Gastrointestinal in class Flashcards
upper GI series
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
lower GI series
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
endoscopy
direct visualization through a flexible endoscope, usually under sedation
Esophagogastrduodenoscopy (EGD)
signed consent, NPO , remove dentures, administer throat spray and sedatives
post procedure: warm saline gargles
what can chronic gastritis lead to
Pernicious Anemia
-you need intrinsic factor from the stomach lining to absorb B12 and thus form RBCs
what is another word for Cobalamin
vitamin b12
two meds for gastritis
Ranitidine H2 blocker, Omeprazole PPI
what type of anemia do you develop from a slow bleed
iron deficiency anemia
what is GERD and what can it lead to
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
treatment of GERD
-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
Drug therapy for GERD
decrease acid secretion: Omeprazole and H2 Blocker
neutralize gastric acid : antacid
cover and protect ulcers: Sucralfate
increase GI motility, prokinetic: Metoclopramide (Reglan)
peptic ulcer umbrella
could be in esophagus, stomach or duodenum,
duodenum is the most common
how would a gastric ulcer be different than a duodenal ulcer
gastric ulcer: anorexia and weight loss, vomiting
duodenal ulcer: pain is relieved by eating , GI bleeding might be first symptom
complications of Peptic ulcer disease
hemorrhage is the most common, perforation is the most lethal
gastric outlet obstruction
medications for PUD
antibiotics (for H pylori)
PPI’s and H2Blockers
Antacids
Protectorants
Prokinetic agents
surgical interventions for PUD
*pyloroplasty for gastric outlet obstruction
*Vagotomy: to reduce gastric acid secretion; it removes part of the vagus nerve
*gastrectomy
giving too much tums leads to
hypercalcemia
giving too much antacids an lead to
metabolic alkalosis
what is dumping syndrome
a potential complication after a gastrectomy
-gastric contents dump too rapidly in to the small intestine and overwhelms its ability to digest nutrients
complications of appendicitis
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
diagnostic tests for peritonitis
CBC with diff –> WBCs will be high, left shift of the bands
ABD with x-ray, CT, ultrasound
electrolytes,
peritoneal aspirations/pericentsis
treatment of peritonitis
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
difference between ulcerative colitis and crohns
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
vomiting and distention obstruction at the pyloris
early and profuse vomiting, clear, golden yellow gastric fluid
vomiting and distention obstruction at the small intestine
mild distention, vomiting bile stained fluid (green)
vomiting would lead to metabolic _______?
metabolic alkalosis
symptoms of a small bowel obstruction
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
small bowel obstruction would you give an NG tube
yes
treatment for diverticular disease and diagnosis and treatment
high fiber diet,
there is no evidence to support the avoidance of certain foods
we do a CT scan
treatment with antibiotics
what is a cholelith? what are they usually made of
a gallstone, usually made of cholesterol
risk factors for gall bladder disease
obesity, female gender, use of oral contraceptives, middle age
forty, female, fat, and fertile
where would the pain usually be for cholelithiasis? when would it occur
RUQ, radiating to mid upper back
would occur 3-6 hrs after a high fat meal
what might jaundice and dark amber urine, clay colored stools, pruritis, & steattorrhea indicate?
bile flow is obstructed
how is hep a & hep b & hep c transmitted ?
fecal-oral, food contamination
blood born, baby
diagnosis studies for hepatitis
liver function tests ast and alt eleated
