
Cause
Intestinal Mucosa Damage
Ingestion Wheat, Barley, Rye
Assessment
GI Distress
Steatorrhea
Weight Loss
Dermatitis Herpetiformis
Interventions
Gluten-free Diet
Considerations
Screening
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2 mins
Gallstones, Cholecystitis, and Cholangitis
Gallstones (cholelithiasis)
Increased cholesterol and/or Increased bilirubin
Decreased bile salts could cause stones
Risk factors: Fat, Female, Fertile, Forty
Estrogen: Induces cholesterol secretion
Progesterone: Gallbladder hypomotility
Cholesterol stones: Radiolucent
Pigment stones: Radiopaque = Calcium bilirubinate or Hemolysis
Pigment stone: Radiolucent (Brown) = Infection
Biliary colic: Neurohormonal activation by CCK
Painless in diabetes
Cholesterol stones seen in: Obesity, Crohn's Advanced Age, Estrogen Therapy, Multiparity, Rapid Weight Loss, Native American
Pigment stones caused by: Crohn's, Chronic hemolysis, Alcoholic cirrhosis, Advanced age, Biliary infections, TPN
Cholecystitis
Acute or chronic inflammation of gallbladder usually from cholelithiasis (stone at neck of gallbladder
Gallbladder wall thickening (yellow arrows)
Commonly block the cystic duct
Can be caused by primary CMV infection
Positive Murphy Sign (inspiratory arrest on RUQ palpation due to pain
Diagnose with Ultrasound or Cholescintigraphy (HIDA - Hepatobiliary iminodiacetic acid scan)
Cholecystitis can lead to porcelain gallbladder -> usually found on imaging -> must remove due to high rate of gallbladder cancer
Cholangitis
Cholangitis is infection of the biliary tract
Charcot triad of cholangitis: Jaundice, Fever, RUQ pain
Increased ALP
Tx: ERCP
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Acute Pancreatitis Interventions
NPO with NG Tube to Suction
Pain Management
Albumin
Lactated Ringers Solution
Proton Pump Inhibitor (PPI)
Antibiotics
Surgery
Nutrition
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2 mins
Omeprazole (Prilosec)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Proton Pump Inhibitor (PPI)
Inhibit H+/K+/ATPase
Side Effects
Hip Fracture
Pneumonia
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2 mins

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