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126 Cards in this Set

  • Front
  • Back
lack or loss of appetite or hunger
Difference between appetite & hunger
Appetite is psychological, depending on memory and associations.
Hunger is the physiological need for food.
The N/V mechanism is part of what nervous system
involuntary autonomic nervous system
Ice pica
Flaking paint, clay, or hair pica
Laundry starch pica
compulsive eating of nunnutritive substances.
Pica occurence common with:
- PG women
- some patients with iron or zinc deficiencies
- Children (beginning at age 2 leave by adolescence)
Dirt pica
S&S of ______
- Intense fear of becoming obese that does not diminish as weight loss increases.
- Disturbance of body image - claim to feel fat.
- 25% weight loss or -> Protein, calorie malnutrition
- Refusal to maintain body weight
- NO known physical illness.
- Amenorrhea
Anorexia Nervosa
Refusal to eat, grossly distorted eating patterns

- loss of 25% of TBW
- Protein/calorie malnutrition
Anorexia Nervosa
Causes of ______
1) Psychological - rejecting behavior/reinforced by the attention it receives.
20 Endocrine disorder
Anorexia Nervosa
- Binge eating
- followed by self-induced vomiting or
- abuse of laxatives and/or diuretics
Binge eating without purging
S&S of ______
- Dental problems
- inflammation of the esophagus & fluid&electrolyte imbalances.
Bulimarexia & Bulimia
- Most prevalent childhood nutritional disorder
- Predictive of adult obesity
- Dieting is dangerous in children
Childhood Obesity
These are types of ______

1. Hematemesis
- Bright red
- Coffee ground
2. Melena
- Bright Red
- Tarry black
G.I. Bleeding
Causes of ______

- Disease, trauma, clotting disorders.
G.I. Bleeding
Difficulty in swallowing
Causes of ______

- Stroke, CA(cancer), stenosis(narrowing), or scarring.
Inability of the lower esophageal sphincter (cardiac sphincter) to relax -> foot setting in the esophagus until it slowly passes into the stomach -> potential for aspiration.
inflammation of the esophagus
causes of ______

- reflux of gastric contents
- chemical injuries, infection
- irritations from hot/spicy foods
S&S of _______

- heartburn and pain (similar to cardiac pain)
Backward movement of gastric contents into the esophagus -> heartburn
(most common GI disorder)
Gastroesophageal Reflux
Causes of ______

- Hietal hernia
- Weak or incompetent cardiac sphincter
Gastroesophageal Reflux
Predisposing factors of ______

- weakness of hiatal muscle
- increased intrabdominal pressure (obesity, PG, ascites)
Gastroesophageal Reflux
S&S of ______

- Gastric reflux -> heartburn, pain occurring 1/2 - 1 hour following a meal. Heartburn worsens with lying.
Gastroesophageal Reflux
(Not required)
Tx for Gastroesophageal Reflux
1. Conservative - lose weight, avoid lying flat, increase HOB(head of bed), frequent small feedings, antacids
2. surgery
Outpouching of the esophageal wall caused by a weakness of the muscle layers
Esophageal Diverticulum
Major complication w/ Esophageal Diverticulum
Food can get trapped in pouch
S&S of ______

- food gets "stuck"
- gurgling
- coughing
- belching
- bad breath
Esophageal Diverticulum
(not required)
TX of Esophageal Diverticulum
- Accounts for about 6% of all GI cancers
- Occurs most often in men > 50
- Predisposing factors = alcohol and tobacco, injury to esophagus
Cancer of the Esophagus
S&S of ______

- dysphagia
- weight loss
- anorexia
- fatigue
- pain or swelling
Cancer of the Esophagus
A transient irritation of the gastric mucosa.
Acute Gastritis
Causes of ______

- bacterial endotoxins
- caffeine
- alcohol
- ASA (aspirin)
Acute Gastritis
Patho of ______

irritant -> inhibit production of prostoglandins (prostoglandins stimulate contraction of uterine and other smooth muscles, decrease B/P, regulate acid secretion of stomach) -> loss of protection of gastric mucosa from normal stomach acids -> disruption of mucosal barrier -> irritation
Acute Gastritis
S&S of ______

