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PathoPharm > Lewis ch 42 - lower GI problems > Flashcards

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

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2
Q

what symptom is associated with E Coli

A

bloody diarrhea

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3
Q

what organism causing infectious diarrhea is hospital acquired

A

C diff

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4
Q

increased risk for diarrhea from infectious organisms (4)

A
  • older adults
  • use of PPIs
  • use of antibiotics
  • immunocompromised
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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)
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6
Q

S+S upper GI diarrhea (4)

A
  • large volume watery stools
  • periumbilical pain
  • cramping
  • low grade/no fever
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7
Q

S+S lower GI diarrhea (2)

A
  • small volume bloody diarrhea

- fever

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8
Q

what ABG imbalance can severe diarrhea lead to

A

metabolic acidosis

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9
Q

2 possible antibiotics for diarrhea

A

floroquinolone

azithromycin

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10
Q

patients at risk for cdiff infection (4)

A
  • antimicrobial agents
  • chemotherapy
  • gastric acid suppressing agents
  • immunosuppressive agents
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11
Q

Involuntary passage of stool related to motor and/or

sensory dysfunction

A

fecal incontinence

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12
Q

common causes fecal incontinence (6)

A
  • anal sphincter weakness
  • functional
  • inflammatory
  • neurologic disease
  • pelvic floor dysfunction
  • other (diarrhea, fecal impaction)
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13
Q

irritating diarrhea-producing foods (4)

A
  • caffeine
  • artificial sweeteners
  • dairy products
  • vegetables with insoluble fiber
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14
Q

◦Difficult or infrequent bowel movements
◦May require excessive exertion to defecate
◦Feeling of incomplete evacuation
◦Symptom, not a disease

A

constipation

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15
Q

difference between acute and chronic constipation (# days)

A

acute: <1 week
chronic: >3 months

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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
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17
Q

4 causes abdominal pain

A

inflammation
peritonitis
obstruction
internal bleeding

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18
Q

2 complications abdominal pain

A

septic shock

hypovolemic shock

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19
Q

S+S abdominal pain (4)

A
  • N/V/D
  • rebound tenderness
  • fever
  • bloating
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20
Q

3 complications abdominal trauma

A
  • shock
  • peritonitis
  • abdominal compartment syndrome
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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
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22
Q

Chronic abdominal pain or discomfort and alteration

of bowel patterns

A

irritable bowel syndrome

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23
Q

4 categories IBS

A
  • IBS w/ constipation (IBS-C)
  • IBS w/ diarrhea (IBS-D)
  • IBS mixed
  • IBS unsubtyped
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24
Q

which type IBS more likely for men v women

A

men: IBS-D
women: IBS-C

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25
Q

S+S IBS (5)

A
  • mucus in stool
  • abdominal pain
  • fatigue
  • headache
  • sleep problems
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26
Q

S+S appendicitis (4)

A
  • persistent pain RLQ
  • rebound tenderness
  • pain
  • N/V
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27
Q

primary cause peritonitis

A

blood-borne organisms

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28
Q

secondary cause peritonitis

A

perforation of organs that spill contents into

peritoneal cavity

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29
Q

S+S peritonitis (5)

A
  • abdominal pain
  • rebound tenderness
  • fever
  • tachycardia
  • N/V
30
Q

complications peritonitis (5)

A
  • hypovolemic shock
  • sepsis
  • intraabdominal abscess
  • paralytic ileus
  • acute respiratory distress syndrome
31
Q

common foodborne cause of gastroenteritis

A

norovirus

32
Q

S+S gastroenteritis (3)

A
  • sudden N/V/D
  • fever
  • abdominal cramping
33
Q

Chronic, inflammation of GI tract characterized by
periods of remission are interspersed with periods of
exacerbation

A

inflammatory bowel disease

34
Q

2 classifications IBD

A

ulcerative colitis

crohns

35
Q

risk factors IBD (5)

A
  • autoimmune diseases
  • diet (high intake sugar and fat, low intake fiber, fruits and veggies)
  • smoking
  • NSAIDs, oral contraceptives, antibiotics
  • genetic links
36
Q

S+S crohns disease (3)

A
  • diarrhea, cramping
  • weight loss
  • rectal bleeding
37
Q

S+S ulcerative colitis (3)

