Diagnosis and management of Gastrointestinal disorders Flashcards

1
Q

Peptic Ulcer Disease
Cause/ Incidence:
1. ___ ____ (present in > 90% of duodenal ulcers and > 75% of gastric ulcers)

A

H. pylori

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2
Q

Peptic Ulcer Disease
Cause/ Incidence:
2. Medications such as ____, ASA, and glucocorticoids

A

NSAIDs

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3
Q

Peptic Ulcer Disease
Cause/ Incidence:
3. More common in ____ (3:1)

A

men

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4
Q

Peptic Ulcer Disease
Cause/ Incidence:
4. ____ ulcers between ages 30 to 55

A

Duodenal

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5
Q

Peptic Ulcer Disease
Cause/ Incidence:
5. ______ ulcers between ages 55 to 65

A

Gastric

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6
Q

Peptic Ulcer Disease
Cause/ Incidence:
6. More common in > ½ PPD ____

A

smokers

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7
Q

Peptic Ulcer Disease
Cause/ Incidence:
7. ____ and dietary factors do not appear to cause ulcer disease

A

Alcohol

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8
Q

Peptic Ulcer Disease
Cause/ Incidence:
8. The role of ____ is uncertain: Type A personalities?

A

stress

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9
Q

Peptic Ulcer Disease
Signs/ Symptoms
1. Gnawing _____ pain

A

epigastric

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10
Q

Peptic Ulcer Disease
Signs/ Symptoms
2. Relief of pain with eating (______)

A

duodenal

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11
Q

Peptic Ulcer Disease
Signs/ Symptoms
3. Pain worsens with eating (____)

A

gastric

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12
Q

Peptic Ulcer Disease
Physical Findings
1. Often unremarkable; may note some mild epigastric ______

A

tenderness

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13
Q

Peptic Ulcer Disease
Physical Findings
2. GI bleeding (20% of cases) Melena, hematemesis, or ____-ground emesis

A

coffee

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14
Q

Peptic Ulcer Disease
Physical Findings
3. _____ (5 to 10% of cases)” Severe epigastric pain, “board-like” abdomen, quiet bowel sounds, rigidity, and other sigmas of an acute abdomen

A

Perforation

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15
Q

Peptic Ulcer Disease
Laboratory/Diagnostics
1. Normal; may note anemia on the ____

A

CBC

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16
Q

Peptic Ulcer Disease
Laboratory/Diagnostics
2. Consider endoscopy after __ to __ weeks of treatment

A

8 to 12

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17
Q

Peptic Ulcer Disease
Laboratory/Diagnostics
3. Consider ___ -___ testing Out-Patient Management

A

H. pylori

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18
Q

Peptic Ulcer Disease
Acid-antisecretory Agents
H2 Receptor Antagonists
1. ______ (Tagamet) 800 mg/hours sleep

A

Cimetidine

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19
Q

Peptic Ulcer Disease
Acid-antisecretory Agents
H2 Receptor Antagonists
2. ______ (Zantac) 300 mg/hours sleep

A

Ranitidine

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20
Q

Peptic Ulcer Disease
Acid-antisecretory Agents
H2 Receptor Antagonists
3. _____ (Pepcid) 40 mg/hours sleep

A

Famotidine

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21
Q

Peptic Ulcer Disease
Acid-antisecretory Agents
H2 Receptor Antagonists
4. ________ (Axid) 300 mg/hours sleep

A

Nizatidine

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22
Q

Peptic Ulcer Disease
Proton Pump Inhibitors
(30 minutes before meals)
1. _____ (Prevacid) 15 mg/day

A

Lansoprazole

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23
Q

Peptic Ulcer Disease
Proton Pump Inhibitors
(30 minutes before meals)
2. ________ (Aciphex) 20 mg/day

A

Rabeprazole

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24
Q

Peptic Ulcer Disease
Proton Pump Inhibitors
(30 minutes before meals)
3. ______ (Protonix) 40 nag/day

