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54 Cards in this Set

  • Front
  • Back
What is the most common cause of GI integrety?
H. pylori
What is forerunner to cancer?
H. Pylori
What is a self-limiting inflammation of the gastric mucosa.
Acute gastritis.
Causes of acute gastritis.
Alcoholic Binge
Symptoms of gastritis
ASA induced- sour stomach
alcohol induced- vomit, bleed, hematemisis
toxin induced- abrubt, violent inset. vomit within 5 hours of contaminated source ingestion.
gastritis is normally self-limiting
Heals in a few days.
With staph
has more pain
similar symptoms
Chronic gastritis usually seen in
What is another name for black, tarry stool (occult blood)?
How much blood does it take in the stomach to cause black, tarry stool?
150-200 cc
What is the most common cause of chronic gastritis?
The bacteria, H. pylori
What causes intense inflammation and activation of immune response (T and B cells)?
Increases production of cytokines which activate neutraphils
This means high neutraphil count.
How is H. Pylori diagnosed?
C. urea breath test
stool antigen test
endoscopic biopsy
urease testing
What is the treatment to eridacate H. pylori?
Combination therapy with two antibiotics and bismuth or protein-pump inhibitor.
What has a direct antimycrombial properties against H. pylori?
Protein Pump inhibitor
What has a direct antibacterial effect against H. pylori?
What are the two main types of peptic ulcers?
duodenal (most common)
gastric ulcer
What percent of the population do either duodenal or gastric ulcers affect?
10 %
Duodenal ulcers are predominate at what age?
Any age but most common in early adulthood.
What causes Peptic Ulcer Disease?
Mostly H. pylori
also from
ASA use
Manifestations of peptic ulcer are what?
-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
How is peptic ulcer disease diagnosed?
With BUN( will be elevated because goes out kidneys)
Manifested by melena or hematemisis
Surgical management of peptic ulcer
gastrectomy- remove cells that cause secretion of acid and pepsin
stimulate vagus nerve (with food) for gastric juice production
What is ordered for pt with "dumping syndrome"?
6 small meals a day
high protein
high fat
low carbs
What is Zollinger Ellison Syndrome?
It is a rare gastrin secreting tumor. Results in very high gastric acid levels- produces ulceration.
Stress ulcers (Curlings Ulcer)
common in critically ill
results from ischemia, tissue acidosis, and bile salts entering stomach.
Critically ill with decreased GI motility
Particularly burn pts.
What is a bacterial invasion or chemical irritation of peritoneum?
Peritonitis (usually from ruptured appendix)
Example of endrocrine
Exocrine example
released into blood stream
digestive enzymes
What is a life threatening disorder with release of activated enzymes into pancreas and surrounding tissues?
Acute Pancreatitis
Acute Pancreatitis presents with what?
severe epigastric pain
severe abdominal pain
pain aggrivated by supine position
abdominal distention
hypoactive BS common
Complications of acute pancreatitis are what?
acute tubular necrosis
hypocalcemia(muscle twitch)
Diagnosis of acute pancreatitis
elevated total serum amylase (most common)
elevated lipase levels
elevated WBC
elevated serum biliruben
Treatment for acute pancreatitis:
pain control
meds for smooth muscle relaxation
NPO and NG suction to
"put the pancreas at rest"
Progressive destruction of pancreas
chronic calcification (most frequently seen in alcoholics and cystic fibrosis)
Makes it pathological
Progressive Destruction of the pancreas results in problems with what?
Diabetes and Malabsorption
Treatment for progressive destruction of pancreas.
enzymes for malabsorption
insulin for diabetes
avoid alcohol
Proton Pump Inhibitor

P= omeprazole (Prilosec)
suppresses last phase of gastric acid production
inhibits H/K atepase enzyme (produced by perietal cells)
H2 Receptor Antagonists (Proton Pump)

P=cimetidine (tagamet)
acts of perietal cells of the gastric mucosa.
What produces HCL?
Parietal Cells
What type of antiacids cause constipation?
Metachlorapramide (Reglan)
-GI stimulant, increases effect of acetylcholine in GI
-increased gastric emptying
-dopamine receptor antagonists that produces antiemetic effect
Adverse effects to reglan
Serious AE not common but include:
extrapyramidal symptoms
tardive dyskinesia
Antiobesity Agents

P= orlistat (Xenical)
used with weight loss diet to manage obesity
GI adverse effects common
Mylicon (symethicone)
used in babies
changes surface tension of gas bubbles, can pass more easily.

1 hour before meals and HS
provides protective barrier at ulcer site
most common S/E constipation
Systemic antidiarrheals

slows intestinal motility
Locally acting antidiarrheal
Types of laxatives:
Stimulant Laxative

Bisacodyl (dulcolax)
direct effect on mucosa
stimulates peristalis
Bulk forming laxative

P=psyllium (metamucil)
increases bulk of fecal matter
Most Natural Type Of Laxative
Lubricant Laxative

P= mineral oil
causes nutritional defiency because of decreased absorption of fat soluble vitamins.
surfactants (stool softeners)

P= Colace
promote movement of water into stool to allow for easier passage.