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TCM Review: Biomed > Gastrointestinal (TCM Review handout Full) > Flashcards

Gastrointestinal (TCM Review handout Full) Flashcards

Review the TCMreview.com notes on GI

1
Q

Obesity

A

Underweight – Below 18% • Healthy – 18.5 – 24% • Overweight – 25 - 30% • Obese – 31% and up

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2
Q

Salivary Amylase

A

Digests Starches

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3
Q

Lipase

A

Digests Lipids

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4
Q

Protease

A

Digests Protein

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5
Q

Ribonuclease

A

Digests Nucleic Acids

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6
Q

Lactase

A

Digests Milk Sugars

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7
Q

Glucoamylase

A

Digests Malt Sugars

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8
Q

Nucleotides & Phosphatases

A

Digests Nucleotides

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9
Q

Bile

A

Digestion of lipids pH of 7.5-8.8

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10
Q

Pepsin

A

Digests Protein

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11
Q

Pancreatic Amylase

A

Maltose, maltotriose, alpha dextrins

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12
Q

Trypsin

A

Peptides

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13
Q

Lysozyme

A

Kills bacteria

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14
Q

Saliva

A

pH of 6.5-7.5 moistens and lubricates

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15
Q

Antihelmintic

A

Mebendazole (vermox), pyrantel pamoate (combantrin, antiminth)

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16
Q

Antibiotics

A

Amoxicillin (amoxil), azithromycin (zythromax), cefproxil (cefzil), ciprofloxacin (cipro), clarithromycin (biaxin XL), levofloxacin (Levaquin)

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17
Q

Anti-diabetic

A

Metformin (Glucaphage), glipizide (Glucotrol), Glyburide (Micronase), Pioglitazone HCL (Actos)

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18
Q

Antidiarrheal

A

Bismuth subsalicylate (Pepto-Bismol), Kaolin and pectin mixtures (Kaopectate), loperamide HCl (Imodium)

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19
Q

Antiemetic

A

Prochlorperazine (Compazine), promethazine (Phenergan), trimethobenzamide HCl (Tigan)

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20
Q

Antifungal

A

Amphotericin B (Fungizone), Fluconazole (Diflucan), Nystatin (Mycostatin), Terbinafine (Lamisil)

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21
Q

Carthartic (Laxative)

A

Bisacodyl (Duclolax), casanthranol (Peri-Colace), magnesium hydroxide (Milk of Magnesia)

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22
Q

Absorption

A

Stomach: Alcohol, water, some fat soluble drugs.
Small Intestine: Nutrients Mainly
Large Intestine: Re-absorption of water, electrolytes
Fat-soluble vits ADEK: absorbed with fats in SI

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23
Q

Type 1 Diabetes

A

S/S: Ketoacidosis, polydipsia, polyuria, polyphagia, fatigue, parasthesia
Complications: Retinopathy, hypertension, neuropathy, ulcerations, infections and fractures
Infections: Foot, mouth, vagina (due to bacterium)
Treatment: Insulin
Lab tests: HbA1C

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24
Q

Type 2 Diabetes

A

S/S: Dry flushed skin, ketonic breath, nausea and vomiting, LOC, seizure, cramping, polyuria, dizziness, blurred vision, confusion
Complications: Retinopathy, loss of vision, nephropathy causing hypertension, neuropathy, ulceration of feet, infections and fractures
Infections: Foot, mouth, vagina (due to bacterium)
Treatment: Insulin replacement, basal and post prandial
Lab tests: HbA1C

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25
Q

Hypoglycemia ( blood glucose less than 70/ 3.9)

A

S/S: Sweating, nausea, warmth, anxiety, tremulousness, palpitations, hunger, headache, blurred or double vision, confusion, seizures, decrease in body temperature
Treatment: Glucagon
Lab Tests: Fasting glucose, serum insulin, C-peptide

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26
Q

Blood Sugar Levels

A

Before meals: less than 100 mg/dl (5.5 mmol/l) non diabetics and 80–130 mg/dl (4.4-7.2 mmol/l) for diabetics
1–2 hours after the start of a meal: less than 140 mg/dl (7.8 mmol/l) for non diabetics and less than 180 mg/dl (10 mmol/l) for diabetics

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27
Q

GERD

A

Lower esophageal sphincter reflux, burning pain and stricture

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28
Q

Emesis

A

Over expansion of the digestive system due to bacteria, virus or micro trauma of the esophagus from stomach acids

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29
Q

Gastritis

A

Pain, nausea, fullness, bleeding, due to NSAIDs or ethanol, or smoking; proton pump inhibitors can be a cause as well as a temporary cure

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30
Q

Peptic ulcer

A

Common in Hispanic and African Americans due to H. Pylori weakening the stomach lining. Can either be gastric or duodenal.

