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176 Cards in this Set
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- Back
- 3rd side (hint)
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What is the basic def of GASTRITIS?
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generalized inflammation of the gastric mucosa
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What does the following describe?
acute gastritis from an alteration in intracranial processes and extreme vagal processes? |
Cushing's ulcer
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What dx test must be pos to confirm Cushing's or ischemic ulcer?
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occult blood in stool
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What can inhibition of prostaglandins in the gastric mucosa cause?
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gastritis
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What's the following describe?
acute gastritis induced by v gastric blood flow which may occur after major burns, trauma, or sepsis? |
ischemic ulcer
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Cushing's ulcer - basic def?
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acute gastritis from alteration in intracranial processes,
extreme vagal stim |
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What form of gastritis can occur for extreme vagal stim?
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Cushing's ulcer
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What form of gastritis can occur after major burns, trauma or sepsis?
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ischemic ulcer
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What is the major clinical manifestation for Cushing's or ischemic ulcer?
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bleeding
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What forms of acute gastritis can occur after major stress event?
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Cushing's or ischemic ulcer
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How long after stress event does bleeding occur in Cushing's or ischemic ulcer?
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2 to 10 days
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Who is most prone to chronic gastritis?
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elderly
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What are two forms of acute gastritis?
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Cushing's or ischemic ulcer
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What are two forms of chronic gastritis?
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Type A (Fundal) gastritis,
Type B (Antral) gastritis |
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Which for of chronic gastritis is more severe?
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Fundal gastritis (type A)
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What type of chronic gastritis is considered precancerous?
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fundal gastritis (type A)
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What type of GI disorders are assoc w/ fundal gastritis (type A)?
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pernicious anemia,
gastric malignancies |
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What's another name for fundal gastritis (type A)?
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atrophic gastritis
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What's another name for atrophic gastritis?
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fundal gastritis (type A)
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What does the following describe?
degeneration of the mucosa in both the body and fundus of the stomach |
fundal gastritis (type A)
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Where does the mucosa degenerate in fundal gastritis (type A)?
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both the fundus and body of the stomach
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What does it mean that gastric function is v in fundal gastritis (type A)?
x3 |
v secretion of pepsinogen, HCL and intrinsic factor
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What type of chronic gastritis is more common?
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antral gastritis (type B)
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What type of gastritis is limited to the antral area of the stomach?
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antral gastritis (type B)
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What kind of gastritis can occur from bile reflux?
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antral gastritis (type B)
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antral gastritis (type B) - bacteria responsible?
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Campylobacter pylori
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What are sym of chronic gastritis?
h |
Gastric bleeding
Anorexia Steatorrhea Twelve - Vit B12 (pernicious anemia) Really stuffed (fullness) Icky feeling (nausea) Throwing up (vomiting) Impaired GI tissue integrity Stomach pain (epigastric pain) |
GASTRITIS
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Chronic gastritis, what are 2 specific GI drugs you may get r/t impaired tissue integrity in GI tract?
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Tagament, and
Maalox |
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Chronic gastritis, what 3 meds do you want to minimize use of?
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aspirin,
corticosteroids, antiinflammatory |
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Chronic gastritis, what 2 things do you want to eliminate from the diet?
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caffeine,
alcohol |
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What kind of chronic gastritis might be r/t C. pylori?
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antral gastritis
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Chronic gastritis, what is the priority assessment r/t bleeding?
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monitor for frank or occult blood in
stools, emesis, NG tube aspirate |
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Chronic gastritis, what are the signs to check for r/t excessive bleeding?
x4 |
hypovolemia,
tachycardia, tachypnea, hypotension |
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Chronic gastritis, what's the progression of rx for bleeding? (4 steps)
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1. NG tube suction
2. iced NS lavage 3. vasopressin 4. laser coagulation |
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What two categories of meds do you give for pain r/t chronic gastritis?
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antacids,
H2 receptor antagonists |
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Chronic gastritis, if po allowed, what are 4 aspects to diet if pain?
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soft,
bland, freq, small |
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Assoc pernicious anemia r/t gastritis w/?
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atrophic gastritis only
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What are two types of peptic ulcers?
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duodenal,
gastric |
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What causes duodenal ulcers?
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^ levels of gastric acid
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What can ^ levels of gastric acid cause?
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duodenal ulcer
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What age is typical for duodenal ulcers?
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40-60 y/o
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What are 6 precipitating factors for duodenal ulcers?
h |
type O blood, long-term anxiety, smoking, caffeine, alcohol, irritating drugs
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blood type?
mood? habits x4? |
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What do the following conditions predispose to?
type O blood, long-term anxiety, smoking, caffeine, alcohol, irritating drugs |
duodenal ulcers
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What are 4 diseases assoc w/ duodenal ulcers?
