GI & Urological Emergencies Flashcards
Where is the appendix located?
Right lower Quad
Where is the Liver located?
Right Upper Quad
Where is the stomach located?
Left Upper Quad
What organs are located in the Right upper quadrant?
Liver, Gallbladder, right kidney & portions of the large and small intestine
Define
Hematemesis
Vommiting blood
Define
Melena
Black tar stools that contain blood
Name the componets of the lower GI
Jejunum,ileum, colon, rectum
define
Peritonitis
Inflammation of the peritoneum
Define
Ecchymosis
Bruising
Define
Hemoptysis
Coughing up blood
What are Gallstones?
Its A Blockage in the outlet of the gallbladder
Pain in the RUQ
Define
Peptic Ulcer Disease
(PUD)
erodes the protective layer ligning the esophagus, stomach or small intestine
BURNING OR GNAWING PAIN located in the upper abdominal. Can lead to hematemesis or melena
Define
Pancreatitis
Inflammation of the pancreas
Upper Abdominal pain and/or back
What does the Pancreas do?
Forms digestive juices and the source of the bodys insulin
Define
Appendicitis
Inflammation or infection of the appendix
Classic signs: pain, fever, reboundtenderness and decrease of food intake
Define
GERD
Gastroesophageal reflux disease
occurs when the lining of the esophagus becomes inflamed by infection or from the acids in the stomach
Define
Esophageal Varices
Pressure within the blood vessels surrounding the esophagus increases, usually a result of liver failure.
Blood vessels eventually drain into the liver.
This can lead to upper GI Bleed that leads to hematemesis
Define
Diverticulitis
Inflammation in small pockets at weak areas in the muscle walls of the intestines
lower left quad pain
Define
Gastroenteritis
comprises a family of conditions revolving around a central theme of infection combined with diarrhea, nausea, and vomiting
Define Numonic
DR GEM
- Distension
- Rigidity
- Guarding
- Eccamosis
- Masses (Pulsating)
Name 5 solid organs
Liver
Spleen
Pancreas
Kidneys
Ovaries
Name 5 hollow organs
gallbladder
stomach
small intestine
large intestine
bladder
How is blood pressure effected by the kidneys?
Blood pressure regulation is associated with the kidney’s
ability to remove sodium chloride from the body
Kidney disease is a
common cause of secondary hypertension.
True or false
The kidneys also rid
the body of toxic wastes and control the body’s balance of fluid and
electrolytes.
true
Define
Cholecystitis
Inflammation of the gallbladder
Define
Cystitis
Inflammation of the bladder
Define
Emesis
Vomiting
Define
Guarding
GI
Involuntary muscle contractions (spasm) of the abdominal wall; an effort to protect the inflamed abdomen
Define
Hernia
The protrusion of an organ or tissue through an abnormal
body opening
Define
ileus
Paralysis of the bowel, arising from any one of several causes; stops contractions that move material through the
intestine.
What are kidney stones?
Solid crystalline masses formed in the kidney, resulting from an excess of insoluble salts or uric acid crystallizing
in the urine; may become trapped anywhere along the urinary
tract.
Define
Uremia
Severe kidney failure resulting in the buildup of waste products within the blood. Eventually brain functions will be impaired.
Pain from Cholecystitis is felt where?
Right upper quadrant (direct)
right shoulder (referred)
Pain from A Ulcer is felt where?
Upper midabdomen or upper part of
back
Pain from Cystitis is felt where?
Lower midabdomen (retropubic)
Pain from a kidney infection is felt where?
Costovertebral angle
Kidney stone pain is felt where?
Right or left flank, radiating to genitalia
Define
peptic ulcer disease (PUD)
the protective layer is eroded, allowing the acid to eat into the organ itself over the course
of weeks, months, or even years.
What 2 things causes peptic ulcers?
- infection of the stomach with Helicobacter pylori bacteria
- chronic use of
nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and
ibuprofen
Explain what someone with Peptic ulcer disease experience
burning or gnawing pain in the stomach that subsides or diminishes
immediately after eating and then reemerges 2 to 3 hours later
The pain usually presents in the upper abdomen, but sometimes may be
found below the sternum
When do symptoms of Cholecystitis appear?
30 minutes after a particularly fatty meal and usually at night
Name 3 ethnicities that are at a higher risk of developing Cholecystitis?
Scandinavian
Native American
Hispanic descent
Esophageal Varices is secondary to _____
Liver failure
or a Mallory-Weiss tear
Bleeding that orginates in the lower GI is usually what color?
Bright red or maroon color
Name some symptoms of liver disease
fatigue, weight loss, jaundice, anorexia, edema in the abdomen, abdominal pain, nausea, and
vomiting
What is a Mallory-Weiss Tear?