31
Q

Gastric ulcer

A

Occurs in the stomach leading to bleeding ulcers: refer to physician ASAP

32
Q

Duodenal ulcer

A

Mostly caused by H.Pylori or NSAIDs, smoking prevents healing; more consistent pain which usually awakens patient at night

33
Q

Thrush

A

Candida Albicans (fungus) possibly from immune compromised persons or people on aggressive antibiotic therapy or steroid (asthma) use: treat with anti-fungals

34
Q

Halitosis

A

Bad breath coming from the stomach

35
Q

Gastric Cancer

A

Indigestion, anorexia, abdominal pain and weight loss; often metastasizes to the lymph, liver, peritoneum, chest and brain: refer to physician STAT

36
Q

Melena

A

Black tarry stool due to long-term stomach or duodenum bleeding

37
Q

Adenovirus

A

4th most common childhood gastroenteritis disease: DNA virus

38
Q

Salmonella

A

Bacterial diarrhea due to under cooked poultry, milk, eggs or contact with reptiles (fecal oral route)

39
Q

Shigella

A

Third most common bacterial diarrhea in U.S. transmitted person to person

40
Q

Escherichia coli

A

Blood in diarrhea from undercooked beef, unpasteurized milk, juice and canning; may also have watery diarrhea; found commonly in nurseries: bacteria

41
Q

Vibrio

A

Diarrhea caused by undercooked seafood: bacteria

42
Q

Listeria

A

Food born and usually found in cheese: bacteria

43
Q

Constipation

A

Red Flag if patient is on opioids

44
Q

Dyspepsia

A

Upper abdominal distention with postprandial fullness that is gnawing or burning; epigastric pain with nausea and vomiting Tx: H2 blockers, Proton pump inhibitors

45
Q

HBA : 甲型肝炎 incubation etc.

A 
Nucleic Acid: RNA
Serologic test: IgM Anti-HA
Major transmission: Fecal-oral
CNT Incubation: 15-50 with AVG: 28
Incubation period days:  15-45
Liver Cancer: No
46
Q

HBV: B型肝炎 incubation etc.

A 
Nucleic Acid: DNA
Serologic test: HBsAG
Major transmission: Blood
CNT Incubation: 45-160
Incubation period days: 40-180
Liver Cancer: Yes
47
Q

HCV: 丙型肝炎 incubation etc.

A 
Nucleic Acid: RNA
Serologic test: Anti-HCV
Major transmission: Blood
CNT Incubation: 14-180 Avg. 5-10 weeks 
Incubation period days: 20-120
Liver Cancer: Yes
48
Q

HVD: 丁型肝炎 incubation etc.

A 
Nucleic Acid: Unknown
Serologic test: Anti-HCD
Major transmission: Needle
CNT Incubation: unknown
Incubation period days: 30-180
Liver Cancer: Yes
49
Q

HVE: 戊型肝炎 incubation etc.

A 
Nucleic Acid: RNA
Serologic test: Anti-HCE
Major transmission: WATER
CNT Incubation: 15-60
Incubation period days: 14-60 avg 40
Liver Cancer: No
50
Q

Most common type of hepatitis in medical field

A

Hepatitis B

51
Q

Most common hepatitis found in the world:

A

Hepatitis A

52
Q

Deadliest type of Hepatitis

A

Hepatitis C

53
Q

HAV S/S

A

Fever, fatigue, loss of appetite, nausea and vomiting, abdominal pain, dark urine, clay colored bowel movement, joint pain, jaundice

54
Q

HBV S/S

A

Fever, fatigue, loss of appetite, nausea and vomiting, abdominal pain, dark urine, clay colored bowl movement, joint pain, jaundice

55
Q

HCV S/S

A

Fever, fatigue, loss of appetite, nausea and vomiting, abdominal pain, dark urine, clay colored bowel movement, joint pain, jaundice

56
Q

Cholecystitis

A

Occurs as a complication to Cholelithiasis. Can be Uncomplicated with no S/S. Can also be complicated
S/S: Localized pain RUQ with rebound and guarding tenderness; positive Murphy sign, frequent fever, absence of peritoneal signs, tachycardia, diaphoresis, may have hypoactive bowel signs.
Misdiagnosed with: Pancreatitis;
CBC, Liver function panel, amylase, lipase

57
Q

Cholelithiasis

A

Symptoms occur when there is stones present.
S/S: Sporadic, unpredictable usually with pain in the epigastrium or RUQ, sometimes radiating to the right scapular tip. Pain is post prandial with an intense or dull pain lasting 1-5 hours which progresses for 10-20 minutes then goes away. Pain is constant, not relieved with emesis, defecation, flatus, positional changes or antacids. Additional symptoms: Indigestion, dyspepsia, belching, bloating. CBC, Liver function panel, amylase, lipase

58
Q

Crohn’s Disease Facts

A

Small intestine is involved in 80% of cases (esophagus to anus can also be affected)
Colon involvement is usually right sided, usually feels like appendicitis
75-85% of cases can have rectal bleeding; fistula and abscesses are common; 25-35% of cases have perianal lesions. TRANSMURAL
Asymmetrical and segmental (skip areas) on X-ray Endoscopy appearance is patchy with normal mucosa