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chronic lung disease,
cirrhosis, pancreatitis, Zolliner-Ellison syndrome |
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What are two things that cause pain r/t duodenal ulcers?
x2 |
acid irritating nerves,
muscle spasm |
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What kind of peptic ulcer is relieved by eating?
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duodenal ulcer
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What relieves pain r/t duodenal ulcer?
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food
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What kind of peptic ulcer is intermittent in nature?
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duodenal ulcer
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What kind of ulcer is chronic in nature?
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gastric ulcer
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What area of the stomach is usually affected by gastric ulcer?
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antral area
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What kind of ulcer is not relieved by any of the follow?
eating, fullness, nausea, vomiting, wt loss |
gastric ulcer
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What are 5 complications from peptic ulcers?
h |
Perforation
Erosion, further of GI mucosa Penetration Testable for H. pylori Intractability Clog (obstruction) |
"PEPTIC"
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Gastoenteritis, definition?
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inflammation of stomach and intestinal tract
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Gastroenteritis, causes? x2
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virus,
bacteria |
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Gastroenteritis, chatacterized by what? x5
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anorexia,
DNV, cramping pain |
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What GI disorder is characterized by anorexia, DNV, cramping pain?
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gastroenteritis
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What does the following describe?
inflammation of the stomach and intestinal tract |
gastroenteritis
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How long does viral gastroenteritis last?
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24 to 48 hrs
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How long does bacterial gastroenteritis last?
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5 to 10 days
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What kind of gastroenteritis lasts 24 to 48 hours?
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viral gastroenteritis
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What kind of gastroenteritis lasts 5 to 10 days?
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bacterial gastroenteritis
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For what kind of gastroenteritis could you admin antidiarrheal meds?
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viral gastroenteritis
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What's the most common route of transmission for gastroenteritis?
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fecal-oral
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What's another name for the following?
gastric flu, stomach flu, and stomach virus, although unrelated to influenza |
gastroenteritis
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What does the following describe?
severe inflammation of the gastrointestinal tract involving both the stomach and small intestine resulting in acute diarrhea and vomiting |
gastroenteritis
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What is the best way to prevent gastroenteritis?
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good hand hygiene
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What is of particular note about the communicability of the infections that cause gastroenteritis?
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host can be asymptomatic for a long time and still communicate the organism
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What is a common complication w/ the elderly and very young r/t gastroenteritis?
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dehydration
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What are two causes of hyperthermia r/t gastroenteritis?
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infection,
dehydration |
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What are 4 causes of appendicitis?
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systemic infections,
hard stools, seeds, tumors |
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What are 7 symptoms of appendicitis?
h |
"UNRAVEL"
Ugly face (grimacing, s/s pain) Nausea RLQ pain Anorexia Vomiting Evading touch of RLQ (guarding) Low-grade fever |
"UNRAVEL"
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What are 3 possible complications of appendicitis?
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perforation,
abscess formation, peritonitis Picture a "PERFect OBSESSed PAROT" stuck in the cecal junction near the appendix repeating, polly want a cracker |
Picture a "PERFect OBSESSed PAROT" stuck in the cecal junction near the appendix repeating, polly want a cracker
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What does the following s/s indicate?
RLQ pain, anorexia, NV, low-grade fever |
appendicitis
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What can cause the following complications?
perforation, abscess formation, peritonitis |
appendicitis
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What can the following cause?
peritonitis, aperistalsis r/t gas distention, hypokalemia, sympathetic stim |
paralytic ileus
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What GI disorder can peritonitis cause?
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paralytic ileus
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What GI disorder is a cause of paralytic ileus?
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peritonitis
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What are the clinical manifestations of peritonitis?
h |
"NAVATH" (Where do KNAVES come from?)
Nausea Abdominal pain Vomiting Abdominal distention Temp Hypovolemia |
Where do KNAVES come from?
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Pain r/t appendicitis, what position and activity level?
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semi-fowler's,
limit activity |
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Pain r/t simple appendicitis, what strength analgesics do you give?
Why? |
mild analgesics,
so they can tell if they perf |
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What are s/s of appendicitis perforation? x6
h |
Distention
Rigidity Pain (see other note) Fever Tachypnea Tachycardia |
DR. P.F. Tachy-Tachy
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Pain r/t peritonitis,
1. what is the onset? 2. what is the quality? 3. where is it? |
1. gradual or abrupt
2. dull to intense 3. generalized to localized |
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What is the progression and quality of pain r/t appendicitis perforation?
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sudden relief of pain followed by intense generalized abdominal pain
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What do you never apply to perf appendix?