- ASA - asymptomatic of heartburn or sour stomach
- Alcohol - vomiting, GI bleeding, hematemesis(blood vomit)
- Endotoxins - abrupt onset, N/V.
Acute Gastritis
(not required)
TX of Acute Gastritis
Usually gone in a few days
aka "bite the bullet"
Progressive and irreversible atrophy of part of the epithelium of the stomach which contains glands (pepsin-producing and acid producing cells) -> lack of hydrochloric acid and vitamin B12 absorption (pernicious anemia)
Chronic Gastritis
lack of intrinsic factor commonly found in gastric mucosa -> failure to absorb B12
Pernicious Anemia
S&S of ______

- Pernicious anemia
- impaired O2 transport
- Alterations in RBC structure
Chronic Gastritis
An ulcer that develops in the upper GI tract which is exposed to acid-pepsin secretions.
- chronic illness with remissions and exacerbations
Peptic Ulcers
enzyme that breaks down proteins
Causes of ______

- H. pylori infections
- NSAIDs, esp ASA
Peptic Ulcers
S&S of ______

> Pain - burning, gnawing or cramping
> Pain - between meals (when stomach is empty) or at 1-2 a.m.
> Pain - located near xiphoid, may rotate toward ribs, the back and the right shoulder
> Pain - recurs at intervals of weeks or months
> Pain - is relieved by food or antacids
Peptic Ulcers
Complications from Peptic Ulcers can include: (3 things)
- Hemorrhage
- Obstruction - due to edema
- Perforation - eats through layers of the GI tract -> peritonitis
DX for Peptic Ulcers (not required)
Endoscopy with biopsy to test for H. Pylori or blood test for titers (measures antibodies to H. Pylori)
History of NSAID use
TX for Peptic Ulcers (not required)
Kill H. Pylori infection with anitbiotics
- Rare
- Caused by gastrin-secreting tumor located in pancreas
- Ulcers form from elevated gastrin levels
- Usually malignant
Zollinger-Ellison Syndrome
- Related to severe stress, trauma, sepsis, head injuries
Stress ulcers or Curling's ulcer
Patho of ______

Head injuries -> hypersecretion of HCL
Others -> ischemia of the gastric mucosa -> disruption of mucosal barrier -> ulcer from normal acid secretions
Stress ulcers or Curling's ulcer
Complications of Stress ulcers or Curling's ulcer include: (2)
- Hemorrhage
- High mortality
TX of Stress ulcers or Curling's ulcer (not required)
- antacids, tagamet (acid secretion)
Causes of ______ & ______

- unknown
- hereditary (esp. Jewish)
- aggravated by psychological stress
Chron's Disease/ Ulcerative Colitis
DX of Chron's Disease/Ulcerative Colitis
- symptoms, x-rays, procto-sigmoidoscopy
Recurrent granulomatous type of inflammatory response that affect any area of the GI tract
Chron's Disease
S&S of ______

- intermittent diarrhea
- colicky pain
- wt. loss & malaise
- low grade fever
- perianal abscesses/fistula
Chron's Disease
A nonspecific inflammatory condition of the colon
- ulcerative & exudative
- affects colon
Ulcerative colitis
S&S of ______

- Bloody diarrhea w/ mucous
- Colicky pain
- Anemia
- Hypoproteinemia
Ulcerative colitis
Bacteria infections of the colon
Infectious Colitis
Common nosocomial infection resulting from antibiotic tx which leads to disruption of the normal bacterial flora of the colon - difficult to treat - must stop antibiotic therapy.
Clostridium difficile Colitis
Bacteria found in feces of cattle and milk - contaminated or poorly cooked meat/milk leads to food-borne transmission. Sever infection leads to production of toxins and hemolytic anemia and renal failure. Most common cause of acute renal failure in children.
Escherichia coli 0157:H7 Colitis
A pouch or sac formed by herniation of intestinal mucous membrane through the muscle layer of the intestine.
Diverticular Disease
S&S of ______

- Change in bowel habits
- Diarrhea
- Constipation
- Bloating
- Gas
Diverticular Disease
Causes of ______

- Idiopathic
- lack of dietary fiber
- Aging
- Lack of exercise
Diverticular Disease
Complications of ______