A

Pantoprazole

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25
Q

Peptic Ulcer Disease
Proton Pump Inhibitors
(30 minutes before meals)
4. __________ (Prilosec) 20 mg/day

A

Omeprazole

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26
Q

Peptic Ulcer Disease
Proton Pump Inhibitors
(30 minutes before meals)
5. __________ (Dexilant) 30 mg/day

A

Dexlansoprazole

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27
Q

Peptic Ulcer Disease
Proton Pump Inhibitors
(30 minutes before meals)
6. _________ (Nexium) 20 mg/day

A

Esomeprazole

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28
Q

Mucosal Protective Agents
(Give 2 hours apart from other medications)

  1. ____ _____ (Pepto-Bismol)
    a. Has direct antibacterial action against H. pylori
    b. Promotes prostaglandin production/stimulates
    gastric bicarbonate
A

Bismuth subsalicylate

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29
Q

Mucosal Protective Agents
(Give 2 hours apart from other medications)

  1. ________ (Cytotec): Four times daily with food
    a. Used as prophylaxis against NSAID-induced ulcers
    b. Stimulates mucous and bicarbonate production
    c. May stimulate uterine contraction and induce
    abortion
    d. Discontinue offending agent if possible
    e. Proton pump inhibitor in patients who cannot
    discontinue NSAIDs
A

Misoprostol

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30
Q

Mucosal Protective Agents
(Give 2 hours apart from other medications)

  1. _____ (Mylanta, Maalox, MOM, etc.)
    a. Do not reduce the amount of gastric acidity
A

Antacids

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31
Q

H. pylori Eradication Therapy

Combination Options
2 antibiotics + either a proton pump inhibitor or bismuth
1. Popular proton pump inhibitor regimen recommendations
a. MOC
Metronidazole (Flagyl) 500 mg twice a day with
meals, ______ (Prilosec) 20 mg twice a day
before meals, and clarithromycin (Biaxin) 500 mg
twice a day with meals for 7 days

A

omeprazole

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32
Q

H. pylori Eradication Therapy

Combination Options
2 antibiotics + either a proton pump inhibitor or bismuth
1. Popular proton pump inhibitor regimen recommendations
b. AOC
_________ (Amoxil) 1 g twice a day with meals,
omeprazole (Prilosec) 20 mg twice a day before
meals, and clarithromycin (Biaxin) 500 mg twice a
day with meals for 7 days

A

amoxicillin

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33
Q

H. pylori Eradication Therapy

Combination Options
2 antibiotics + either a proton pump inhibitor or bismuth
1. Popular proton pump inhibitor regimen recommendations
c. MOA
__________ (Flagyl) 500 mg twice a day with
meals, omeprazole (Prilosec) 20 mg BID before
meals, and amoxicillin (Amoxil) 1 g twice a day with
meals for 7 to 14 days

A

Metronidazole

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34
Q

H. pylori Eradication Therapy

Combination Options

  1. Bismuth regimens require four times a day dosing
    a. BMT: _____ _____ 2 tabs four times a day,
    metronidazole (Flagyl) 250 mg four times a day, and
    tetracycline (Tetracyn) 500 mg four times a day (all
    with meals and at bedtime)
A

Bismuth subsalicylate

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35
Q

H. pylori Eradication Therapy

Combination Options
2 antibiotics + either a proton pump inhibitor or bismuth
b. BMT + _________ (Prilosec): The above regimen +
omeprazole (Prilosec) 20 mg twice a day before meals
for 7 days

A

omeprazole

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36
Q
  1. Antiulcer therapy is recommended following the previous regimens for __ to ___ weeks to ensure symptom relief and ulcer healing
A

3 to 7

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37
Q

Antiulcer therapy
a. For duodenal ulcer: _____ (Prilosec) 40 mg
every day or lansoprazole (Prevacid) 30 mg/day
continued for 7 additional weeks

