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GENERAL- TOP8 > GASTROINTESTINAL TRACT > Flashcards

GASTROINTESTINAL TRACT Flashcards

1
Q

-Incompetent Lower esophageal sphincter
-Pyloric Stenosis
-Delayed emptying
-Lead to: Backflow

A

GERD

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2
Q

Dx of GERD

A

24- hour ambulating ph monitoring
Endoscopy

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3
Q

Interventions: GERD

A

Non surgical
Avoid acids
No meal before bedtime
Surgical:
Laparoscopic Nissen Fundoplication

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4
Q

Life Modifications: Drug Therapy (GERD)

A

Antacids
H2 Receptor
Chloride Ion Channel

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5
Q

Poor man’s laborer

A

Gastric Ulcer

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6
Q

Executive ulcer

A

Duodenal Ulcer

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7
Q

50 Above ulcer

A

Gastric Ulcer

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8
Q

25-50 yrs old ulcer

A

Duodenal Ulcer

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9
Q

Malnourished ulcer

A

Gastric Ulcer

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10
Q

Well-nourished ulcer

A

Duodenal Ulcer

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11
Q

Pain is felt when eating ulcer

A

Gastric Ulcer

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12
Q

Pain is relieved by eating ulcer

A

Duodenal Ulcer

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13
Q

Pain on the left ulcer

A

Gastric Ulcer

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14
Q

pain on right ulcer

A

Duodenal Ulcer

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15
Q

hematemesis ulcer

A

Gastric Ulcer

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16
Q

Melena ulcer

A

duodenal ulcer

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17
Q

(+) h-pylori

A

gastric & duodenal ulcer

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18
Q

dx ulcer

A

Hemoccult test /Guac Test
EGD- Esophagogastroduodenoscopy

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19
Q

Interventions: DIET for Ulcer

A

Bland diet (walang lasa)

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20
Q

Interventions: ulcer surgical

A

Gastrectomy
Vagotomy: removal branch of stomach
Bilroth Procedure
Billroth 1: Gastroduodenostomy: Stomach joined to duodenum
Billroth 2: Gastrojejunostomy: jejunum and stomach is attacthed at opening hole next to small intestine.
Pyloroplasty:allows gastric drainaige

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21
Q

-Rapid emptying of stomach contents into the small intestines

A

dumping syndrome

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22
Q

s/sx of dumping syndrome

A

Hyposmolar jejunal chyme–> Intraluminal fluid sequestration
Decrease blood volume
Hypotension
Tachycardia
Bloating
Abdominal pain
Diarrhea
Rapid Glucose absorption
Inappropriate insulin release
Late hypoglycemia

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23
Q

Interventions: dumping syndrome

A

Avoid sugar
High protein (CHON), high fat, & low CHO
-Protein & fat= digest slower
-Carbohydrate=digest faster
Small meals
Avoid fluids (high fluid hasten digestion)
lie down after meals

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24
Q

-Weakness in the abdominal muscle wall in which a segment of the bowel protrudes.

A

herniation

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25
Q

Intervention for hernia: non-surgical

A

truss

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26
Q

Intervention for hernia: surgical

A

Herniorrhaphy

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27
Q

Common type of hernia in male

A

Inguinal

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28
Q

common type of hernia in female

A

Umbilical hernia???

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29
Q

-idiopathic inflammatory disease of the small/large intestine, or both

A

CHRONIC INFLAMMATORY BOWEL DISEASE (IBD)

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30
Q

-Inflammatory disease of the large intestines that begins in the rectum-upward.

A

Ulcerative Colitis:

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31
Q

Regional enteritis
Environmental
Diarrhea
no bleeding
5-6 stools (soft)
Anorexia
Dehydration/Weight loss
abd pain

A

Chron’s Disease

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32
Q

Large intestine
Rectum
Emotional
With bleeding
20-30 wattery stool
Severe form of anorexia
DHN/weight loss
abd pain

A

ulcerative colitis

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33
Q

Intervention for IBD: NON-SURGICAL

A

NPO
IV fluids

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34
Q

Intervention for IBD: DRUG THERAPY

A

Salicylate compound (Sulfasalazine)
Prednisone
SE:immunosupression
Cyclosporine
Anti-diarrheals

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35
Q

Intervention for IBD: Surgical

A

Total proctocolectomy with permanent ileostomy
Ileoanal anastomosis

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36
Q

frequent urge to defecate. Sensation of incomplete evacuation.

