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Sinclair Paramedic 2150 > 11- GI And GU > Flashcards

11- GI And GU Flashcards

1
Q

Define Digestion

A

Breaking down of large food particles into molecules

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2
Q

Define absorption

A

Passage of molecules into blood and lymph

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3
Q

Alimentary Canal parts (GI Tract) (7)

A
  • Mouth
  • Pharynx
  • Esophagus
  • Stomach
  • Small intestine
  • Large intestine
  • Anus
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4
Q

Accessory Organ parts (GI Tract) (6)

A

-Teeth
-Tongue
-Salivary glands
-Liver
Gall bladder
-Pancreas

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5
Q

What 2 reasons are food important

A

Nutrients- Building and repairing damaged tissues

Energy- Glucose (food)+O2=Energy

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6
Q

What are Gastoenterologists

A

Work on the Upper GI Tract

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7
Q

What are Proctologist’s

A

Work on the Lower GI Tract

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8
Q

Process of Digestion (6)

A
  1. Ingestion
  2. Secretion
  3. Mixing propulsion
  4. Mechanical and Chemical digestion
  5. Absorption
  6. Defecation
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9
Q

Mechanical digestion types (3)

A
  • Mastication (chewing)
  • Peristalsis (contraction and relaxation)
  • Churning (stomach and small intestine)
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10
Q

Chemical digestion types (2)

A
  • Series of catabolic reactions

- Bigger molecules break down into smaller molecules

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11
Q

Layers of GI tract (Outer to Inner)

A 
Mesentary
Serosa 
Muscularis
Submucosa
Mucosa
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12
Q

Role of the Peritoneum

A

Protect and encase organs

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13
Q

Role of the salivary glands (2)

A

Produce saliva

Start digestion

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14
Q

What system controls salivation

A

Autonomic nervous system

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15
Q

What drug blocks salivation

A

Atropine

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16
Q

Functions of the Esophagus

A

Pass food bolus to stomach by peristalsis

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17
Q

What controls esophageal peristalsis

A

Medulla Oblongata

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18
Q

How long does it take food to reach the stomach

A

4-8 seconds

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19
Q

Functions of the stomach (4)

A
  • Mixing and holding food
  • Begin protein digestion
  • Continue triglyceride digestion
  • Convert food bolus to chyme
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20
Q

Vomiting aka Emesiss

A

Forcible expulsion of Upper GI contents

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21
Q

What 2 things stimulate emesis

A
  • Irritation and distention of stomach

- Unpleasant nerve impulses

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22
Q

What is a main function of the liver

A

Produce bile

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23
Q

What are the 2 functions of Bile

A
  • Decrease surface tension of fat

- Mies fat to increase surface area

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24
Q

Function of the Gall Bladder

A

Stores and concentrates bile

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25
Q

What are 2 stool colors

A

Melena- Black (slow)

Hematochezia- Red (rapid)

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26
Q

What constitutes a positive tilt test

A

20 bpm increase

10 BP decrease

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27
Q

Ominous GI assessment findings

A
  • Abdominal distention
  • Cullens sign
  • Grey-Turners sign
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28
Q

General GI Treatment (2)

A
  • Position of comfort

- Manage pain/Nv

29
Q

What is the drug of choice for abdominal pain

A

Meperidine (Demerol)

30
Q

What are the 3 types of GI pain

A

Visceral
Somatic
Referred

31
Q

What is Visceral pain and organ type

A
  • Dull, not localized
  • Hollow organs
  • Ruptured hollow organs cause peritonitis
32
Q

What is Somatic pain and organ type

A
  • Sharp, localized
  • Solid organs
  • Ruptured solid organs cause bleeding
33
Q

What is Referred pain

A

Pain that travels from the site of origin usually following peripheral nerves

34
Q

What separates the Upper from Lower GI

A

Ligament of Treitz

35
Q

Common causes of Upper GI bleeds

A

Esophageal vacancies
Gastroenteritis
Peptic Ulcers

36
Q

Common causes of Lower GI bleeds

A 
Colitis
Chrons Disease
Diverticulitis
Hemorrhoids
Bowel obstruction
37
Q

What are peptic ulcers

A

Erosions caused by gastric acid

38
Q

What is Gatritis

A

Pre-ulcerative state, stomach is inflamed, erosion has not yet occurred

39
Q

What are the 2 types of Peptic Ulcers

A

Gastric

Duodenal

40
Q

Gastric Ulcer

S/S

A

S/S

  • LUQ pain
  • Over 50 y/o
  • Pain AFTER eating or AFTER physical activity
41
Q

Duodenal Ulcer

S/S

A

S/S

  • LUQ pain
  • 25 to 50 y/o
  • Stomach pain RELIEVED by eating
  • Pain can be caused by stress
42
Q

What is a Peptic Ulcer and main causes (

A

Ulcers created due to erosion of stomach, esophagus or duodenum from excess gastric acid

