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30 Cards in this Set
- Front
- Back
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246. Tx of IBS?
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a. Usually, no specific tx is necessary.
b. Manage diarrhea/constipation sx as indicated below. c. These may help: Avoidance of dairy, avoid excessive caffeine |
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247. Drug specifically indicated for tx of IBS?
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a. Tegaserod maleate (Zelnorm).
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248. MOA of Tegaserod maleate (Zelnorm)?
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a. It is a serotonin agonist recently introduced for the treatment of IBS.
b. In a short-term study, it improved abdominal pain, bloating, and constipation in Women. |
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249. Tx of diarrhea associated w/IBS (2)?
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a. Diphenoxylate, loperamide
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250. Tx of constipation associated with IBS (3)?
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a. Colace
b. Psyllium c. Cisapride |
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251. What features must frequently be excluded in the diagnosis of IBS?
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a. Obstruction (plain abdominal films)
b. IBD c. Lactose or sorbitol intolerance d. Malignancy (in older pts or those w/family hx)- colonoscopy, occult blood in stools. |
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252. 2 most common causes of N/V?
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1. Viral gastroenteritis
2. Food poisoning. |
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253. 5 metabolic causes of N/V?
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a. Diabetic ketoacidosis
b. Addisonian crisis c. Uremia d. Electrolyte disturbance- Hypercalcemia, hypokalemia e. Hyperthyroidism |
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254. GI causes of N/V?
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a. Gastroenteritis
1. Viral (most common) 2. Food poisoning (e.g., salmonella, shigella) 3. Cholera b. PUD c. GERD d. Gastric retention – Gastroparesis (diabetic pts), gastric outlet obstruction. e. Intestinal obstruction (small bowel obstruction, or pseudo-obstruction), ileus f. Peritonitis |
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255. Acute visceral conditions causing N/V?
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a. Pancreatitis
b. Appendicitis c. Pyelonephritis d. Cholecystitis e. Cholangitis |
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256. Neurologic causes of N/V?
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a. Increased ICP
b. Vestibular disturbance (vertigo) c. Migraine HA. |
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257. Cardiac cause of N/V?
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a. Acute MI
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258. Drug cause of N/V?
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a. Chemo meds (cisplatin especially)!
b. Digitalis toxicity c. NSAIDs, aspirin d. Narcotics Abx (erythromycin) |
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259. Misc causes of N/V?
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a. Excessive ETOH intake (after binge drinking and morning-after hangover).
b. Motion sickness c. Systemic illness d. Radiation therapy e. Postop |
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260. Psych causes of N/V?
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a. Eating disorder
b. Anxiety |
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261. Bilious vomiting, think of?
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a. Obstruction distal to ampula of Vatar
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262. Feculent vomiting, think of?
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a. Distal intestinal obstruction
b. Bacterial overgrowth c. Gastrocolic fistula. |
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263. Vomiting of undigested food?
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a. Oesophageal problem more likely (achalasia, stricture, diverticulum
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264. Projectile vomiting?
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a. Increased intracranial pressure or pyloric stenosis
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265. Coffee-ground vomiting or blood?
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a. GI bleeding.
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266. What does diarrhea and fever as accompanying symptoms with N/V suggest?
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a. Infectious cause (gastroenteritis)
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267. Abdominal pain accompanying N/V suggests?
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a. Obstruction
b. Acute inflammatory conditions (e.g., peritonitis, cholecystitis). |
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268. What do HA, visual disturbances, and other neurologic findings along w/N/V point to?
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a. Increased ICP or Intraocular pressure.
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269. Note: Be sure to always order a pregnancy test in any woman of child-bearing age w/n/v?
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269. Note: Be sure to always order a pregnancy test in any woman of child-bearing age w/n/v?
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270. Tx of N/V?
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a. Most causes are self-limiting.
b. If vomiting is severe it may cause dehydration requiring hospitalization. c. Assess hydration status- Fluid replacement is the first step in management; use ½ NS with potassium replacement. |
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271. Rx Symptomatic relief of N/V?
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a. Prochloroperazine (Compazine) and Promethazine (Phenergan) are commonly used.
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272. Symptomatic relief of N/V?
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a. Follow a liquid diet (liquid is cleared from the stomach more quickly than solids).
b. Avoid large meals and fatty meals. c. Nasogastric suction may improve symptoms. |
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273. Possible complications of severe of prolonged or prolonged vomiting?
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a. Fluid/electrolyte:
1. Dehydration 2. Metabolic alkalosis 3. Hypokalemia b. Dental caries c. Aspiration pneumonitis |
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274. GI complications of severe or prolonged vomiting?
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a. Mallory-Weiss tears
b. Boerhaave’s syndrome c. Mallory-Weiss syndrome. |
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275. Most common abnormality seen after severe vomiting?
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a. Hypokalemia w/metabolic alkalosis.
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