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med surg 3 test 3 > intestinal disorders > Flashcards

intestinal disorders Flashcards

1
Q

diverticular disease is?

A

Diverticulosis, also known as “diverticular disease”, is the condition of having diverticula in the colon, which are outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. These are more common in the sigmoid colon, which is a common place for increased pressure. This is uncommon before the age of 40, and increases in incidence after that age.

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2
Q

what is another name for the tiny pockets in the lining of the bowel?

A

diverticula

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3
Q

diverticulosis is formed by?

A

increased pressure on weakened spots of the intestinal walls by gas, waste, or liquid

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4
Q

where is diverticulosis most common?

A

95-98% of the time in the sigmoid colon

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5
Q

diverticulosis occurs in _____% over 40 and _____% of people over 60

A

10%

50%

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6
Q

True or False

There are many symptoms to diverticulosis

A

False

there are few

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7
Q

Diverticulosis: it is _______ reversible and complications occur in about _____% of people

A

rarely

20

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8
Q

what is diverticular bleeding?

A

chronic injury to small blood vessels next tot he diverticula

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9
Q

what is diverticulitis?

A

inflammation and infection in one or more diverticula

diverticula become blocked with waste

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10
Q

what are S/S of diverticular bleeding?

A

bright red-colored/wine-colored stools
painless urge to defecate
copious bleeding that stops spontaneously

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11
Q

S/S of diverticulitis?

A

Can occur suddenly and without warning
Alternating diarrhea with constipation
Painful cramps/ tenderness in lower abdomen
Chills or fever over 101°
Recurrent urinary tract infections (colovesicular fistulas)
Severe/ generalized abdominal pain (diffuse peritonitis)
Back or lower extremity pain (perforation)

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12
Q

diverticular disease risk factors are?

A 
Low-fiber diet 
Advanced age 
Obesity 
Pelvic Floor disorder (females)
Male gender= diverticulitis 
High fat intake 
Lack of regular physical activity
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13
Q

true or false

Men have a higher chance of diverticulitis

A

True

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14
Q

how can diverticular disease be prevented?

A

maintain good bowel habits
fiber consumption
exercise regularly

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15
Q

what is the recommended amount of fiber intake according to the American Dietetic Association?

A

20 to 35 grams a day

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16
Q

what are 3 drug therapies for DD?

A

antibiotics for infection
anticholinergics for relieving cramps
analgesic for pain relief

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17
Q

in an emergency with DD, a ______ procedure is performed

A

Hartmans

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18
Q

what is the Hartmans Procedure?

A

In an emergency- detach the sigmoid colon from the rectum, close the rectum, reconnect the sigmoid colon directly to an opening created on the surface of the body
Reversed within 6 months

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19
Q

a colonoscopy with __________ can be used to stop bleeding

A

electrocoagulation

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20
Q

DD primarily affects ?

A

industrialized western societies
males= females
older age

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21
Q

western societies have _____ sided gut pain while eastern societies have _____ sided gut pain

A

left

right

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22
Q

complications occur in about ____-____% of patients with diverticulosis during life

A

10-20%

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23
Q

morbidity for DD is worse in _______ patients

A

younger

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24
Q

Prognosis of DD is ______ with early detection and treatment of complications

A

good

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25
Q

what is Colorectal Cancer (CRC) ?

A

cancer of colon (large intestine) and/or rectum

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26
Q

CRC affects the colon about ____% of the time

A

70%

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27
Q

CRC affects the rectum about ____% of the time

A

30%

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28
Q

if CRC is found early, the 5 year survival is _____%

A

90

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29
Q

if CRC metatsis to lymph nodes, the 5 year survival goes to ____-____%

A

35-60%

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30
Q

if CRC metastasis to liver, the 5 year survival goes to _____%

A

<10%

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31
Q

True or False

When CRC first develops, the symptoms are the worse

A

False

1st develops with no symptoms

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32
Q

what are S/S of CRC?

A

Blood in stool

Change in bowel habits

Stools narrower than usual

General stomach discomfort

Frequent gas/ pains/indigestion

Unexplained weight loss

Low Back Pain

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33
Q

what are CRC risk factors?

A

Inflammation of bowel (DD)
family history of CRC or colorectal polyps
certain hereditary syndromes
lifestyle factors

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34
Q

Lifestyle factors that increase the chance of CRC include?

A 
Lack of regular physical activity 
Low fruit and vegetable intake 
Low-fiber and high-fat diet
Overweight/obese 
Alcohol consumption 
Tobacco use
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35
Q

what does CRC prevention include?

A 
CRC Screening 
Increasing physical activity
Eating fruits & vegetables
Limit alcohol consumption
Avoid tobacco
36
Q

True or False

All men and women aged 50 years or older routinely screened

A

True

37
Q

what are the 4 screening options for CRC?

A

Fecal Occult Blood Test (FOBT)
Flexible Sigmoidoscopy
Double-contrast Barium Enema
Colonoscopy

38
Q

what is the fecal occult blood test?

A

checks for occult blood in stool

At home, you place a small amount of your stool from 3 consecutive bowel movements on test cards

Return the cards to your doctor’s office or a lab

Recommended yearly

39
Q

the FOBT is recommended ______?

A

yearly

40
Q

what is the flexible sigmoidocopy?

A

Before test, use a strong laxative and/or enema
A narrow, flexible, lighted tube inserted in rectum and the lower portion of the colon
May remove abnormalities
Recommended every five years

41
Q

Flexible Sigmoidoscopy is recommended every ______ years?

A

5

42
Q

what is the double-contrast barium enema?

A

enema with a barium solution
X-ray of the rectum and colon
Barium coats lining of intestines so that polyps/ abnormalities visible on X-ray
Recommended every 5years

43
Q

Double-Contrast Barium Enema is recommended every ______ years?

