GI 1 - STOMACH & INTESTINES Flashcards
In the small intestine, chyme mixes with what 3 substances?
Intestinal secretions, bile, pancreatic enzymes
What factors are produced by the microorganisms of the large intestine?
Vitamin K and B
Serum electrolytes are especially important to monitor in patients with which statuses?
- NG for decompression
- Poor intake
- Altered absorption
What 7 tests make up the LFTs?
Liver enzymes:
ALT, ALP, AST, GGT
Bilirubin
Albumin
Total protein
Which diagnostic test would be used to assess fluid collections or blood flow to various areas?
CT scan
What are 4 ways to take a culture for H.pylori?
Breath, urine, serum, biopsy
What is the etiology of appendicitis?
Occlusion of appendiceal lumen by a fecalith, causing tissue irritation, bacterial invasion
Where is pain usually located in appendicitis?
Periumbilical, leading to RLQ
How is management of perforated appendicitis different than regular appendicitis?
6-8 hrs conservative management (fluids and antibiotics) before appendectomy
What surgical intervention may be performed in patients with ulcerative colitis?
Total proctocolectomy with permanent ileostomy or ileoanal reservoir
What are differences between ulcerative colitis and crohn’s disease?
UC: bloody diarrhea, colonic dilation, risk for cancer
Crohn’s: autoimmune, colonic stricture, fistula formation
What is the most common cause for small bowel occlusion?
Adhesions (scar tissue)
What are 3 most common causes for large bowel occlusion?
- Carcinoma
- Volvulus (twisting)
- Diverticular disease
What are 2 examples of underlying causes for non-mechanical bowel obstruction?
Neuromuscular or vascular disorder
After total gastrectomy, what reconstructive surgery is performed?
Roux-en-Y esophagojejunostomy
(as well as jejunojejunostomy)
After subtotal gastrectomy, what reconstructive surgery is performed?
Roux-en-Y gastrojejunostomy
(as well as jejunojejunostomy)
When advancing the diet of patients post gastrectomy, what 3 complications should be monitored for?
- Dumping syndrome
- Postprandial hypoglycemia
- Anastomotic leak
What are the two terms for ostomies that specify whether the ostomy is permanent or temporary?
End or loop
When is temporary ostomy indicated, and how long are they usually present for?
Bowel rest and healing; 6 months
About how long can an ostomy flange be worn?
5-7 days
What is the only thing that should be used to wash the stoma?
Water
What is the term for surgical removal of the distal sigmoid, rectum, and anus via a perineal incision?
Abdominoperineal resection (APR)
During GI assessment, why is asking about appetite relevant?
It can indicate perfusion to GI tract
After insertion of an NG tube and confirming placement, what else needs to be done before you can use it?
Need to get a doctor’s order
