GERD (gastroesophageal disease): abnormal reflux of acid into the esophagus

• GER: short-lived, occurs acutely after meals

• GERD: long-lived, occurs chronically

- risk factors: age (>50 years), sex (M>F), pregnancy, smoking, obesity, excessive alcohol consumption, high fat diet

- caused by: weak lower esophageal sphincter, delayed gastric emptying, decrease salivation/salivary volume, increased gastric volume/pressure

- sx: heartburn, dysphagia, sensation of lump in throat, upper abd/chest pain, aspiration

- tx: surgery, antacids, alginic acid, H2 antagonists, proton pump inhibitors (PPIs)

• Barret’s esophagus: esophageal damage due to prolonged GERD and metaplasia of esophageal cells

• adenocarcinoma: begins in the mucos-secreting glands of the esophagus

Croup: common childhood infection primarily affecting respiratory system, typically upper resp. (worse @ night, lasts 3-5 days)

- risk factors: age (6 months - 5 years), sex (boys > girls), season (fall, winter)

- sx: barking cough, hoarse or loss of voice, inspiratory stridor, fever, runny/stuffy noise

- pathophysiology: virus or bacteria infects resp tract tissues → WBCs rush to area → swelling, partial obstruction

- dx: based on sx, chest auscultation, inspect of nose & throat, may use labs, CT, or x-ray

• Westley score: (0-17) used to determine severity of croup (mild to impending resp failure)

- tx: comfort measures, antipyretics, corticosteroids, epinephrine

Cystic Fibrosis (CF): progressive inherited disorder affecting digestive secretory glands; affects neuro, GI, respiratory, integumentary, reproductive, musculoskeletal, and CV systems

- risk factors: race (Caucasians), family hx

- sx: blocked intestine, SOB, low BMI, clubbing, stunted growth, etc.

- dx: through routine screening after birth (sweat test, blood test, gene test)

- pathophysiology: thick sticky mucus produced that is difficult to clear from lungs/body; also clogs pancreatic ducts → impaired digestion

• CFTR gene: mutation causes CF due to high salt in cells and not enough water

- tx: no cure, airway clearance techniques, feeding tubes, cystic fibrosis transmembrane conductase regulator (CFTCR)

Asthma:

Emphysema: