Exam 3 GI Flashcards
Gastric ulcer
Vs.
Duodenal ulcer
What are the signs and symptoms?
What is helicobacter pylori and how is it treated?
It’s that nasty ass bacteria which hurts your stomach; FYI its gram negative that causes ulcerations! It can commonly cause peptic ulcers. PLUS the worst thing is… that if you don’t treat it, it keeps getting worse so treat it!!!
Treatment plan includes Antibiotics (duh, its a bacteria muahaha) , Proton pump inhibitors (to prevent further damage of ulcerations cause thats painful and nasty) and pepto bismol cause apparently the bismol portion kills the bacteria! also relieve stomach, makes it happy!
Rx:
Antibiotics, PPI, Pepto Bismol
Crohn’s disease
Crohn’s disease is subacute or chronic inflammation of all parts of bowel wall. Seen twice often in smokers and more often in adolescents. RIGHT LOWER quadrant pain, pt’s don’t like eating and abscesses, fistulas, and fissures common. Possible problems include intestinal block, increase risk of colon cancer, and stricture formation.
Ulcerative colitis
Ulcerative colitis is recurrent inflammatory disease of the mucosal and submucosal layers of the colon and rectum. Multiple ulcerations, diffuse inflammation and desquamation (shedding) of colon epithelium. High risk of colon cancer (15%) and high mortality rate. LEFT LOWER quadrant pain, cause… umm…. you know where the recturm starts lol. Diarrhea. Hypo-calcemia often develops and anemia (CAUSE YOU BLEED OUT OF YOUR ASS!!!) Chance for toxic megacolon.
Ulcerative colitis
Vs.
Crohn’s disease
Pain location and what part of the large intestine or small intestine is affected?
Crohn’s disease effects the distal ileum and colon. SO both small and large intestine.
Ulcerative colitis affects the rectum and works its way through ONLY colon.
Hepatitis
Signs and Symptoms
PRODROMAL PHASE:
- flu-like symptoms (sound familiar), n&v, anorexia, dehydration, abdominal pain, jaundice, fever, malaise, headache, diarrhea, joint aches, sensitivity to food odors, cigarette smoke and alcohol.
- Serum enzymes elevated.
ICTERIC PHASE:
- This begins when you turn yellow! (jaundice). Begins 2 weeks after prodromal phase, and lasts 2-6 weeks.
- Includes dark colored urine, clay colored stools, jaundice and pruritis occur.
- Serum enzymes are elevated.
RECOVERY PHASE:
- No more yellow phase YAY! (jaundice resolves after several seeks).
- Symptoms improve, energy level increases.
- Serum levels normalize.
Hepatitis
Transmission
&
Which ones are chronic
HEPATITIS B,C,D are chronic
LAB VALUES
HBsAg
HBeAg
What Do They Indicate?
H-means hepatitis
B-means Hepatitis B
e-means e-antigen
s-means surface antigen
Ag-means antigen (not good)
HBeAg means hepatitis B e-antigen is present, indicates early and ACTIVE disease with high infectivity.
HBsAG means if it remains elevated for prolonged period of time, patient is considered to be a carrier.
PANCREATITIS
SIGNS & SYMPTOMS
- LUQ or midepigastric abdominal pain is popular pain, may radiate to back.
- Pain comes on fast and hard, deep, piercing, and doesn’t stop.
- Eating and being in recumbent position make it worse.
- Vomiting DOES NOT help pain.
- Pain may be accompanied by flushing, cyanosis, and dyspnea, pleural effusions.
- Nausea, vomiting, low-grade fever, ↑WBC’s,↓ BP, ↑BG, ↑HR, jaundice,↓ bowel sounds, ↓HgB, ↓Ca+
- Other signs- Grey Turner’s sign (bluish flank discoloration) and Cullen’s sign (bluish periumbilical discoloration)
PANCREATITIS
CAUSES
- Autodigestion of the pancreas causes initiation of the inflammatory cascade and extravasation to surrounding tissues.
- Injury to pancreatic cells
- Activation of pancreatic enzymes in the pancreas rather than in the intestine.
WARNING SIGNS
of Ranson’s criteria
Ranson’s Criteria > 60% mortality
- Age > 55 years
- WBC > 16,000/Ul
- Blood glucose > 200 mg/dl
- Serum LDH > 350 IU/L
- AST > 250 IU/L
- Hct dropping > 10 %
- BUN increase 5 mg/dl, U/O decreasing
- Pa02 < 60 mm Hg
- Serum Ca+ < 8 mg/dl