Causes

  • Helicobacter Pylori bacteria
  • Chronic NSAID use
  • Severe burns
  • Trauma
43
Q

What are Curlings ulcers

A

Ulcers as a result stress related to burns

44
Q

What are Cushings ulcers

A

Ulcers caused by head injuries or brain tumors

45
Q 
Acute Gastroenteritis
Explain
S/S
Causes
Treatment
A

Inflammation of the stomach and intestines

S/S- Rapid onset N/v, Fever, Diarrhea, Diffuse pain

Causes- Food allergies, Viruses, Bacteria, Parasites, Alcohol, Tobacco, NSAIDs

Treatment

  • Antiemetics
  • (Ortho)Vitals
  • ECG
  • Fluids if needed
46
Q 
Esophageal Varices 
Explain
S/S
Causes
Treatment
A

Pressure increase in blood vessels of esophagus and stomach

S/S- Upper GI bleed, Fatigue, Weight loss, Jaundice, other abd s/s, Chest pain

Causes- Portal HTN, Caustic ingestion, Hep C

Treatment

  • ABC’s
  • Suction
  • Shock management
47
Q

Mallory-Weiss Tear
S/S
Cause
Treatment

A

PARTIAL tear at the junction of the esophagus and stomach

S/S- Bleeding, epigastric pain, hematemesis, Melena

Cause- Prolonged vomiting causes severe increase in stomach pressure

Treatment
-Estimate blood loss

48
Q

Boerhaave Syndrome
S/S
Cause
Treatment

A

Complete latitudinal tear through wall of esophagus, usually after large meal with alcohol consumption

S/S- SubCu emphysema, Resp distress, chest pain, fever

Cause-Forceful vomiting

Treatment

  • Determine blood loss
  • Auscultation
  • Treat chest pain
49
Q

Diverticulitis
S/S
Causes
Treatment

A

Inflammation of small pockets of the GI Tract

S/S- LLQ pain, Fever, Body Aches, N/v, Lower GI bleeding

Causes- Infection, Trapped food

Treatment

  • Patient comfort
  • Manage sepsis
  • Supportive
50
Q

Ulcerative Colitis
S/S
Causes
Treatment

A

Inflammation of the large intestine (colon), generalized, not in patches, damaging the lining

S/S- Lower quadrant cramp/spasm, Rectal mucous discharge, Rectal fullness (tenesmus)

Causes-Genetics, stress

Treatment

  • Assess for shock
  • Supportive
51
Q

Hemorrhoids
S/S
Causes
Treatment

A

Swelling and inflammation of the vascular cushions surrounding the rectum, can result in lower GI bleeding, can be internal or external

S/S- Bright red blood with defecation, Itching, Small mass on rectum

Causes- Increased rectal pressure or Irritation, Straining stools, Chronic constipation, Anal sex, Diarrhea

Treatment

  • Supportive
  • Ensure hemodynamic stability
  • Ortho static vitals
52
Q

Appendicitis
Causes
S/S (3 stages)
Treatment

A

Inflammation of the veriform appendix from obstruction, usually in older kids or young adults, rupture can cause peritonitis

Causes- Fecal matter or other material accumulate in appendix

S/S
Early-Periumbilical pain, N/v, Loss of appetite
Ripe-McBurney point pain
Rupture-Decrease in pain/pressure, Rebound Tenderness

Treatment

  • Assess for Septicemia/Septic Shock
  • Fluid/Vasopressors as needed
  • Manage pain and vomiting
53
Q

Cholecystitis (+4 similar conditions)
Causes
S/S
Treatment

A

Inflammation of the Gall bladder

  • Cholangitis; Bile duct
  • Cholelithiaseis; Stones in gallbladder
  • Choledocholithiases; Stone in common bile duct
  • Acalculous Cholecystitis; Gall bladder inflammation w/o gallstone(s)

Causes-Decreased flow of biliary materials from Major Trauma, Sepsis, Sickle Cell, Prolonged fasting

S/S- RUQ PAIN AFTER FATTY/FRIED MEAL, Murphy Sign (Exhale, pressure intercostal RUQ, Inhale=Pain), N/v, Fever, JAUNDICE

Treatment

  • Supportive
  • Watch for vagal stimulation
  • Manage pain, N/v
54
Q

Pancreatitis
Causes
S/S
Treatment

A

Blocked tube that carries food breakdown enzymes, and they breakdown pancreas itself, causing inflammation

Causes- Excess alcohol, Medication reactions, Trauma, Cancer, High Triglycerides

S/S- Sharp/Severe epigastric pain, Distention, N/v, Fever, HypoT, Muscle spasms, Shock, Resp failure, Cullen Sign, Grey Turners sign

Treatment

  • Assess for severe hemorrhage
  • Treat for shock
  • Watch and treat for respiratory failure
55
Q