59
Q

Ulcerative Colitis Facts

A

Disease is in the colon only; Superficial lesions, primarily in the descending section. Involvement is usually left sided. Rectal bleeding is always present; fistulas do not occur; no perianal lesions.
Symmetrical and uninterrupted bowel wall Inflammation is uniform and diffuse

60
Q

Appendicitis Facts

A

LRQ pain that can lead to peritonitis.
McBurney’s point: pressing on LRQ with rebound tenderness
Rovsing’s sign: press on LLQ causing more pain on LRQ
Appendectomy

61
Q

Diverticulosis Facts

A

Small pouches bulging outward through weak spots in large intestine; asymptomatic until inflamed; patient usually has low fiber diet; caused by heavy pressing due to constipation. Barium enema or colonoscopy. High fiber diet, angiographic or endoscopic treatment of bleeding: avoid seeds and antispasmotics.

62
Q

Diverticulitis Facts

A

Inflamed Diverticuli due to low fiber diet. Abdominal CT, colonoscopy. Liquid diet, oral antibiotics; severe cases require IV antibiotics or surgery

63
Q

Ulcerative colitis Facts

A

Extensive inflammation and ulceration (superficial) of large intestine, bloody diarrhea (a bit more acute) , cramping pain.
Dx:
Tx:

64
Q

Irritable Bowel Syndrome (IBS) Facts

A

Usually due to stress however etiology unknown; gas, bloating, cramping, bowel changes, constipation or diarrhea (See Crohn’s and UC) add: eye discomfort, extreme fatigue, joint pain, rectal bleeding. Counseling, normal diet, avoid gas-producing foods, diarrhea producing foods, increase fiber for constipation, loperamide for diarrhea, tricyclic antidepressants

65
Q

Rotavirus

A

Viral: most common cause of diarrhea in children and day care workers in America; can lead to dehydration due to watery diarrhea for 3-8 days
Toys, bathroom fixtures, changing tables, diaper pails, public swimming pools
Thoroughly wash hands and surfaces after changing diapers, refrain from going to pools when child has had diarrhea within the last 14 days

66
Q

Giardia

A

Parasite: very common; found in day care centers, international travelers, hikers, unfiltered or untreated water; spreads community wide
Uncooked food that has been contaminated, swallowing water from pools, water exposed to wildlife, day care facilities, toys
Wash foods properly, avoid consuming unfiltered water, (boil water if needed), refrain from using swimming pools for 14 days following a child who’s been diagnosed with giardia

67
Q

Cryptosporidium

A

Parasite: water borne and resistant to chlorine
Treatment Appendectomy
Pool water; can be found in day care settings
Avoid contaminated fruit or vegetables, drinking water from lakes or ponds, swimming in pools where children have had diarrhea within 14 days; this parasite can live in highly chlorinated water for several days

68
Q

Meckel’s Diverticulum

A

All ages will have intestinal obstruction manifested by cramping, abdominal pain, nausea and vomiting. Acute cases will have abdominal pain either below or to the left of the umbilicus often accompanied by vomiting and are similar to appendicitis. FTests: H/H, Stool Smear, CT Scan, Trechnetium scan. Complications: Excess bleeding, intessuception, peritonitis, perforation refer To PCP

69
Q

Roundworm

A

Intestinal blockage, bloating, large round worms in bowel movements, vomiting or crawling from nose. Unwashed raw foods, soil with eggs or water contaminated from pig feces; migrates through blood, lungs and then intestines. Small intestine is mostly affected Tx: antihelminics

70
Q

Hookworm (common in U.S.)

A

Loss of appetite, loss of weight, abdominal distention, anemia, intestinal bleeding. Contaminated soil, water contamination, unwashed raw foods. Infests biliary tract, pancreas Tx: corticosteroids and antihelminics

71
Q

Pinworm

A

Very common in schools and daycare centers and passed on to people in one household: itchy perineum is the most common symptom. Very common in day care centers, anus to mouth transmission and then spreads from clothing, bedding, furniture. Affects lower intestine Tx: antihelminics

72
Q

Tapeworm

A

Abdominal distention, pain, diarrhea, malnutrition, Weight Loss. Can develop large cysts in the liver and lungs, usually found in contaminated soil or fish, poor sanitation; may have no symptoms for months to years. Can develop large cysts in the liver and lungs, usually found in contaminated soil or fish, poor sanitation; may have no symptoms for months to years

73
Q

Trichinosis

A

Stomach pain, extreme fatigue, nausea and vomiting, diarrhea, fever, headache, chills, swelling of the eyes, cough, muscle aches, may have constipation, heart palpitations, dyspnea. Mimics Syphillis. Large intestine is primarily affected; also affects muscles, brain and other organs Tx: antihelminics

74
Q

Manual Tests

A

McBurney’s Point: Appendicitis, look for rebound tenderness.
Murphy’s Sign: Cholelithiasis, cholecystitis
Obturator Muscle Test: Rule out appendicitis
Psoas Sign: Rule out appendicitis
Rovsing’s Sign: Rule out appendicitis

TCM Review: Biomed (11 decks)

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