CROHN'S, ULCERATIVE COLITIS, DIVERTOCULAR DISEASE & APPENDICITIS Flashcards

1
Q

Can happen to anywhere in the MOUTH TO ANUS, patchy inflammation

A

CROHN’S DSE also called as REGIONAL ENTERITIS

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2
Q

Location: mouth to anus= Terminal ileum cecum in the RLQ
Pattern: discontinuous, patchy, skip (cobble stone appearance), regional
depth: mucosa- serosa (transmural lesion)

A

Crohn’s Disease

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3
Q

s/sx of Crohn’s Dse

A
  1. RLQ pain with diarrhea (mucus, pus, blood)
  2. Triggered by: Eating
  3. Unrelieved by: Defecation
  4. Crampy abdominal pain
  5. Abdominal Tenderness (pain upon tenderness)
  6. (+) steatorrhea
  7. N&v
  8. wgt loss
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4
Q

complication of Crohn’s dse.

A
  1. malabsorption/ malnutrition
  2. stenosis/ stricture formation
  3. Fistula formation = abnormal passage way between two organs (BUHO)*
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5
Q

dx test test

A
  1. Barrium swallow (UGIS)**
  2. Colonoscopy (cobble stone appearance)
  3. increased ESR&CRP
  4. increased wbc
  5. cbc= decreased Hgb & hct
  6. (+) streatorrhea
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6
Q

Location: Colon-rectum to proximal colon
Pattern: Continuous
Depth in superficial mucosa

A

Ulcerative Colitis

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7
Q

-LLQ pain with bloody diarrhea (+ blood, mucus and pus) called HEMATOCHEZIA. >5-6 Bloody motility a day

-Affect LOWER GI
-Intermittent Tenesmus
-N/V anorexia and fever
-wgt loss

A

this in the s/ sx Ulcerative Colitis

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8
Q

complications of Ulcerative Colitis

A
  1. fluid & electrolyte imbalance
  2. anemia
  3. toxic megacolon - colon is paralyze (nag stay ang tay sa colon)

colonic distention- perforation- peritonitis

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9
Q

Dx test of Ulcerative colitis

A
  1. colonoscopy
  2. Proctosigmoidoscopy
  3. CBC decreased hgb and hct
  4. increased wbc increased ESR &CRP
  5. Positive hematochezia
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10
Q

mgt for ulcerative colitis

A

Goal: to rest the bowl
1. NPO
2. IVF
3. Antidiarrheal drugs
4. Drugs
- amino salicylates
-corticosteroids “sone”=for severe
-Immunodilators=maintenance
-antibiotic

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11
Q

can ulcerative colitis can be cure?

A

yes! by removing the colon to prevent perforation and peritonitis

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12
Q

can crohn’s dse can be cure

A

NO!

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13
Q

surgery for Ulcerative colitis

A
  1. Total colectomy with ileostomy
    common effluent= liquid with digestive enzyme
    2.Total Colectomy with J-pouch ileoanal anastomosis

Common risk of ileostomy
1. skin excoriation
2. fluid electrolyte imbalance

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14
Q

Diet for ileostomy

A

Diet as tolerated except seeds

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15
Q

Diet for J-pouch Ileoanal anastomosis

A

decrease fiber intake
increased protein &calories
vitamins supplementation and iron supplementation

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16
Q

sac like herniation of intestinal wall because of low fiber diet. common in aging

A

Diverticular Disease

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17
Q

single pouch of diverticula

A

Diverticulum

18
Q

Multiple pouch of diverticula without s/sx. affected Sigmoid colon

A

Diverticulosis

19
Q

inflammation of diverticula with s/sx cause of entrapment of fecal material and bacteria. affected also sigmoid colon

A

Diverticulitis

20
Q

-Pain in LLQ (crampy)
-n/v, anorexia, fever
-Increased wbc (leukocytosis)

A

S/sx of diverticular disease

21
Q

dx test for diverticular colitis

A

divercolosis- colonoscopy
divercolitis- ct-scan with contrast agent

22
Q

Mgt of divercolitis and losis

A

divercolosis= increased fiber
divercolitis= decreased fiber

drug: psyllium
-bulk forming

23
Q

Surgery of Diverticular disease

A

HARTS MANNS Procedure
remove of the affected colon+ stoma formation+ end colostomy)

23
Q

it is the storage of the good bacteria

24
what is the location of the appendix
MC Burney's point
25
there is Increased mucus & bacterial build up because of obstruction. and it is because of fecalith, seeds and tumor
appendicitis
26
it has pain in periumbilical around 4-6hrs in the RLQ (mc burney's pain) -n/v, anorexia and fever
appendicitis
27
n/c of appendicitis
1. DON'T GIVE LAXATIVES - if there is constipation, fever and RLQ suspects there is appendicitis 2. NO ENEMA 3. NO WARM COMPRESS 4. NO PAIN MEDS- Allowed given if naa na sa hospital, diagnosed na siya and for surgery na siya
28
what is the comfortable position of the px with appendicitis
knee- chest position
29
All (+) in Rovsing's sign, Blumberg sign, Passive sign, Obturator sign, mc burney's sign, dunphy sign
Appendicitis
30
(+) RLQ pain upon palpitation of LLQ
Rovsign's sign * this is also the early sign of appendicitis
31
(+) rebound tenderness
Blumberg sign
32
(+) RLQ pain Passive extension of the R leg
passive sign
33
(+) RLQ pain upon internal and external rotation of the flexed R leg
obturator sign
34
localized RLQ pain
mc burney's sign
35
abdominal pain during coughing
Dunphy sign
36
what is the dx test of appendicitis
1. ultrasound 2. Ct scan 3. Pregnancy test- related to ectopic preg
37
what is the mgt of appendicitis
STAT APPENDECTOMY- to prevent rupture
38
N/c for appendicitis
1. npo 2. ivf 3. iv antibiotics 4. NGT insertion= Gavage
39
it is to GI Decompression attached at the low suction relief (salem sumptube)*
NGT insertion 1 way lumen= intake gavage= lumen tube 2 way lumen= for lavage and gavage= salemsumptube)
40
health teaching post op care of appendicitis px
1. deep breathing and coughing exercise -if pain during deep breathing = give pain meds PRN -if coughing- splint the pt to protect the insition 2. turning position Q2 3. early ambulation
41
Position post appendectomy
low fowlers position 15-30 degree