GIT 1

GIT notes

• Dyspepsia (upper GIT symptoms) + alarm symptoms >> do upper GIT endoscopy

• Alarm symptoms: Anorexia, Dysphagia, heamatemsis or Melina, sever vomiting, Abdominal pain or unexplained iron deficiency anemia

• Vomiting don’t forget Drug causes, increase ICT, MI and pneumonia

• Oral whit patches>> Candida (HIV, Steroids), Leucoplekia (take biopsy) and Lichen planus (precancerous)

• Gum swelling: Drugs (nifidipin, phyntoin and ciclosporn), pregnancy, Vit C deficiency, infection and acute leukemia

• Oral pigmentation>> peutz-Jegher syn. (AD), Addisons disease, ant malaria drugs and bithmus

• Parotid enlargement >> Bilateral in Sarcoidosis, Lymphoma and alcohol. Unilateral in tumors

• GERD: if no alarm symptoms try PPI >> No improvement do Endoscopy and PH monitoring. Before surgery u should do PH monitoring and Manomertry to exclude motility disorders (Scleroderma). DD misdiagnosis of uncontrolled asthma

• Barretes esophagus: d2 long standing GERD, Squamous cell replaced by columner cells, premalignant 30-50x, Central Obesity increase its malignancy

• Achalasia: Investigation of choice is esophageal manometry (noncontractil LOS and Poor peristalsis in the wall of esophagus), But UGIT endoscopy is mandatory

• Esophageal tumor sq.cc > adeno.c