N2261 WEEK 4 GI EXAM STUDY GUIDE
100% PASS
generally accepted HB - ANSWER > 80
a decreased in this amount of hB is too much - ANSWER 20
Barium swallow - ANSWER barium contrast is taken orally
(or via NGT), and GI system is visualized on xray. Useful for motility studies, blockages,
and perforations.
Colonoscopy - ANSWER (visual inspection of the colon) -
a scope is inserted from the anus to visualize the
GI system from the end → up; Useful for
imaging large intestine and distal small intestine,
and can also be used for biopsy or clipping
•Esophagogastroduodenoscopy (EGD) - ANSWER (visual inspection of the esophagus,
stomach, and duodenum) - a scope is inserted from the mouth to visualize the GI system
from the top → down; Useful for imaging the UGI system until the small intestine, and
can also be used for biopsy and clipping
X-ray (chest or abdo/pelvis depending on what is to be visualized) - ANSWER May be
used to assess obstructions, ileus, fecal loading, NG placement, early workup to find
dense areas...
CT scan (with or without contrast (chest or abdo depending on what is to be visualized) -
ANSWER May be used to further work up findings from x-ray that need better
visualization, assess collections of fluids, blood flow to various areas...
MRI - ANSWER May be used for further increased detail from CT, may be used for
surgical planning/anatomy mapping...
Gastritis: - ANSWER Inflammation of the gastric mucosa
Gastritis: etiology - ANSWER Breakdown of normal gastric mucosa barrier, allowing for
digestion of the stomach lining by stomach enzymes. Many factors can cause
breakdown of the mucosa, including NSAIDs, H. pylori, and stress.
Manifestations: gastritis - ANSWER Poor appetite, nausea/vomiting, epigastric
tenderness, hemorrhage
, Diagnostics: gastritis - ANSWER Endoscopy with biopsy; H. pylori breath, urine, serum,
or biopsy cultures, CBC if bleeding
management of gastritis - ANSWER Often self-limiting or resolves when cause is
removed. Supportive therapies (eg.
if vomiting, replace fluid losses via IV). Monitor fluid status related to decreased intake,
vomiting, etc. May require NPO status until resolved. Drug therapies for decreasing
stomach
acid may be indicated (eg. pantoprazole). If bleeding is suspected, CBC and vital signs
regularly. Antibiotics if active H. pylori infection.
GASTRIC CANCER: manifestations - ANSWER Anemia related to chronic blood loss due
to erosion of the gastric mucosa
Pain and discomfort that may be relieved with belching or antacid use; often believed
to be PUD or GERD
Indigestion
Poor appetite/nutrition status
Mass may be palpable in abdomen
Diagnostics: gastric cancer - ANSWER Endoscopic examination with biopsy Barium
swallow for concerns about GI motility Labwork: CBC for anemia, LFTs/serum amylase
for involvement of liver or pancreas (nearby structures), tumor markers
Common sites for perioperative UGIB: - ANSWER Mallory-Weiss tear
Stomach and/or duodenal ulcers
• Bleeding at a surgical site (e.g. anastomosis, blood vessel not cauterized, etc.)
Mallory-Weiss tear: locaiton and cause - ANSWER Occurs at the gastro-esophageal
junction • Often caused by severe retching/vomiting
Stomach and/or duodenal ulcers" - ANSWER • 36% of UGIB are related to these ulcers •
Lining is eroded and exposes a blood vessel, which may be small or may be a large
artery • May be caused by medications (e.g. ASA, NSAIDs) • Physiological stress ulcers
occur when the body has undergone major stress (e.g. surgery)
Esophageal varices are common with - ANSWER liver cirrhosis, and can result in
massive bleeding. Keep this in mind when we get to the GI III week!)
how is nsaids related to UGIB - ANSWER Many sites minimize NSAID use and/or provide
alternative analgesia alongside NSAIDs and/or administer a PPI alongside them
100% PASS
generally accepted HB - ANSWER > 80
a decreased in this amount of hB is too much - ANSWER 20
Barium swallow - ANSWER barium contrast is taken orally
(or via NGT), and GI system is visualized on xray. Useful for motility studies, blockages,
and perforations.
Colonoscopy - ANSWER (visual inspection of the colon) -
a scope is inserted from the anus to visualize the
GI system from the end → up; Useful for
imaging large intestine and distal small intestine,
and can also be used for biopsy or clipping
•Esophagogastroduodenoscopy (EGD) - ANSWER (visual inspection of the esophagus,
stomach, and duodenum) - a scope is inserted from the mouth to visualize the GI system
from the top → down; Useful for imaging the UGI system until the small intestine, and
can also be used for biopsy and clipping
X-ray (chest or abdo/pelvis depending on what is to be visualized) - ANSWER May be
used to assess obstructions, ileus, fecal loading, NG placement, early workup to find
dense areas...
CT scan (with or without contrast (chest or abdo depending on what is to be visualized) -
ANSWER May be used to further work up findings from x-ray that need better
visualization, assess collections of fluids, blood flow to various areas...
MRI - ANSWER May be used for further increased detail from CT, may be used for
surgical planning/anatomy mapping...
Gastritis: - ANSWER Inflammation of the gastric mucosa
Gastritis: etiology - ANSWER Breakdown of normal gastric mucosa barrier, allowing for
digestion of the stomach lining by stomach enzymes. Many factors can cause
breakdown of the mucosa, including NSAIDs, H. pylori, and stress.
Manifestations: gastritis - ANSWER Poor appetite, nausea/vomiting, epigastric
tenderness, hemorrhage
, Diagnostics: gastritis - ANSWER Endoscopy with biopsy; H. pylori breath, urine, serum,
or biopsy cultures, CBC if bleeding
management of gastritis - ANSWER Often self-limiting or resolves when cause is
removed. Supportive therapies (eg.
if vomiting, replace fluid losses via IV). Monitor fluid status related to decreased intake,
vomiting, etc. May require NPO status until resolved. Drug therapies for decreasing
stomach
acid may be indicated (eg. pantoprazole). If bleeding is suspected, CBC and vital signs
regularly. Antibiotics if active H. pylori infection.
GASTRIC CANCER: manifestations - ANSWER Anemia related to chronic blood loss due
to erosion of the gastric mucosa
Pain and discomfort that may be relieved with belching or antacid use; often believed
to be PUD or GERD
Indigestion
Poor appetite/nutrition status
Mass may be palpable in abdomen
Diagnostics: gastric cancer - ANSWER Endoscopic examination with biopsy Barium
swallow for concerns about GI motility Labwork: CBC for anemia, LFTs/serum amylase
for involvement of liver or pancreas (nearby structures), tumor markers
Common sites for perioperative UGIB: - ANSWER Mallory-Weiss tear
Stomach and/or duodenal ulcers
• Bleeding at a surgical site (e.g. anastomosis, blood vessel not cauterized, etc.)
Mallory-Weiss tear: locaiton and cause - ANSWER Occurs at the gastro-esophageal
junction • Often caused by severe retching/vomiting
Stomach and/or duodenal ulcers" - ANSWER • 36% of UGIB are related to these ulcers •
Lining is eroded and exposes a blood vessel, which may be small or may be a large
artery • May be caused by medications (e.g. ASA, NSAIDs) • Physiological stress ulcers
occur when the body has undergone major stress (e.g. surgery)
Esophageal varices are common with - ANSWER liver cirrhosis, and can result in
massive bleeding. Keep this in mind when we get to the GI III week!)
how is nsaids related to UGIB - ANSWER Many sites minimize NSAID use and/or provide
alternative analgesia alongside NSAIDs and/or administer a PPI alongside them