A tear in the junction between the esophagus and the stomach, causing severe bleeding and potentially death
Violent coughing or vomiting is the principal cause
Primary risk factors include alcoholism and eating disorders
Name some signs & symptoms of diverticulitis?
fever, malaise, body aches, chills, nausea, and vomiting
abdominal pain, which is localized to the left side of the lower abdomen
Bleeding is rare with this condition
What is diverticulitis?
Inflammation or infection of small pouches, called diverticula, that form in the wall of the large intestine (colon).
How are hemorrhoids created?
swelling and inflammation of the blood vessels surrounding the rectum
Whats the function of the Kidneys?
eliminating waste from the blood
Define
AAA
abdominal aortic aneurysm
if the aneurysm tears and ruptures, massive hemorrhage may occur
Back pain & pulsating mass
Define
Hernia
a protrusion of an organ or tissue through a hole or opening into a body cavity where it does not belong
strangulation can happen, this can lead to a emergency
Signs & Symptoms
Serious hernia
Reducible mass that is no longer reducible
Pain at the hernia site
Tenderness when the hernia is palpated
Red or blue skin discoloration over the hernia
Questions specific to the sign and symptom
Nausea and vomiting
Do you feel nauseous?
Have you vomited?
How many times?
Over what period of time?
Was there red blood?
Did it look like coffee grounds?
Questions specific to the sign and symptom
Changes in bowel habits
Has there been any change in your
bowel habits?
Have you been constipated? Did the stool look dark and tarry?
Have you had diarrhea?
How many times and over what period of time?
Was there any red blood in it?
Questions specific to the sign and symptom
Urination
Have you been urinating more or less often?
Is there pain when you urinate?
Is the color dark or unusual?
Is there an unusual odor?
Questions specific to the sign and symptom
Weight loss
Have you had unexplained weight loss recently?
How many pounds?
Questions specific to the sign and symptom
Belching or flatulence
Have you experienced belching or flatulence?
For how long?
Questions specific to the sign and symptom
Pain
What does the pain feel like?
How long have you had this pain?
Is the pain constant or intermittent?
Have you had similar pain in the past?
Have you done anything to relieve the pain?
For any abdominal discomfort, use OPQRST to ask the patient what
makes the pain better or worse.
Define
Peritoneal Dialysis or Hemodialysis
the patient’s blood is filtered and cleansed of the toxins and then returned to the body
Define
Referred pain
It originates in a particular organ but is
described or perceived by the patient as pain in a different location or pain at the point of origin and another location
Unlike with radiating pain, there is no pain in
between the two points.
What could melena indicate?
Bleeding in the upper GI tract where blood has been digested
What could hematemesis indicate?
peptic ulcer, esophageal varices or gastritis
Causes of pain in
Right upper quadrant
Cholecystitis
gallstones
hepatitis
Causes of pain in
Left upper quadrant
Gastritis
splenic injury
pancreatitis
Causes of pain in
Right lower quadrant
Appendicitis
ovarian cyst rupture
ectopic pregnancy
Causes of pain in
Left lower quadrant
Diverticulitis
ovarian cyst rupture
ectopic pregnancy
Define
Hematuria
blood in urine
Define
Dysuria
Pain with urination
What could hematuria indicate?
Kidney stones, UTI, trama to kidneys or bladder, or more serious condition
Where are the kidneys located?
In the retroperitoneal space on either side of the spine, below the rib cage
Define
Visceral Pain
Pain originating from organs
dull, aching, cramping
Define
Parietal Pain
Pain originating from irritation of the peritoneum
sharp, localized, constant, and worsen by movement
Define
Jaundice
A yellowing of the skin and the whites of the eyes caused by a buildup of bilirubin in the blood
indicates liver or gallbladder disease
Define
Ascites
An abnormal accumulation of fluid within the peritoneal cavity
What are the two primary functions of the spleen?
Filtering blood (removing old or damaged red blood cells)
Immune response
Also a red blood cell reservoir
What are the two main ways kidneys affect blood pressure?
Fluid Control (Volume Knob) and Hormone Control (Chemical Messengers - RAAS)
How do kidneys control fluid volume to affect blood pressure?
By regulating how much water stays in the blood versus being excreted as urine. More fluid = higher pressure; less fluid = lower pressure.
Explain the role of the Renin-Angiotensin-Aldosterone System (RAAS) in blood pressure regulation.
A hormone system triggered by low blood pressure. It causes blood vessel constriction and the body to retain sodium and water, both increasing blood pressure.
What are the two main effects of the RAAS that help raise blood pressure?