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hot water bottle
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What position is best for peritonitis?
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knees flexed
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What is nutritional status of pt w/ peritonitis?
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NPO
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What are signs of septicemia r/t peritonitis? x5
h |
Tachycardia,
Hypovolemia, Diaphoresis Shortness of breath Fever |
"Tactless Hippos Die a Short Feverish death"
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Where do diverticula usu dev?
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sigmoid colon
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What can a low fiber diet be a risk factor for?
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diverticulitis &
Crohn's |
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What are 5 complications from diverticulitis?
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peritonitis,
bleeding, fistula, ureteral obstruction, intestinal obstruction |
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What are two kinds of gallstones?
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cholesterol,
pigmented stones |
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When will cholesterol gallstones develop?
(what 3 chemicals contribute?) |
w/ imbalance of cholesterol, bile salts, and phopholipids (lecithin)
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What 2 substances contribute to pigmented gallstones?
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bilirubin,
ionized Ca |
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To what kind of gallstone do bile salts contribute?
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cholesterol gallstones
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To what kind of gallstones does bilirubin contribute?
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pigmented gallstones
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What are two conditions that contribute to pigmented gallstones?
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hemolysis,
cirrhosis |
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Chronic cholecystitis, s/s? x6
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Repeated episodes of:
RUQ pain, Dyspesia, Heartburn (Pyrosis), Nausea ... after eating fatty food |
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What are:
1. cholecystitis? 2. cholelythiasis? |
1. cholecystitis: inflammed gallbladder
2. cholelythiasis: gallstones |
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Acute cholecystitis, 6 s/s?
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RUQ pain,
tenderness, anorexia, NV, jaundice if CBD blocked |
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What are 8 risk factors for cholecystitis?
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obesity,
sedentary, women, esp multiparous, 40+ y/o, pregnancy, familial tendency, hypothyroidism, ^ cholesterol |
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What is the common diet for peritonitis and cholecystitis?
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fat free,
fluids as tolerated |
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How do parasites enter GI tract?
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fecal-oral route
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What's the range of intensity of parasite sym?
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none to severe
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Parasite sym, mild to moderate? x5
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smelly stools w/ mucous,
cramping, flatulence, fatigue, wt loss |
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What do these sym indicate?:
smelly stools w/ mucous, cramping, flatulence, fatigue, wt loss |
parasites (mild to moderate sym)
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Parasite sym, severe? x4
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freq liquid stools w/ blood & mucous,
high fever, abd tenderness, vomiting |
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What do these sym indicate?:
freq liquid stools w/ blood & mucous, high fever, abd tenderness, vomiting |
parasites (severe sym)
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What are 2 dx tests for parasites?
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serial exam of stools,
sigmoidoscopy for ulcerations |
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What are the 4 most important things for parasites?
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hand-washing is essential,
fecal-oral transmission, carrier may have no sym, enteric precautions |
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Giardia Lamblia, what and how long is each phase?
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acute: days or weeks
chronic: years |
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Malabsorption r/t parasites, create deficits in what? x4
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fat,
protein, Vit B12, lactase |
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Salmonella - incubation period duration?
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8 to 48 hours
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Salmonella - duration of sym?
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3 to 5 days
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Salmonella - sym? x7
h |
"SALMON FEVER"
Sanguineous stool maybe Abdominal pain Loose poop (diarrhea) Miserable cramps Ousted dinner (vomit) Nausea FEVER |
"SALMON FEVER"
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How long might a person carry SALMONELLA?
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up to a year
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Salmonella - dx test?
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stool culture
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What's the following indicate?
cramping abdominal pain, nausea, vomiting, diarrhea that may be bloody, fever |
salmonella
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What's the following describe?
chronic inflammatory disease that can affect any area of the alimentary canal from the mouth to the anus |
Crohn's disease
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What's the poss etiology of Crohn's disease?
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autoimmune
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What are dietary risk factors r/t Crohn's? x4
h |
chemical food additive,
refined carbs, low fiber diet, heavy metals |
added to food,
carb related x2, we shouldn't eat it or listen to it |
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Skip lesions - assoc w/?
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Crohn's
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What does the following describe?
normal bowel with diseased segments |
skip lesions r/t Crohn's
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T/F lymph nodes enlarge w/ Crohn's?
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T
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T/F lymph nodes enlarge w/ Ulcerative Colitis?
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Well, it's not on the handout...
