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130 Cards in this Set
- Front
- Back
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lack of desire to eat despite physiologic stimuli that would normally produce hunger
often accompanies disorders of other organ systems |
anorexia
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the forceful emptying of stomach and intestinal contents through the mouth
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vomiting
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What are some stimuli that can initiate vomiting?
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ipecac
copper salts severe pain distention of the stomach or duodenum torsion/trauma affecting ovaries, testes, uterus, bladder, or kidney motion activation of the trigger zone in the medulla |
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difficult or infrequent defecation
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constipation
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What are some causes of constipation?
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neurogenic disorders
low-residue diet (not much fiber) sedentary lifestyle hypothyroidism opiates (loritab) MS stroke spinal cord trauma |
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How is constipation evaluated?
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digital rectal exam to assess sphincter tone and detect anal lesions
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How is constipation treated?
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treat/manage the underlying cause
give laxatives |
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an increase in the frequency of defecation and the fluidity and volume of feces
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diarrhea
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diarrhea in which the volume of feces is increased
caused by excessive amounts of water or secretions in the intestines |
large-volume diarrhea
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diarrhea in which the volume of feces is not increased
usually results from excessive intestinal motility |
small-volume diarrhea
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What are the 3 major mechanisms of diarrhea?
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osmotic
secretory motility |
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What are the CM of diarrhea?
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dehydration
electrolyte imbalance weight loss fever cramping pain metabolic acidosis |
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What is the treatment for diarrhea?
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restoration of fluid/electrolyte balance
correct nutritional deficiencies (fiber) |
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can lead to bleeding in the esophagus
tear in the esophagus or gastroesophageal junction often caused by retching or vomiting |
Mallory-Weiss tear
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inflammation of the esophagus
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esophagitis
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What are the 3 types of abdominal pain?
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parietal
visceral referred |
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localized, intense pain in the abdomen
often lateralizes |
parietal pain
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poorly localized pain that arises from a stimulus acting on an abdominal organ
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visceral pain
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visceral pain felt at some distance from a diseased or affected organ
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referred pain
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bleeding in the esophagus, stomach, or duodenum
characterized by frank, bright red bleeding or "coffee ground" material that has been affected by stomach acids |
upper GI bleeding
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What are some causes of upper GI bleeding?
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varicose veins in the esophagus
peptic ulcers Mallory-Weiss tear from severe retching |
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bleeding from the jejunum, ileum, colon, or rectum
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lower GI bleeding
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What are some causes of lower GI bleeding?
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polyps
inflammatory disease cancer hemorrhoids |
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What are the best indicators of massive blood loss in the GI tract?
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changes in blood pressure and heart rate
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bloody vomitus
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hematemesis
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black, sticky, tarry, foul-smelling stools caused by digestion of blood in the GI tract
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melena
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fresh, bright red blood passed from the rectum
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hematochezia
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trace amounts of blood in normal-appearing stools or gastric secretions
detectable only with a guaiac test |
occult bleeding
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difficulty swallowing
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dysphagia
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What are some causes of dysphagia?
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mechanical obstruction of the esophagus (ex. tumor)
neural/muscular disorders that inferefere with voluntary swallowing or peristalsis (CVA, Parkinson disease) |
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What are the CM of dysphagia?
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pain
regurgitation of undigested food unpleasant taste vomiting aspiration weight loss aspiration pneumonia |
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used to visualize the contours of the esophagus and identify structural defects
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barium swallow
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What is the treatment for dysphagia?
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Eat slowly
Eat small meals Mechanical dilation of esophageal sphincter |
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the reflux of chyme from the stomach through the lower esophageal sphincter to the esophagus
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gastroesophageal reflux disease (GERD)
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inflammatory response to acid reflux
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reflux esophagitis
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With GERD, the severity of esophagitis depends on what 2 things?
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the composition of the gastric contents
the length of time they are in contact with the esophageal mucosa |
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What are the CM of GERD?
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heartburn
acid regurgitation dysphagia chronic cough asthma upper abdominal pain within 1 hour of eating |
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What is the treatment for GERD?
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antacids
weight reduction cessation of smoking proton pump inhibitors |
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replacement of the squamous epithelium of the esophagus with metaplastic columnar epithelium after many years of GERD
occasionally leads to esophageal cancer |
Barrett's esophagitis
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the protrusion (herniation) of the upper part of the stomach through the diaphragm and into the thorax
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hiatal hernia
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What are the CM of hiatal hernia?
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often asymptomatic
can cause: GERD dysphagia heartburn epigastric pain |
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What is the treatment for hiatal hernia?
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Eat small, frequent meals.
Avoid lying down after eating. Weight control Antacids |
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the narrowing or blocking of the opening between the stomach and the duodenum
can be congenital (born with it) or acquired (caused by peptic ulcer disease or carcinoma near the pylorus) |
pyloric obstruction
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What are the CM of pyloric obstruction?