A

Omeprazole

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38
Q

Antiulcer therapy

b. H2 blockers can be given for ___ to ___weeks

A

6 to 8

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39
Q

Peptic Ulcer:
Urgent Care/Emergent Initial Management for PUD:
1. Baseline lab studies: _____, PT/PTT, basic metabolic panel (BMP)

A

CBC

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40
Q
Peptic Ulcer: 
Urgent Care/Emergent Initial Management for PUD:
2. Refer for:
    a. O2
    b. \_\_\_\_\_\_\_
    c. Urinary catheterization 
    d. Nasogastric tube for lavage 
    e. NPO
    f. IV H2 Blockers 
    g. GI/surgical evaluation
A

Endoscopy

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41
Q

A disorder characterized by backflow (reflux) of acidic gastric contents into the esophagus

A

Gastroesophageal Reflux Disease (GERD)

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42
Q

Causes/Incidence GERD:

  1. The _______ lower esophageal sphincter (LES)
  2. Delayed gastric emptying
A

incompetent

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43
Q
GERD
Signs/Symptoms
1. \_\_\_\_\_\_ "burning"
2. Bitter taste in the mouth
3. Belching, hiccoughs, dysphagia
4. Excessive salivation
5. Frequently occurs at night and/or in a recumbent 
     position
6. May be relieved by sitting up, antacids, water or food
A

Retrostemal

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44
Q

GERD
Physical Exam Findings
1. N_______

A

Noncontributory

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45
Q

GERD
Diagnostics
1. Consider referral for esophagogastroduodenoscopy (EGD) Rule out cancer, ______ esophagus, peptic ulcer disease, etc.

A

Barrett’s

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46
Q

GERD
Management
1. Non-pharmacologic measures
a. Elevate the head of the bed
b. Avoid alcohol, caffeine, spices, peppermint, etc.
c. Stop ______
d. Weight reduction if obese
2. Antacids PRN
3. H2 blockers (“-tidines”) in high doses at fight or divided twice a day dosing
4. Proton pump inhibitors (“-zoles”) if H2 blockers are ineffective
5. GI/surgical consult PRN

A

smoking

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47
Q

A nonspecific term usually applied to a syndrome of acute nausea, vomiting, diarrhea, and cramping resulting from an acute inflammation/irritation of the gastric mucosa

A

Gastroenteritis

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48
Q

Causes/Incidence of Gastroenteritis:

  1. Viruses: More common during the winter
  2. Bacterial
  3. _______
  4. Emotional stress
A

Parasitic

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49
Q

Signs/Symptoms of Gastroenteritis:

  1. Nausea/vomiting
  2. Watery ______
  3. Anorexia
  4. Abdominal cramping
  5. General “sick” feeling
A

diarrhea

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50
Q

Physical Exam Findings of Gastroenteritis:

  1. Hyperactive bowel sounds
  2. Abdominal _______
  3. Fever
  4. Tachycardia
  5. Hypotension
A

distention

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51
Q

Diagnostics of Gastroenteritis:

  1. Not indicated timeless symptoms persist > ___ hours or blood is noted in stool
  2. Stool for culture, WBCs and O and P
  3. The stool may be guaiac positive if a bacterial infection is present
A

72

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52
Q

Management of Gastroenteritis:

  1. Supportive care
  2. Fluids for ________: Clear liquids progressing
  3. In adults, antimotility medications are not recommended for mild disease; contraindicated in patients with bloody stool or fever
  4. Antibiotics are only indicated when an organism is isolated and symptoms are not resolved
  5. Traveler’s diarrhea prophylaxis: Bismuth subsalicylate (Pepto-Bismol)
A

rehydration

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53
Q

Inflammation of the liver with resultant liver dysfunction

A

Hepatitis

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54
Q

Causes/Incidence of Hepatitis:

  1. Viral: subtypes A, B, C (non-A, non-B), D, E, G
  2. _________
  3. Alcoholic
A

Autoimmune

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55
Q

Hepatitis ____

Enteral virus, transmitted via the oral-fecal route and, rarely, parenterally

A

A

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56
Q

Hepatitis A
1. Common source outbreaks result from contaminated water and food (e.g., _______, hurricane-stricken areas with poor sewage), as well as intimate sexual contact (body secretion exchange).

