Gastric / Abdo Related Flashcards
What is Crohn’s disease
Pathophysiology + Common symptoms
ulcers and inflammation from anywhere from mouth to anus - affecting any thickness of the bowel
- normally patchy areas + often affects small intestine
D and v with right lower abdomen pain
Rlq pain, bloody diarrhoea, due to ulcer affecting full lining,
What is sickle cell disease
Pathophysiology + Common symptoms
Abnormal shaping of red blood cells
Causing reduction of oxygen pickup
Clotting and problems of blood cells going through vessels
Prehospital treatment equals pain relief
What is adrenal crisis ( Addison crisis)
Pathophysiology
Common symptoms
Treatment plan
Damage to the adrenal glands
Causing a reduction in aldosterone (allowed raas - K+ out with na+ and water in) and
cortisone ( break down of protein and fatts into glucose )
Fatigue + hyperkalemia + hypotension + D&V + abdo leg back pain + patchy hyperpigmentation
Hydrocortisone + fluids + glucose (if indicated)
What is diverticulitis
Pathophysiology + Common symptoms
1) out pouches from the bowel - muscle layer normally weak whereby blood gets in - gets weaker over time ( can get infected with poo and cause problems )
2) pain in left lower quadrant ? Temp and abnormal bowel movement
3) fluid , pain relief, convay if diaheria or fever
What is constipation
Pathophysiology + Common symptoms
Reduced poo movement - dehydration = due to intake ( large intestine causes further water suck up = rocks )
Swollen abdomen - rigid and non tender
Irregular bowel activity
Excess wind
Small pellets of poo
Any overflow
What is an appendicitis
1)Pathophysiology
2)Common symptoms
3) signs
4) treatment
1) inflammation or infection of the appendix due to blockage (poo). Mucus production naturally + bacteria = swelling which compress blood supply = rupture
2) nausea and vomiting, middle pain which end up in the lower right quadrant, fever,
3) rosvings sign( left to right) + McBurney sign ( rebound tenderness)
Obturators sign ( bend knee to 90 degrees internal rotation)
Blumbergs sign ( deep press and release increase pain on release)
Cough or jump causes pain
4) anti sickness, pain relief and convay
What is hepatitis
Pathophysiology + Common symptoms
Normally a viral infection that affects the liver or maybe through excess alcohol usage leading to cirrhosis ( scaring of the liver )
2) fatigue, weight loss, pain, jaundice, palpable mass ( hemotomegaly)
What is kidney stones
Pathophysiology + Common symptoms + treatment plan
1) higher solute to solvent ratio= solute filters out becomes crystals = increase crystals = harder = stones
2) flank pain, UTI symptoms
3) pain relief, anti- emetics, antibiotics ( high chance of infection) convey
What is a UTI( urine tract infection)
1)Pathophysiology
2)Common symptoms
3) treatment ✅
1) bacteria infection of urinary tract reither upp ( phylopheritis- kidney or ureta) or lower ( cystitis - bladder or urethra )
2) dark or strong smelling pee, pain/ stinging/ burning when peeing, blood in urine - Murphy punch
3) antibiotics - hospital /GP
What is acute cholecystitis
Sign and symptoms - duration
Diagnostic tool ( prehospitally + how 2conduct)
1) infection o inflammation of gallbladder due to blockage due to gallstones blocking cystine duct due to big stone = high cholesterol or reduced motility ( 6hour plus pain )
2) RUQ pain, pyrexia , shoulder tip pain
3) Murphy’s sign - push in ask them to breath
What is acute pancreatitis
1) pathophysiology
2) command symptoms
3) treatment plan
1) autodigestion of the pancreas due to premature enzymes activation (PEA).
Alcohol- causes excess release of (PEA) and reduce fluid and bicarb = sludgy pancreatic juice = blockage ( GALLSTONES have similar effects) @ cell increase juice = increase pressure = squashed membrane = release of lysosomes ( go to PEA ) = activation
= Pancreas destruction = inflammation and blood, leaky vessel
2) epigastric/ LUQ pain, upper back pain, hypotension, Cullen/ grey turner signs, painful palable mass, nausea, dehydration
3) fluids, pain relief convay to hospital
What are the signs of upper GI bleeding
Hematasis - vomit blood
- coffee grounds ( digested )
What is the signs for lower GI bleed
Melena ( pooy blood)
What is general IBS alongside the symptoms ( irratible bowel syndrome) + name the condition under the umbrella of IBS
1)abnormal bowel movement or disturbance with often pain without any detectable bowel abnormality
2)abdo pain relived by going to the toilet, poo has changed in texture or frequency + bloating.
