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113 Cards in this Set
- Front
- Back
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s/s of a GI tract disorder (6)
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-anorexia -vomiting -diarrhea -constipation -abdominal pain -GI bleeding |
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occult definition
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-hidden |
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metabolic acidosis GI cause
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-diarrhea
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metabolic alkalosis GI cause
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-vomiting
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major side effect of losing potassium
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heart problems |
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dysphagia definition, s/s, diagnosis, treatment |
-trouble swallowing -pain, difficulty swallowing, vomiting, weight loss, aspiration pneumonia -barium swallow, endoscopy -stent, mechanical dilation, drugs to increase peristalsis |
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mechanical obstructions |
-extrinsic |
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intrinsic
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ex: scleroderma, stricture |
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extrinsic
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ex: tumor |
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functional obstruction |
-involves nerve function ex: stroke, ALS |
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gastrointestinal reflux disease (GERD) s/s, diagnosis, treatment |
-heartburn, dysphagia, regurgitation, discomfort swallowing certain foods (acidic, alcohol) -causes esophagitis and possible cancer -barium swallow, endoscopy -proton pump inhibitor |
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hiatal hernia types (2)
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-paraesophageal |
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hiatal hernia definition, s/s, diagnosis, treatment |
-causes gerd due to delayed stomach emptying -gerd, dysphagia, heartburn, discomfort -barium swallow, endoscopy -caused by weakened diaphragmatic muscles -careful food choices, don't eat then lie down, if severe enough may have surgery |
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where are hiatal hernias located?
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-large intestine -small intestine |
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what causes hiatal hernias?
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-injury or damage weakening muscle -old surgery site -obstructions may be partial or complete |
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intussusception
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-telescoping of one part of intestine into another -causes strangulation of blood supply -more common in infants 10-15 months |
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volvulus
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-twisting of intestine on it mesenteric pedicle -often includes fibrous adhesions -causes occlusion of blood supply -most common in middle aged/ elderly men |
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adhesions
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-peritoneal irritation from surgery, trauma, or crohn disease -attach to intestine, omentum, or peritoneum -cause obstruction -most common in small intestine |
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functional obstruction
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-drug side effect -paralyticilius |
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hernia
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-protrusion of intestine through weakness in abdominal muscles or inguinal rings
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common hernia locations
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-umbilical -inguinal (most common) -femoral -surgery sites |
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pyloric obstruction s/s |
-impairs gastric emptying -anorexia, nausea, vomiting, abdominal distention, dehydration |
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why does pyloric obstruction cause metabolic alkalosis? diagnosis treatment |
-scope -treatment, correct problem ex: surgery |
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s/s of intestinal obstruction
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-intermittent pain -distention -change in bowel sounds (high pitched) -absence of stool |
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intestinal obstruction diagnosis treatment |
-scope -surgical |
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acute gastritis
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-inflammation of stomach lining due to disruption of mucosal barrier -superficial erosion -self limiting (goes away within a few days of stimulus being removed |
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acute gastritis causes
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-drugs or chemicals (especial NSAIDS, aspirin, alcohol) -food contaminated with salmonella, e. coli, staph |
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chronic gastritis
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-unrelated to acute gastritis -thinning and degeneration with atrophy -increases risk of gastric cancer -more common in elderly and those with ulcers |
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chromic gastritis types (3) |
-H. Pylori -chemical gastropathy |
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s/s of acute gastritis
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-abdominal pain -epigastric tenderness -anorexia -nausea -vomiting -hematemesis (bloody puke) -melena (bloody stool) |
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s/s of chronic gastritis |
-may be no symptoms -sudden onset of gastric bleeding |
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peptic ulcer disease- location layers affected most common risk factors |
-affects mucosa and submucosa -duodenal are most common (esp. in men) -smoking, H. Pylori, NSAIDS, aspirin, alcohol, stress |
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ulcers- patho |
-hyperscretion of HCL acid and pepsin -decrease in bicarb -penetrates mucosal barrier |
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gastric ulcers
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-increases risk for gastric cancer |
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-caused by severe stress to body ex: ischemia to stomach -primary symptom is vomiting blood |
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s/s of ulcers
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-pain beginning when stomach is empty and relived when stomach is full -hematemesis -melena -periods of remission and exacerbation (bright red bleeding, no complaints of pain) |
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diagnosis of ulcers treatment |
-identify H. Pylori -antacids, ulcer coating drug- Carfate, suppress acid secretion, antihistamine, antibiotics |
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dumping syndrome
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-nausea, vomiting, cramps, diarrhea, weakness, pallor, diaphoresis -rapid transfer of fluid from vascular system to digestive system -treatment includes limiting fluids, no fluid with meals, small meals |
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malabsorption syndromes (2)
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-pancreatic insufficiency -lactase insufficiency |
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pancreatic insufficiency