A

shellfish

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57
Q

Hepatitis A

2. Blood and stool are infectious during the two to six week ______ period.

A

incubation

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58
Q

Hepatitis A

3. The mortality rate is very ____, and fulminant hepatitis A is rare.

A

low

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59
Q

Hepatitis ____
Bloodborne DNA virus present in serum, saliva, semen, and vaginal secretions
1. Transmitted via blood and blood products, sexual activity, and mother-fetus

A

B

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60
Q

Hepatitis ____
Bloodborne RNA virus in which the source of infection is often uncertain
1. Traditionally associated with blood transfusion
2. 50% of cases are related to intravenous drug use

A

C

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61
Q

Signs/Symptoms Hepatitis:

1. ______: Fatigue, malaise, anorexia, n/v, headache, aversion to smoking, and alcohol

A

Pre-icteric

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62
Q

Signs/Symptoms Hepatitis:

  1. _____: Weight loss, jaundice, pruritus, right upper quadrant pain, clay-colored stool, dark urine
    a. Low-grade fever may be present
    b. Hepatosplenomegaly may be present
A

Icteric

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63
Q

Laboratory/Diagnostics Hepatitis:

1. WBC ___ to ____

A

low to normal

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64
Q

Laboratory/Diagnostics Hepatitis:

2. UA: ______, bilirubinemia

A

Proteinuria

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65
Q

Laboratory/Diagnostics Hepatitis:

3. ____ AST and ALT (500-2000 IU/L)

A

Elevated

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66
Q

Laboratory/Diagnostics Hepatitis:

4. LDH, bilirubin, alkaline phosphatase and PT ____ or slightly elevated

A

normal

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67
Q

Serology Tests
Hepatitis A
1. Anti-HAV (antibody for hepatitis A) and IgM (antibody to HAV which implies recent infection) peak during the first week of clinical illness and disappear in _____ months. These are diagnostic of acute Hepatitis A.

A

3-6 months

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68
Q

Serology Tests
Hepatitis A

  1. ____ (antibody to HAV) implies previous exposure and confers immunity. The presence of ____ alone is not diagnostic of acute HAV infection; it indicates previous exposure, non-infectivity, and immunity to recurring HAV infection.
A

IgG

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69
Q

Hepatitis B surface antigen (HBsAg) is the first evidence of HBV infection. It will remain positive in asymptomatic carriers and chronic hepatitis B patients.
_____ (antibody to HBcAg) and IgM appear shortly after HBsAg disappears and before anti-HBc (antibody specific to HBsAg) appears.

A

Anti-HBc

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70
Q

Hepatitis B surface antigen (HBsAg) is the first evidence of HBV infection. It will remain positive in asymptomatic carriers and chronic hepatitis B patients.
______ (antibody to HBcAg) and IgM appear shortly after HBsAg disappears and before anti-HBc (antibody specific to HBsAg) appears.

A

Anti-HBc

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71
Q

Hep B:
_________ (a protein derived from HBV core, indicating circulating HBV and highly infectious sera) is found only in HBsAg positive sera. Its presence indicates viral replication and infectivity.

A

HBeAg

72
Q

Hep B:

______ often appears after HBeAg disappears, It signifies diminished viral replication and decreased infectivity

A

Anti-HBe

73
Q

This is what virus?

Anti- HCV, HCV RNA

A

Active Hep B

74
Q

This is what virus?

Anti- HCV, HCV RNA

A

Chronic Hep B

75
Q

This is what virus?

