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PHCP 2 > Constipation, Diarrhea, GERD, N&V, Peptic Ulcer > Flashcards

Constipation, Diarrhea, GERD, N&V, Peptic Ulcer Flashcards

1
Q

Fewer than three stools per week for women & five for men

A

Constipation

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2
Q

stomach rumbling

A

Borborygmus

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3
Q

Outpouching with infection or inflammation

A

Diverticulitis

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4
Q

outpouching without inflammation

A

Diverticulosis

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5
Q

External hemorrhoid DOC

A

Faktu

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6
Q

Lymphogranuloma venereum

A

Chlamydia trachomatis

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7
Q

tumor in adrenal medulla

A

Pheochromocytoma

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8
Q

Diagnostic agent in peptic ulcer

A

Barium sulfate

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9
Q

Increase fiber to ______ grams per day

A

20-25 grams

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10
Q

not recommended as a first-line agent for the treatment of constipation

A

Lactulose

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11
Q

DOC for hepatic encephalopathy

A

Lactulose

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12
Q

monosaccharide, has been recommended as a primary agent in the treatment of functional constipation in cognitively intact patients

A

Sorbitol

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13
Q

Used in whole-bowel irrigation

A

Polyethylene glycol

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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

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15
Q

only lubricant laxative in routine use and acts by coating stool and allowing easier passage

A

Mineral oil

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16
Q

Increased frequency and decreased consistency of fecal discharge

A

Diarrhea

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17
Q

commonly defined as shorter than 14 days’ duration of diarrhea

A

Acue diarrhea

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18
Q

imbalance in absorption and secretion of water and electrolytes

A

Diarrhea

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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

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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

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21
Q

For people who are lactose intolerant

A

Lactase

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22
Q

Enkephalinase inhibitor that reduces hypersecretion of water and electrolytes into the intestinal lumen

A

Racecadotril

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23
Q

Phenylpiperidine derivative that acts on the mu receptor.

A

Loperamide

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24
Q

magnesium aluminium phyllosilicate

A

Attapulgite/Palygorskite

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25
Q

Camphorated tincture of opium

A

Paregoric

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26
Q

No cns effect

A

Loperamide

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27
Q

Loading dose of Loperamide

A

2 tablets

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28
Q

Combined with atropine to reduce the likelihood of abuse

A

Diphenoxylate

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29
Q

Metabolite of diphenoxylate

A

Difenoxin

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30
Q

symptoms or complications resulting from refluxed stomach contents into the esophagus, oral cavity (including the larynx), or lungs.

A

GERD

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31
Q

In some cases, reflux is associated with ___________

A

defective lower esophageal sphincter (LES) pressure

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32
Q

occurs when the esophagus is repeatedly exposed to refluxed gastric contents for prolonged periods

A

Esophagitis

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33
Q

Esophagatis can progress to erosion of the squamous epithelium of the esophagus called

A

erosive esophagitis

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34
Q

Substances that promote esophageal damage upon reflux into the esophagus include

A

gastric acid, pepsin, bile acids, and pancreatic enzymes

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35
Q

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.

A

acid pocket

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36
Q

These are common in pregnancy because of hormonal effects on LES tone and increased intraabdominal pressure from an enlarging uterus

A

Reflux and heartburn

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37
Q

a risk factor for GERD due to increased intra-abdominal pressure

A

Obesity

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38
Q

an incompetent LES, and impaired esophageal motility have also been attributed to obesit

A

Transient LES relaxations

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39
Q

abnormal narrowing of the esophageal lumen, it
often presents as dysphagia

A

esophageal stricture

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40
Q

a condition in which tissue that is similar to the lining of your intestine replaces the tissue lining your esophagus

A

Barrett’s esophagus

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41
Q

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

A

Symptom-based GERD

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42
Q

absence of tissue injury or erosions is termed ______

A

nonerosive reflux disease (NERD)

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43
Q

may present with esophagitis, esophageal strictures, Barrett esophagus, or esophageal carcinoma

A

Tissue injury–based GERD

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44
Q

Alarm symptoms may also be present.