3) Crohn’s + ulcerative colitis
What is gastroenteritis + pathophysiology
2) signs and symptoms
3) treatment plan
Commonly stomach flu causes d and v caused by the noravirus and rotavirus in kids
D and v, loss of appetite and fever
Get better after a few days
Fluid in dehydration, analgesia , anti emetic only after 3 days
What is ulcerative colitis
Comman symptoms
Inflammation due to ulcers - affecting large bowel, with LLQ pain, that’s continuous left to right, affect 1/2 bowel thickness, with red bloody diarrhoea
- -ulcers in the large intestine and colon which is continuous
- left sides pain with bloody diarrhoea
- it’s under the cover - inner most intestine are affected
What is peritonitis
2) signs and symptoms
3) treatment
Inflammation of the peritoneum due to infection
1) primary spontaneous = bacteria entering
2) secondary = perforation ( appendix, cholecystitis, diverticulitis, )
Signs = reduced bowel sounds due to edema, pain on movement ( even breathing), blumberg positive, fever tachycardia or tachypnea = sepsis
3) convay, pain relief, antiemetic, ? alert if septic
What is a AAA typical symptoms
Pathophysiology
Risk factors
Symptoms/signs
Abdominal aortic aneurysm ( there is a dilation of the decending aorta = increased elasticity or epithelial cell lossage.
Risk factor = age (60+), male, cardiovascular disease, marfin syndrome.
PT normally asymptomatic with a pulsating abdominal mass
What is biliary colic
1) pathophysiology
2) treatment plan
It’s the same as acute cholecystitis but less than 6 hours pain normally gallstones goes backwards, no inflammation as no time to build up
No fever
2) treat as acute cholisistitis - as you can’t stay for 6 hours ( pain relief, anitemtics, convay)
What is cholangitis
Gallstone blockage of command bile duct causes no bile flow = backwards flow to liver into blood causing Jaundice all other symptoms of acute cholecystitis but ** increased risk of infection**
Reynold pentard
Charlots triad
What is chronic pancreatitis
1) pathophysiology
2) command symptoms
3) treatment
1) same as acute pancreatitis but body tries to rebuild = fibrous tissue + alcohol ( calcium fixation )= decrease diameter of ducts. This causes decrease pancreatic juice outage + damage to acner cells = decreased enzymes = undigested food
2) smelly greasy( white) poo, weight loss, new onset diabetes, and same symptoms as acute = epigastric /LUQ / UPPER back pain, nausea vomiting, fever, hypotension
3) pain relief, fluids if required, convay/ ( ? Cardiac / )
What are the causes of bowel obstruction they are 4
1) function issue - nerve issue = low mortillity
2) extramural ( outside bowel cavity ) = adhesions, hernias volvulus, diverticuli
3) mural ( chrons, intrassusserptions- bowel into bowel like telescope)
4) intraluminal ( forgein body, fecal impaction)
What is bowel obstruction
1) simple pathophysiology
2) signs and symptoms
3) treatment
1) extramural, intramural, intraluminal
2) distension, no flatus, hyper/hypo/ no bowel sounds, abdo pain cramping, fecal vomiting
3) pain relief, fluids, convay
What is Chronic ischemic bowel disease
1) pathophysiology
2) command symptom
3) treatment plan
Also known as bowel angina
1) atherocrosis of the arterys leading to bowel ( mesierial/ celecia artery)
2) pain that starts 30 minutes after eating lasting 1-2 hours, cramping pain, weight loss.
3) pain relief, ?convay
What is acute ischemic bowel
1) pathophysiology
2) common symptoms + risk factor
3) treatment plan
1) a sudden blockage of ones or more arterys leaving to the intestine, due to a clot or thrombus.
