Lewis ch 42 - lower GI problems Flashcards
1
Q
difference between acute, chronic, and persistent diarrhea (# days)
A
acute: <14 days
chronic: >14 days
persistent: >30 days
2
Q
what symptom is associated with E Coli
A
bloody diarrhea
3
Q
what organism causing infectious diarrhea is hospital acquired
A
C diff
4
Q
increased risk for diarrhea from infectious organisms (4)
A
- older adults
- use of PPIs
- use of antibiotics
- immunocompromised
5
Q
noninfectious causes of diarrhea (4)
A
- drugs (laxatives)
- food intolerances (lactose, undigested carbs)
- osmotic (rapid GI transit)
- malabsorption (celiac disease, short bowel syndrome)
6
Q
S+S upper GI diarrhea (4)
A
- large volume watery stools
- periumbilical pain
- cramping
- low grade/no fever
7
Q
S+S lower GI diarrhea (2)
A
- small volume bloody diarrhea
- fever
8
Q
what ABG imbalance can severe diarrhea lead to
A
metabolic acidosis
9
Q
2 possible antibiotics for diarrhea
A
floroquinolone
azithromycin
10
Q
patients at risk for cdiff infection (4)
A
- antimicrobial agents
- chemotherapy
- gastric acid suppressing agents
- immunosuppressive agents
11
Q
Involuntary passage of stool related to motor and/or
sensory dysfunction
A
fecal incontinence
12
Q
common causes fecal incontinence (6)
A
- anal sphincter weakness
- functional
- inflammatory
- neurologic disease
- pelvic floor dysfunction
- other (diarrhea, fecal impaction)
13
Q
irritating diarrhea-producing foods (4)
A
- caffeine
- artificial sweeteners
- dairy products
- vegetables with insoluble fiber
14
Q
◦Difficult or infrequent bowel movements
◦May require excessive exertion to defecate
◦Feeling of incomplete evacuation
◦Symptom, not a disease
A
constipation
15
Q
difference between acute and chronic constipation (# days)
A
acute: <1 week
chronic: >3 months
16
Q
risk factors constipation (7)
A
- low fiber diet
- decreased physical activity
- ignoring urge to defecate
- anxiety, depression
- diseases that slow GI transit
- drug induced (opioids)
- cathartic colon syndrome
17
Q
4 causes abdominal pain
A
inflammation
peritonitis
obstruction
internal bleeding
18
Q
2 complications abdominal pain
A
septic shock
hypovolemic shock
19
Q
S+S abdominal pain (4)
A
- N/V/D
- rebound tenderness
- fever
- bloating
20
Q
3 complications abdominal trauma
A
- shock
- peritonitis
- abdominal compartment syndrome
21
Q
S+S abdominal trauma (4)
A
- hard distended abdomen
- decreased or absent bowel sounds
- cullens or grey turners sign (bruising)
- signs hypovolemic shock
22
Q
Chronic abdominal pain or discomfort and alteration
of bowel patterns
A
irritable bowel syndrome
23
Q
4 categories IBS
A
- IBS w/ constipation (IBS-C)
- IBS w/ diarrhea (IBS-D)
- IBS mixed
- IBS unsubtyped
24
Q
which type IBS more likely for men v women
A
men: IBS-D
women: IBS-C
25
S+S IBS (5)
- mucus in stool
- abdominal pain
- fatigue
- headache
- sleep problems
26
S+S appendicitis (4)
- persistent pain RLQ
- rebound tenderness
- pain
- N/V
27
primary cause peritonitis
blood-borne organisms
28
secondary cause peritonitis
perforation of organs that spill contents into
| peritoneal cavity
29
S+S peritonitis (5)
- abdominal pain
- rebound tenderness
- fever
- tachycardia
- N/V
30
complications peritonitis (5)
- hypovolemic shock
- sepsis
- intraabdominal abscess
- paralytic ileus
- acute respiratory distress syndrome
31
common foodborne cause of gastroenteritis
norovirus
32
S+S gastroenteritis (3)
- sudden N/V/D
- fever
- abdominal cramping
33
Chronic, inflammation of GI tract characterized by
periods of remission are interspersed with periods of
exacerbation
inflammatory bowel disease
34
2 classifications IBD
ulcerative colitis
| crohns
35
risk factors IBD (5)
- autoimmune diseases