- Perforation
- Peritonitis
- Hemorrhage
- Bowel obstruction
Diverticular Disease
- Kills ~ 57,000 each year
- 2nd most common site of fatal CA
- By the time you have symptoms, disease is too far
- Asymptomatic until progressed disease
Colorectal Cancer
DX for Colorectal Cancer
- Hemocult - stool (occult blood)
- Digital rectal exam
- Proto - sigmoidoscopy
Inflammation of the peritoneum is a serious complication which commonly results from spread of infection from abdominal organs (appendicitis), rupture in GI tract, or from penetrating wounds to the abdomen
Pathophysiology of ______

Initial assault (bacteria/chemical)
-> exudate (sticky, substance) Adhesions -> seals off area -> pockets of puss form and glue the surfaces together -> localizes the infection (however may become generalized) -> adhesions usually disappear when infection disappears but may persist which later -> intestinal obstruction
S&S of ______

- N/V
- Pain & abdominal tenderness w/ movement
- Shallow resp. (due to pain)
- Rigid, distended abdomen
- Fever, increase WBC's
TX of Peritonitis (not required)
- Antibiotics
- Surgery
The interference (from whatever cause) with the normal flow of intestinal contents then the intestinal tract
Intestinal Obstruction
Types of intestinal obstruction (four)
- acute
- chronic
- partial
- complete
peristalsis halts -> no movement (i.e. obstruction)
Paralytic Ileus
Causes of ______

- Abdominal surgery
- Trauma
- Peritonitis
- Chemical irritation
- Ischemia
- Electrolyte imbalances
Paralytic Ileus
Causes of ______

- Adhesions
- Hernias
- Volvulus - twisting of bowel
- Intussusception - telescoping of bowel
- Fecal impaction
- Strictures
- Tumors
Mechanical Ileus
Effects of Intestinal Obstruction
Fluid and electrolyte imbalance
S&S of ______

- No bowel sounds or hypoactive
- Continuous pain
- N/V
- Distended abdomen
- lack of BMs
Paralytic ileus
S&S of ______

- Hyperactive bowel sounds at beginning which later diminish and become absent
- N/V
- Distended abdomen
- lack of BMs
Mechanical ileus
TX of Intestinal Obstruction
- Fluid and electrolytes
- Surgery
Inflammation of the liver
Causes of ______

- virus
- infections
- drug toxicity (alcohol)
Acute inflammatory disease caused by hepatitis virus or other virus (CMV, herpes and measles)
Viral hepatitis
Fecal, oral route liver inflammation
Hepatitis A (HVA)
Blood borne liver inflammation
Hepatitis B (HVB)
Other (Non-A, Non-B) liver inflammation
Hepatitis C (HVC)
TX of Hepatitis (prevention)
- Gamma globulin - HVA
- HVB vaccine/ may prevent HVD
- No vaccine for HBC or HBE
S&S of ______

- Prodromal stage - malaise
- Icteric stage - increased bilirubin lvls (jaundice)
- dark urine, pale stools
- increased liver size
- convalescent stage
- presents quickly
Hepatitis A
S&S of Hepatitis B
- carry virus w/out symptoms for long time
Fibrosis and "hardening" of the liver
Causes of _____

- Viral hepatitis
- Alcoholism
- Drug toxicity
- Chemical exposures
- Biliary obstructions
- Cardiac disease
- Metabolic disorders
- Others
Types of cirrhosis
1. nodules (fibrous) develop
2. Dmg. to the bile ducts
3. 4th leading cause of death in US adults, most common cause of cirrhosis = alcoholism
1. Postnecrotic

2. Biliary

3. Portal of alcoholic
Stages of Cirrhosis
1. Fatty changes (asymptomatic)
2. liver tenderness, pain, anorexia, fever, jaundice, ascites and liver failure
3. Cirrhosis
S&S of _______

- Portal hypertension - fibrous tissue increase portal venous pressure -> dilation of connecting veins (to handle increase pressure) -> venous shunting and congestion -> splenomegaly, Hemorrhoids, esophageal varices, caput medusae (dilated surface veins around the umbilicus), ascites and peripheral edema
Portal Cirrhosis
Causes of ______ with Cirrhosis

- Impaired protein synthesis in liver -> colloid osmotic pressure

- Obstruction of venous flow through liver -> increase production of lymph -> oozing of serous fluid from liver surface

- increase aldosterone -> NA and H2O retention and K loss
Ascites and edema
A condition in which acute renal failure occurs with disease of the liver or biliary tract, the cause of which is believed to be either a decrease in renal blood flow or damage to both the liver and the kidneys as from carbon tetrachloride poisoning or leptospirosis.
Hepatorenal syndrome
Effects of _______

