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NP > Adult - GI II > Flashcards

Adult - GI II Flashcards

1
Q

inflammation or localized perforation of diverticula with abcess formation

A

diverticulitis

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2
Q

diverticulitis - more common in men or women

A

women

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3
Q

Typical location of pain of diverticulitis?

A

LLQ

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4
Q

Signs and symptoms of diverticulitis? (3)

A

LLQ pain
low grade fever
nausea, vomiting
constipation or loose stools

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5
Q

What is a potentially significant complication of diverticulitis?

A

bowel perforation –> peritonitis –> acute abdomen

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6
Q

What test rules out perforation of the bowel?

A

plain abdominal films

+ for perforation if free air under diapragm

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7
Q

What might lab work show in diverticulitis?

A

leukocytosis

elevated ESR

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8
Q

Management of diverticulitis (2)

A

patient may be NPO

may refer to GI

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9
Q

What is the cause of irritable bowel syndrome?

A

etiology is unknown but there is a stress theory

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10
Q

Irritable bowel syndrome - more common in men or women

A

women

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11
Q

What are the signs and symptoms of irritable bowel syndrome? (4)

A

abdominal cramping relieved by defecation
preoccupation with symptoms
fatigue
anxiety or depression

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12
Q

Management of irritable bowel syndrome (3)

A

emotional support
high fiber diet
SSRIs

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13
Q

What can be used in severe cases of irritable bowel syndrome? (2)

A

anticholinergics

antidiarrheals

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14
Q

what often precipitates cholecystitis?

A

a large or fatty meal

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15
Q

What is the typical pain of cholecystitis?

A

steady, severe pain in RUQ

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16
Q

What is classic SIGN for cholecystitis?

A

Murphy’s sign - pain on INspiration when fingers placed under the R rib cage

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17
Q

What is the gold standard for cholecystitis evaluation?

A

ultrasound

18
Q

What is the management for cholecystitis? (6)

A 
Refer for:
pain management
NG tube for gastric decompression
IV crystalloids
broad spectrum ABT
GI and surgical consult
19
Q

Possible causes of bowel obstruction (6)

A 
tumor
hernia
fecal impaction
adhesions
volvulus - in children - twisting/malrotation of bowel
ileus (functional obstruction)
20
Q

Vomiting with minutes of pain indicates what about the location of the obstruction?

A

proximal location

21
Q

More marked distention indicates what about the location of the obstruction?

A

distal location

22
Q

Bowel sounds of obstruction?

A

high-pitched tinkling…going around the obstruction

23
Q

Bowel sounds of perforation?

A

quiet….ominous

24
Q

Patient with obstruction will tell you what about their stool or gas?

A

“unable to even pass gas”

25
Q

What will plain abdominal films show in obstruction?

A

dilated loops of bowel
and
air-fluid levels

26
Q

What does management include in obstruction? (5)

A 
Refer for:
NG tube
broad spectrum ABT
fluid resuscitation
GI - surgical consult
27
Q

What is hallmark symptom of ulcerative colitis?

A

bloody diarrhea

28
Q

What test establishes the diagnosis of ulcerative colitis?

A

sigmoidoscopy

29
Q

What factors are associated with increased risk of colon cancer?

A 
family history of colon cancer or other adenocarcinomas
inflammatory bowel disease
polyps
high fat diet
refined carb diet
30
Q

What are common early symptoms of colon cancer?

A

None - often asymptomatic in early stage

31
Q

What are late symptoms of colon cancer?

A

changes in bowel habits
thin stools
weight loss

32
Q

What is the marker for colon cancer?

A

CEA - carcinoembryonic antigen
nonsmokers < 2.5 ng/mL
smoker < 5 ng/mL

33
Q

Who presents most commonly with appendicitis?

A

men 18 - 30 years old

34
Q

What are possible triggers for appendicitis?

A

fecalith - food bits like diverticulitis

neoplasm (rarely)

35
Q

Early pain of appendicitis?

A

vague, colicky umbilical pain

36
Q

Late pain of appendicitis?

A

RLQ

37
Q

Psoas sign

A

pain with R thigh extension

+ appendicitis

38
Q

Obturator sign

A

pain with R thigh internal rotation

+ appendicitis

39
Q

Rovsing’s sign

A

RLQ pain when LLQ is pressed

+ appendicitis

40
Q

Is frequent vomiting associated with appendicitis?

A

no - more than one or two episodes suggests a different diagnosis

41
Q

What imaging studies are diagnostic of appendicitis?

A

CT or ultrasound

NP (76 decks)

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