GI/GU Flashcards
S+S
- Bloating
- Excess gas
- Constipation
- Diarrhoea
- Heart burn
- Nausea and vomiting
- Abdominal px
- Incontinence
- Weight loss
- Blood in stool
- Px
- Difficulty swallowing
- Changes in appetite
Abdo P- P generalised throughout abdomen
o Appendicitis
o Crohn’s disease
o Traumatic injury
o IBS
o UTI
o Flu
Abdo P- lower abdominal
o Appendicitis
o Intestinal obstruction
Abdo P- reproductive organs in females
o Ectopic pregnancy
o Dysmenorrhea (severe menstrual px)
o Ovarian cysts
o Miscarriage
o Fibroids
o Endometriosis
o Pelvic inflammatory disease
Abdo P- upper
o Gallstones
o Heart attack
o Hepatitis
o Pneumonia
Abdo P- centre
o Appendicitis
o Gastroenteritis
o Injury
o Uraemia (build-up of waste products in the blood)
Lower left abdominal P
o Crohn’s disease
o Cancer
o Kidney infection
o Ovarian cysts
o Appendicitis
Upper left abdomen P
o Enlarged spleen
o Faecal impaction (hardened stool that can’t be eliminated)
o Injury
o Kidney infection
o Heart attack
o Cancer
Lower right abdominal P
o Appendicitis
o Hernia
o Kidney infection
o Cancer
o Flu
Upper right abdominal P
o Hepatitis
o Injury
o Pneumonia
o Appendicitis
Generalised P
- Means that the pt feels it in more than half of their abdomen
- This type of px is typical for
o Stomach virus
o Indigestion
o Gas - If the px becomes more severe it can be caused by a blockage of the intestines
Localised P
- Px found in only one area of your belly
- More likely to be a sign of a problem in an organ
Crampy P
- Most of the time not serious
- Likely due to gas and bloating and is often followed by diarrhoea
- More worrisome signs include px that
o Occurs more often
o Lasts longer than 24 hours
o Occurs with a fever
Colicky P
- Px that comes in waves
- Often starts and ends suddenly
- Often severe
- Kidney stones and gallstones are common causes of this type of px
Sudden onset
- Occurs within a second
- Pt will relate the time of onset at a precise moment, usually stating exactly what activity was going on at the time the px began
- Commonly associated with
o Perforation of the gastrointestinal tract from a gastric or duodenal ulcer
o A colonic diverticulum
o Foreign body
o Ruptured eptopic pregnancy
o Mesenteric infraction
o Ruptured aortic aneurysm
o Embolism of an abdominal vessel
Rapid onset
- Begins with a few seconds and increases in severity over the next several minutes
- Pt will recall the time of onset in general but without the precision noted in px of sudden onset
- Associated with
o Cholecystitis
o Pancreitis
o Intestinal obstruction
o Diverticulitis
o Appendicitis
o Ureteral stone
o Penetrating gastric or duodenal ulcer
Gradual onset
- Px that comes on slowly and becomes more severe after a number of hours or even days have elapsed
- Pt memory as to the time of onset of the px is vague; they can only pinpoint the day or maybe the week of onset
- Generally associated with
o Neoplasms
o Chronic inflammatory processes
o Large bowel obstructions
Progression
- Its of real diagnostic significance to determine the progression of the px over the interval of the time of onset until the pt seeks medical attention
o Has the px abated or increases?
o Have there been intervals of total absence of the px or has the px always been present, changing only in character?
Associated features
- Symptoms that accompany abdominal px are important in making an accurate diagnosis
- Some of the most important symptoms are
o Nausea
o Vomiting
o Abdominal distention
o Diarrhoea
o Constipation
o Obstipation
o Tarry stools
o Chills
o Fever
o Urinating frequently
o Haematuria
o Jaundice
Gastroesophageal reflux disease
- Occurs when the acid from the stomach leaks up into the oesophagus
- Usually occurs as a result of lower esophageal sphincter weakness
GORD cause
Frequent acid reflux or non acidic content of stomach
- When you swallow, a circular band of muscle around the bottom of the oesophagus relaxes to allow food and liquid to flow into the stomach, the sphincter then closes again
- If the sphincter does not relax as it should or it weakens, stomach acid can flow back into the oesophagus
- This constant backwash of acid irritates the lining of the oesophagus, often causing it to become inflamed
GORD population
Young adults and teenagers
GORD risks
- Obesity
- Hiatal hernia
o Bulging of the top of the stomach up above the diaphragm - Pregnancy
- Connective tissue disorders, such as scleroderma
- Delayed stomach emptying
GORD aggravating factors
- Smoking
- Eating large meals or eating late at night
- Eating certain foods such as fatty or fried foods
- Drinking certain beverages, such as alcohol or coffee
- Taking certain medications, such as aspirin
GROD S+S
- Heart burn
o Usually after eating, which might be worse at night or while lying down - Regurgitation of food or sour liquid
o Backwash - Upper abdominal or chest px
- Dysphagia (trouble swallowing)
- Sensation of a lump in your throat
- If you have nighttime acid reflux other symptoms may be
o An ongoing cough
o Laryngitis (Inflammation of the vocal cords)
o New or worsening asthma
GORD prognosis
