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46 Cards in this Set
- Front
- Back
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what is the ligament of Treintz?
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it's like the dividing line of the GI tract
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bleeding proximal to the ligament would be?
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upper Gi
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bleeding distal to the ligament wold be?
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lower GI
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what makes up the upper GI tract?
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esophagus, stomach, duodenum
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what makes the lower GI tract?
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JEJUNUM
ILEUM COLON RECTUM |
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what is the small intestine?
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duodenum, jejunum, and ileum
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where is diverticulitis?
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colon
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what cells make acid in the gut?
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parietal cells
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what is the normal ph in the gut?
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1.5 to 2
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what does a proton pump do?
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pushes the Hcl out into the stomach
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what does an H2 antagonist do?
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slows the production of Hcl
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what does an proton pump inhibitor do?
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stops the delivery of Hcl
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what are the common causes of peptic ulcer disease?
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nsaids and hpylori bacteria
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how do you get the hpylori?
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contaminated food, unwashed hands
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who are the primary pts of stress related erosive syndrome?
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post op trauma, shock, burns and acute neurological disease
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what is the cause of sres?
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increased acid production, decreased mucosal blood flow
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where is sres limited to?
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the stomach and has a rapid onset
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what causes esophageal varices?
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portal hypertension
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where is the most common site for diverticulitis?
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sigmoid colon
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what type of diet causes diverticulitis?
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high fat, low fiber
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what are the signs of hypovolemic shock
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low bp, High HR, high RR, low urine output
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what are the s/s of an upper GI bleed?
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hematesis and melena
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what does hematesis look like?
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bright red blood, usually a varcies acute bleeding
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what does a slow upper gi bleed look like?
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coffee grounds appearance, the gastric acid has had ^ contact with the blood and converted the bright red hemoglobin to brown hematin
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what is melena?
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ingested blood, can cause dark tarry stools that smell horrible
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what is hematochezia?
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massive lower GI bleed; blood in the gi tract causes an increase in peristalis and diarrhea
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what is another term for bloody hemorroids?
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piles
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what does a guaiac test show?
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blue shows that there is blood
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what blood work would you monitor?
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alt and aph, watch liver
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why do you monitor Ca++ and K when giving blood?
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after 3rd unit you are effecting serum lvls; BUN will go up b/c gut is breaking down the blood
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what is a vagotomy?
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cuts the vagus nerve to stop the production of acetacholine
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what is a pyloriplasty?
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replaces the pyloric spincter
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why are these procedures performed?
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to stop gi bleeding
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how do you control the bleeding in esphageal varices?
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beta blockers are given prophalacticaly to lower portal HTN; in acute bleeding use balloon tamponade
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what does free air in the gut mean on a ct scan?
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medical emergency, perforated stomach
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what are the s/s of free air?
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rigid adb; horrible pain
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how many units of blood does it take to raise the H/h?
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two units
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what would you do first for a GI bleed?
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IV because circulation is the problem
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what else should be done for a GI bleed/
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lavage with room temp water til clear, not cold - it causes a left shift; i/o for perfusion status; o2 and intubation
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what is the course of treatment for PUD and SRES?
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antibiotics ie: amoxillicin, flagyl, tetracycline
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what are the H2 receptor antagonists?
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tagamet, pepcid, zantac
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what cells do proton pump inhibitors work on?
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parietal cells
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What are the proton pump inhibitors?
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protonix, nexium,prilosec
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what does prostaglandin E work on?
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mucous cells
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how does cytotec work?
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increases bicarb and improves mucous
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how does carafate work?
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it is a gastric acid barrier
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