GI, GU, and Oncology

Question 1

What is the term for difficulty swallowing?

Answer 1

Dysphagia

Question 2

What is the difference between oropharyngeal and esophageal dysphagia?

Answer 2

Oropharyngeal is in the pharynx or upper esophagus

Esophageal is in the esophageal body or lower esophageal sphincter

Question 3

What is achalasia?

Answer 3

neuromuscular disorder of esophageal motility characterized by impaired lower esophageal sphincter relaxation and peristalisis in smooth muscle

Question 4

What is GERD?

Answer 4

Gastric acid backflow into the esophagus (gastroesphageal reflux disease)

Question 5

What are some clinical manifistations of GERD?

Answer 5

heartburn, nausea, gagging, cough, and hoarseness

Question 6

How often do you have to have episodes of heartburn or complications from regurgitation per week to be diagnosed with GERD?

Answer 6

2 episodes a week

Question 7

What are esophageal varicies?

Answer 7

Dilated blood vessels in the esophagus caused by portal hypertension

Question 8

What is a special consideration with patients with a GI bleed?

Answer 8

They will need their complete blood count and coagulation profiles reviewed frequently for physical therapy management

Question 9

What are the 2 primary causes of peptic ulcer disease

Answer 9

H. pylori infection and NSAID use

Question 10

What are some manifestations of peptic ulcer disease?

Answer 10

Abdominal pain located in epigastric region that is burning, gnawing, or hunger-like in quality

Question 11

What are the classifications of appendicitis?

Answer 11

Acute - inflamed but intact
Gangrenous - presence of focal or extensive necrosis with perforations
Perforated - gross disruption of appendix wall

Question 12

What is diverticular disease?

Answer 12

When the out pocketing of diverticula become symptomatic

Question 13

What are the 2 types of hernia?

Answer 13

Abdominal - protrusion of bowel

Hiatal - stomach upward through esophageal hiatus

Question 14

What are the 2 types of intestinal obstructions?

Answer 14

Mechanical - blockage of bowel

Functional - inhibition of propulsive bowel activity due to paralysis

Question 15

How are malabsorption syndromes defined?

Answer 15

General term for disorders that involve the small intestine’s failure to absorb or digest carbs, proteins, fats, water, vitamins and electrolytes.

Question 16

What is Crohn’s Disease?

Answer 16

A chronic inflammatory bowel disease that affects the lining of the digestive tract.

Question 17

What are polyps?

Answer 17

Abnormal tissue growth in the mucous membrane.

Question 18

What are the BMI scales for obesity?

Answer 18

18.5-24.9 normal
25-29.9 overweight
>30 obese

Question 19

Name some comorbidites to obesity?

Answer 19

type 2 DM, CVD, dyslipidemia, obstructive sleep apnea, DJD, Renal disease, everything you can think of,

Question 20

When should exercise be terminated after surgery?

Answer 20

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

Question 21

What is the most common cause of hepatitis?

Answer 21

Viral
Hep A, B, and C are most common
A = fecal-oral route (contaminated water sources)
B and C = through blood and bodily fluids

Question 22

What is the primary complications that can occur from cirrhosis?

Answer 22

Portal Hypertension, ascites, Jaundice, impaired clotting ability, hepatic encephalopathy, and variceal bleeding

Question 23

What are some signs and symptoms of hepatic encephalopathy?

Answer 23

impaired mental status and neuromuscular dysfunction, 
Altered consciousness (changes in personality sleep disturbance, stupor, coma)

Question 24

What is the West haven cirteria for altered mental status in hepatic encephalopathy?

Answer 24

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

Question 25

What is cholecystitis with cholelithiasis (gallstones)?

Answer 25

Acute or chronic inflammation of gallbladder. Most commonly associated with gallstones (90% of cases)

Question 26

What can acute pancreatitis lead to?

Answer 26

ARDS, and/or shock

Question 27

What are the most common contributing factors to pancreatitis?

Answer 27

Gallstones, and alcohol and drug abuse

Question 28

How can drug treatments for GI disorders be categorized?

Answer 28

Those that control gastric acid secretion

Those that normalize gastric motility

Question 29

What are some PT considerations when it come to surgical procedures for GI interventions?

Answer 29

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

Question 30

What are the 3 goals for PT with GI patients

Answer 30

1 - optimize functional mobility
2 - maximize activity tolerance and endurance
3 - prevent post-op pulmonary and integumentary complications

Question 31

What are some guidelines for PT management?

Answer 31

1. Patients may have poor nutritional status = increase fatigue
2. Positional precautions (supine is mostly bad, avoid valsalva)
3. Non Pharmacological pain management may benefit patient
4. Patients with ascites or large incisions are at risk for pulmonary complications (also hinder cough effectivness and functional mobility)