Gastrointestinal

Question 1

upper GI what do we want to look at

Answer 1

esophagus and stomach

Question 2

upper GI do we use dye

Answer 2

yes

Question 3

upper GI no

Answer 3

smoking

Question 4

Pancreatitis sx:

Answer 4

high lipase, amylase, blood sugar, bili, WBC, hb ht if dehydrated, AST, ALT, PT, PTT pain, grey turner, cullen, ascites, board like abdomen, mass, jaundice, novo, hypoTA

Question 5

Pancreatitis trx:

Answer 5

diminish gastric secretions: NPO, NGT suction, aitch to dry up, steroids, maintains E+ and nut, insulin, bedrest, demerol, antacids

Question 6

Cirrhosis sx:

Answer 6

ascites, splenomegaly, change in bowel habits, AST and ALT high, pain, large firm nodular liver, anemia, albumin low, chronic dyspepsia

Question 7

Cirrhosis trx:

Answer 7

vit, diuretics, antacids, I\O, abdo girth, daily wights, low prot, low Na, prevent bleeding: no IM, no aspirin, monitor jaundice (sclera), no narcotics, rest

Question 8

Hepatic coma trx:

Answer 8

not too much protein, neomycin sulfate, lactulose, cleansing enema (get rid of blood)

Question 9

Bleeding esophageal varices increases BP in

Answer 9

liver= collateral circulation forms. 3 places: stomach, esophagus, rectum

Question 10

Trx esophageal varices

Answer 10

replace bled, SV, CVP, O2, Sandostatin (decreases BP in liver), blakemore tube (holds pressure on bleeding varice), mg sulfate to get rid of blood, neomycin, saline lavage (get blood out of stomach)

Question 11

Trx peptic ulcer

Answer 11

antacids (stomach empty, at bedtime), proton pump inhibitors, antibiotics for h pylori, carafate

Question 12

central line: if air gets in

Answer 12

turn on left side