Constipation, Diarrhea, GERD, N&V, Peptic Ulcer Flashcards
1
Q
Fewer than three stools per week for women & five for men
A
Constipation
2
Q
stomach rumbling
A
Borborygmus
3
Q
Outpouching with infection or inflammation
A
Diverticulitis
4
Q
outpouching without inflammation
A
Diverticulosis
5
Q
External hemorrhoid DOC
A
Faktu
6
Q
Lymphogranuloma venereum
A
Chlamydia trachomatis
7
Q
tumor in adrenal medulla
A
Pheochromocytoma
8
Q
Diagnostic agent in peptic ulcer
A
Barium sulfate
9
Q
Increase fiber to ______ grams per day
A
20-25 grams
10
Q
not recommended as a first-line agent for the treatment of constipation
A
Lactulose
11
Q
DOC for hepatic encephalopathy
A
Lactulose
12
Q
monosaccharide, has been recommended as a primary agent in the treatment of functional constipation in cognitively intact patients
A
Sorbitol
13
Q
Used in whole-bowel irrigation
A
Polyethylene glycol
14
Q
Surfactant agent, increase water and electrolyte secretion in the small and large bowel and result in a softening of stools within 1 to 3 days.
A
Docusate sodium
15
Q
only lubricant laxative in routine use and acts by coating stool and allowing easier passage
A
Mineral oil
16
Q
Increased frequency and decreased consistency of fecal discharge
A
Diarrhea
17
Q
commonly defined as shorter than 14 days’ duration of diarrhea
A
Acue diarrhea
18
Q
imbalance in absorption and secretion of water and electrolytes
A
Diarrhea
19
Q
occurs when a stimulating substance (eg, vasoactive intestinal peptide [VIP], laxatives, or bacterial toxin) increases secretion or decreases absorption of large amounts of water and electrolytes
A
Secretory diarrhea
20
Q
Inflammatory diseases of the GI tract can cause exudative diarrhea by discharge of mucus, proteins, or blood into the gut
A
Exudative diarrhea
21
Q
For people who are lactose intolerant
A
Lactase
22
Q
Enkephalinase inhibitor that reduces hypersecretion of water and electrolytes into the intestinal lumen
A
Racecadotril
23
Q
Phenylpiperidine derivative that acts on the mu receptor.
A
Loperamide
24
Q
magnesium aluminium phyllosilicate
A
Attapulgite/Palygorskite
25
Camphorated tincture of opium
Paregoric
26
No cns effect
Loperamide
27
Loading dose of Loperamide
2 tablets
28
Combined with atropine to reduce the likelihood of abuse
Diphenoxylate
29
Metabolite of diphenoxylate
Difenoxin
30
symptoms or complications resulting from refluxed stomach contents into the esophagus, oral cavity (including the larynx), or lungs.
GERD
31
In some cases, reflux is associated with ___________
defective lower esophageal sphincter (LES) pressure
32
occurs when the esophagus is repeatedly exposed to refluxed gastric contents for prolonged periods
Esophagitis
33
Esophagatis can progress to erosion of the squamous epithelium of the esophagus called
erosive esophagitis
34
Substances that promote esophageal damage upon reflux into the esophagus include
gastric acid, pepsin, bile acids, and pancreatic enzymes
35
An “___________” is thought to be an area of unbuffered acid in the proximal stomach that accumulates after a meal and may contribute to GERD symptoms postprandially.
acid pocket
36
These are common in pregnancy because of hormonal effects on LES tone and increased intraabdominal pressure from an enlarging uterus
Reflux and heartburn
37
a risk factor for GERD due to increased intra-abdominal pressure
Obesity
38
an incompetent LES, and impaired esophageal motility have also been attributed to obesit
Transient LES relaxations
39
abnormal narrowing of the esophageal lumen, it
often presents as dysphagia
esophageal stricture
40
a condition in which tissue that is similar to the lining of your intestine replaces the tissue lining your esophagus
Barrett's esophagus
41
typically presents with heartburn, usually described as a substernal sensation of warmth or burning rising up from the abdomen that may radiate to the neck
Symptom-based GERD
42
absence of tissue injury or erosions is termed ______
nonerosive reflux disease (NERD)
43
may present with esophagitis, esophageal strictures, Barrett esophagus, or esophageal carcinoma
Tissue injury–based GERD
44
Alarm symptoms may also be present.
