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AFN Health Assessment > GI > Flashcards

GI Flashcards

1
Q

Name some factors/agents that decrease LES tone

A

-inhaled anesthetics
-propofol
-opioids
-anticholinergics
-beta agonists
-glucagon
-obesity
-hiatal hernia
-pregnancy
-cricoid pressure

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2
Q

Name some factors/agents that increase LES tone

A

-SCh (RSI w/ this)
-cholinergics
-acetylcholine
-anticholinesterase
-alpha agonist
-antacids
-serotonin
-histamine
-metoprolol
-metoclopramide

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3
Q

What CNs innervate the LES?

A

CN 9, 10, 11

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4
Q

What is achalasia

A

LES can’t relax, so food backs up in esophagus and leads to regurg

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5
Q

What disorders have development of achalasia

A

-DM
-CVA
-ALS
-Amyloidosis
-Scleroderma

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6
Q

What is barrett’s esophagus

A

Chronic GERD leading to epithelial cell changes (malignancy risk)

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7
Q

When elements from abdominal cavity (usually stomach) herniates through the esophageal hiatus to the mediastinum

A

Hiatal hernia

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8
Q

What do you worry about w/ hiatal hernia?

A

Aspiration (decreased LES tone)

***Aspiration profilaxis if pt. is symptomatic

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9
Q

What is the worst complication w/ gastritis?

A

Major gastric bleeding

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10
Q

With severe bleeding w/ gastritis, what 3 blood products are you giving?

A

RBCs/Plts/FFP

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11
Q

Main focus on gastritis tx. (non-emergent)

A

H. pylori (via antibiotics)

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12
Q

2 most common causes of peptic ulcer disease

A

H pylori

NSAIDs

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13
Q

Is bleeding risk w/ PUD similar to gastritis?

A

Yes

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14
Q

Most frequent complication of gastric ulcer disease

A

Perforation

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15
Q

4 Big anesthesia takeaways/implications for gastritis/PUD/GUD

A

-Avoid placing anything in esophagus

-GI profilaxis

-RSI

-A-line & be ready to give blood products/volume resuscitation

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16
Q

What 2 complications would you put in NGT and drain preop?

A

Adynamic colon

Colon obstruction

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17
Q

What meds do you avoid w/ GI obstruction????

A

GI prokinetics

***REGLAN

***N2O

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18
Q

__________ analgesia can be used to reduce post op Ileus

A

Multimodal

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19
Q

what is the most common general surgery emergency?

A

appendicitis

20
Q

Classic presentation of appendicitis

A

-RLQ pain
-N/V
-anorexia
-fever

21
Q

Signs of appendix perforation

A

abd pain gets more intense and diffuse

Abdominal rigidity

HR increase

Temp increase

22
Q

Does appendectomy require GA?

A

Yes

23
Q

Aspriation risk w/ appendectomy?

A

YESSS

24
Q

Is routine GI profilaxis recommended?

A

No

25
Q

Take GERD meds DOS?

A

Yes

26
Q

Most important factor in aspiration risk reduction

A

Know your patient

27
Q

Name some risk factors for aspiration

A

-full stomach
-emergency surgery
-OB pts (esp. C-section)
-GI obstruction
-DM
-GERD
-Hiatal hernia
-inadquate anesthesia
-hypotension
-Low LES tone
-head injury
-decrease LOC
-seizures
-obesity
-N/V
-opioids
-cardiac arrest
-scleroderma

28
Q

Where do we look w/ ultrasound to check gastric volume?

A

Pyloric antrum

29
Q

Effects of preop fasting?

A

-insulin resistance/postop hyperglycemia

-dehydration

-muscle waisting

-immune compromise

30
Q

clear liquids minimum fasting period

A

2 hrs

31
Q

Breast milk minimum fasting period

A

4hrs

32
Q

Infant formula, non-human milk, light meal minimum fasting period

A

6hrs

33
Q

t/f, type of liquid matters more than volume w/ preop fasting

A

true

34
Q

High fat content w/ meal requires ___hrs of fasting

A

8hrs

35
Q

If post pyloric, can TF be continued?

A

Yes

36
Q

If not post pyloric, how long to hold TF?

A

8hrs

37
Q

NO fluid or solid fluid ___hrs prior to procedure

A

2hrs

38
Q

Meals NPO > ___ hrs may be detrimental

A

8hrs

39
Q

_______ antacids are NOT recommended at all

A

Particulate antacids

40
Q

Non-particulate antacids (bicitrate/sodium citrate) do what?

A

increase pH

41
Q

H2 receptor antagonists & PPIs do what?

A

reduce volume

increase pH

42
Q

How many doses of PPI preop

A

2

43
Q

When should you not give gastric prokinetics (reglan)?

A

Parkinsons

Bowel obstruction

44
Q

Antiemedics do what?

A

moderate N/V

45
Q

Do antiemetics help prevent aspiration?

A

NOO

46
Q

Are anticholinergics (atropine/glycopyrrolate) recommended at all?

A

NOO

AFN Health Assessment (12 decks)

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