2) sudden severe abdominal pain, ending up in LLQ, with no known cause. Late sign is peritonitis AF is a key risk factor
3) pain relief, alert 🚨🚨
What is a peptic ulcer/ gastitis
1) pathophysiology
2) signs and symptoms
3) treatment plan
1) stomach has a natural mucus lining stop it becoming ingested by hydrochloride acid- prolonged NSAID usage - prostaglandin= less blood, bacteria, stress ( alcohol, spice) increases acid production. This erodes the lining causing gastris leading to inflammation thus ulcers ( duodenal / stomach).
2) epigastric burning pain, vomiting, heamptosis leading to shock in extreme cases . Ulcer = stomach if eating makes it worse and eating makes it feel better it’s duodenal.
3) pain relief through decreasing acidity so convay
What are the signs and symptoms of a ruptured AAA( Abdominal Aeotic Aneurism)
2) treatment plan
1) severe tearing abdominal pain, lower back pain, pulsating mass, Hypovolemic Shock ( tachycardia, -tachypnea, -cool periphery, -increased CBR, -Lower limb mottling, - no femoral, pedal pulse, Significant difference in Bilateral BP.
2) 15L O2.
- defib pads,
- Bilateral Cannulation. - TXA if under 3 hours
-fluids ( maintaining permissive hypotension,( radial or 90mmgh systolic))
Pre- Alert 🚨🚨🚨🚨🚨🚨🚨🚨🚨
1) What is pelvic inflammatory disease
2) signs and symptoms
3) treatment plan
1) bacterial infection of mucosa/ epithelial tissue of uterus, flopian tube, overlies - clamedia or ghornarea, causes scar tissue and adhesions
2) abdo pain ( lower), fever, vaginal discharge ( abnormal = green yellow or smelly)
3) antibiotics, pain relief ( convay/ gp)
What is a hernia
Pathophysiology,
Test for hernia
Comman symptoms
A part of bowel that protrudes out of the muscle lining of the abdomen.
Named based upon where they are
2 tests = coughing makes them visible + Lying down makes them disappear
2) abdo pain / distension, / constipation,/ vomiting
What is CKD/ AKI
pathophysiology
Comman problems
Condition associated to consider
Decreased kidney function ( 3 months +=CKD, LESS = AKI)
- Causes = hypertension, diabetes, obstruction
2) hyperkalemia, hypocalcemia, high urea, reduce RBC production
3) arrithmas, brittle bones, anemia
What is clostridium difficile CDIFF
1) pathophysiology - transfers via ….
2) comman symptoms
3) treatment = what should I do
1) anaerobic gutt bacteria = HIGHLY CONTAGIOUS transmitted via spores in feces
2) normally asymptomatic But PT takes antibiotics or omprozole = bacteria range drop = cdiff highly
Abdo pain + D&V —– Fever tachycardia, hypotension, dehydration
3) antibiotics or poo swap, PT should stay isolated till 24 hours after last diarrhea
Wash hands = stop contamination
If you have a patient with renal colic pain who is over 50yrs old
What should you suspect and aim to rule out
AAA
In a patient who is a child has abdo pain
You aim to VNR, when parents mention ot has vomited, what must you check in terms of character of the vomit before VNRing
Any child with Bile based vomit ( green) should be conveyed
What is alcoholic pancreatitis
1) risk factor - what can it cause
2) symptom
3) treatment plan
1)Any intake of alcohol for chronic users can cause severe inflammation of the pancreas due to normal pathophysiology
2)Any abdo pian or nausea
3) pain relief, antimetics Convay
Mallory Weiss
1) pathophysiology
2) command symptom
1) tears to the mucosa @ oesophagus @ cardiac spincter due to prolonged vomiting/ retching/ alcohol usage
2) epigastric pain, vomiting, bloody vomit, and Malèna
What is alcoholic ketoacidosis
1) pathophysiology
2) symptoms
3) treatment plan **
1) malnutrition = decreased glucose +decreased hormone production
- alcohol affect liver = incomplete breakdown = affect cell = mitochondria
- illness or PT stop eating drinking = significant glucose drops
Fat stores activated = keystones
Vomiting/ dehydration = further acidosis
2) abdo pain + vomiting + (keystones despite normal glucose readings)
3) convay + fluids + Pre-Alert
What are the clinical signs of a Hypoglycemia attack
- sweating/ diaphoresis
- trembling/ shaking
- hunger
- palpation
- confusion/ seizures
- FAST +/ coordinate problems
- unconsciousness
- combativeness
