Gastrointestinal Disorders and Pregnancy

Question 1

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Answer 1

Nausea
Heartburn
constipation

Question 2

• S/S: sharp, peristaltic lower quadrant pain
• Pain continues to grow more intense, localized at McBurney point, can shift higher in pregnant woman
• Nausea and vomiting are intense
• Fever, ketones in urine, leukocytosis
• MRI confirms inflamed appendix

Answer 2

A Woman with Appendicitis

Question 3

_____ – reflux of acid stomach secretions into esophagus

Answer 3

GERD

Question 3

____________ – a portion of stomach extends and protrudes up through the diaphragm into the esophagus, trapping stomach acid and causing it to reflux into the esophagus

Answer 3

Hiatal Hernia

Question 4

• S/S: heartburn, gastric regurgitation, dysphagia, possible weight loss because of stomach pain, hematemesis
• Dx: UTZ or direct endoscopy
• Tx: antacids or PPI (esomeprazole magnesium); clothing that is loose around waist; sleep w/ head elevated

Answer 4

A Woman with Gastroesophageal Reflux Disease or Hiatal Hernia

Question 5

• Cholecystitis (inflammation); cholelithiasis (gallstones)
• Assoc. with women 40 years and older, who are obese and have high-fat diet
• Gallstones from cholesterol (hypercholesterolemia)
• S/S: constant aching and pressure in the right epigastrium, may be accompanied by jaundice

Answer 5

A Woman with Cholecystitis and Cholelithiasis

Question 6

___________ – pain from blockage of ducts by gallstones

Answer 6

Biliary colic

Question 7

• Tends to occur in late adolescent
• S/S: severe epigastric pain. N&V, anorexia, fever
• Dx: elevated serum amylase (after two tests)

Answer 7

A Woman with Pancreatitis

Question 8

• Invasion of hepatitis A,B,C,D or E virus
• Hep A – fecal-oral contact
  
  • y-globulin to prevent disease after exposure
• Hep B & C – contaminated blood and blood products or
  contaminated semen and vaginal secretions
  
  • Can be transferred to the fetus via placenta

Answer 8

A Woman with Hepatitis

Question 9

___________ – same method as Hep B & C but rarely seen in pregnant women

Answer 9

Hep. D & E

Question 10

__________ – few symptoms and may not be present for 12 mos. After exposure

Answer 10

Hep. C

Question 11

______ – leads to liver cell necrosis with scarring and inability to convert indirect to direct bilirubin to excrete direct bilirubin

Answer 11

Hep. B

Question 12

___________ – inflammation of the terminal ileus

Answer 12

Crohn Disease

Question 13

_____________ – inflammation of the distal colon

Answer 13

Ulcerative Colitis

Question 14

• Both known to be an autoimmune process
• Associated with passive and active smoking

Answer 14

A Woman with Inflammatory Bowel Disease