A

Tenesmus:

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37
Q

pouchlike herniations of the small intestines or colon

A

Diverticula

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38
Q

Presence of many pouchlike herniations

A

Diverticulosis:

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39
Q

Inflammation of one or more diverticula

A

Diverticulitis

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40
Q

Interventions:
Non-surgical: DIVERTICULAR DISEASE

A

Bedrest
NPO, or clear liquids
Fiber rich food
Avoid gas formers/ seeds/ Nuts

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41
Q

Drug therapy:DIVERTICULAR DISEASE

A

Antibiotics: Metroni/ Ciproflox
Analgesics
Laxatives

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42
Q

Surgical: DIVERTICULAR DISEASE

A

Total proctocolectomy with permanent ileostomy
Ileoanal anastomosis
Colon resection

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43
Q

cause: appendicitis

A

Fecalith-small fecal material

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44
Q

Assessment: appendicitis

A

-Pain in the McBurney’s point: 2/3 distance from navel to Right Anterior superior iliac spine.
Rovsing’s obturator: referred pain in the RLQ when LLQ is palpated.
 Psoas sign :lie on side and right thigh is flexed backward.
Fever/elevated WBC
Anorexia
N/V

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45
Q

pt lies on the left side and extension of the right thigh

A

Psoas sign

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46
Q

flexion of the obturator muscle.

A

Obturator sign

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47
Q

referred pain in the RLQ when LLQ is palpated

A

Rovsing’s sign

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48
Q

intervention of appendicitis

A

Non-surgical
NPO
IV therapy
Proper positioning
Surgical
Appendectomy

49
Q

-Unnaturally swollen or distended vein in the anorectal region

A

HEMORRHOIDS

50
Q

Pathophysiology:HEMORRHOIDS

A

Activities that increases intra-abdominal pressure leading to proplapse of the hemmorhoidal vessels.

51
Q

Interventions: hemorrhoids

A

Cold packs followed by sitz bath
Witch hazel soaks
High fiber diet
Avoid straining
Hemorrhoidectomy

52
Q

-A progressive liver disease with diffused degeneration & destruction of hepatocytes.

53
Q

Laënnec’s cirrhosis

A

primarily caused by excessive alcohol consumption

54
Q

breath of the dead; fecal in nature.

A

Fetor hepaticus:

55
Q

Ammonia that reaches the brain; inability to maintain posture, flappy/tremor hands.

56
Q

assessment: cirrhosis

A

Spider angioma
Caput medusae: swollen cluster vein in abd
Esophageal varices
Fetor hepaticus: breath of the dead; fecal in nature.
Asterixis: Ammonia that reaches the brain; inability to maintain posture, flappy/tremor hands.
Jaundice: cannot excrete bilirubin thru stool
Ascites: vein problem co2 tha liver cant accpet.
Hepatic Encephalopathy

57
Q

interventions: cirrhosis

A

Diet: CHO (Carbohydrates)
Surgical:
Paracentesis: Removal of fluid in peritoneal area

58
Q

Drug Therapy: cirrhosis

A

Diuretics
Lactulose
Neomycin Sulfate
-Metronidazole

59
Q

Assessment: cholecystitis

A

RUQ pain going to the scapula hours post eating fatty foods.
Mass palpated in the RUQ
Biliary obstruction
Jaundice
Dark orange & foamy urine
Streatorrhea
Clay-colored stool: No Bilirubin

60
Q

Interventions: DIET CHOLECYSTITIS

A

NPO
Low-fat meals
Eat in small amount

61
Q

Interventions: Surgery; CHOLECYSTITIS

A

Cholecystectomy
Choledoclithotomy
Cholecystostomy

62
Q

-Inflammation of the pancreas with escape of pancreatic enzymes into surrounding tissues.