A

5

44
Q

what is a colonoscopy?

A

Given a sedative for comfort
Narrow, flexible, lighted tube to look at the inside of the rectum and the entire colon
May remove abnormalities
Recommended every 10 years.
Used as a follow-up test if anything unusual is found during other screening tests

45
Q

what test is used a follow up if any other the other test are positive?

A

colonoscopy

46
Q

the colonoscopy is similar to the______ ______, but the tube is _____ and allows visions of the _____ ____?

A

flexible sigmoidoscopy
longer
entire colon

47
Q

CRC treatment includes?

A

Tumor Removal
Resection
Colostomy
Chemotherapy

48
Q

what is a colostomy?

A

a surgical operation in which a piece of the colon is diverted to an artificial opening in the abdominal wall so as to bypass a damaged part of the colon.

49
Q

CRC may initially present to a PT as ____ ___ ___

A

low back pain

50
Q

Hip/thigh pain may be referred from ______ ______

A

iliopsoas abscess

51
Q

PT need to make sure pts avoid the ___ ____during exercises?

A

valsalva maneuver

52
Q

what is paralytic Ileus?

A

is a disruption of the normal propulsive ability (peristalsis) of the gastrointestinal tract

functional intestinal obstruction

53
Q

signs and symptoms of Paralytic Ileus include?

A

Mild to moderate abdominal pain

Absent bowel sounds

Dehydration

Generalized abdominal distention

Constipation

54
Q

how is paralytic Ileus diagnosed?

A

Clinical signs and symptoms

Radiography of abdomen

Barium enema

55
Q

what is the treatment of paralytic Ileus?

A

Removal of the cause

Restricted oral intake

Complete elimination of food and fluids

Aspiration of gastric secretions

Parenteral nutrition

56
Q

what is Crohn’s Disease?

A

a chronic inflammatory disease of the intestines, esp. the colon and ileum, associated with ulcers and fistulae.

57
Q

Crohn’s Disease is more common in ?

A

the west and Causcasians

58
Q

M:F of Crohn’s disease?

A

1 : 1.2

59
Q

Crohns disease occurs at a mean age of _____, although elderly are also at ______ risk

A

26

increased

60
Q

pathology of crohn’s disease?

A

Involved small bowel is thickened and narrowed

Colonic fistulae-enteroenteral,enterovaginal, or enterocutaneous

Deep mucosal ulcers

Skip lesions

61
Q

what are Skip lesions?

A

A skip lesion is a wound or inflammation that is clearly patchy, “skipping” areas that thereby are unharmed. It is a typical form of intestinal damage in Crohn’s disease, but may also be the kind of damage to the renal tubules in acute tubular necrosis

62
Q

clinical features of Crohn’s Disease include?

A

Prolonged diarrhea in 80%

Low-grade fever

Generalised fatigability

abdominal pain

63
Q

Medical management of Crohn’s Disease includes?

A

inducing remission through the use of oral glucocorticosteroids and/or enteral nutrition

maintenance through the use of drugs

64
Q

surgical management of Crohn’s disease is indicated when?

A

failure of medical therapy

complications such as toxic dilatation, obstruction, perforation, abscesses, fistulas

failure to thrive

65
Q

______% of pts with Crohn’s disease require an operation at some point

A

80%

66
Q

pt’s with Crohn’s disease are ___-___ times more likely to develop bowel cancer, but < ____

A

6-10

Ulcerative colitis

67
Q

Ulcerative Colitis (UC) is?

A

form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the colon (the largest portion of the large intestine), that includes characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset.

68
Q

True or False

UC is an acute GI disorder?

A

False

chronic

69
Q

age of onset for UC is?

A

any age, but 10-40 years are most common

70
Q

UC male to female prevalence?

A

equal

71
Q

True or False

pt’s with UC are at an increased chance of cancer

A

true

72
Q

True or False

Pts with UC can help prevent cancer risk with bowel resection

A

true

73
Q

where are the location of lesions in UC?

A

large intestine; rectum

74
Q

UC: inflammation and ulceration involve the _____/_____ layers

A

mucosal/submucosal

75
Q

True or False

The symptoms of UC come and go, fairly short periods between flare-ups

A

False

long periods

76
Q

Clinical manifestations of just UC?

A 
1st symptom – progressive loosening/bloody stools
Abdominal pain (relieved by BM)
77
Q

Clinical manifestations of just Crohn’s Disease?

A 
Abdominal pain (not relieved by BM)
Abdominal mass
Anorexia
78
Q

Clinical manifestations that are common in both UC and Crohn’s disease?

A

Diarrhea
Weight Loss
Skin rashes
Joint pain

79
Q

a related serious acute complication of UC and Crohn’s disease is?

A

toxic megacolon

80
Q

diagnosis of UC is done by?

A

exclusion based on medical Hx & clinical presentation
sigmoidoscopy
barium enema

81
Q

what are the 4 major drug classes used today to treat UC?

A

aminosaliclylates
steroids
Immune modifiers
antibiotics

82
Q

True or False

UC can be managed without hospitalization

A

True

83
Q

UC: there is a ______% mortality rate when complications occur in the first ten years

A

20%

84
Q

UC: 10 years of chronic attacks can lead to?

A

colon cancer

85
Q

UC: how can colon cancer be prevented?

A

removal of the affected section

86
Q

what is IPPA?

A

ileal pouch-anal anastomosis

primary elective operation for UC pts

87
Q

what are the PT implications for IBD?

A

Screen for medical disease any time a pt presents with LBP, hip, or SI pain of unknown origin

Know what medications a pt is taking

Observe for any signs of dehydration

med surg 3 test 3 (9 decks)

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