- Managed with OTC medications
o Antacids
o An H2 receptor blocker
o Proton pump inhibitor - If these don’t work a doctor can prescribe
o Sucralfate
o Metoclopramide - Often simple lifestyle changes help relieve symptoms
Peptic ulcer disease
- Peptic ulcers are sores that develop on the inside lining of your stomach and the upper portion of your small intestine
- Peptic ulcers include
o Gastric ulcers that occur on the inside of the stomach
o Duodenal ulcers that occur on the inside of the upper portion of your small intestine
Peptic ulcer disease cause
- Occur when the acid in the digestive tract eats away at the inner surface of the stomach or small intestine
- Common causes are
o A bacterium
Helicobacter pylori bacteria
o Regular use of certain pain relievers
Aspirin
NSAIDs
o Other medications
Steroids
Anticoagulants
SSRIs
Peptic ulcer disease population
Gastric ulcers- 60+, women
Duodenal- 30-50, men
Peptic ulcer disease risks
- These won’t cause stomach ulcers but they may make them worse and more difficult to heal
- Smoking
- Drinking alcohol
- Have untreated stress
- Eat spicy foods
Peptic ulcer disease S+S
- Burning stomach px
o Most common symptom
o This is made worse by stomach acid or having an empty stomach - Feeling of fullness, bloating or belching
- Intolerance to fatty foods
- Heartburn
- Nausea
- Many people with peptic ulcers don’t have any symptoms
- But sometimes people may experience severe symptoms, such as
o Vomiting or vomiting blood – which appear red or black
o Dark blood in stools, or stools that are black or tarry
o Trouble breathing
o Feeling faint
o Nausea and vomiting
o Unexplained weight loss
o Appetite changes
Peptic ulcer disease prognosis
- Prognosis is excellent after the underlying cause is successfully treated
- Recurrence may be prevented by maintaining good hygiene and avoiding alcohol, smoking and NSAIDs
- Recurrence is common with rates exceeding 60% in most cases
Diverticular disease
- Diverticula are small, bulging pouches that can form in the lining of the digestive system
- Found most often in the colon
Diverticular disease causes
- Diverticula usually develop when naturally weak placed in your colon give way under pressure
- This causes marble-sized pouches to protrude through the colon wall
- Diverticulitis occurs when diverticula tear, resulting in inflammation and in some cases infection
Diverticular disease population
40+
Diverticular disease risks
- Aging
- Obesity
- Smoking
- Lack of exercise
- Diet high in animal fat and low in fibre
- Certain medications
o Steroids
o Opioids
o NSAIDs
Diverticular disease S+S
- Px
o May be constant and persist for several days
o Lower left side of the abdomen is the usual site of px
o Sometimes the right side of the abdomen is more painful, especially in people of Asian descent - Nausea
- Vomiting
- Fever
- Abdominal tenderness
- Constipation
- Diarrhoea (less common)
Diverticular disease prognosis
- Treatment is
o Oral antibiotic, such as amoxicillin
o Rest
o Over the counter medicines for pain relief
o Low-fiber diet or liquid diet - Surgery is also an option
- Recurrence rate is about 20%
IBS
- A common disorder that affects the stomach and intestines
IBS cause
- Causes aren’t fully known
- Muscle contractions in the intestine
- Nervous system
o Poorly coordinated signals between the brain and intestines can cause your body to overreact to changes that typically occur in the digestive process - Severe infection
o Can develop after a severe bout of diarrhoea caused by bacteria or a virus
o May also be associated with a surplus of bacteria in the intestines - Early life stress
o People exposed to stressful events, especially in childhood, tend to have more symptoms of IBS - Changes in gut microbes
- Triggers
o Food
o Stress
IBS population
Female under 50
IBS risks
- Younger people
o Under 50 - Sex
o Women affected more than men - Have a family history of IBS
- Have anxiety, depression or other mental health issues
IBS S+S
- Symptoms vary but are usually present for a long time
- Abdominal px, cramping or bloating that is related to passing a bowel movement
- Changes in appearance of bowel movement
- Changes in how often you are having a bowel movement
- Diarrhoea
- Constipation
- Other symptoms include
o Sensation of incomplete evacuation
o Increased gas
o Mucus in the stool
IBS prognosis
- IBS does not shorten the lifespan of affected individuals or lead to major life-threatening complications in most patients
- Most serious symptoms can be avoided through a controlled diet and avoiding stressful situations
IBD
A term that describes disorders including chronic inflammation of tissues in your digestive tract
Crohns and ulcerative colitis
Crohns
Inflammation of tissues in digestive tract
Crohns cause
Unknown
Diet and stress, aggravate but don’t cause
Immune system- virus/bacteria can trigger
Hereditary
Crohns population
White people under 30
Crohns risks
Age- before 30
White people
Family Hx
Smoking
NSAIDs
Crohns S+S
Mild- severe
Usually develop gradually
Diarrhoea
Fever
Fatigue
Abdominal P and cramping
Blood in stool
Weight loss