Blood vessel constriction (narrowing) and increased sodium and water retention.
What hormone is released by the kidneys when blood pressure is low?
Renin
How might kidney problems contribute to high blood pressure (hypertension)?
By not effectively removing enough fluid from the body or by having an overactive RAAS.
A patient with a history of kidney disease presents with significantly elevated blood pressure. What might be a contributing factor related to their kidneys?
Impaired fluid removal leading to increased blood volume and/or an overactive Renin-Angiotensin-Aldosterone System (RAAS).
Dehydration can lead to low blood pressure. How might the kidneys attempt to compensate for this?
By retaining more water (reducing urine output) and activating the RAAS to constrict blood vessels and further increase fluid retention.
Certain medications, like diuretics (“water pills”), are used to treat high blood pressure. How do these medications often work in relation to the kidneys?
By increasing urine production, which reduces blood volume and lowers blood pressure.
What is the initial trigger for the release of renin from the kidneys?
Low blood pressure or low blood flow to the kidneys.
Define
Partial peritoneum
Lines the abdominal cavity
Can perceive sensations
Define
Visceral peritoneum
Covers the surface of organs
Supplied by the autonomic nervous
Define
Visceral pain
Usually occurs when receptors in the hollow structures are stimulated
What is the primary function of the gallbladder?
Stores and concentrates bile
What substance is stored in the gallbladder?
Bile (produced by the liver)
Does the gallbladder produce bile?
No, the liver produces bile. The gallbladder only stores it.
What triggers the release of bile from the gallbladder?
Eating fatty foods
Is the gallbladder essential for life?
No, but it aids in fat digestion.
What types of molecules do pancreatic enzymes help digest?
Carbohydrates, fats, and proteins.
What does insulin do?
Helps lower blood sugar by allowing glucose into cells.
Is the pancreas essential for life?
Yes, due to its roles in digestion and blood sugar regulation.
What is one key difference between the gallbladder and the pancreas in terms of what they produce?
The gallbladder stores bile, while the pancreas produces digestive enzymes and hormones.
Which organ, the gallbladder or the pancreas, produces insulin?
The pancreas.
Which organ, the gallbladder or the pancreas, stores bile?
The gallbladder
Signs & Symptoms
Sudden, severe abdominal pain with a rigid, board-like abdomen.
This could indicate peritonitis, an inflammation of the peritoneum often caused by a ruptured organ
Signs & Symptoms
Vomiting blood or coffee-ground like material.
This is hematemesis, a sign of upper gastrointestinal bleeding, potentially from ulcers or varices.
Signs & Symptoms
Black, tarry stools.
These are melena, indicating bleeding in the upper gastrointestinal tract where blood has been digested.
Signs & Symptoms
Bright red blood in the stool
This is hematochezia, suggesting bleeding in the lower gastrointestinal tract, such as from hemorrhoids or diverticulitis.
Signs & Symptoms
Severe abdominal pain in the right lower quadrant.
This is a classic sign of appendicitis, an inflammation of the appendix requiring prompt treatment.
Signs & Symptoms
Severe abdominal pain that radiates to the back.
This pain pattern is characteristic of pancreatitis, an inflammation of the pancreas
Signs & Symptoms
Abdominal distension with inability to pass gas or stool.
These are key signs of a bowel obstruction, where the passage of intestinal contents is blocked.
Signs & Symptoms
Right upper quadrant pain, especially after eating fatty foods.
This suggests cholecystitis, an inflammation of the gallbladder, often due to gallstones.
Severe, cramping abdominal pain that comes and goes in waves.
This type of pain can be associated with bowel obstruction as the intestines try to push contents through.
Signs & Symptoms
Fever, left lower quadrant abdominal pain, and a change in bowel habits.
These symptoms may indicate diverticulitis, an inflammation of small pouches in the colon.
Signs & Symptoms
Sudden onset of severe chest and upper abdominal pain, often after forceful vomiting.
This could indicate an esophageal rupture (Boerhaave Syndrome), a tear in the esophagus wall.
Signs & Symptoms
A painful, non-reducible bulge in the groin or abdomen.
This could be an incarcerated hernia, where part of the intestine is trapped and its blood supply may be compromised.
Signs & Symptoms
Severe rectal pain, swelling, and bluish discoloration around the anus.
This could indicate a strangulated hemorrhoid, where the blood supply to an external hemorrhoid is cut off.
Signs & Symptoms
Significant abdominal pain accompanied by signs of shock, such as rapid heartbeat and low blood pressure.
This could indicate a perforated viscus (ruptured organ) leading to widespread infection and shock.
Signs & Symptoms
Sudden, severe flank pain radiating to the groin
Kidney Stones