Hepatitis (A,B)
Causes (A,B,C,D,E)
S/S
Treatment

A

Inflammation or Viral infection of the liver
A- Enters liver, reproduces, leaves with feces, antibodies develop, immune for life
B- Highest fatality rate of Hep type, Greatest Hep risk to health care

Causes-
A- Fecal to Oral
B- Injections or sexual contact
C- Through blood and bodily fluids
D- Type B first
E- Contaminated drinking water

S/S- JAUNDICE, Clay colored skin, Fever, N/v, Weak, Muscle pain, Dull RUQ tenderness, JVD, Ascites, Hepatomegaly

56
Q

4 causes of Bowel Obstruction

A
  • Hernia- Through abd wall
  • Adhesion- Weblike bands of tissue (adhesions) contract diameter of intestine
  • Intussusception- Intestine folds into itself reducing the lumen
  • Volvulus- Torsion/knot of the intestine
57
Q

Bowel obstruction
Causes
S/S
Treatment

A

Intestinal blockage inhibiting movement of contents in the intestine

Causes- Tumors, foreign body, previous surgery

S/S- VOMITING BOWEL, Absent bowel sounds, Abdominal distention, Feculent smelling breath, Diffuse pain, Shock

Treatment

  • Supportive
  • Fluids for dehydration
58
Q

Anatomy of the urinary system (4)

A
  • Kidneys
  • Ureters
  • Urinary bladder
  • Urethra
59
Q

Kidney filtration/Nephron steps (7)

A
  • Afferent arteriole bings blood to Glomerulus
  • Filtrates move to Bowmans capsule
  • Travel down convoluted tubule
  • Filtrate moves to descending loop of Henle into medulla (Water removal)
  • Ascending loop of Henle and out of medulla (Na removal)
  • Distal convoluted tubal, last big filtrates are removed
  • Collecting ducts where last of water is removed
60
Q

What is the cause of most renal emergencies

A

Changes in Glomerular Filtration Rate (GFR)

61
Q

What do diuretics do

A

Make the medulla very salty

62
Q

Renal Calculi
Causes
S/S
Treatment

A

Crystallized urinary salts held together by organic matter, form in urinary tract

Causes-HTN, UTI, Immobilization, HyperCa, Gout, Tumors

S/S- Moving pain from flank to groin, Worst pain ever, Painful/Frequent urination, Hematuria, Shock looking, TachyC, HyperT

Treatment

  • ABC’s
  • POC
  • IV/Fluid
  • Pain meds (Meperidine, Morphine)
63
Q

Urinary Tract Infection (UTI)
Causes
S/S
Treatment

A

Normal flora bacteria enter urethra and grown, usually in sexually active females, can cause kidney infection (Pyelonephritis)

Causes- Listed above

S/S
Triad)1.PAINFUL urination, 2.FREQUENT urination, 3.DIFFICULTY urinating
Foul smelling urine, Restless, Changes in VS

Treatment

  • ABC’s
  • IV
  • Consider analgesics
64
Q

Acute Renal Failure
Causes
S/S
Treatment

A

Sudden decrease in filtration rate of glomeruli, and toxins accumulate

Causes- Reduced renal blood flow, Hypovolemia, Diabetes, Rhabdomyolysis, Chronic inflammation of interstitial nephron cells, Urine flow obstruction from kidneys

S/S- Impaired mentation, Edema, HyperK ecg, Shock like,

65
Q

Urinary Rentention
Causes
S/S
Treatment

A

Inability to urinate

Causes: Benign prostate hypertrophy, Renal calculus, Narrowed ureter

S/S: Abd pain, Inability to urinate, Oliguria

Treatment: Supportive

66
Q

Pyelonephritis
Causes
S/S
Treatment

A

Inflamed kidney parenchyma from microbial infection
(More common in women, pts w/ obstructive lesions along GI tract)

S/S: Flank pain, Fever, Chills, N/V

Treatment: Supportive, watch for sepsis

67
Q

Chronic Renal Failure
Causes
S/S
Treatment

A

Permanent loss of nephrons, Irreversible

Causes: Congenital, Prolonged pyelonephritis, Diabetes, Hypertension

S/S: Uremic frost, Delirium, Muscle twitching, Thin extremities, GI problems, Altered LOC, Abnormal ABG’s

Treatment: IV kvo, ABC’s, Monitor, Vitals

68
Q

Disequilibrium Syndrome (From Dialysis)
S/S
Treatment

A

Group of signs during or after dialysis

S/S: Usually mild can be severe

Treatment: Diazepam for seizures

69
Q 
Air Embolism (From Dialysis)
Treatment
A

Negative pressure on venous side of tubing or malfunction can allow air embolism into blood stream

Treatment: High flow O2, Left lateral (Modified trendelenburg)

Sinclair Paramedic 2150 (16 decks)

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