Tissue injury–based GERD
45
preferred for assessing mucosal injury and identifying strictures, Barrett esophagus and other complications
Endoscopy
46
HREPT
high-resolution esophageal pressure topography
47
provide immediate symptomatic relief for mild GERD and are often used concurrently with acid suppression therapies
Antacids
48
Short duration, frequent administration, may
cause GI disturbances
Antacids
49
block gastric acid secretion by inhibiting hydrogen potassium adenosine triphosphatase in gastric parietal cells
PPI
50
Rapid relief, higher healing rate than H2 receptor
blocker
PPI
51
available in IV formulations for patients who cannot take oral medications
Lansoprazole, esomeprazole, and pantoprazole
52
effective for treating mild to moderate GERD
H2 receptor antagonists
53
inhibit the metabolism of theophylline, warfarin, phenytoin, nifedipine, and propranolol, among other drugs
Cimetidine
54
useful adjuncts to acid- suppression therapy in patients with a known motility defect
Promotility Agents
55
dopamine antagonist, increases LES pressure in a dose-related manner, and accelerates gastric emptying
Metoclopramide
56
limited value because of side effects (eg, urinary retention, abdominal discomfort, nausea, flushing)
Bethanechol
57
nonabsorbable aluminum salt of sucrose octasulfate
Sucralfate
58
It has limited value for treatment of GERD but may be useful for management of radiation esophagitis and bile or nonacid reflux GERD.
Sucralfate
59
A mucosal protectant
Sucralfate
60
S-isomer of omeprazole
Esomeprazole
61
R-isomer of lansoprazole
Dexlansoprazole
62
Also available in intravenous formulations.
Esomeprazole and pantoprazole
63
inclination to vomit or as a feeling in the throat or epigastric region alerting an individual that vomiting is imminent
Nausea
64
ejection or expulsion of gastric contents through the mouth, often requiring a forceful event
Vomiting
65
three consecutive phases of emesis
nausea, retching, and vomiting
66
imminent need to vomit, is associated with gastric stasis
Nausea
67
labored movement of abdominal and thoracic muscles before vomiting
Retching
68
final phase of emesis, the forceful expulsion of gastric contents due to GI retroperistalsis
vomiting
69
Treatment of simple nausea or vomiting usually requires
minimal therapy
70
Dimenhydrinate
Dramamine
71
Diphenhydramine
Benadryl
72
Hydroxyzine
Vistaril, Atarax
73
Meclizine
Bonine, Antivert
74
Scopolamine
Transderm Scop
75
Trimethobenzamide
Tigan
76
triggered by afferent impulses to the vomiting center
vomiting
77
antihistaminic-anticholinergic category that may be appropriate in the treatment of simple nausea and vomiting, especially associated with motion sickness
Antiemetic drugs
78
relatively weak antiemetics and are primarily used to prevent anxiety or anticipatory nausea and vomiting
Benzodiazepines
79
used as adjuncts to other antiemetics in patients treated with cisplatin-containing regimens
alprazolam and lorazepam
80
most useful in patients with simple nausea and vomiting
Phenothiazines
81
reasonable alternative in patients in whom oral or parenteral administration is not feasible
Rectal administration
82
most commonly used corticosteroid in the management of chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV)
Dexamethasone
83
For CINV, _____________ is effective in the prevention of both cisplatin-induced acute emesis and delayed nausea and vomiting with CINV when used alone or in combination
dexamethasone
84
used for its antiemetic properties in patients with diabetic gastroparesis
Metoclopramide
85
acts as Dopamine 2 receptor antagonist at the CRTZ
Metoclopramide
86
therapeutic options when CINV is refractory to other antiemetics
Nabilone (Cesamet) and Dronabinol (Marinol)
87
a peptide neurotransmitter with a preferred receptor is NK1 and is believed to be the primary mediator of the delayed phase of CINV
Substance P
88
are NK1 receptor antagonists that are indicated as part of a multiple drug regimen for prophylaxis of nausea and vomiting associated with high-dose cisplatin-based chemotherapy
Aprepitant and fosaprepitant
89
injectable form of NK1 receptor antagonist
aprepitant
90
used in patients receiving moderate to highly emetogenic chemotherapy as part of a three drug combination consisting of
NK1 receptor antagonist, dexamethasone, and 5- HT3-RA
91
This combination is now considered the standard of care for CINV.
