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30 Cards in this Set
- Front
- Back
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Orthostatic means that _____% blood loss.
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30
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What is the normal range of alkaline phosphatase?
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35-105 IU/l
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What is the normal range of AST?
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0-40 IU/l
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What is the normal range of GGT?
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11-50 IU/l
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What are two of the best markers for liver failure?
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PT & Cholesterol (albumin is also a good marker for chronic liver failure)
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GTT commonly increases with ________.
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chronic alcohol use
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An increase in AST greater than an increase in Alk Phosphatase usually means what?
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There is a hepatocellular problem going on.
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What is alkaline phosphatase and what does an increase in this suggest?
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-an enzyme in liver canaliculi
-means there is some kind of obstruction (in the bile canaliculi) |
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What are some signs of liver failure?
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-jaundice
-distended abdomen -gynecomastia -spider naevi |
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True or False: an initial CBC is a good marker for GI bleed.
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FALSE-- only as a CHRONIC marker --it takes awhile for the body to adjust--CBC may initially be NORMAL.
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What is third spacing?
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the physiological concept that body fluids may collect in a "third" body compartment that isn't normally perfused with fluids
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Give some examples of third spacing.
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-after sx (ie ileus, obstruction)
-pancreatitis (fluids may "leak out" into the peritoneal cavity, also causing depletion of the first & second compartments) |
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Name the two classic signs of third spacing?
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-tachycardia
-decreased urine output |
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What is the treatment of 3rd spacing?
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-tx the underlying cause
-IV hydration w/isotonic fluids |
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What is pre-renal failure after surgery due to?
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third-spacing
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What is the best SCREENING test for H. pylori?
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Elisa blood test
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Is the ELISA blood test for H. pylori sensitive? specific?
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sensitive, but not specific
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What does a positive ELISA blood test for H. pylori mean? What is a disadvantage of the test?
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+ test means the pt has antibodies to H. pylori
disadvantage is the possibility of false + results in pts previously treated for ulcers since the levels of H. pylori antibodies fall slowly |
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What is the best INITIAL DX test for H. pylori? How accurate is this test?
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Breath test; 90% accurate
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What is the most ACCURATE test for H. Pylori?
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Tissue test-- done during endoscopy; a rapid urease test detects the bacteria's enzyme urease
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What is a paracentesis?
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procedure for obtaining acidic fluid-- which is then sent for tests such as albumin, gram stain, etc.
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What pathogen is the most common in acidic fluid?
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E. coli
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What pathogen is most common during peritoneal dialysis infections?
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staph
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The length of the esophagus is _____.
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25 cm
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How does the lower esophageal sphincter (LES) prevent reflux and what must it do to allow food passage with swallowing?
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through contraction; it must RELAX
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Where is the upper esophageal sphincter located?
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near the cricopharyngeas muscle
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What are some red flags that suggest the need for an endoscopy?
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weight loss
+ blood in stool fever loss of appetite |
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What does GERD consist of?
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1- injury to esophageal mucosa
2- inflammation |
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What are some potential causes of GERD?
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- reflux of gastric contents into the lower esophagus
-decrease in LES tone (due to pregnancy, smoking, alcohol, fat, etc) -hiatal hernia -poor esophageal clearance, delayed gastric emptying -poor reparative capacity of mucosa |
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What are some supportive measures & behavioral changes to treat GERD?
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-elevate HOB to help with sleep
-weight reduction -avoid fatty foods, coffee, chocolate, alcohol, smoking |
