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NP > Adult - GI > Flashcards

Adult - GI Flashcards

1
Q

What conditions are part of the umbrella Peptic Ulcer Disease (PUD)?

A

gastric ulcer

duodenal ulcer

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2
Q

Is PUD more common in men or women?

A

men

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3
Q

Younger adults tend to get which type of ulcer?

A

duodenal

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4
Q

Older adults tend to get which type of ulcer?

> age 55

A

gastric

Geros Get Gastric

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5
Q

Of smoking, alcohol, and diet, which seem to contribute to the development of PUD?

A

smoking

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6
Q

Which medications contribute to the formation of peptic ulcer disease?

A

NSAIDs
ASA
glucocorticoids

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7
Q

What is the typical description of PUD pain?

A

gnawing

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8
Q

Which type of ulcer is relieved by eating?

A

duodenal

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9
Q

Which type of ulcer is aggravated by eating?

A

gastric

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10
Q

What are two potential complications of PUD?

A

GI bleeding

GI perforation

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11
Q

What are signs of bowel perforation?

A

severe epigastric pain
“board like abdomen”
QUIET bowel sounds (ominous)

–> ACUTE ABDOMEN = VERY SERIOUS

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12
Q

What are Xray findings in PUD?

A

free air under diaphragm

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13
Q

When would endoscopy be considered in PUD?

A

After 8 - 12 weeks of treatment

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14
Q

First line pharmacology in PUD

A

H2 receptor antagonist at HS

next step BID

third step PPI

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15
Q

Examples of H2 receptor antagonist

A

ranitidine (Zantac)

famotidine (Pepcid)

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16
Q

Examples of PPI

A

omeprazole (Prilosec)

lansoprazole (Prevacid)

17
Q

What are the 3 leading causes of bowel perforation?

A

ulcer
diverticulitis
appendicitis

18
Q

What are 3 mucosal protective agents?

A

bismuth subsalicylate
misoprostol
antacids - mylanta, maalox, MOM

19
Q

When should mucosal protective agents be given?

A

2 hours apart from other medications

20
Q

What is the only medication used as a prophylaxis against NSAID-induced ulcers?

A

misoprostol (Cytotec)

21
Q

What is a side effect of misoprostol?

A

stimulates uterine contraction and can lead to pregnancy loss (used for chemical abortions)

22
Q

When should PPIs be given?

A

30 minutes before meals

23
Q

When should H2 blockers be given?

A

as scheduled - at HS or BID

24
Q

What is the general pattern for H. pylori eradication options?

A

2 antibiotics and a PPI or Bismuth

25
Q

What is in the MOC for H. pylori eradication?

A

metronidazole (Flagyl)
omeprazole (Prilosec)
clarithromycin (Biaxin)

26
Q

What is in the AOC option for H. pylori eradication?

A

amoxicillin (Amoxil)
omeprazole (Prilosec)
clarithromycin (Biaxin)

27
Q

What is in the MOA for H. pylori eradication?

A

metronidazole (Flagyl)
omeprazole (Prilosec)
amoxicillin (Amoxil)

28
Q

What treatment follows H. pylori eradication therapy?

A

up to 2 months of “step-down therapy” with a PPI or H2 blocker

29
Q

What is patient at risk for when d/c’ing PPI?

A

rebound GERD

30
Q

What is the typical description of GERD pain?

A

burning or churning

vs. gnawing of PUD

31
Q

Other than burning or churning, what are signs and symptoms of GERD?

A

bitter taste in mouth
belching
hiccups

32
Q

What is a common complaint of GERD in the elderly?

A

dysphagia

r/o esophageal tumor

33
Q

What time of day does GERD frequently occur?

A

at night, after a large meal, in recumbent position

34
Q

What is a concern of long-standing GERD?

A

progression to Barrett’s esophagus

which can lead to esophageal cancer

35
Q

What are four steps of therapy options in GERD?

A

antacids
H2 blockers
PPI if H2 ineffective
GI/surgical consult

36
Q

When are diagnostics indicated in gastroenteritis?

A

not indicated unless symptoms persist > 72 hours or if blood is noted in stool

37
Q

What diagnostics are used in gastroenteritis?

A

stool for culture, WBCs, and O & P

38
Q

What medication can be used for traveler’s diarrhea prophylaxis?

A

bismuth salicylate

NP (76 decks)

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