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vague epigastric fullness
nausea epigastric pain anorexia weight loss **vomiting** |
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What is the treatment for pyloric obstruction?
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large-bore tube: aspirate stomach contents and relieve distention
nasogastric suction: decompress stomach and restore normal motility Give IV fluid/electrolytes Surgery |
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caused by any condition that prevents the normal flow of chyme through the intestinal lumen
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intestinal obstruction
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What are the 4 common causes of intestinal obstruction?
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hernia
diverticulosis tumor paralytic ileus |
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loss of peristaltic motor activity in the intestine
associated with abdominal surgery and other disorders |
paralytic ileus
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Intestinal obstruction can cause occlusion of the blood supply. This effect is called:
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strangulated
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What are the CM of intestinal obstruction?
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colicky pains followed by vomiting
bowel sounds early on |
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What is the treatment for intestinal obstruction?
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nasogastric suction
replacement of fluid/electrolytes surgery |
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inflammatory disorder of the gastric mucosa
can be acute or chronic |
gastritis
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type of gastritis that is usually the result of injury caused by drugs or chemicals (NSAIDs, alcohol, histamine)
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acute gastritis
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What are the CM of acute gastritis?
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vague abdominal discomfort
epigastric tenderness bleeding |
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What is the treatment for acute gastritis?
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discontinue injurious drugs
use antacids |
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type of gastritis that tends to occur in the elderly and causes thinning and degeneration of the stomach wall (loss of chief cells and parietal cells)
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chronic gastritis
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What can chronic gastritis lead to?
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pernicious anemia
gastric carcinoma |
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What are the CM of chronic gastritis?
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*gastric bleeding may be only symptom
can cause: anorexia fullness N/V epigastric pain |
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What is the treatment for chronic gastritis?
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small meals
soft, bland diet avoid alcohol and aspirin give Vitamin B12 to correct pernicious anemia |
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a break (ulceration) in the protective mucosal lining of the lower esophagus, stomach, or duodenum
can be acute or chronic, superficial or deep frequently caused by H. pylori |
peptic ulcer
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What are the risk factors for peptic ulcers?
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smoking
habitual use of NSAIDs alcohol |
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What are the CM of a duodenal ulcer?
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chronic intermittent pain in the epigastric area
(pain is relieved rapidly by ingestion of food or anatacids) |
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How are duodenal ulcers treated?
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H2 blockers, antibiotics, and proton pump inhibitors to treat H. pylori
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ulcers of the stomach
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gastric ulcers
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an acute form of peptic ulcer that tends to accompany severe illness, systematic trauma, or neural injury
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stress ulcer
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ulcer that develops as the result of a burn injury
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Curling ulcer
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stress ulcer associated with severe head trauma or brain surgery
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Cushing ulcer
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occurs when a peptic ulcer erodes into a vessel, causing occult bleeding
can be life-threatening bright red or coffee ground hematemesis |
erosive peptic ulcer disease (PUD)
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deficient production of amylase and lipase by the pancreas caused by pancreatic injury
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pancreatic insufficency
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inhibits the breakdown of lactose into monosaccharides and therefore prevents lactose disgestion and absorption across the intestinal wall
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lactase deficiency
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results in decreased micelle formation and fat malabsorption
CM are related to poor intestinal absorption of fat and fat-soluble vitamins treatment involves giving vitamins A, D, and K |
bile salt deficiency
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a chronic inflammatory disease that causes ulceration of the colonic mucosa, usually in the rectum and sigmoid colon
cause is unknown, but there is a familial tendency |
ulcerative colitis
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What are the CM of ulcerative colitis?
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periods of remission and exacerbation:
frequent diarrhea urgency bloody stools continuous, crampy pain may have decreased Hgb |
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What is the treatment for ulcerative colitis?
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steroids
immunomodulary agents antibiotics surgical resection of the colon |
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an inflammatory disorder that affects both the large and small intestines but can be anywhere from the mouth to the anus
risk factors and theories of causation are the same as those for ulcerative colitis |
Crohn disease
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What are the CM of Crohn disease?
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nonbloody diarrhea
weight loss lower abdominal pain |
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herniations or saclike outpouchings of mucosa through the muscle layers, usually in the wall of the sigmoid colon
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diverticula
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asymptomatic diverticular disease
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diverticulosis
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inflammation of diverticula in the intestine
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diverticulitis
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What are the CM of diverticular disease?
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cramping pain of the lower abdomen
fever leukocytosis |
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What is the treatment for diverticular disease?
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increase dietary fiber
surgical resection |
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inflammation of the vermiform appendix, which is a projection from the apex of the cecum
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appendicitis
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What is thought to be the cause of appendicitis?
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obstruction of the lumen with stool, tumors, or foreign bodies with consequent bacterial invasion and gangrene
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What are the CM of appendicitis?
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gastric or periumbilical pain that may move to the right lower quadrant
N/V perforation peritonitis abscess formation |
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What is the treatment for appendicitis?