A

Pancreatitis

63
Q

Cause: PANCREATITIS

A

-Alcohol -gallstones
-idiopathic -others: drugs
-hyperlipidemia
-hypercalcemia
-Trauma -Ductal Obstruction

64
Q

Ecchymosis in the side of abdomen

A

Grey Turner Sign:

65
Q

(+) cullen sign & (+) grey turners sign

A

pancreatitis

66
Q

DOC: Pancreatitis

A

1st : Mild-NSAIDS
2nd :Moderate- Codeine/Meperidone demerol
3rd:Severe: Morphine
SE: spasm in sphincter of ODDI

67
Q

Deficiency of one or more AP hormones

A

HIPOPITUITARISM

68
Q

Hypersecretion of pituitary hormones
-GH, ACTH, & Prolactin are commonlu oversecreted
-caused by tumor in pituitary gland (PG)

A

HYPERPITUITARISM

69
Q

DOC: acromegaly/gigantism

A

Bromocriptine Mesylate (Parlodel)
SE: orthostatic hypotension

70
Q

SURGERY: acromegaly/gigantism

A

Transphenoidal Hypophysectomy

71
Q

POST-OP MANAGEMENT:Transphenoidal Hypophysectomy

A

HOB elevated 2 weeks
Nasal packing
No blowing
Nasal drainage
Halo test/sign: CSF is formed around blood when drop to cloth sheet.

72
Q

Hypersecretion of ADH
-excessive retention of water.

A

SIADH/ SCHWARTZ-BATTER SYNDROME

73
Q

MANAGEMENT:SIADH

A

Diuretics
Hypertonic IV
Fluid restriction
Provide safe environment

74
Q

ADH deficiency or kidney ignoring the ADH
-Excessive release of water
-Inability to retain water

A

DIABETES INSIPIDUS

75
Q

MANAGEMENT:DIABETES INSIPIDUS

A

Administer ADH:
-Desmopressin
-Vasopressin
Sit up when spraying
SE: Stomatitis, Allergy, Chest Tightness
Alternative: when experiencing SE
SUBQ VASOPRESSIN

76
Q

Thyroid Hormones:

A

T3 (Triiodothyronine)
T4 (Thyroxine)
Thyrocalcitonin: Normalizes calcium when too high.

77
Q

hormone that Normalizes calcium when too high.

A

Thyrocalcitonin:

78
Q

-Has too much ADH retention of fluid
-Concentrated urine
-Low sodium

79
Q

-Has too little ADH secretion of fluid
-Diluted urine
-High Sodium

80
Q

Deficiency of thyroid hormones
Cause: Thyroidectomy; Antithyroid Drugs

A

HYPOTHYROIDISM

81
Q

MANAGEMENT: HYPOTHYROIDISM

A

VS
Diet: Low calories, Low fat, High Fiber
Administer thyroid replacement drug

82
Q

Medication:HYPOTHYROIDISM

A

Synthoid
Levothroid
Cytomel
Thyrolar
Thycar

83
Q

Excessive thyroid hormone secretion
Cause: Emotional stress, Autoimmune

A

HYPERTHYROIDISM

84
Q

S/SX : All symptoms are high except weight & Irregular Menstruation.

A

Hyperthyroidism

85
Q

MANAGEMENT:HYPERTHYROIDISM

A

Rest
Non-stimulating event
Diet: High calories
Safety
Artificial tears
Avoid stimulants

86
Q

Medications:Hyperthyroidism

A

Beta-blockers
Calcium channel blockers
Oral radioactive iodine
-Destroys thyroid hormone
-i 131:destruction of follicular cells
Takes effect in 6-8 weeks

87
Q

Medication alternative for pregnant hyperthyroidism pt?

88
Q

-Adrenal insufficiency
-hyposecretion of adrenal cortex
-decrease S-S-S :Sugar, Sodium, Sex

A

ADDISON’S DISEASE

89
Q

Diet for Addison’s disease:

A

High protein, High Carbohydrate, High Sodium, Low Potassium

90
Q

Hypercorticolism
Cause: could be Steroid Medications

A

CUSHING’S DISEASE

91
Q

Manifestations of cushing

A

Obese trunk
Moon face
Buffalo hump
Reddich-Purple striae on trunk
Hypertension
Hyperglycemia
Hypokalemia
Hirsutism, acne
Low immunity

92
Q

MANAGEMENT: Cushing Syndrome

A

Monitor Weights/ VS
Monitor: Serum Na, Serum K
-If adrenal tumor is the caused
Two/Bi: Lifelong hormone replacement
Uni/one: 2 years of HR & stop