- diet (high intake sugar and fat, low intake fiber, fruits and veggies)
- smoking
- NSAIDs, oral contraceptives, antibiotics
- genetic links
36
S+S crohns disease (3)
- diarrhea, cramping
- weight loss
- rectal bleeding
37
S+S ulcerative colitis (3)
- protein loss in stool
- pseudopolyp formation
- bloody diarrhea
38
2 options drug therapy for IBD
Sulfasalazine (folic acid)
| corticosteroids (calcium and potassium)
39
4 types intestinal obstruction
- partial
- complete
- simple (intact blood supply)
- strangulated (no blood supply)
40
what ABG imbalance can result from high intestinal obstruction
metabolic alkalosis
41
4 hallmark S+S intestinal obstruction
- abdominal pain
- N/V
- distention
- constipation
42
2 types polyps
- hyperplastic: non-cancerous, <5 mm, asymptomatic
| - adenomatous: neoplastic
43
saccular dilations or outpouchings of the mucosa in the colon
diverticula
44
multiple, noninflamed diverticula
diverticulosis
45
one or more inflamed diverticula
diverticulitis
46
complications diverticulitis (4)
- perforation
- abscess
- fistula
- bleeding
47
risk factors diverticulitis (5)
- constipation/lack of dietary fiber
- obesity/lack of activity
- smoking
- excess alcohol use
- excess NSAID use
48
S+S diverticulosis (4)
(most asymptomatic)
- abdominal pain
- bloating
- changes in bowel habits
- serious: bleeding
49
S+S diverticulitis (4)
- pain LLQ
- distention
- decreased/absent bowel sounds
- N/V
50
Abnormal tract between two hollow organs or a hollow
| organ and the skin
fistula
51
difference between simple and complex fistula
simple: 1 short direct tract
complex: multiple organs, abscesses, opens into base of wound
52
low, moderate, and high outputs for fistula (mL)
low: <200 mL/day
moderate: 200-500 mL/day
high: >500 mL/day
53
early signs fistula (2)
fever
| abdominal pain
54
Protrusion of intestine through an opening or weakened area in the cavity wall
hernia
55
hernia that cannot be placed back into abdominal cavity; abdominal contents are trapped
irreducible/incarcerated
56
complications of irreducible hernia
strangulated - blood supply compromised
intestinal obstruction
gangrene and necrosis
57
4 types hernias
◦Inguinal
◦Umbilical
◦Femoral
◦Incisional
58
S+S strangulated hernia (4)
- severe pain
- vomiting
- cramping and abdominal pain
- distention
59
Impaired absorption of fats, carbohydrates, proteins,
| minerals, and vitamins
malabsorption syndrome
60
5 common causes malabsorption syndrome
- IBD
- celiac disease
- tropical sprue
- cystic fibrosis
- lactose intolerance
61
most common cause malabsorption syndrome
lactose intolerance
62
most common signs malabsorption syndorme (3)
- weight loss
- diarrhea
- steatorrhea (fat in feces)
63
Autoimmune disease that damages small intestine
| mucosa; triggered by gluten
celiac disease
64
classic S+S celiac disease (5)
- foul-smelling diarrhea
- abdominal pain
- abdominal distention
- flatulence
- malnutrition
65
risk factors hemorrhoids (6)
- pregnancy
- constipation
- straining
- diarrhea
- obesity
- heavy lifting
66
S+S hemorrhoids (4)
- bleeding with defecation
- prolapse
- itching, burning, edema
- thrombosis
67
Skin ulcer or crack in lining of anal wall
anal fissure
68
causes of anal fissures (4)
- trauma from hard stool
- anal trauma
- local infection (STDs)
- inflammation
69
S+S anal fissure (2)
- pain with defecation and pressure
| - bleeding
70
Perianal collection of pus due to obstruction of anal
| glands results in infection
anorectal abscess
71
S+S anorectal abscess (5)
- local severe pain and swelling
- foul-smelling drainage
- tenderness
- fever
- possible: sepsis
72
Abnormal tunnel from anus or rectum to skin, vagina,
| or buttocks
anal fistula