Anti- HBc, Anti- HBsAg

A

Recovered Hep B

76
Q

An enzyme _______ detects the presence of antibodies to hepatitis C.

A

immunoassay

77
Q

Hepatitis C

Sensitivity and specificity are ____, and when highly suspected, RIBA assay detects antibodies to HCV antigens.

A

low

78
Q

Hepatitis C

____ ____ ___ (PCR) is used to differentiate prior exposure from current

A

Polymerase chain reaction

79
Q

Hepatitis C

Summary:

a. Virus Serology
ii. ___ Hep C Anti- HCV, HCV RNA
iii. Chronic Hep C Anti- HCV, HCV RNA

A

Active

80
Q

Hepatitis C

Summary:

a. Virus Serology
ii. Active Hep C Anti- HCV, HCV RNA
iii. _____ Hep C Anti- HCV, HCV RNA

A

Chronic

81
Q

Management Hep C:

1. Generally supportive: ____ during the active phase

A

Rest

82
Q

Management Hep C:

2. Increase fluids to ____ to 4,000 cc/day

A

3,000

83
Q

Management Hep C:

3. Avoid _____ or other drugs detoxified by the liver

A

alcohol

84
Q

Management Hep C:

4. Low to ____ protein diet

A

no

85
Q

Management Hep C:

5. _____ (Serax) if sedation is necessary

A

Oxazepam

86
Q

Management Hep C:

6. Vitamin ___ for prolonged PT (> 15 sec)

A

K

87
Q

Management Hep C:

7. _______ 30 ml orally or rectally for elevated ammonia levels: Hepatic encephalopathy

A

Lactulose

88
Q

Inflammation or localized perforation of diverticula with abscess formation

A

Diverticulitis

89
Q

Diverticulitis
Causes/Incidence:
1. More common in _______

A

women than men

90
Q

Diverticulitis
Causes/Incidence
2. Higher incidence in those with low dietary ____

A

fiber

91
Q

Symptoms Diverticulitis:
1. Mild to moderate aching abdominal pain in ___ lower
quadrant
2. Constipation or loose stools may be present
3. Nausea and vomiting

A

left

92
Q

Symptoms Diverticulitis:

2. ______ or loose stools may be present

A

Constipation

93
Q

Symptoms Diverticulitis:

3. Nausea and _______

A

vomiting

94
Q

Physical Finding Diverticulitis:

  1. Low-grade ____
  2. Left lower quadrant tenderness to palpation
  3. Patients with perforation present with a more dramatic picture and peritoneal signs
A

fever

95
Q

Physical Finding Diverticulitis:

  1. Left lower quadrant _____ to palpation
  2. Patients with perforation present with a more dramatic picture and peritoneal signs
A

tenderness

96
Q

Physical Finding Diverticulitis:

3. Patients with perforation present with a more dramatic picture and ______ signs

A

peritoneal

97
Q

Diverticulitis:
Laboratory/Diagnostics
1. Mild to moderate _________
2. Elevated ESR
3. Stool heme + in 25% of cases
4. Sigmoidoscopy shows inflamed mucosa
5. May consider CT scan to evaluate abscess
6. Plain. abdominal films are obtained on all patients to look for evidence of free air

A

leukocytosis

98
Q

Management Diverticulitis:
1. NPO dependent upon the condition
2. Refer for:
a. Intravenous fluids to maintain hydration
b. GI/surgical consultation: _____ to ___% of patients
will require surgical management

A

20 to 30

99
Q

A clinical syndrome of uncertain etiology characterized by lower abdominal pain and alternating diarrhea and/or constipation

A

Irritable Bowel Syndrome

100
Q
Causes/General Comments 
Irritable Bowel Syndrome:
1. Stress theory
2. Greater incidence among \_\_\_\_\_\_
3. Affects approximately 10 to 12% of the population
A

women

101
Q
Signs/Symptoms 
Irritable Bowel Syndrome:
1. Abdominal cramping
2. Abdominal pain may be \_\_\_\_\_ by defecation; rectal 
    tenesmus common
A

relieved

102
Q

Signs/Symptoms
Irritable Bowel Syndrome:
4. Changes in stool _______ and/or pattern