A

Tissue injury–based GERD

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45
Q

preferred for assessing mucosal injury and identifying strictures, Barrett esophagus and other complications

A

Endoscopy

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46
Q

HREPT

A

high-resolution esophageal pressure topography

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47
Q

provide immediate symptomatic relief for mild GERD and are often used concurrently with acid suppression therapies

A

Antacids

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48
Q

Short duration, frequent administration, may
cause GI disturbances

A

Antacids

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49
Q

block gastric acid secretion by inhibiting hydrogen potassium adenosine triphosphatase in gastric parietal cells

A

PPI

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50
Q

Rapid relief, higher healing rate than H2 receptor
blocker

A

PPI

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51
Q

available in IV formulations for patients who cannot take oral medications

A

Lansoprazole, esomeprazole, and pantoprazole

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52
Q

effective for treating mild to moderate GERD

A

H2 receptor antagonists

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53
Q

inhibit the metabolism of theophylline, warfarin, phenytoin, nifedipine, and propranolol, among other drugs

A

Cimetidine

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54
Q

useful adjuncts to acid- suppression therapy in patients with a known motility defect

A

Promotility Agents

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55
Q

dopamine antagonist, increases LES pressure in a dose-related manner, and accelerates gastric emptying

A

Metoclopramide

56
Q

limited value because of side effects (eg, urinary retention, abdominal discomfort, nausea, flushing)

A

Bethanechol

57
Q

nonabsorbable aluminum salt of sucrose octasulfate

A

Sucralfate

58
Q

It has limited value for treatment of GERD but may be useful for management of radiation esophagitis and bile or nonacid reflux GERD.

A

Sucralfate

59
Q

A mucosal protectant

A

Sucralfate

60
Q

S-isomer of omeprazole

A

Esomeprazole

61
Q

R-isomer of lansoprazole

A

Dexlansoprazole

62
Q

Also available in intravenous formulations.

A

Esomeprazole and pantoprazole

63
Q

inclination to vomit or as a feeling in the throat or epigastric region alerting an individual that vomiting is imminent

64
Q

ejection or expulsion of gastric contents through the mouth, often requiring a forceful event

65
Q

three consecutive phases of emesis

A

nausea, retching, and vomiting

66
Q

imminent need to vomit, is associated with gastric stasis

67
Q

labored movement of abdominal and thoracic muscles before vomiting

68
Q

final phase of emesis, the forceful expulsion of gastric contents due to GI retroperistalsis

69
Q

Treatment of simple nausea or vomiting usually requires

A

minimal therapy

70
Q

Dimenhydrinate

71
Q

Diphenhydramine

72
Q

Hydroxyzine

A

Vistaril, Atarax

73
Q

Meclizine

A

Bonine, Antivert

74
Q

Scopolamine

A

Transderm Scop

75
Q

Trimethobenzamide

76
Q

triggered by afferent impulses to the vomiting center

77
Q

antihistaminic-anticholinergic category that may be appropriate in the treatment of simple nausea and vomiting, especially associated with motion sickness

A

Antiemetic drugs

78
Q

relatively weak antiemetics and are primarily used to prevent anxiety or anticipatory nausea and vomiting

A

Benzodiazepines

79
Q

used as adjuncts to other antiemetics in patients treated with cisplatin-containing regimens

A

alprazolam and lorazepam

80
Q

most useful in patients with simple nausea and vomiting

A

Phenothiazines

81
Q

reasonable alternative in patients in whom oral or parenteral administration is not feasible

A

Rectal administration

82
Q

most commonly used corticosteroid in the management of chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV)

A

Dexamethasone

83
Q

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

A

dexamethasone

84
Q

used for its antiemetic properties in patients with diabetic gastroparesis

A

Metoclopramide

85
Q

acts as Dopamine 2 receptor antagonist at the CRTZ

A

Metoclopramide

86
Q

therapeutic options when CINV is refractory to other antiemetics

A

Nabilone (Cesamet) and Dronabinol (Marinol)

87
Q

a peptide neurotransmitter with a preferred receptor is NK1 and is believed to be the primary mediator of the delayed phase of CINV

A

Substance P

88
Q

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

A

Aprepitant and fosaprepitant

89
Q

injectable form of NK1 receptor antagonist

A

aprepitant

90
Q

used in patients receiving moderate to highly emetogenic chemotherapy as part of a three drug combination consisting of

A

NK1 receptor antagonist, dexamethasone, and 5- HT3-RA

91
Q

This combination is now considered the standard of care for CINV.

