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Normal CCRN Values > GI > Flashcards

GI Flashcards

1
Q

Alpha cell

A

Secrete Glucagon

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2
Q

Beta cell

A

Secrete insulin

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3
Q

Delta cell

A

Inhibit alpha and beta cells from releasing glucagon and insulin

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4
Q

Pancreas secretes

A

Bicarbonate for stomach acid
Water
Na and K
Digest enzymes trypsin, amylase, lipase

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5
Q

Acute panc s/s

A 
Boring abd pain, all quads and lumbar 
Rigid abd no rebound tenderness
BL crackles, L pleura effus L lobe collapse
Raised diaphragm
Amylase⬆️
Lipase⬆️
Calcium⬇️
Bg ⬆️
Surfactant⬇️from💀alveolar cells
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6
Q

Cullen sign

A

Blue discolor and bruising of umbilicus from methylalbumin formation from acute panc, intraperitoneal bleed

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7
Q

Grey Turner sign

A

Bruised flank, can be retro bleed, from acute panc

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8
Q

Acute panc tx

A 
Fluids
Ca++,K+,Mg++
H2 blocker or PPI
NG suct 
TF below duodenum
Monitor for ARDS, diaphragm elevation, atelectasis, and l sd plearual effus
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9
Q

Upper GIB tx

A 
Address cause
Fluids
PRBC
Clotting factor replacement
Vasopressin-constrict spleen art bed, ⬇️portal vein HTN
Octeotride -⬇️spleen blood flow GI motil
Lactulose-excrete nitrous content pvn ammonia
Bblocker -⬇️portal vein flow
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10
Q

Hepatic failure labs

A 
Protein⬇️
Albumin⬇️
Ascites
Ammonia⬆️
Pancytopenia
Coagulopathy
AST/ALT⬆️
Bilirubin⬆️
BG⬇️
RR⬆️
Creatinine⬆️
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11
Q

Hepatic failure s/s

A 
AMS
Asterixis (flapping hand tremor)
Ascites
Jaundice
Renal fail
Sepsis
Liver starts inflamed then shrinks
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12
Q

Factors increasing serum ammonia

A

K⬇️
BUN⬆️
LA⬆️
Protein⬆️

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13
Q

Manage Hepatic failure

A 
K sparing diuretic(Aldactone)
Neomycin to kill NH3 gut bacteria
Lactulose for NH3
Prevent ⬆️BUN, GIB, acid buildup 
Tips procedure
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14
Q

Spleen

A

Hx of splenectomy has poor immune fn, kehr sign, abdominal distention no bowel sounds, LUQ

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15
Q

Kehr Sign

A

Sharp L shoulder pain associated with ruptured spleen

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16
Q

Intrabdominal hypertension IAH

A

12-15mmHg

17
Q

Abdominal perfusion pressure APP

A

MAP-IAP; >60 ideal

18
Q

Abdominal compartment syndrome ACS

A

Sustained IAP >20, with or without APP of 60

19
Q

IAH tx

A

If IAP >12 reverse trend, restrict fluid, NGT, rectal tube

IAP>20 decompressive surgery

20
Q

Small intestine is perfumed by

A

Superior messnteric artery

21
Q

SBO s/s

A 
Sharp episodic pain
Early vomiting 
K⬇️
High pitch BS
dilated loops on KUB
Hypovolemia(3rd spacing)
22
Q

LBO S/s

A 
Dull pain
Bowel habit change
Vomiting (late)
Distention 
Low pitch BS
dilated loops KUB
23
Q

Bowel perf causes

A 
PUD
BO
appendicitis
UC
Wound
24
Q

Bowel perf s/s

A 
NV, temp, ⬆️HR, ⬆️RR
Abd tenderness c coughing hip flex
Rigid abd
Rebound tender
⬇️BS
air in peritoneum in KUB
25
Q

Bowel perf tx

A

NGT
fluids
ABX
Surgery and possible bowel diversion for healing

26
Q

Gastritis pain

A

Epigastric, indigestion, NV

27
Q

Peptic ulcer pain

A

Epigastric or RUQ
burning
Tenderness, Melena or BRB vomit

28
Q

Pancreatitis pain

A

Epigastric or LUQ
boring
Temp, NV

29
Q

Cholecystitis pain

A

Epigastric or RUQ
Cramping
NV tenderness

30
Q

Appendicitis pain

A

Epigastric then RUQ periumbilical
Dull or sharp
NV anorrhexia, fever, leukocytosis rebound tenderness

31
Q

SBO pain

A

Across abd in waves
Cramping, sharp
Abd distention, K⬇️, BS⬇️

32
Q

Ruptured spleen pain

A

Kehr sign
Sharp
Abd distention no BS

33
Q

Peritonitis pain

A

General pain
Dull then sharp
Rigid board like, rebound tenderness, BS⬇️

Normal CCRN Values (8 decks)

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