Lower GI Flashcards

1
Q

lower GI

A

small intestines and below

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2
Q

what is appendicitis

A

inflammation of the appendix

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3
Q

cause of appendicitis

A
  • appendix is obstructed which leads to inflammation
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4
Q

complications of appendicitis

A

gangrene
abscess formation
peritonitis

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5
Q

key points of appendicitis

A

classic pain: RLQ in periumbilical area
rebound pain: pain severe when release pressure off site
sudden pain relief: ma indicate rupture, peritonitis

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6
Q

what is peritonitis

A

inflammation of the peritoneum

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7
Q

what is the peritoneum

A

serous membrane that lines the abdominal cavity and covers visceral organs

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8
Q

what happens when the peritoneum becomes inflammed

A

fluids shift resulting in third spacing which can lead to hypovolemic shock and sepsis, dec peristalsis, intestinal obstruction

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9
Q

causes of peritonitis

A

perforated ulcers
ruptured gallbladder, spleen, bladder, appendix
pancreatitis
when stuff that should be in your gut gets outside your gut

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10
Q

clinical manifestations of peritonitis

A

sudden and SEVERE ab pain
tenderness
rigid, board like abdomen –> hard to touch
NV
fever, inc WBC
inc HR, dec BP –> from pain but mostly fluid shifts (third spacing)

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11
Q

treating peritonitis

A

can treat but usually treat whatever caused it and it will subside on its own

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12
Q

what is irritable bowel syndrome

A

chronic condition characterized by alterations in bowel patterns due to changes in intestinal motility
- either have constipation or D

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13
Q

symptoms of IBS

A

vary by ind
- ad distention, fullness, flatus, bloating
- intermittent ab pain exacerbated by stress and relieved by defecation
- bowel urgency
- intolerance to certain foods (gluten, sorbitol, lactose)
- non bloody stool that contains excess mucus

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14
Q

what is the relationship btw psychosocial stress and IBS

A

IBS is never the result of psychological causes but stress can exacerbate IBS
- IBS can also cause an inc in stress, like to live with etc

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15
Q

cause of IBS

A

unknown, thought to be triggered by stress, foods, hormone changes, GI infections, menses

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16
Q

what is inflammatory bowel disease

A

chronic illnesses that are life changing that are characterized by chronic inflammation of the intestines and exacerbations and remissions

17
Q

two types of inflammatory bowel diseases

A

crohn’s and ulcerative colitis

18
Q

IBD affect who

A

women
caucasians
Jewish decent
smokers

19
Q

thought cause of IBD

A

genetic autoimmune that is activated by an infection

20
Q

crohns disease pathogenesis

A
  • lymph structures of GI tract are blocked and tissue becomes engorged and inflamed
  • deep linear fissures and ulcers develop in a patchy pattern in the bowel wall (skip lesions and cobblestone appearance)
21
Q

complications of crohns

A

malnutrition
anemia
scar tissue and obstructions
fistulas –> connection btw structures that shouldnt be connected
cancers

22
Q

clinical manifestations of crohns disease

A

crampy lower ab pain (RLQ)
watery D
systemic: wt loss, fatigue, malabsorption of nutrients
palpable abdominal mass (RLQ)
mouoth ulcers
s/s of fistulas
granulomas and skip lesions

23
Q

what is ulcerative colitis

A

inflammation of the mucosa of the rectum and colon

24
Q

when does ulcerative colitis typically occur

A

3rd decade of life

25
Q

UC typically develops in which people

A

white, european decent (esp. ashkenasi jews
occasionally black
rare in asians

26
Q

UC pathogenesis

A

inflammation begins in the rectum and extends in a continuous segment that may involve the entire colon
- inflammation leads to large ulcerations
- necrosis of the epithelial tissue can result in abscesses (crypt abscesses)
colon and rectum try to repair damage with new granulation tissue but this tissue is fragile and bleeds easily

27
Q

clinical manifestations of UC

A

ab pain
bloody D
systemic: wt loss, fatigue, no appetite, fever

28
Q

complications of UC

A

hemorrhage
perforation
cancer
malnutrition
anemia
strictures
fissures
abscesses
toxic megacolon
colorectal carcinoma
liver disease
fluids, electrolyte, and PH imbalances
higher risk for DVT, VTE

29
Q

what is toxic megacolon

A

rapid dilation of large intestine that can be life threatening

30
Q

why can UC cause liver disease

A

inflammation and scarring of the bile ducts

31
Q

what is the pathogenesis of diverticulosis

A

development of diverticula which are small pouches in the lining of the colon that bulge through weak spots

32
Q

why does diverticulosis occur

A
  • may be congential or acquired
  • thought to be caused by low fiber diet resulting with chronic C
33
Q

where do diverticula typically occur

A

descending colon

34
Q

difference btw diverticulosis vs diverticulitis

A

losis= outpouching
itis= outpouching with inflammation or infection

35
Q

clinical manifestations of diverticulosis

A

usually asymptomatic
discovered accidentally or with presentation of acute diverticulitis

36
Q

what is diverticulitis

A

inflammation of one or more of the pouches (diverticula)

37
Q

what usually causes inflammation of diverticula

A

retained fecal material in diverticula

38
Q

clinical manifestations of diverticulitis

A

LLQ ab pain
fever
inc WBC
C or D
acute large passage of frank blood
may resolve spontaneously

39
Q

complications of diverticulitis

A

perforation
peritonitis
obstruction