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-pancreatitis, pancreatic cancer -weight loss, decreased muscle mass, fatty stool |
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lactase insufficiency (lactose intolerance) |
-inhibits break down of lactose 3 F's -fatty, frothy, foul smelling |
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bile salt insufficiency involves:
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-vitamin A (night blindness) -vitamin D (bone pain) -vitamin K (prevent bleeding) -vitamin E (neuro deficits in kids) (fat soluble vitamins) |
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bile salt insufficiency causes: treatment: |
-oral bile salts, IV replacement |
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ulcerative colitis vs crohns disease similarities |
-periods of remission and exacerbation -stress increases s/s -diarrhea big symptom -effects men and woman equally -weightloss |
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crohns disease
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-affects large and small intestine -begins in submucosa and spreads to entire wall -turns fibrous -inflammatory lesions are not continuous "skip lesions", cobble stone appearance -granuloma formation -ascending (right side) |
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ulcerative colitis
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-ulceration of colonic mucosa layer only -mucosa appears dark red and velvety -narrowed lumen -located in rectum and sigmoid colon -diarrhea and bloody stools - descending (left sided) -continuous lesions |
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diagnosis and treatment of crohns and ulcerative colitis
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-colonoscopy, barium enema -broad spectrum antibiotics, steroids, surgery |
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diverticular disease cause, diagnosis, treatment |
-resembles hernia in sigmoid colon -caused by low fiber diets -sigmoidoscopy -increase fiber, antibiotics, possible surgery -may perforate bowel if left untreated |
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s/s of diverticular disease
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-diarrhea -constipation -distension -flatulence -abscess formation -fever -leukocytosis |
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appendicitis cause, diagnosis, treatment |
-inflamed appendix -cause is unknown -may perforate (emergency) -diagnosed by WBC count, CAT scan -treatment involves surgery |
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s/s of appendicitis
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-vague epigastric pain -R lower quadrant pain -rebound tenderness -nausea and vomiting -fever -diarrhea |
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colitis |
-can be acquired through contaminated food and water |
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infectious colitis cause, s/s, treatment |
-C. Diff -caused by antibiotics -diarrhea, horrible odor, usually no systemic manifestations -discontinue antibiotic, start fragile |
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irritable bowel syndrome s/s, diagnosis, treatment |
-more common in women -constipation alternating with diarrhea, anxiety, depression, gas, bloating, nausea -rule out all other diseases -antispasmodic medications, add fiber to diet |
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liver disease
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-portal hypertension causing: 1. esophageal varices (bumps lining esophagus) 2. splenomegaly (increased pressure in splenic vein) 3. jaundice 4. ascites 5. hepatic encephalopathy |
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ascites
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- due to increased pressure in portal vein -fluid goes into peritoneal cavity -most common cause is cirrhosis -weight gain -perisentesis |
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hepatic encephalopathy
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-caused by accumulation of ammonia -causes brain damage |
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hepatitis
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-differ in transmission, incubation period, and damage caused to liver (acute/ chronic) -destroys hepatocytes during inflammation -serologic markers used to diagnose |
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Hepatitis A
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-30 day incubation period -acute -get vaccine |
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Hepatitis B
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-60-180 day incubation period -chronic -predisposed to liver cancer and cirrhosis |
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Hepatitis C
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-perinatal, sexual -35-60 day incubation period -chronic |
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liver enzymes |
-ATL alanine aminotransferase -LDH lactic dehydrogenase -ALP alkaline phosphate elevate with damage |
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phases of hepatitis
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-icteric (jaundice) -posticteric or recovery (liver enzymes become normal) |
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s/s of hepatitis preicteric
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-malaise, fatigue -nausea and vomiting -anorexia -diarrhea -pain |
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s/s of hepatitis icteric
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-pruritis -light colored stools -dark urine -increased flu s/s followed by decrease |
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cirrhosis
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-excessive collagen formation -obstructs biliary and vascular channels -forms over many years (Laennec, alcoholism) -diagnosed off of liver enzymes -no alcohol, treat symptoms |
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s/s of cirrhosis
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-anorexia -nausea -jaundice -ascites -firm, large, palpable liver |
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cholelithiasis
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-gall stones made of bile pigments and hardened cholesterol -most common |
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cholecystitis s/s diagnosis treatment |
-pain, heartburn, fat intolerance, jaundice, nausea, vomiting -leukocytosis, elevated serum amylase 25-125 -removal of organ |
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pancreatitis
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-enzymes become activated while still inside pancreas -alcohol use causes chronic |
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s/s of pancreatitis
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-pain radiating to back -nausea and vomiting -jaundice -abdominal distension -decreased bowel sounds |
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diagnosis of pancreatitis treatment |
-elevated serum amylase -elevated serum lipase 20-180 -elevated to WBC treatment includes hospitalization |
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esophageal cancer causes, diagnosis, treatment |
-painless, dysphagia, pain on swallowing -early metastasis, rapid growth -endoscopy -remove tumor and local lymph nodes |
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stomach cancer causes, diagnosis, treatment |
-anorexia, weightloss (s/s) -early metastasis, rapid growth -endoscopy -chemo, radiation, surgery, nothing |
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colon and rectal cancer causes, diagnosis, treatment |
-high fat, low fiber diet, polyps, diverticulitis -change in bowel habits, pain, melena, anorexia, weightloss -screen for occult blood -chemo, radiation, surgery, nothing |
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liver cancer causes, diagnosis, treatment |
