GI/GU Flashcards
gerd also known as
acid reflux- very common
s/sx of GERD
cough
sore throat
regurgitation
chest pain
risk factors for GERD
smoking
obesity
pregnancy
aging
GERD diagnostic
generally exam but can use
EGD
if pt c/o heartburn
and PPI or H2 blocker controls symptoms- not really a need to order EGD
educated GERD pts
sitting up
weightloss
not drinking with meals
The eternal debate: PPI or H2 blocker?
these are both first line for the correct pt
mild- H2
severe- PPI
if pt can’t afford PPI- they are more expensive.
H2 blocker not as strong at decreasing gastric secretion
What is more effective for GERD, PPIs or H2 blockers?
PPIs more effective for GERD
- Long-term complications of PPIs
osteoporosis
C Diff
B12 deficiency anemia
Why is it so important for GERD pts to take their meds consistently?
Reflux put them at high risk for Barret’s esophagus.
trying to prevent this by actively treating GERD appropriately
Prescription-strength proton pump inhibitors.
These include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant).
Gastric reflux symptoms
Symptoms
* Chest pain, chronic sore throat/hoarseness, dysphagia, erosion of teeth, chronic cough/asthma, postnasal drip, pyrosis (heartburn), lump in throat, fatigue, anemia
GERD diff dx
asthma, cardiac disease, cholelithiasis, esophageal CA, H Pylori, hiatal hernia, IBS, lower resp infection PUD
- Ulcerative colitis symptoms, diagnosis and
Symptoms
* Bloody/mucus diarrhea, rectal bleeding, fecal incontinence, tenesmus (cramping of anal sphincter), abd pain, decreased appetite, weight loss, fever, tachycardia, anemia, fatigue, clubbing of fingernails, peripheral edema
ulceratice colitis treatment plan
treatment plan
* non pharm: bowel rest (for acute flareup), avoid triggers (caffeine, alcohol, carbonated beverages, lactose), stress management, exercise, healthy diet, surgery if unresponsive to 2-3 weeks of medical therapy
* Pharm: aminosalicylates (5-ASA); may use IV steroids during exacerbations
Ex of 5-ASA: Asacol, Pentasa, Lialda
Works by preventing leukocyte recruitment into the bowel wall
Wilms’ tumor characteristics
Rare unilateral kidney cancer (nephroblastoma)
* Painless swelling/lump in the child’s abdomen
* Can cause hematuria
Urge incontinence
Overactive bladder with a strong sensation of a need to urinate
Diagnosis
Pelvic exam may show vaginal atrophy
Ensure negative UA and culture
Functional incontinence
- Inability to reach the toilet on time/unaware of need to void
- May find limited mobility or altered LOC
- Diagnosis
Ensure negative UA and culture
Stress incontinence
- Leaking urine with cough, sneeze, exercise
- Diagnosis
Ensure negative UA and culture
Chronic prostatitis diagnosis and treatment plan
s/s: urinary frequency, urgency, pressure, dysuria, hematuria, testicular or penile pain, abdominal pain, painful ejaculation
* Exam: swollen, firm, warm, tender prostate
* Diagnosis: UA with culture
* treatment plan
An antibiotic is used to treat prostatitis that is caused by an infection. Some antibiotics that might be used are trimethoprim-sulfamethoxazole, doxycycline, ciprofloxacin, norfloxacin and ofloxin.
* TMP/SMX
* Fluroquinolones
* Alpha-blockers to relax muscles in bladder
Irritable bowel syndrome (IBS) Symptoms
- Abdominal cramping
- pain relieved after bowel movement or passing of gas
- feeling of incomplete passing of stool
- Constipation or diarrhea
- mucus in stools
- abdominal distention or bloating
- RED FLAGS: rectal bleeding, nocturnal pain, weight loss
*
Irritable bowel syndrome (IBS) Diagnosis*
CBC, CMP, IGA SED RATE, STOOL CULTURES, COLONOSCOPY
*
Irritable bowel syndrome (IBS) treatment
Treatment plan
* Non-pharm: consider lactose-free diet, exclude gas producing foods, stress management, heat to abdomen, avoid triggers/stimulants
* Pharm: do NOT use SSRIs; do use stool softeners (colace), bulk-producing agents (psyllium), stimulants (bisacodyl/Dulcolax), bentyl (antispasmodic)
Diverticulitis diagnosis and treatment plan
- LLQ pain
- Diagnosis: CT abdomen
- treatment plan
- low-fiber diet
- antibiotics (Flagyl)
Difference between unlcerative collitis and IBS
Colitis is a whole-body disease, while IBS is a syndrome that mainly affects the gut. Doctors do not yet know the triggers of colitis, although certain foods may be suspect. IBS may include triggers such as stress or particular food groups. Colitis results in physical damage to the colon, while IBS does not.