- decreased sex hormones
- decreased synthesis of plasma proteins -> ascites, edema
- synthesis of blood-clotting factors -> bleeding
- failure to remove and conjugate bilirubin -> jaundice
- impaired bile synthesis
- impaired gluconeogenesis
- decreased ability to convert ammonia to urea -> increased blood ammonia levels
Hepatocellular dysfunction
- common problem esp. for women
- cholesterol and bilirubin "rocks"
- caused by increase in cholesterol in bile
Cholelithiasis (gallstones)
S&S of _______

- many asymptomatic until obstruction of bile flow
- jaundice (when bile flow obstructed)
- biliary colic = sudden onset of pain which increases in intensity to reach climax in 30-60 minutes
- pain located = upper right quadrant, episgastric area, often radiates to the back, right shoulder and right scapula
- pain rare on left side but possible
- N/V may occur
Cholelithiasis (gallstones)
DX of gallstones (not required)
- oral cholecystogram (x-ray of gb with contrast), ultrasound, gb scan
TX of gallstones (not required)
- surgery or lithotripsy
Inflammation of gallbladder, can be acute or chronic
- associated with gallstones and bile obstruction.
S&S of ______

1. acute - symptoms like in gallstones

2. chronic - intolerance to fatty foods
- vague
- belching
- possible colicky pain

3. DX/TX same as gallstones
Severe life threatening disorder due to loss of pancreatic enzymes into surrounding tissues and abdominal cavity. Enzymes begin to autodigest tissues -> necrosis -> hemorrhage
Acute hemorrhagic pancreatitis
Causes of ______

- Gallbladder disease
- Alcohol abuse
Acute hemorrhagic pancreatitis
S&S of ______

- abrupt and dramatic
- may follow heavy metal or alcoholic binge
- severe epigastric pain and abdominal pain radiating to back
- pain is worse when person lies flat
- abdominal distension
- hypoactive bowel sounds
- hypovolemia from loss of large volumes of fluid in retroperitoneal and abdominal cavity
- hypovolemic shock
- fever
- elevated serum amylase/lipase after 24 hrs.
Acute hemorrhagic pancreatitis
Prognosis: Acute hemorrhagic pancreatitis
5% die, life-threatening disease
TX for Acute hemorrhagic pancreatitis
- pain relief
- resting pancreas
- restoring lost plasma volume
Progressive destruction of pancreas, two types
Chronic Pancreatitis
stones form in pancrease, seen most often in alcoholics
Chronic calcifying pancreatitis
Stenosis of the sphincter of Oddi
Chronic obstructive pancreatitis
S&S of ______ & ______

- recurring episodes of epigastric and upper left quadrant pain, precipitated by alcohol abuse and overeating
- anorexia
- constipation
- N/V
- flatulence
- finally diabetes mellitus and malabsorption syndrome
Chronic calcifying pancreatitis
and Chronic obstructive pancreatitis
TX of Chronic calcifying and obstructive pancreatitis
low fat diet, alcohol withdrawal, TX biliary disease
- 5th leading cause of cancer deaths in US
- occurs mostly after age 50, usually between ages 65 and 79
- prognosis poor and usually not dx until advanced, survival <3%
Cancer of Pancreas
Cause of ______

- idiopathic, but smoking is major risk factor
Cancer of Pancreas
S&S of Cancer of Pancreas
- pain and jaundice
DX for Cancer of Pancreas
ulrasound and CT
TX for Cancer of Pancreas
surgery, radiation, and chemo
- source is feces
- fecal-oral route of transmission
- no chronic infection
- pre/post-exposure immunization to prevent
Hepatitis A
- source is blood/blood-derived body fluids
- percutaneous/permucosal route of transmission
- chronic infection occurs
- pre/post-exposure immunization to prevent
Hepatitis B
- source is blood/blood-derived body fluids
- percutaneous/permucosal route of transmission
- chronic infection occurs
- blood donor screening; risk behavior modification to prevent
Hepatitis C
- source is blood/blood-derived body fluids
- percutaneous/permucosal route of transmission
- chronic infection occurs
- pre/post-exposure immunization; risk behavior modification to prevent
Hepatitis D
- source is feces
- fecal-oral route of transmission
- no chronic infection
- ensure safe drinking water to prevent
Hepatitis E