A
  • protein loss in stool
  • pseudopolyp formation
  • bloody diarrhea
38
Q

2 options drug therapy for IBD

A

Sulfasalazine (folic acid)

corticosteroids (calcium and potassium)

39
Q

4 types intestinal obstruction

A
  • partial
  • complete
  • simple (intact blood supply)
  • strangulated (no blood supply)
40
Q

what ABG imbalance can result from high intestinal obstruction

A

metabolic alkalosis

41
Q

4 hallmark S+S intestinal obstruction

A
  • abdominal pain
  • N/V
  • distention
  • constipation
42
Q

2 types polyps

A
  • hyperplastic: non-cancerous, <5 mm, asymptomatic

- adenomatous: neoplastic

43
Q

saccular dilations or outpouchings of the mucosa in the colon

A

diverticula

44
Q

multiple, noninflamed diverticula

A

diverticulosis

45
Q

one or more inflamed diverticula

A

diverticulitis

46
Q

complications diverticulitis (4)

A
  • perforation
  • abscess
  • fistula
  • bleeding
47
Q

risk factors diverticulitis (5)

A
  • constipation/lack of dietary fiber
  • obesity/lack of activity
  • smoking
  • excess alcohol use
  • excess NSAID use
48
Q

S+S diverticulosis (4)

A

(most asymptomatic)

  • abdominal pain
  • bloating
  • changes in bowel habits
  • serious: bleeding
49
Q

S+S diverticulitis (4)

A
  • pain LLQ
  • distention
  • decreased/absent bowel sounds
  • N/V
50
Q

Abnormal tract between two hollow organs or a hollow

organ and the skin

A

fistula

51
Q

difference between simple and complex fistula

A

simple: 1 short direct tract
complex: multiple organs, abscesses, opens into base of wound

52
Q

low, moderate, and high outputs for fistula (mL)

A

low: <200 mL/day
moderate: 200-500 mL/day
high: >500 mL/day

53
Q

early signs fistula (2)

A

fever

abdominal pain

54
Q

Protrusion of intestine through an opening or weakened area in the cavity wall

A

hernia

55
Q

hernia that cannot be placed back into abdominal cavity; abdominal contents are trapped

A

irreducible/incarcerated

56
Q

complications of irreducible hernia

A

strangulated - blood supply compromised
intestinal obstruction
gangrene and necrosis

57
Q

4 types hernias

A

◦Inguinal
◦Umbilical
◦Femoral
◦Incisional

58
Q

S+S strangulated hernia (4)

A
  • severe pain
  • vomiting
  • cramping and abdominal pain
  • distention
59
Q

Impaired absorption of fats, carbohydrates, proteins,

minerals, and vitamins

A

malabsorption syndrome

60
Q

5 common causes malabsorption syndrome

A
  • IBD
  • celiac disease
  • tropical sprue
  • cystic fibrosis
  • lactose intolerance
61
Q

most common cause malabsorption syndrome

A

lactose intolerance

62
Q

most common signs malabsorption syndorme (3)

A
  • weight loss
  • diarrhea
  • steatorrhea (fat in feces)
63
Q

Autoimmune disease that damages small intestine

mucosa; triggered by gluten

A

celiac disease

64
Q

classic S+S celiac disease (5)

A
  • foul-smelling diarrhea
  • abdominal pain
  • abdominal distention
  • flatulence
  • malnutrition
65
Q

risk factors hemorrhoids (6)

A
  • pregnancy
  • constipation
  • straining
  • diarrhea
  • obesity
  • heavy lifting
66
Q

S+S hemorrhoids (4)

A
  • bleeding with defecation
  • prolapse
  • itching, burning, edema
  • thrombosis
67
Q

Skin ulcer or crack in lining of anal wall

A

anal fissure

68
Q

causes of anal fissures (4)

A
  • trauma from hard stool
  • anal trauma
  • local infection (STDs)
  • inflammation
69
Q

S+S anal fissure (2)

A
  • pain with defecation and pressure

- bleeding

70
Q

Perianal collection of pus due to obstruction of anal

glands results in infection

A

anorectal abscess

71
Q

S+S anorectal abscess (5)

A
  • local severe pain and swelling
  • foul-smelling drainage
  • tenderness
  • fever
  • possible: sepsis
72
Q

Abnormal tunnel from anus or rectum to skin, vagina,

or buttocks

A

anal fistula

PathoPharm (42 decks)

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