-nausea, vomiting, anorexia, pain, fullness, ascites, jaundice -gallbladder primary cancer is rare |
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pancreatic cancer
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-early metastasis |
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hormones of anterior pituitary
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-growth hormone -prolactin -thyrotropic hormone -ACTH -FSH -LH |
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diabetes insipidus vs SIADH |
-diabetes insipidus too little ADH -usually caused by tumor or head injury -SIADH too much ADH -osmolality regulates amount of ADH released |
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s/s of diabetes insipidus |
-nocturia -dehydration -hypernatremia -low urine specific gravity -extreme thirst |
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test
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-water deprivation test -keep urinating continuously |
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treatment
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-replace ADH |
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s/s of SIADH
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-water retention -no edema -neurologic impairment -decreased urine output -elevated urine specific gravity |
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treatment
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-treat underlying cause -may give diuretic |
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growth hormone disorders
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-excess causes giantism before puberty -excess after puberty causes acromegaly |
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giantism
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-too much growth hormone before puberty -pituitary tumor -remove tumor -give drugs to reduce growth hormone |
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acromegaly
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-pituitary tumor -remove tumor -drugs to reduce growth hormone |
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thyroid disorders
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-iodine needed for synthesis of hormones -thyroid regulates metabolic rate -diagnosed by blood test of t3 and t4 levels -goiter is enlargement of thyroid gland |
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hyperthyroidism causes treatment |
-thyroid cancer -toxic multinodular goiter -increased levels of TSH -remove thyroid and replacement meds -autoimmune disorder |
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hyperthyroidism s/s
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-flushed, warm -fine hair -increased appetite -weight loss -nausea -vomiting -diarrhea -tachycardia -restlessness -short attention span -insomnia |
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s/s |
-hyperthermia -tachycardia -systolic hypertension -vomiting -diarrhea -agitation -tremors -confusion -psychosis -delirium -seizures -death |
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hypothyroidism
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-caused by tumors and hormones -hashimotos disease (auto immune) -treatment includes meds |
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mixedema coma |
-life threatening -treatment is IV thyroid hormone replacement |
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s/s of hypothyroidism
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-dry, brittle hair -poor wound healing -fluid retention -decreased appetite -weight gain -constipation -bradycardia -confusion -memory loss -depression |
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parathyroid function
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-regulate secretion of serum levels of calcium -calcium levels are increased by fall in PTH |
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sources of calcium |
-intestines -kidneys -phosphate excretion -PTH excretion -vitamin D -strong bones, heart function, nerve transmission, blood clotting |
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hyperparathyroidism |
-too much PTH PTH secreting tumor of lung adenoma of parathyroid gland -secondary: chronic renal failure |
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hyperparathyroidism s/s
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-nausea -vomiting -dehydration -muscle weakness -bone pain -renal caliculi -cardiac dysrhythmias -abdominal pain -constipation -deposits of calcium into soft tissue |
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hyperparathyroidism diagnosis and treatment |
-diuretics, calcitonin (causes renal excretion of calcium) |
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hypoparathyroidism causes |
-accidental removal or injury -possible autoimmune origin |
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s/s, diagnosis, treatment |
-laryngospasm -muscle spasms, nerve excitement -hyperreflexes -seizures -may progress to death -test levels -IV calcium |
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diabetes mellitus
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-involves alpha and beta cells -alpha cells create glucagon -beta cells produce insulin -leading risk factor for CVA, MI, amputation, blindness, kidney disease, coronary artery disease, etc -without insulin protein and fat used for energy |
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type 1 diabetes
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-result of genetic/ environmental agents -beta cells being destroyed -no insulin production -sudden onset, long preclinical period |
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type 2 diabetes
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-NIDDM accounts for 85-90% of diabetics -age range 40 and older -risk factors include family history, obesity -metabolic syndrome: raised triglycerides, raised fasting blood glucose -insulin resistance |
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gestational diabetes
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-risk factors include large baby, obesity, family history -screening done -increases risk of type 2 diabetes |
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s/s of diabetes |
-polydipsia -polyphasia -weight loss -malaise -fatigue -glycosuria -dehydration -recurrent infections -blurred vision -paresthesia -genital pruritis -increased blood glucose, increased renal blood flow, increased urine output |
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diabetes diagnosis
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-glucose tolerance test -random blood glucose -glycosated hemoglobin (most accurate) -fasting sugar of 100-125 is prediabetic |
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medical treatment for type 1 diabetes
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-life long insulin replacement -dietary management -exercise -SMBG |
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medical treatment type 2 diabetes
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-oral hypoglycemic agents -dietary management -exercise |
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acute complications of diabetes
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-diabetic ketoacidosis -hyperosmolar hyperglycemic nonketotic syndrome -somogi effect -dawn phenomenon |
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diabetic ketoacidosis |
-body begins breaking down fats and proteins -fatty acids released, ketones form, causing metabolic acidosis -decreased fluid volume -decreased potassium |
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s/s of diabetic ketoacidosis
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-blood glucose over 250 -correct imbalance, insulin IV |
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