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54 Cards in this Set
- Front
- Back
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What is the most common cause of GI integrety?
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H. pylori
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What is forerunner to cancer?
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H. Pylori
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What is a self-limiting inflammation of the gastric mucosa.
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Acute gastritis.
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Causes of acute gastritis.
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Alcoholic Binge
Aspirin Staph |
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Symptoms of gastritis
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ASA induced- sour stomach
alcohol induced- vomit, bleed, hematemisis toxin induced- abrubt, violent inset. vomit within 5 hours of contaminated source ingestion. |
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gastritis is normally self-limiting
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Heals in a few days.
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With staph
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has more pain
similar symptoms |
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Chronic gastritis usually seen in
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smokers
alcoholics |
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What is another name for black, tarry stool (occult blood)?
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Melena
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How much blood does it take in the stomach to cause black, tarry stool?
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150-200 cc
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What is the most common cause of chronic gastritis?
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The bacteria, H. pylori
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What causes intense inflammation and activation of immune response (T and B cells)?
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Infection
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Increases production of cytokines which activate neutraphils
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This means high neutraphil count.
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How is H. Pylori diagnosed?
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C. urea breath test
stool antigen test endoscopic biopsy urease testing |
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What is the treatment to eridacate H. pylori?
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Combination therapy with two antibiotics and bismuth or protein-pump inhibitor.
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What has a direct antimycrombial properties against H. pylori?
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Protein Pump inhibitor
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What has a direct antibacterial effect against H. pylori?
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Bismuth
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What are the two main types of peptic ulcers?
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duodenal (most common)
gastric ulcer |
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What percent of the population do either duodenal or gastric ulcers affect?
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10 %
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Duodenal ulcers are predominate at what age?
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Any age but most common in early adulthood.
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What causes Peptic Ulcer Disease?
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Mostly H. pylori
also from ASA use NSAID use |
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Manifestations of peptic ulcer are what?
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-rhythmic burning, gnawing epigastric pain when stomach is empty
-pain at midline, near xiphoid. may radiate into coastal margins, back, and right shoulder -Deep epigastric tenderness - Relieved by food or antiacids |
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How is peptic ulcer disease diagnosed?
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With BUN( will be elevated because goes out kidneys)
Manifested by melena or hematemisis |
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Surgical management of peptic ulcer
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gastrectomy- remove cells that cause secretion of acid and pepsin
stimulate vagus nerve (with food) for gastric juice production |
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What is ordered for pt with "dumping syndrome"?
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6 small meals a day
high protein high fat low carbs |
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What is Zollinger Ellison Syndrome?
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It is a rare gastrin secreting tumor. Results in very high gastric acid levels- produces ulceration.
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Stress ulcers (Curlings Ulcer)
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common in critically ill
results from ischemia, tissue acidosis, and bile salts entering stomach. Critically ill with decreased GI motility Particularly burn pts. |
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What is a bacterial invasion or chemical irritation of peritoneum?
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Peritonitis (usually from ruptured appendix)
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Example of endrocrine
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Insulin
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Exocrine example
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released into blood stream
amylase digestive enzymes |
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What is a life threatening disorder with release of activated enzymes into pancreas and surrounding tissues?
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Acute Pancreatitis
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Acute Pancreatitis presents with what?
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severe epigastric pain
severe abdominal pain pain aggrivated by supine position abdominal distention hypoactive BS common |
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Complications of acute pancreatitis are what?
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ARDS
acute tubular necrosis hypocalcemia(muscle twitch) |
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Diagnosis of acute pancreatitis
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elevated total serum amylase (most common)
elevated lipase levels elevated WBC hyperglycemia elevated serum biliruben |
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Treatment for acute pancreatitis:
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pain control
meds for smooth muscle relaxation NPO and NG suction to "put the pancreas at rest" |
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Progressive destruction of pancreas
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chronic calcification (most frequently seen in alcoholics and cystic fibrosis)
Makes it pathological |
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Progressive Destruction of the pancreas results in problems with what?
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Diabetes and Malabsorption
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Treatment for progressive destruction of pancreas.
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enzymes for malabsorption
insulin for diabetes avoid alcohol |
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Proton Pump Inhibitor
P= omeprazole (Prilosec) |
suppresses last phase of gastric acid production
inhibits H/K atepase enzyme (produced by perietal cells) |
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H2 Receptor Antagonists (Proton Pump)
P=cimetidine (tagamet) |
acts of perietal cells of the gastric mucosa.
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What produces HCL?
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Parietal Cells
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What type of antiacids cause constipation?
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Aluminum
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Metachlorapramide (Reglan)
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-GI stimulant, increases effect of acetylcholine in GI
-increased gastric emptying -dopamine receptor antagonists that produces antiemetic effect |
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Adverse effects to reglan
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Serious AE not common but include:
extrapyramidal symptoms tardive dyskinesia |
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Antiobesity Agents
P= orlistat (Xenical) |
used with weight loss diet to manage obesity
GI adverse effects common |
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Mylicon (symethicone)
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used in babies
changes surface tension of gas bubbles, can pass more easily. |
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Antiulcer
Karafate |
1 hour before meals and HS
provides protective barrier at ulcer site most common S/E constipation |
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Systemic antidiarrheals
Lomotil |
slows intestinal motility
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Locally acting antidiarrheal
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Kaolin
Pectin Bismuth salicylate |
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Types of laxatives:
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Saline
Stimulant Bulk-forming Surfactant Lubricatting Miscellaneous |
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Stimulant Laxative
Bisacodyl (dulcolax) |
direct effect on mucosa
stimulates peristalis |
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Bulk forming laxative
P=psyllium (metamucil) |
increases bulk of fecal matter
Most Natural Type Of Laxative |
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Lubricant Laxative
P= mineral oil |
causes nutritional defiency because of decreased absorption of fat soluble vitamins.
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surfactants (stool softeners)
P= Colace |
promote movement of water into stool to allow for easier passage.
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