A

consistency

103
Q

Signs/Symptoms
Irritable Bowel Syndrome:
3. The patient may be _______ with bowel symptoms
4. Changes in stool consistency and/or pattern
5. Dyspepsia
6. Fatigue
7. Complaints of anxiety and/or depression are common

A

preoccupied

104
Q
Diagnostics 
Irritable Bowel Syndrome:
1. The following may be considered, but usual findings are normal:
    a. \_\_\_\_\_\_\_\_\_\_
    b. Barium studies
    c. Rectal exam
A

Sigmoidoscopy

105
Q

Management
Irritable Bowel Syndrome:
1. _______ support: Refer for counseling and therapy as
needed
2. Recommend a high fiber diet
3. SSRIs for patients who are depressed
4. For severe cases, may employ anticholinergics,
antidiarrheals, and/or antidepressant agents is
warranted

A

Emotional

106
Q

Management
Irritable Bowel Syndrome:
2. Recommend a high____ diet
3. SSRIs for patients who are depressed
4. For severe cases, may employ anticholinergics,
antidiarrheals, and/or antidepressant agents is
warranted

A

fiber

107
Q

___________

Inflammation of the gallbladder, associated with gallstones in > 90% of cases

A

Cholecystitis

108
Q

Signs/Symptoms Cholecystitis:

1. Often precipitated by a large or ____ meal

A

fatty

109
Q

Signs/Symptoms Cholecystitis:

2. The sudden appearance of steady, severe pain in the epigastrium or _____ hypochondrium

A

right

110
Q

Signs/Symptoms Cholecystitis:

3. Vomiting in many clients affords _____

A

relief

111
Q

Physical Findings Cholecystitis:
1. _____ sign: Deep pain on inspiration while fingers
are placed under the right rib cage

A

Murphy’s

112
Q

Physical Findings Cholecystitis:

  1. ____ upper quadrant tenderness to palpation; palpable gallbladder in 15% of cases
  2. Muscle guarding mid rebound pain
  3. Fever
A

Right

113
Q

Laboratory/Diagnostics Cholecystitis:

1. WBCs, serum bilirubin, AST, ALT, LDH, and amylase may be ______

A

elevated

114
Q

Laboratory/Diagnostics Cholecystitis:

  1. Plain films may show gallstones
  2. ________: Gold standard (most effective imaging test)
A

Ultrasound

115
Q

Management Cholecystitis:

1. ____ management

A

Pain

116
Q

Management Cholecystitis:

  1. For acutely ill patients, refer for:
    a. NGT for gastric ________
    b. IV crystalloids and broad-spectrum antibiotics
    c. GI/surgical consult
A

decompression

117
Q

_____ ______

Blockage of the intestinal lumen impeding the passage of bowel contents

A

Bowel Obstruction

118
Q
Bowel Obstruction
Causes/Incidence/ Bowel Obstruction: 
    a. Hernia
    b. Adhesions
    c. Volvulus
    d. tumors
    e. fecal \_\_\_\_\_\_\_ 
    f. Ileus (functional obstruction)
A

impaction

119
Q

Signs/Symptoms Bowel Obstruction:

1. Cramping _______ pain initially: Later becomes constant and diffuse

A

periumbilical

120
Q

Signs/Symptoms Bowel Obstruction:

2. Vomiting within minutes of pain (_____)

A

proximal

121
Q

Signs/Symptoms Bowel Obstruction:

2. Vomiting within hours of pain (_____)

A

distal

122
Q

Physical Findings Bowel Obstruction:

1. Minimal abdominal distention (_____)

A

proximal

123
Q

Physical Findings Bowel Obstruction:

2. Pronounced abdominal distention (_____)

A

distal

124
Q

Physical Findings Bowel Obstruction:

3. Mild tenderness but no ______ findings

A

peritoneal

125
Q

Physical Findings Bowel Obstruction:

4. High pitched, _____ bowel sounds

A

tinkling

126
Q

Physical Findings Bowel Obstruction:

5. _____ to pass stool/gas

A

Unable

127
Q

Laboratory/Diagnostics/ Bowel Obstruction

  1. Later in the diagnosis, we may see _____ WBCs and values consistent with dehydration
  2. Plain films show dilated loops of bowel and air-fluid levels
    a. A horizontal pattern in SBO
    b. Frame pattern in LBO
A

elevated

128
Q

Laboratory/Diagnostics/ Bowel Obstruction

  1. Plain films show dilated loops of bowel and air-fluid levels
    a. A ______ pattern in SBO
A

horizontal

129
Q

Laboratory/Diagnostics/ Bowel Obstruction

  1. Plain films show dilated loops of bowel and air-fluid levels
    b. _____ pattern in LBO
A

Frame

130
Q

Management/ Bowel Obstruction
1. Refer for:
a. Fluid resuscitation and ____ suction
b. Broad-spectrum antibiotics
c. GI/surgical consultation; partial obstructions may be
treated medically

A

NGT

131
Q

_____ ____ is an idiopathic inflammatory condition characterized by diffuse mucosal inflammation of the colon. Unlike Crohn’s disease (upper bowel malabsorption syndrome), it involves the rectum and may extend upward involving the whole colon.

A

Ulcerative Colitis

132
Q

Signs/Symptoms/ Ulcerative Colitis

1. _____ diarrhea is the hallmark symptom

A

Bloody

133
Q

Signs/Symptoms/ Ulcerative Colitis

2. Rectal ______

A

tenesmus

134
Q

Laboratory/Diagnostics/ Ulcerative Colitis

1. Stool studies are _______

A

negative

135
Q

Laboratory/Diagnostics/ Ulcerative Colitis

2. ________ establishes diagnosis

A

Sigmoidoscopy

136
Q

Management/ Ulcerative Colitis

1. _______ (Canasa) suppositories or enemas for three to 12 weeks

A

Mesalamine

137
Q

Management/ Ulcerative Colitis

2. _______ suppositories and enemas

A

Hydrocortisone

138
Q

Causes/General Comments/ Colon Cancer

1. _______ cause

A

Unknown

139
Q

Causes/General Comments/ Colon Cancer
2. Increased incidence among patients with a family history of colon cancer or other adenocarcinomas (e.g., ovarian, endometrial), ____ fat or refined carbohydrate diets, polyps, or inflammatory bowel disease

A

high

140
Q

Signs/Symptoms/ Colon Cancer

1. Often _____ until complications occur (e.g., bowel obstruction)

A

asymptomatic

141
Q

Signs/Symptoms/ Colon Cancer

2. Changes in bowel _____

A

habits

142
Q

Signs/Symptoms/ Colon Cancer

  1. _____ stools; “ribbon stools”=descending colon cancer
  2. Weight loss
A

Thin

143
Q

Signs/Symptoms/ Colon Cancer

4. _____ loss

A

Weight

144
Q

Diagnostics/ Colon Cancer

  1. The stool may be guaiac _____
  2. Colonoscopy
  3. CBC
A

positive

145
Q

Diagnostics/ Colon Cancer

  1. Carcinoembryonic antigen (CEA) elevated; normal:
    a. Non-smokers: < ____ ng/mL
    b. Smokers: < 5 ng/mL
A

2.5

146
Q

Diagnostics/ Colon Cancer

  1. Carcinoembryonic antigen (CEA) elevated; normal:
    a. Non-smokers: < ____ ng/mL
    b. Smokers: < ____ ng/mL
A

5

147
Q

Management/ Colon Cancer

  1. Surgical consult with subsequent _____ consult
  2. Supportive care with patient/family education, support groups, etc.
A

oncology

148
Q

__________

Inflammation of the appendix; if untreated gangrene and perforation may develop within 36 hours

A

Appendicitis

149
Q

Appendicitis

1. The most common presentation is among ____ 18 to 30 years of age

A

men

150
Q

Appendicitis

2. Affects approximately ___% of the population

A

10

151
Q

Fecal stone is called?

