GI, GU, and Oncology Flashcards
What is the term for difficulty swallowing?
Dysphagia
What is the difference between oropharyngeal and esophageal dysphagia?
Oropharyngeal is in the pharynx or upper esophagus
Esophageal is in the esophageal body or lower esophageal sphincter
What is achalasia?
neuromuscular disorder of esophageal motility characterized by impaired lower esophageal sphincter relaxation and peristalisis in smooth muscle
What is GERD?
Gastric acid backflow into the esophagus (gastroesphageal reflux disease)
What are some clinical manifistations of GERD?
heartburn, nausea, gagging, cough, and hoarseness
How often do you have to have episodes of heartburn or complications from regurgitation per week to be diagnosed with GERD?
2 episodes a week
What are esophageal varicies?
Dilated blood vessels in the esophagus caused by portal hypertension
What is a special consideration with patients with a GI bleed?
They will need their complete blood count and coagulation profiles reviewed frequently for physical therapy management
What are the 2 primary causes of peptic ulcer disease
H. pylori infection and NSAID use
What are some manifestations of peptic ulcer disease?
Abdominal pain located in epigastric region that is burning, gnawing, or hunger-like in quality
What are the classifications of appendicitis?
Acute - inflamed but intact
Gangrenous - presence of focal or extensive necrosis with perforations
Perforated - gross disruption of appendix wall
What is diverticular disease?
When the out pocketing of diverticula become symptomatic
What are the 2 types of hernia?
Abdominal - protrusion of bowel
Hiatal - stomach upward through esophageal hiatus
What are the 2 types of intestinal obstructions?
Mechanical - blockage of bowel
Functional - inhibition of propulsive bowel activity due to paralysis
How are malabsorption syndromes defined?
General term for disorders that involve the small intestine’s failure to absorb or digest carbs, proteins, fats, water, vitamins and electrolytes.
What is Crohn’s Disease?
A chronic inflammatory bowel disease that affects the lining of the digestive tract.
What are polyps?
Abnormal tissue growth in the mucous membrane.
What are the BMI scales for obesity?
18.5-24.9 normal
25-29.9 overweight
>30 obese
Name some comorbidites to obesity?
type 2 DM, CVD, dyslipidemia, obstructive sleep apnea, DJD, Renal disease, everything you can think of,
When should exercise be terminated after surgery?
increase in SBP by 20 Decrease in DBP by 20 HR increase or decrease by more than 20 Severe dyspnea Dizziness Excessive sweating patient reports feeling faint
What is the most common cause of hepatitis?
Viral
Hep A, B, and C are most common
A = fecal-oral route (contaminated water sources)
B and C = through blood and bodily fluids
What is the primary complications that can occur from cirrhosis?
Portal Hypertension, ascites, Jaundice, impaired clotting ability, hepatic encephalopathy, and variceal bleeding
What are some signs and symptoms of hepatic encephalopathy?
impaired mental status and neuromuscular dysfunction, Altered consciousness (changes in personality sleep disturbance, stupor, coma)
What is the West haven cirteria for altered mental status in hepatic encephalopathy?
Scale of 0-4
0 = normal
1 = mild lack of awareness, shortened attention span, mild tremor
2 = Lethargic, disoriented, slurred speech, obvious tremor
3 = Somolent (sleepy) but arousable, gross disorientation, muscular rigidity and clonus
4 = Coma, decerebrate posturing
What is cholecystitis with cholelithiasis (gallstones)?
Acute or chronic inflammation of gallbladder. Most commonly associated with gallstones (90% of cases)
What can acute pancreatitis lead to?
ARDS, and/or shock
What are the most common contributing factors to pancreatitis?
Gallstones, and alcohol and drug abuse
How can drug treatments for GI disorders be categorized?
Those that control gastric acid secretion
Those that normalize gastric motility
What are some PT considerations when it come to surgical procedures for GI interventions?
Ensure colostomy pouch is secure and closed before moving patient
Side-lying positions may be more comfortable after abdominal surgeries
Bend knees up before lower head to decrease incisional discomfort
Be respectful of patients time to adjust to colostomies
What are the 3 goals for PT with GI patients
1 - optimize functional mobility
2 - maximize activity tolerance and endurance
3 - prevent post-op pulmonary and integumentary complications
What are some guidelines for PT management?
- Patients may have poor nutritional status = increase fatigue
- Positional precautions (supine is mostly bad, avoid valsalva)
- Non Pharmacological pain management may benefit patient
- Patients with ascites or large incisions are at risk for pulmonary complications (also hinder cough effectivness and functional mobility)