93
Q

DOC: Cushing syndrome

A

MITOTANE
- Reduces Cortisol

94
Q

Surgery: cushing syndrome

A

Hypophysectomy
Adrenalectomy

95
Q

Catecholamine: Producing Tumor
Cause: Unknown

A

Pheochromocytoma

96
Q

Hallmark sign of pheochromocytoma

A

Hypertension

97
Q

Manifestation: of pheochromocytoma

A

Hypertension: Hallmark sign
Headache
Hyperhidrosis
Hypermetabolism
Hyperglycemia

98
Q

Management: pheochromocytoma

A

Monitor VS/ Blood glucose
Position: Elevate HOB
Do not palpate the abdomen
Surgery:
Adrenalectomy

99
Q

-AKA juvenile DM as it happens 10-16 years old.
-Diabetes of infancy: Hyperglycemia onset before 6 months
-Absolute deficiency of insulin

A

DIABETES MELLITUS TYPE 1 DM

100
Q

Determine the compliance to regimines/therapy of DM for the past 3-4 months.

A

HBA1C or glycosylated hgb

101
Q

results of HBA1C:

A

Normal: 5.7 % Below
Prediabetes: 5-7-6.4 %
Diabetes: 6.5 % Higher

102
Q

Order of 3P’S

A

1st: Polyphagia
2nd: Polyuria
3rd: Polydipsia
4th: weight loss (4th sign)

103
Q

MANIFESTATION: DM1

A

Polyuria
Polydipsia
Polyphagia
Weight loss
Weakness
Hyperviscosity
Hemoconcentration
Hypoperfusion

104
Q

TYPES OF INSULIN

A

-quick acting/ very rapid acting
-short-acting
-intermediate acting
-long-acting
-very long acting

105
Q

Quick acting: Onset & Peak

A

L-A-G
Lispro
Aspart (Novolog)
Glulisine (apidra)

Onset:
5-15 mnutes (effect)

Peak:
30 minutess to 1 hour

106
Q

Short acting: Onset & Peak

A

Regular (humulin R)

Onset: 30 minutes -1 hour

Peak: 2-4 hours

107
Q

Intermediate acting: Peak and hour

A

NPH (Humulin N)

Onset: 1-2 hrs
Peak: 6-12 hrs

108
Q

Long acting: onset and Peak

A

Ultralente (Humulin U)

Onset: 2-4 hours
Peak: 16-24 hours

109
Q

Very long acting: onset & peak

A

Lanthus (Glargine)

Onset:3-5 hours
No peak time: basal insulin

110
Q

CLEAR INSULIN

A

=L-A-G (quick acting)
=Regular
=Lanthus (glargine)

111
Q

OHA: 1

A

Sulfonylureas Agents : (ask help on pancreas)
Chlorpropamide (Diabenase)
Glimepiride (Amaryl)
Glipizide (Glucotrol)
Tolazamide (Tolinase)

112
Q

OHA 2:

A

BIGUANIDES: ask help on liver
-appetite suppresant

METFORMIN
-Metformin: Decrease liver glucose release
-30 minutes before meals
-do not give for: 48 hours for contrast dye procedures
***Metformin + contrast dye = Lactic Acid result to Spasm in muscle

113
Q

OHA 3

A

Alpha-Glucosidase inhibitors
-Slows intestine
-Take with first bite

Acarbose (Precose)
Miglitol (Glyset)
SE:
Flatulence
Abdominal discomfort
Diarrhea

114
Q

OHA 4:

A

insulin; 20 glucose (kumpras)
-Thiazolidinedione (anti-diabetic agents)
-Increase insulin Sensitivity, improving glucose absorption
-with or without food
-Rosiglitazone (Avandia)
-Pioglitazone (Actos)

115
Q

Causes: HHNKS

A

Causes:
-from DM2
-Underdose or missed dose of OHA
-Illness or infection
-Overeating
-Stress,Surgery

116
Q

MANAGEMENT: HHNKS

A

Administer oxygen
Nacl or 0.45 % NaCl
Regular insulin IV

117
Q

CAUSE:DKA

A

CAUSE:
-from DM 1
-Under dose or missed dose of insulin
-Illness or infection
-Overeating
-Stress, Surgery

118
Q

CHRONIC COMPLICATONS OF DM:

A

Neuropathy 1st
Retinopathy 2nd
Nephropathy 3rd

GENERAL- TOP8 (25 decks)

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