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What are 4 initial sym of Crohn's?
h |
"FAMA"
Fever Anorexia Malaise Abd discomfort *Old crones seek fame (FAMA) first, later they only get SNIDE and derogatory Abd discomfort |
Old crones seek fame (FAMA) first, later they only get SNIDE and derogatory
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What are the later sym of Crohn's?
h |
"SNIDE"
Small stools, No blood, pus, or mucous Increased abd pain Diarrhea Endless BMs (frequent) *Old crones seek fame (FAMA) first, later they only get SNIDE and derogatory |
Old crones seek fame (FAMA) first, later they only get SNIDE and derogatory
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Crohn's DIsease, extraintestinal manifestations?
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joint problems,
skin lesions, ocular inflammation, oral ulcers |
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Crohn's Disease, med for watery stools?
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psyllium agents
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Crohn's Disease, 2 meds for frequent stools?
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diphenoxylate,
codeine |
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Crohn's Disease, med for diarrhea from malabsorption of bile salts?
h |
cholestyramine
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No added (bile) salt for Tyra's colon, she's running a high BP
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Crohn's Disease, diet?
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high cal,
high protein |
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Crohm's, what's an area particularly vulnerable to skin breakdown?
How bad is it? |
area around the anus,
excruciating pain |
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What's the following describe?
rectal bleeding and diarrhea, small frequent stools WITH blood, pus, mucous or high volume watery diarrhea |
Ulcerative colitis
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Ulcerative colitis, sym? x2
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rectal bleeding
diarrhea |
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Ulcerative colitis, what kind of diarrhea?
(how often? what's in it? how much of it?) |
freq,
contains blood, pus, mucous, small or high volume & watery |
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Ulcerative colitis, 4 sys manifestations?
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skin lesions,
eye lesions, joint abnormalities, liver disease |
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Crohn's or UC?:
involves any segment of bowel? |
Crohn's
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Crohn's, what part of the bowel is most commonly involved?
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terminal ileum and ascending colon (right-sided)
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Crohn's or UC?:
most commonly in the terminal ileum and ascending colon |
Crohn's
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Crohn's or UC?:
involves colon and rectum only |
UC
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UC, where does is start and progress?
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begins in rectum
proceeds proximally |
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Crohn's or UC?:
begins in rectum and proceeds proximally |
UC
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Crohn's or UC?:
skip lesions |
Crohn's
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Crohn's or UC?:
transmural |
Crohn's
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Crohn's or UC?:
mucosal only |
UC
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Crohn's or UC?:
abd pain |
Crohn's
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Crohn's or UC?:
usu. low volume stools |
Crohn's
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Crohn's or UC?:
non-bloody diarrhea |
Crohn's
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Crohn's or UC?:
rectal bleeding |
UC
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Crohn's or UC?:
pus or mucous in stool |
UC
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Crohn's or UC?:
rake ulcers |
Crohn's
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Crohn's or UC?:
thickening of bowel wall |
Crohn's
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Crohn's or UC?:
friable & edematous bowel mucosa |
UC
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Crohn's or UC?:
GI strictures |
Crohn's
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Crohn's or UC?:
pseudopolyps |
UC
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Crohn's or UC?:
shortening of colon (not short bowel syn) |
UC
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Crohn's or UC?:
Fistulas & abscesses |
Crohn's
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Crohn's or UC?:
anorectal disease |
Crohn's
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Crohn's or UC?:
short bowel syndrome (not shortening of colon) |
Crohn's
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Crohn's or UC?:
toxic megacolon |
UC
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Crohn's or UC?:
perforation poss |
UC
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Crohn's or UC?:
^ risk of colorectal CA |
UC
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What's the big NSG DX for young person r/t Crohn's or UC?
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alteration to body image
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What's another name for a Billroth I procedure?
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gastroduodenostomy
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What's another name for a Billroth II procedure?
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gastrojejunostomy
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What's another name for a gastrodudenostomy procedure?
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Billroth I
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What's another name for a gastrojejunostomy procedure?
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Billroth II
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What's the name of the following procedure?
distal stomach is removed and gastric remnant is anastomosed directly to duodenum |
Billroth I
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What's the name of the following procedure?
distal stomach and proximal duodenum are resected, gastric remnant is anastomosed to jejunum |
Billroth II
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What two conditions in this unit can cause pernicious anemia?
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chronic fundal gastritis (Type A),
total gastrectomy |
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Gastroenteritis, what part of the GI tract does it affect?
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small intestine
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Avoid what foods if pregnant r/t listeriosis?
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raw milk,
deli meat, soft cheese |
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What's the best way to assess a nutritional deficit?
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amount of wt loss
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What's a common sign of hemorrhoids?
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frank bleeding
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Hemorrhoids Rx:
internal? external? |
internal: laser
external: laser and rubber banding |
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Hemorrhoids, 3 things you can do at home to rx?
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1. sitz bath
2. witch hazel compress 3. cat pose |
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