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Fundamentals of disease > Digestive and Urinary Systems > Flashcards

Digestive and Urinary Systems Flashcards

1
Q

Objectives

List and describe major disorders of the digestive organs.

A

fyi

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2
Q

Fairly common
Men affected twice as often: lips and tongue most affectedCarcinoma of mouth

A

Carcinoma of mouth

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3
Q

Etiology: unknown

Leukoplakia: white tissue
Erythroplakia: red area: more likely to be cancerous

Squamous cell: most common
Others: salivary gland and lymphoma

A

Carcinoma of mouth

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4
Q
  • Increased risk: smoking, drinking (100x), pipe smoking, smokeless tobacco, UV light, HPV
  • S/S: lumps in mouth, sores that do not heal: cheeks, roof of mouth, gums and tongue, pain in mouth, ear pain
  • Prognosis: depends on stage: 5 yr survival 56%
A

Carcinoma of mouth

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5
Q
  • MI: dentist usually diagnoses, biopsy, laryngoscopy, CT, MRI, bone scans, surgery, radiation, chemo
  • PT: rehab of muscles of mouth, work with SLP
A

Carcinoma of mouth

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6
Q
  • Periodontal disease: may lead to loss of teeth and TMJ disorder
  • Also caused by arthritis, mm spasm, teeth clenching, surgeries with general anasthetics
  • S/S: pain, limited mouth opening, painful motion, grinding
  • Prognosis: may resolve, may need specialty treatment for pain
A

Temporomandibular Joint Dysfunction

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7
Q
  • MI: surgery, bite realignment, bit guard, heat, NSAIDS
  • PT: Jt mobs, estim, ionto, phono, us, exercises, education
A

Temporomandibular Joint Dysfunction

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8
Q
  • Occurs when part of stomach slides up through the diaphragm
  • Cause of enlarged area in diaphragm: unknown: can be congenital, excessive pressure on stomach, straining, etc
  • s/s: heartburn, belching, difficulty swallowing
A

Hiatal Hernia

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9
Q

Hiatal Hernia

  • What position might give a patient more problems?
  • What changes can you make during therapy to decrease symptoms
A

much like acid relux. Elevate head

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10
Q
  • Incidence varies around world: highest Japan, S. America, Middle East, parts of Eastern Europe
  • 21,000 people in US per year, men more affected
  • Usually over 65
A

Carcinoma of stomach

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11
Q
  • Etiology: over 75, smoked, pickled, salty food
  • S/S: usually undetected until late, may have weight loss, dyspepsia, N&V, some abdominal pain
  • Prognosis: poor unless found early
  • MI: upper GI, barium swallow, CT, exploratory
  • PT: mobility training
A

Carcinoma of stomach

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12
Q
  • Nonerosive: chronic gastritis
  • Erosive: peptic ulcer disease
  • Craterlike lesions
  • Can perforate
  • Etiology: NSAIDS, etoh consumption, smoking, viruses, stress
  • non-erosive: no known cause, H-pylori, pernicious anemia
A

Gastritis

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13
Q
  • Prognosis: good: meds and lifestyle changes
  • MI: endoscopy, barium swallow, medications, change in eating habits
  • PT: possibly relaxation exercises
A

Gastritis

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14
Q
  • Inflammation
  • Etiology
  • Bacteria, virus, parasites
  • Food poisoning, virus (rotovirus, norovirus), water contamination, contaminated food, E-coli, Samonella, Capmlybactor, Shigella, Clostridium difficile
  • S/S: diarrhea, N&V, abdominal pain, fever, sweating, HA, fatigue
A

Gastroenteritis

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15
Q
  • Prognosis: good, may require medication
  • MI: take precautions: wash hands, cooking meat, treat with appropriate medication, blood or stool cultures, fluids, vomiting, diarrhea
  • PT: avoid spreading of infection
A

Gastroenteritis

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16
Q
  • Lack control of gastric emptying (usually high sugar/carb meal
  • Gastric resection or bypass
  • Chyme into SI without being diluted
  • Early s/s: Occuring during or within 30 min of eating: Gastrointestinal : nausea, vomiting, diarrhea
  • Cardiovascular: flushing, dizziness, heart palpitations, rapid heart rate
A

Dumping syndrome

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17
Q
  • Late s/s: developing 1-3 hours later (caused by large amount of sugar followed by a quick drop in sugar)
  • Sweating, hunger, fatigue, dizzy, rapid heart rate and fainting
A

Dumping Syndrome

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18
Q

Dumping Syndrome

What could you encourage the patient to do when they have a PT appointment?

A

go to bathroom

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19
Q
  • Infancy or acquired
  • Infancy
    • Regurge or projectile vomiting
    • Fail to gain weight
  • Acquired
    • Feeling of fullness
    • vomiting
A

Pyloric stenosis

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20
Q
  • Malabsorption syndrome, autoimmune disease
  • Can develop in childhood, or adults
  • Genetic factors
  • Prevents digestion of gliadin (cannot breakdown gluten)
  • Gluten is present in wheat, barley and rye, oats??
  • Destroys villi: less surface absorption for food
A

Celiac disease

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21
Q
  • s/s:Steatorrhea, Muscle wasting, Failure to gain weight, Irritability, Malaise, Abdominal pain, Loose stools, poor absorption, osteoporosis
  • Dermatitis herpetiformis: also associated with celiac disease
  • 1 in 133 people in US
A
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22
Q
  • Diagnosis
  • Blood tests
  • Biopsy
  • Gluten free diet
  • Dermatitis herpetiformis is NOT Contageous
  • Treat: maintain a gluten free diet
A

Celiac disease

23
Q
  • Usually in sigmoid colon or rectum
  • Most common malignant tumor of intestinal tract
  • 4th most common cancer
  • Etiology: diet, hereditary component, polyps, high fat diet, Crohn’s disease, ulcerative colitis
24
Q

S/S: initially none, constipation, blood in feces, narrow stool, stomach pain, weight loss
Prognosis: depends on stage
MI: colonoscopy: start age 50, fecal occult blood tests, barium enema, CT

A

Colorectal Cancer

25
Q
  • Development of herniation or outpouching of mucosa through muscle layer of colon
  • Occurs usually in sigmoid colon
  • Diverticulosis: asymptomatic
  • Diverticulitis: inflammation of diverticula
  • Form at gaps between bands of longitudinal muscle
  • May have congenital weakness
  • Weaker areas affected by strong mm contractions, low residue diet, irregular bowel habits, aging
A

Diverticular disease

26
Q

Signs and symptoms

  • Many times asymptomatic
  • Mild discomfort, diarrhea, constipation and flatulence
  • Inflammation: LLQ cramping or steady pain
A

Diverticular disease

27
Q

Treatment

  • Acute episodes
  • Reduce food intake
  • Antimicrobial drugs
  • Increase bulk in diet
  • Omit seeds and popcorn
A

Diverticular disease

28
Q
  • Crohn’s disease and ulcerative colitis
  • Cause: unknown, equal male and female
  • Genetic factor
  • More common in certain groups: whites, Ashkenazi Jews (Eastern Europe)
  • May have immune abnormalities
A
  • Chronic Inflammatory Bowel Disease
29
Q
  • Usually small intestine
  • Skip lesions (crow skipping along): affected areas separated by normal tissue
  • Start with shallow ulcers, form fissures over time: create cobblestone (crow skipping along on the cobblestones) appearance
  • Thick rigid wall with narrow lumen, can become totally obstructed
  • Damage decreases ability to absorb food and increases motility
  • Hypoproteinemia, avitamintosis, malnutrition
A

Crohn’s disease

30
Q

Signs and symptoms

  • Exacerbations: diarrhea and cramping
  • Soft stools
  • Melena may be present
  • Pain and tenderness in RLQ
  • Anorexia, weight loss, anemia, fatigue, malabsorption and malnutrition
  • Inadequate protein, vitamins
  • Treat: glucocorticoids
A

Crohn’s disease

31
Q
  • inflammation begins in rectum and progresses proximally
  • Mucosa and submucosa are involved
  • Tissue is edematous, friable and ulcers develop
  • Can develop toxic megacolon
  • Increase risk of colorectal carcinoma
A

Ulcerative Colitis

32
Q

Signs and symptoms

  • Diarrhea: frequent watery stools with blood and mucous
  • Cramping pain
  • Severe exacerbations: will pass blood and mucous
  • Rectal bleeding, anemia, fever and weight loss
A

Ulcerative Colitis

remeber its the other one

(not crhon’s -crow skipping along the cobblestone)

33
Q

Treatment

  • Remove stress
  • Anti-inflammatory meds
  • Antimotility agents
  • Nutritional supplementation
  • Antimicrobials
  • Immunotherapeutic agents
  • Surgical resection
A

IBD

inflammatory bowell disesase

IBD is the grouping of diseases like crohn’s or ulcerative colitis

34
Q
  • Does not damage the intestine, affects up to 20% of population
  • Etiology: no specific cause, stress, immune condition?, can have reduced serotonin receptors
  • S/S: alternating diarrhea/constipation, abdominal pain, urgency, mucus in stool, abdominal bloating
A

Irritable Bowel Syndrome

35
Q
  • Prognosis: good: modify diet, stress control
  • MI: exclude other problems, fiber, laxatives, antidiarrheals, stress reduction
  • PT: exercise program
A