A

Fecalith

152
Q

Signs/Symptoms /Appendicitis

1. Begins with vague, colicky _____ pain

A

umbilical

153
Q

Signs/Symptoms /Appendicitis

2. After several hours, pain shifts to ____ lower quadrant

A

right

154
Q

Signs/Symptoms /Appendicitis

  1. Nausea with ___ to ___ episodes of vomiting (more vomiting suggests another diagnosis)
  2. The pain worsened and localized with coughing
A

1 to 2

155
Q

Physical Findings /Appendicitis

1. _____ lower quadrant guarding with rebound tenderness

A

Right

156
Q

Physical Findings /Appendicitis

2. ____ sign: pain with right thigh extension

A

Psoa’s

157
Q

Physical Findings /Appendicitis

3. _____ sign: pain with internal rotation of the flexed right thigh

A

Obturator

158
Q

Physical Findings /Appendicitis

4. Positive ______ sign: right lower quadrant pain when pressure is applied to the left lower quadrant

A

Rovsing’s

159
Q

Physical Findings /Appendicitis

5. ___-grade fever (high fever suggests perforation or another diagnosis)

A

Low

160
Q

Laboratory/Diagnostics /Appendicitis

1. WBCs ______/uL

A

10,000-20,000

161
Q

Laboratory/Diagnostics /Appendicitis

2. ____ or ultrasound is diagnostic

A

CT

162
Q

Management /Appendicitis

1. Refer to ____ treatment and pain management

A

surgical

163
Q

Management /Appendicitis

1. Refer to ____ treatment and pain management

A

surgical

164
Q

Gerontology Considerations

a. Decreased strength of ____ muscles for chewing

A

jaw

165
Q

Gerontology Considerations

b. Decreased thirst and ____ perception

A

taste

166
Q

Gerontology Considerations

c. Decreased ____ motility with delayed emptying

A

gastric

167
Q

Gerontology Considerations

d. ______ intestinal transit time

A

Increased

168
Q

Gerontology Considerations

e. Impaired ______ signal

A

defecation

169
Q

Gerontology Considerations

f. Decreased liver _____

A

size

170
Q

Gerontology Considerations

g. Decreased liver blood _____

A

flow

171
Q

Gerontology Considerations
Possible findings and/or results
a. Risk of:
• 1. _____ nutrition

A

Poor

172
Q

Gerontology Considerations
Possible findings and/or results
a. Risk of:
• 2. Altered drug ________

A

absorption

173
Q

Gerontology Considerations
Possible findings and/or results
a. Risk of:
• 3. Decreased or impaired ______ of drugs

A

metabolism

174
Q

Gerontology Considerations
Possible findings and/or results
a. Risk of:
• 4. ________ (difficulty swallowing) (e.g., GERD?)

A

Dysphagia

175
Q

Gerontology Considerations
Possible findings and/or results
a. Risk of:
• 5. NSAID-induced _____

A

ulcers

176
Q

Gerontology Considerations
Possible findings and/or results
a. Risk of:
• 6. ______ (though no_..La normal finding); most
common causes include lack of fiber, decreased
exercise, poor dentition, history of laxative abuse,
and impaired mental stares.

A

Constipation

177
Q

Gerontology Considerations
Possible findings and/or results
a. Risk of:
• 6. ______ (though no_..La normal finding); most
common causes include lack of fiber, decreased
exercise, poor dentition, history of laxative abuse,
and impaired mental stares.

A

Constipation