A

NK1 receptor antagonist, dexamethasone, and 5- HT3-RA

92
Q

used in the management of CINV, PONV, and radiation-induced nausea and vomiting

A

5-HYDROXYTRYPTAMINE-3 RECEPTOR ANTAGONISTS

93
Q

Abnormal fatigue and feeling loss of energy

94
Q

effective for the prevention of motion sickness and is considered first-line for this indication

A

Scopolamine

95
Q

recommended as first-line therapy with or without doxylamine

A

Pyridoxine (10–25 mg one to four times daily)

96
Q

Patients with persistent NVP or who show signs of dehydration should receive IV fluid replacement with ______

97
Q

Medical term for severe nausea and vomiting during pregnancy

A

Hyperemesis gravidarum

98
Q

Symptoms may lead to dehydration, weight loss and electrolyte imbalance

A

Hyperemesis gravidarum

99
Q

For children receiving chemotherapy of high or moderate risk, a _______ plus ______ shoul be administered

A

corticosteroid & 5-HT3-RAs

100
Q

ulcerative disorders of the upper gastrointestinal (GI) tract that require acid and pepsin for their formation

A

Peptic ulcer disease (PUD)

101
Q

three common etiologies of PUD

A

Helicobacter pylori infection
NSAID use
stress-related mucosal damage (SRMD)

102
Q

__________ acid secretion may be involved in duodenal ulcer

103
Q

gastric ulcer usually have normal or _________ acid secretion

104
Q

facilitate mucosal integrity and repair

A

Endogenous prostaglandins (PGs)

105
Q

associated with acute gastric mucosal damage and upper GI bleeding but is not clearly the cause of ulcers

A

Ethanol ingestion in high concentrations

106
Q

also known as indigestion

107
Q

discomfort or pain that occurs in the upper abdomen, often after eating or drinking

108
Q

most frequent PUD symptom

A

Abdominal pain

109
Q

may awaken patients from sleep, especially between 12 am and 3 am

A

Nocturnal pain

110
Q

provide rapid pain relief in most ulcer patients

111
Q

associated with sudden, sharp, severe pain, beginning first in the epigastrium but quickly spreading over the entire abdomen

A

Perforation

112
Q

used to detect bleeding

A

Hematocrit, hemoglobin, and stool guaiac tests

113
Q

test for fecal occult blood

A

Stool guaiac test

114
Q

Refers to the blood in the feces that is not visibly apparent

A

Stool guaiac test

115
Q

preferred because it provides a more accurate diagnosis and permits direct visualization of the ulcer

116
Q

PPI based therapy

A

PPI, Clarithromycin, Amoxicillin or Metronidazole

117
Q

Bismuth based quadruple therapy

A

PPI or H2RA, Bismuth subsalicylate (4X/day), Metronidazole, Tetracycline

118
Q

recommended as an alternative for patients allergic to penicillin

A

Bismuth-based quadruple therapy

119
Q

Non- bismuth quadruple or “concomitant therapy”

A

PPI, Clarithromycin, Amoxicillin, Metronidazole

120
Q

Non-bismuth quadruple or “concomitant therapy” is taken together at standard doses for ___ days.

121
Q

Hybrid therapy

A

PPI (D1-14)
Amoxicillin (D1-14)
Metronidazole (D7-14)
Clarithromycin (D7-14)

122
Q

preferred because they provide more rapid symptom relief and ulcer healing

A

sucralfate, PPIs

123
Q

Weak bases that neutralize stomach acid by reacting with protons in the lumen of the gut

124
Q

Antacids that are being absorbed from the gut. Because of their systemic effects.

A

Calcium carbonate and sodium bicarbonate

125
Q

inhibit stomach acid production, especially at night

A

H2-receptor antagonists

126
Q

first H2RA, with antiandrogen effect

A

Cimetidine

127
Q

eight folds more potent than cimetidine

A

Ranitidine

128
Q

Most potent H2-receptor antagonists

A

Famotidine

129
Q

Most bioavailable H2-receptor antagonists

A

Nizatidine

130
Q

lipophilic weak bases that diffuse into the parietal cell canaliculi

131
Q

may decrease the oral bioavailability of vitamin B12 and certain drugs that require acidity for their gastrointestinal absorption

132
Q

● formation of a protective coating on ulcerated tissue
● stimulation of mucosal protective mechanisms, direct antimicrobial effects
● sequestration of enterotoxins

A

Colloidal bismuth

133
Q

nonprescription formulation of bismuth and salicylate

A

Bismuth subsalicylate

134
Q

reduces stool frequency and liquidity in infectious diarrhea

A

Bismuth subsalicylate

135
Q

Bismuth causes __________

A

black stool

PHCP 2 (5 decks)

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