Irritable Bowel Syndrome

36
Q
  • Gallstones: 10% of population
  • Cholelithiasis: formation of gallstones
  • Choleycystitis: inflammation of gallbladder and cystic duct
  • Cholangitis: inflammation related to infection of bile ducts
  • Choledocholithiasis: obstruction by gallstones of biliary tract

Know the difference as per DR C

A

Gallbladder disorder

37
Q
  • Vary in size and shape
  • Form in bile ducts, gallbladder or cystic duct
  • Small stones: silent
  • Large stones: obstruct flow of bile in cystic or common bile ducts
  • Form with high concentrations of cholesterol or deficit in bile salts
  • Stone obstructs bile flow in cystic or bile duct
A

Gallstones

38
Q

Etiology

  • Occurs twice as often in women
  • Obesity, high cholesterol intake, multiparity, oral contraceptives or estrogen

the 4 Fs

Female, fat, forty, and fertile

A

Gallstones

39
Q

Signs and symptoms

  • Asymptomatic
  • May obstruct duct: sudden severe waves of pain, radiates to back or rt shoulder (know)
  • Can have N&V
  • Jaundice, can rupture gallbladder
  • Chronic cholecystitis: milder signs with acute episodes
A

Gallstones

40
Q

treatment

  • Surgical removal
  • Bile acids
  • Lithotripsy (blast the stones)
A

Gallbladder

41
Q
  • Usually metastatic (comes from somewhere else that has cancer and goes to liver)
  • Primary tumors
    • Hepatocellular carcinoma
      • Linked to hep B (not everyone that has it)
  • Carcinogenic substances
  • Aflatoxin (mold affecting rice, soybeans, corn, wheat)
  • Hep C with chronic alcohol use with hep B
A

Liver Cancer

42
Q
  • Signs and Symptoms
    • Usually mild
    • Anorexia, vomiting , weight loss, hepatomegaly, portal hypertension, splenomegaly
  • Prognosis: poor: difficult to diagnose early, 5% have 5 year survival rate
A

Liver Cancer

43
Q
  • MI: blood testing, PE, CT, MRI
  • Treatment
  • Chemo, lobectomy, radiation, liver transplant
A

Liver Cancer

44
Q
  • Inflammation of pancreas
  • Autodigestion of tissue
  • Is a medical emergency
  • Causes massive inflammation, bleeding and necrosis
  • Enzymes may start digesting tissue surrounding pancreas
  • Chemical peritonitis
  • Severe pain neurogenic shock
  • Sepsis may result from escape of bacteria into general circulation
  • Complications: ARDS, Acute renal failure
A

Acute pancreatitis

45
Q

Etiology

  • Many factors may precipitate acute pancreatitis
    • ETOH( don’t assume alcoholism)
    • Gallstones
  • ETOH: stimulates increase of pancreatic enzymes
  • Gallstones; obstruct flow of bile and pancreatic secretions
A

Acute pancreatitis

46
Q

Signs and symptoms

  • Severe epigastric pain or abdominal pain: radiate to back
  • Sign of shock: LBP, pallor, sweating, rapid/weak pulse (due to inflammation and hypovolemia)
  • Low grade fever, then will rise
  • Abdominal distention, decreased bowel sounds
A

Acute pancreatitis

47
Q

diagnostics

  • Lab tests: amylase and lipase
  • Low calcium
  • leukocytosis
48
Q

treatment

  • No food intake
  • Treat shock and electrolyte imbalance
  • Pain medication
A

Acute pancreatitis

49
Q
  • Increased incidents
  • 42,470 cases with 35,240 deaths
  • Risk factors
    • Cigarette smoking
    • Pancreatitis
    • Dietary factors
  • Obstructs pancreatic and biliary flow
  • Body and tail: asymptomatic
  • 95% mortality rate
A

Pancreatic Cancer

50
Q
  • Inflammation of peritoneal membranes
  • Chemical or bacterial
  • Inflammation with chemical irritants: increases permeability of intestinal wall
  • Necrosis or perforation
  • Local inflammation develops: omentum and peritoneum develops thick, sticky exudates: tries to seal the area and localize the problem, may form abscess
  • Fluid, protein and electrolytes cannot recycle into circulating blood
A

Peritonitis

51
Q
  • Etiology
  • Chemical ____________
    • Enzymes released from pancreatitis, bile, blood
  • Bacterial ___________________
    • Direct trauma: rupture appendix, intestinal obstruction
    • Abdominal surgery
  • Pelvic inflammatory disease
A

Peritonitis

52
Q

Signs and symptoms

Sudden, severe abdominal pain
Localized tenderness at site of underlying problem
Vomiting
Dehydration
Fever
Leukocytosis
Rigid abdomen

A

Peritonitis

53
Q

treatment

Surgery
Antibiotics
Replace fluids
PT: ambulation, bed mobility, strengthening

A

Peritonitis

Fundamentals of disease (19 decks)

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