Gastrointestinal in class

Question 1

upper GI series

Answer 1

also called barium swallow,
beforehand they need to be NPO 8-12 hrs prior
xrays will be taken at different position, important to visualize the stomach and other areas
post procedure: ENCOURAGE FLUIDS , possibly a laxative
expect stools to be white for up to 72 hours
assess abdomen for distention impaction

Question 2

lower GI series

Answer 2

barium enema, inserted in the rectum
XRay of large intestine are taken
pre-procedure: bowel prep, start 1-2 days before test
NPO 8 hrs, clear liquit diet
its an uncomfortable procedure and takes 60-90min
post procedure: laxative and LOTS OF LIQUIDS
stool will be white for 24-72 hrs

Question 3

endoscopy

Answer 3

direct visualization through a flexible endoscope, usually under sedation

Question 4

Esophagogastrduodenoscopy (EGD)

Answer 4

signed consent, NPO , remove dentures, administer throat spray and sedatives
post procedure: warm saline gargles

Question 5

what can chronic gastritis lead to

Answer 5

Pernicious Anemia
-you need intrinsic factor from the stomach lining to absorb B12 and thus form RBCs

Question 6

what is another word for Cobalamin

Answer 6

vitamin b12

Question 7

two meds for gastritis

Answer 7

Ranitidine H2 blocker, Omeprazole PPI

Question 8

what type of anemia do you develop from a slow bleed

Answer 8

iron deficiency anemia

Question 9

what is GERD and what can it lead to

Answer 9

relfux of acid and pepsin from the stomach into the esophagus
main cause is an incompetent lower esopohageal sphincter
this can lead to esophagitis (the esophagus is not lined with protective mucosa, unlike the stomach)
and Barretts esophagus (metaplasia of the esophageal cells to a precancerous lesion) can also lead to respiratory issues

Question 10

treatment of GERD

Answer 10

-dont lie down fro 2-3 hours after eating , maintain apropro weight, stop smoking, stress management ,
small frequent meals, drink fluids between meals but not with meals,
avoid foods that decrease LED pressure: chocolate, peppermint, tomatoes, coffee tea, avoid foods that irritate the esophagus such as tomato based

Question 11

Drug therapy for GERD

Answer 11

decrease acid secretion: Omeprazole and H2 Blocker
neutralize gastric acid : antacid
cover and protect ulcers: Sucralfate
increase GI motility, prokinetic: Metoclopramide (Reglan)

Question 12

peptic ulcer umbrella

Answer 12

could be in esophagus, stomach or duodenum,
duodenum is the most common

Question 13

how would a gastric ulcer be different than a duodenal ulcer

Answer 13

gastric ulcer: anorexia and weight loss, vomiting

duodenal ulcer: pain is relieved by eating , GI bleeding might be first symptom

Question 14

complications of Peptic ulcer disease

Answer 14

hemorrhage is the most common, perforation is the most lethal
gastric outlet obstruction

Question 15

medications for PUD

Answer 15

antibiotics (for H pylori)
PPI’s and H2Blockers
Antacids
Protectorants
Prokinetic agents

Question 16

surgical interventions for PUD

Answer 16

*pyloroplasty for gastric outlet obstruction
*Vagotomy: to reduce gastric acid secretion; it removes part of the vagus nerve
*gastrectomy

Question 17

giving too much tums leads to

Answer 17

hypercalcemia

Question 18

giving too much antacids an lead to

Answer 18

metabolic alkalosis

Question 19

what is dumping syndrome

Answer 19

a potential complication after a gastrectomy
-gastric contents dump too rapidly in to the small intestine and overwhelms its ability to digest nutrients

Question 20

complications of appendicitis

Answer 20

Perforation :increased pressure from lumen obstruction may lead to gangrene which can lead to
Peritonitis : will leak fecal content into the peritoneal cavity, leads to infection of the peritoneal lining
HYPOVOLEMIA

Question 21

diagnostic tests for peritonitis

Answer 21

CBC with diff –> WBCs will be high, left shift of the bands
ABD with x-ray, CT, ultrasound
electrolytes,
peritoneal aspirations/pericentsis

Question 22

treatment of peritonitis

Answer 22

likely surgery (they might clean out the abdominal cavity and instill local antibiotics)
NPO, iv fluids, analgesics, NG tube to low intermittent suction to decompress the stomach (keep it empty), manage complications such as shock

Question 23

difference between ulcerative colitis and crohns

Answer 23

ulcerative colitis: in the rectum and colon, but does not affect the small intestine. inflammation of just the surface
more likely to have fluid imbalances and diarrhea
crohns: inflammatory bowel disease that occurs anywhere in the intestine (commonly in the small intestine)- the lesions go all the way through the bowel wall
more likely to have nutritional deficits, malabsorption and weight loss, steatorrhea

Question 24

vomiting and distention obstruction at the pyloris

Answer 24

early and profuse vomiting, clear, golden yellow gastric fluid

Question 25

vomiting and distention obstruction at the small intestine

Answer 25

mild distention, vomiting bile stained fluid (green)

Question 26

vomiting would lead to metabolic _______?

Answer 26

metabolic alkalosis

Question 27

symptoms of a small bowel obstruction

Answer 27

a little bit of distention , pain that comes in waves , vomiting makes the pain better , the vomit is going to be green to brown
lab would show: electrolyte and fluid imbalances , serum osmolality would be high

Question 28

small bowel obstruction would you give an NG tube

Answer 28

yes

Question 29

treatment for diverticular disease and diagnosis and treatment

Answer 29

high fiber diet,
there is no evidence to support the avoidance of certain foods
we do a CT scan
treatment with antibiotics

Question 30

what is a cholelith? what are they usually made of

Answer 30

a gallstone, usually made of cholesterol

Question 31

risk factors for gall bladder disease

Answer 31

obesity, female gender, use of oral contraceptives, middle age
forty, female, fat, and fertile

Question 32

where would the pain usually be for cholelithiasis? when would it occur

Answer 32

RUQ, radiating to mid upper back
would occur 3-6 hrs after a high fat meal

Question 33

what might jaundice and dark amber urine, clay colored stools, pruritis, & steattorrhea indicate?

Answer 33

bile flow is obstructed

Question 34

how is hep a & hep b & hep c transmitted ?

Answer 34

fecal-oral, food contamination
blood born, baby

Question 35

diagnosis studies for hepatitis

Answer 35

liver function tests ast and alt eleated