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appendectomy
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can develop secondary to congestive heart failure, acute MI, hemorrhage, stenosis, thrombus formation, or any condition that decreases arterial blood flow
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chronic mesentary insufficiency
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What is the cardinal symptom of chronic mesenteric insufficiency?
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colicky abdominal pain
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What is the treatment for mesenteric artery obstruction?
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inject vasodilating agent into vessel to improve circulation
surgery to remove necrotic tissue or repair sclerosed vessels |
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What are the 3 leading causes of death related to obesity?
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cardiovascular disease
Type II diabetes cancer |
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the presence of 4 interrelated atherosclerotic risk factors: insulin resistance, hypertension, hyperlipidemia, and obesity
associated with increased triglycerides and LDL and decreased HDL |
metabolic syndrome
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What are 3 modifiable risk factors associated with obesity?
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hypertension
cardiovascular disease osteoarthritis |
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a psychologic and physiologic syndrome characterized by the following:
1. Fear of becoming obese despite progressive weight loss 2. Distorted body image 3. Body weight 15% less than normal for age and height 4. Absence of 3 consecutive menstrual periods in females |
anorexia nervosa
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disorder characterized by binging followed by self-induced vomiting or purging of the intestines with laxatives
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bulimia nervosa
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a relatively common systemic disease that primarily affects the liver
caused by 5 strains of viruses |
viral hepatitis
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What are the 3 phases of hepatitis?
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prodromal phase
icteric phase recovery phase |
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phase of hepatitis that begins about 2 weeks after exposure and ends with the appearance of jaundice
marked by fatigue, anorexia, malaise, N/V, headache, hyperalgia, cough, and low-grade fever infection is highly transmissible during this time |
prodromal phase
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phase of hepatitis that begins 1-2 weeks after prodromal phase and lasts 2-6 weeks
jaundice, dark urine, and clay-colored stools are common liver is enlarged this is the ACTUAL phase of illness |
icteric phase
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phase of hepatitis that begins with resolution of jaundice, about 6-8 weeks after exposure
symptoms diminish but liver remains enlarged and tender liver function returns to normal about 2-12 weeks after onset of jaundice |
recovery phase
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the persistence of CM and liver inflammation after acute hepatitis B, C, and D
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chronic active hepatitis
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What is the treatment for hepatitis?
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Prevention is key!!
handwashing gloves hygiene vaccines |
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an irreversible inflammatory disease that disrupts liver structure and function
develops slowly over a period of years |
cirrhosis
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caused by the toxic effects of alcohol on the liver, immunologic alterations, and oxidative stress from lipid peroxidation
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alcoholic cirrhosis
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type of cirrhosis that is autoimmune; the cause is unknown
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biliary cirrhosis
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type of cirrhosis that occurs after an infection, such as Hepatitis B
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post necrotic cirrhosis
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What are the 3 most common causes of cirrhosis?
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chronic excessive alcohol consumption
viral hepatitis fatty liver |
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gallstone formation
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cholelithiasis
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What are the 2 types of gallstones?
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cholesterol
pigmented |
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What are the risk factors for developing a gallstone?
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obesity
middle age female |
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form in bile that is supersaturated with cholesterol produced by the liver
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cholesterol gallstones
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What are the CM of cholelithiasis?
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abdominal pain
jaundice food intolerance, particularly to fats |
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inflammation of the gallbladder or cystic duct
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cholecystitis
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inflammation of the pancreas
can be acute or chronic |
pancreatitis
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What is acute pancreatitis commonly associated with?
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alcoholism
biliary tract obstruction |
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What are the CM of acute pancreatitis?
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epigastric or midabdominal pain
fever leukocytosis |
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What is the treatment for acute pancreatitis?
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nasogastric suction to relieve pain
drugs that decrease gastric acid production antibiotics |
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structural or functional impairment of the pancreas leads to:
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chronic pancreatitis
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What is the most common cause of chronic pancreatitis?
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chronic alcohol abuse
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What is chronic pancreatitis a risk factor for?
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pancreatic cancer
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What are the risk factors for esophageal cancer?
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tobacco use
alcoholism reflux esophagitis |
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What are the CM of esophageal cancer?
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chest pain
dysphagia |
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What is the treatment for esophageal cancer?
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surgery
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What are the risk factors of gastric cancer?
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H. pylori
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What are the CM of gastric cancer?
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anorexia
weight loss abdominal pain |
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What is the treatment for gastric cancer?
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surgery
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What are the risk factors for colorectal cancer?
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high fat, lower fiber diet
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What is the treatment for colorectal cancer?
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Screen for polyps
Radiation Surgery (resection of colon) |
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What are the CM of liver cancer?
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pain
anorexia ascites (fluid buildup in stomach) jaundice |
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What are the CM of pancreatic cancer?
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N/V
abdominal pain weight loss |
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What are the CM of gallbladder cancer?
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early stages are asymptomatic
upper right quadrant pain diarrhea belching weakness loss of appetite weight loss vomiting |
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What does a HIDA scan look at?
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the liver
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