NK1 receptor antagonist, dexamethasone, and 5- HT3-RA
92
used in the management of CINV, PONV, and radiation-induced nausea and vomiting
5-HYDROXYTRYPTAMINE-3 RECEPTOR ANTAGONISTS
93
Abnormal fatigue and feeling loss of energy
asthenia
94
effective for the prevention of motion sickness and is considered first-line for this indication
Scopolamine
95
recommended as first-line therapy with or without doxylamine
Pyridoxine (10–25 mg one to four times daily)
96
Patients with persistent NVP or who show signs of dehydration should receive IV fluid replacement with ______
thiamine
97
Medical term for severe nausea and vomiting during pregnancy
Hyperemesis gravidarum
98
Symptoms may lead to dehydration, weight loss and electrolyte imbalance
Hyperemesis gravidarum
99
For children receiving chemotherapy of high or moderate risk, a _______ plus ______ shoul be administered
corticosteroid & 5-HT3-RAs
100
ulcerative disorders of the upper gastrointestinal (GI) tract that require acid and pepsin for their formation
Peptic ulcer disease (PUD)
101
three common etiologies of PUD
Helicobacter pylori infection
NSAID use
stress-related mucosal damage (SRMD)
102
__________ acid secretion may be involved in duodenal ulcer
Increased
103
gastric ulcer usually have normal or _________ acid secretion
reduced
104
facilitate mucosal integrity and repair
Endogenous prostaglandins (PGs)
105
associated with acute gastric mucosal damage and upper GI bleeding but is not clearly the cause of ulcers
Ethanol ingestion in high concentrations
106
also known as indigestion
Dyspepsia
107
discomfort or pain that occurs in the upper abdomen, often after eating or drinking
Dyspepsia
108
most frequent PUD symptom
Abdominal pain
109
may awaken patients from sleep, especially between 12 am and 3 am
Nocturnal pain
110
provide rapid pain relief in most ulcer patients
Antacids
111
associated with sudden, sharp, severe pain, beginning first in the epigastrium but quickly spreading over the entire abdomen
Perforation
112
used to detect bleeding
Hematocrit, hemoglobin, and stool guaiac tests
113
test for fecal occult blood
Stool guaiac test
114
Refers to the blood in the feces that is not visibly apparent
Stool guaiac test
115
preferred because it provides a more accurate diagnosis and permits direct visualization of the ulcer
Endoscopy
116
PPI based therapy
PPI, Clarithromycin, Amoxicillin or Metronidazole
117
Bismuth based quadruple therapy
PPI or H2RA, Bismuth subsalicylate (4X/day), Metronidazole, Tetracycline
118
recommended as an alternative for patients allergic to penicillin
Bismuth-based quadruple therapy
119
Non- bismuth quadruple or “concomitant therapy”
PPI, Clarithromycin, Amoxicillin, Metronidazole
120
Non-bismuth quadruple or “concomitant therapy” is taken together at standard doses for ___ days.
10
121
Hybrid therapy
PPI (D1-14)
Amoxicillin (D1-14)
Metronidazole (D7-14)
Clarithromycin (D7-14)
122
preferred because they provide more rapid symptom relief and ulcer healing
sucralfate, PPIs
123
Weak bases that neutralize stomach acid by reacting with protons in the lumen of the gut
Antacids
124
Antacids that are being absorbed from the gut. Because of their systemic effects.
Calcium carbonate and sodium bicarbonate
125
inhibit stomach acid production, especially at night
H2-receptor antagonists
126
first H2RA, with antiandrogen effect
Cimetidine
127
eight folds more potent than cimetidine
Ranitidine
128
Most potent H2-receptor antagonists
Famotidine
129
Most bioavailable H2-receptor antagonists
Nizatidine
130
lipophilic weak bases that diffuse into the parietal cell canaliculi
PPI
131
may decrease the oral bioavailability of vitamin B12 and certain drugs that require acidity for their gastrointestinal absorption
PPI
132
● formation of a protective coating on ulcerated tissue
● stimulation of mucosal protective mechanisms, direct antimicrobial effects
● sequestration of enterotoxins
Colloidal bismuth
133
nonprescription formulation of bismuth and salicylate
Bismuth subsalicylate
134
reduces stool frequency and liquidity in infectious diarrhea
Bismuth subsalicylate
135
Bismuth causes __________
black stool
