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joy's deck for FNP > GI > Flashcards

GI Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

acute pancreatitis

A

rapid onset abdomina pain radiates TO BACK.
+ cullen’s sign (blue at umbilicus)
+ grey turner (blue at flanks)
ED

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2
Q

acute diverticulitis

A

Left lower quadrant pain
Rovsing’s sign.
If palpation of the left lower quadrant of a person’s abdomen increases the pain felt in the right lower quadrant, the patient is said to have a positive Rovsing’s sign

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3
Q

acute appendicitis

A 
umbilical pain. 
\+ psoas sign
\+obturator sign
\+mcburnye's point 
markle test

Psoas sign—pain on extension of right thigh
Obturator sign—pain on internal rotation of right thigh
Rovsing’s sign—pain in right lower quadrant with palpation of left lower quadrant
Dunphy’s sign—increased pain with coughing
Flank tenderness in right lower quadrant (retroperitoneal retrocecal appendix)

Patient maintains hip flexion with knees drawn up for comfort

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4
Q

mc burneys point

A

McBurney’s point is the name given to the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus (navel). This point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum.

seen in appendicitis

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5
Q

cholecysitis

A

epigastric pain after eating fatty meal
pain radiates to RIGHT shoulder
overweight female
requires hospitalization dt risk of gangrene of the gall bladder

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6
Q

colon cancer

A

> 50 yo, blood in stool

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7
Q

zollinger ellison syndrome

A

increased gastrin level =ulcers

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8
Q

chron’s disease

A

higher risk for colon cancer

right lower quadrant pain, diarrhea with mucus,

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9
Q

cdif

A

watery diarrhea 10-15 stools/day, fever.
appears 5-10 days after antibiotics
clindaymcin, fluroquinolones, cephalopsorin/pcn

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10
Q

murphys sign

A

positive in cholestitis

press deeply on the RIGHT quadrant under costal boarder during inspiration

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11
Q

GERD

A

may result in barrets esophagus (pre cancer)

gold standard- esophageal motility study (upper endoscopy)

tx:
1) lifestyle (avoid large/fatty meals)
2) OTC antiacids/h2 blockers

3) prescribe
h2 blockers: ranitidiine or PPI omeprazole/prlosec

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12
Q

lifestyle changes for gerd

A

no mints, avoid caffeine, etc

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13
Q

cullens/gray turner

A

pancreatitis

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14
Q

mid epigastric pain radiate to back

A

pancreatitis

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15
Q

rovsings sign

A

Pain on RIGHT (rovsings= right) when palpate to the left

acute diverticulitis

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16
Q

IBS

A

chronic disorder of the colon. stress makes it worse

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17
Q

class case of ibs

A

young adult female cramping pain on left lower quadrant, bloating, relief after defecation.

increase fiber (metamucil/psyllium)
antispasmodics (bentyl) prn
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18
Q

PUD disease, duodenal/gastric ulcers

A

duodenal more common
gastric >risk for cancer
H. pylori
chronic nsaids, chronic bisphosphanates (fosamax, actonel)

PAIN relieved by food or antacids

upper endoscopy
r/o zollinger ellison

tx: ppi and h2 blockers

19
Q

TRIPLE therapy for H. pylori

A

1) clairithroymycin (biaxin)
2) amoxicillin
3) PPI - 6-8 wks

(CAP)

20
Q

quadruple therapy h. pylori

A

busmuth subsalicylate (pepto)
metronidazole (flagyl)
tetracycline
PPI: (pineapple-zole)

ie
omeprozole (prilosec)
exomeprazole (nexium)

21
Q

h pylori negative ulcer tx

A

4-6 wks treatments

H2:
ranitidine (zantac)
cimetidine (tagamet)

PPI: (pineapple-zole)
omeprozole (prilosec)
exomeprazole (nexium)

22
Q

diverticulitis

A

postive rosvings sign ( pain on right, when press on left )
LLQ pain
pain
rebound tenderness

herniation on colon, lack of FIBER

if elder and fever= ED can bleed

23
Q

diverticulosis

A

physical exam normal, no mass, no tenderness

24
Q

tx plan for diverticulosis

A

cipro/metronidazole ( flagyl)

25
Q

acute pancreatitis

A

alcohol, gallastones (+murphys),

triglycerites >800mg= high risk .

26
Q

tx for cdif

A

metronidazole ( flagyl)

AVOID anti motility agents (loperamide/immodium) or opiates.

27
Q

HbsAG (hep b surface antigen)

A

screening test for hep B
+= has the virus AND INFECTIOUS
how: acute infection or chronic hep B

28
Q

igG anti-HAV (hepatitis A antibody) positive

A

IMMUNE, non infectious
G=good
how: hx of hep A infection or vaccination (havrix)

29
Q

igM anti-HAV (hep A antibody) positive

A

infected and CONTAGIOUS!

M= miserable

30
Q

anti-HB (Hep B surface antibody) +

A

immunie

past infection or vaccination

31
Q

chronic hepatitis 2 types

A

1) chronic with mildly >LFT
chronic and active (ELEVATE LFT)= active viral replication

high risk for liver failture/cirrhosis

32
Q

anti -HCV

A

screen test for Hep C
**up to 85% become carriers , may indicated current infection !!

MAY STILL BE INFECTIOUS ( unlike hep a/hep b antibody)

order HCV RNA or PCR (polymerase chain reaction ) r/o chronic infection
if Positive, refer

33
Q

hep D (delta virus)

A

requires HEPATITIS B

B plus D increases risk for livery damage

34
Q

LIVER fuction tests

A

AST. ALT

35
Q

ast normal values

A

0-45mg/dl
aka: serum glutamic oxaloacetic transaminase (SGOT)
not specific to liver (also heart, muscle, lungs, etc)

36
Q

ALT

A

aka SGPT
0-40mg/dl
Liver specific

37
Q

AST/ALT ratio

A

sgot/sgpt ratio

a ratio of 2.0 or higher=alcohol abuse

38
Q

GGT elevated when

A

alcohol abuse
liver disease
pancreatitis

39
Q

HEP A

A

transmission: oral route; fecal, food/drink
self limiting, traveler
vaccine Havrix
no chronic or carrier state

40
Q

HEP B

A

blood, sex (semen, vaginal secretion, saliva), vertical transmission

41
Q

Hep C

A

IV drugs, blood, sex
IV (50%), drug use
HIGHEST risk for chronic infection and cirrhosis, liver cancer

tx: alpha interferon injections, ribavirin, biospy

42
Q

acute hepatitis (liver) causes

A

viral infection
statins
alcohol

43
Q

class case of hepatitis

A 
new sex partner, dark colored urine, fatigue/nausea
skin/sclera yellow (jaundice)
tender liver 
ALT/AST: elevated 10x
bilirubin and GGT elevated 
tx: supportive
avoid statins (prevastatin/pravachol)
44
Q

HbEag

A

“e”
active viral replication, infectious.
positive= chronic HEP B

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