Lower GI Flashcards

1
Q

Appendicitis

A

Inflammation of the appendix after an obstruction

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2
Q

Complications of appendicitis

A

Abscess, gangrene, peritonitis

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3
Q

CM of appendicitis

A

RLQ pain in periumbilical area, rebound tenderness, dull, steady pain in periumbilical area, progressive over 4-6h to RLQ, low fewer, N, anorexia

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4
Q

Peak incidence for appendicitis

A

10-12Y

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5
Q

Sudden relief of pain with appendicitis

A

CONCERN - BURST - risk of peritonitis

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6
Q

Appendicitis dx

A

US or laporotomy

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7
Q

Peritonitis

A

Inflammation of the peritoneum from stuff in the stomach getting outside the gut; serous membrane that lines the abdominal cavity and covers the visceral organs

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8
Q

Risks with peritonitis

A

Get fluid shifts (3rd spacing) that lead to hypovolemia and sepsis; dec peristalses and paralytic ileus

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9
Q

Causes of peritonitis

A

Perforated ulcers, ruptured gallbladder, pancreatitis, ruptured spleen, ruptured appendix

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10
Q

CM of peritonitis

A

Sudden abdominal pain, tender, rigid, board-like abdomen, N/V, fever, inc WBCs, inc HR, dec BP

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11
Q

Peritonitis patho

A

Pain and fluid shifts causing SNS action

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12
Q

tx for peritonitis

A

Anti-inflammatory, fixing the cause

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13
Q

IBS

A

change in bowel pattern with changes in intestinal motility; includes IBSC (constipation) and IBSD (diarrhea)

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14
Q

Sx of IBS

A

Vary by person
- ab distention, fullness, bloat, flatulence
- intermittent ab pain exac by stress and relieved with pooping
- bowel urgency
- food intolerances (lactulose, gluten, sorbitol)
- non-bloody stool containing mucus

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15
Q

Can stress cause IBS?

A

No but it can exacerbate IBS

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16
Q

Cause of IBS

A

Unknown, triggered by food, stress, hormonal changes, GI infection, menses

17
Q

Inflammatory bowel disease

A

UC and Crohn’s
- life-changing chronic illness
- chronic inflam of intestines and exac and remissions
- autoimmune activated by infx

18
Q

Risk factors for IBD

A

women, white, Jewish, smokers

19
Q

Crohn’s

A
  • lymphatic structures of GI tract are blocked
  • tissues engage and inflam
  • deep liver fissure and ulcer dev in “patchy” pattern on bowel wall (skip lesions aka cobblestone look)
20
Q

Sx of Crohn’s

A

Anemia, scar tissue, fistula, inc risk of cancer, RLQ cramp, watery diarrhea, wt loss, fatigue, fever, malabsorption of nutrients, palpable ab mass, mouth ulcer

21
Q

What is Crohn’s associated with?

A

Granulomas

22
Q

UC

A

inflammation of mucosa in the rectum and colon

23
Q

Risk fx for UC

A

white euro descent, esp ashkenazi jews, some Black, rare in asians
- often dev in 3rd decade of life

24
Q

UC patho

A

Inflam begins in rectum and extends into continuous segment that might involve the whole colon
- inflam leads to big ulcers
- necrosis of epithelial tissue (crypt abscesses)
- colon and rectum try to fix w/ new granulated tissue (tissues fragile, bleed easy)

25
Q

Sx of UC

A

bleeding, diarrhea, wt loss, fatigue, anorexia, fever

26
Q

Complications of UC

A

hemorrhage, perforation, cancer (colon carcinom), malnutrition, anemia, strictures, fissures and abscesses, liver disease from scarred bile ducts, VTE and DVT, F&E, pH imbalance

27
Q

V dangerous risk of UC

A

Toxic megacolon - rapid dilation of L intestine–life threatening

28
Q

Diverticular disease

A

Develop diverticula - small pouches in the lining of the colon that bulge out thru weak spots (often in the descending colon)

29
Q

Is diverticular disease congenital or acquired?

A

BOTH

30
Q

Diverticulosis

A

w/o inflam

31
Q

Diverticulitis

A

with inflam

32
Q

Cause of diverticular disease

A

May be from low fiber diet resulting with chronic constipation

33
Q

Risk fx of diverticulosis

A

chronic constipation

34
Q

CM for diverticular disease

A

Often asymptomatic, diagnosed accidentally or with acute -litis exac

35
Q

Patho of diverticulitis and CM

A

Inflamed pouch from retained fecal material
- LLQ ab pain, fever, inc WBCs, constipation or diarrhea, large frank bleed
- may resolve spontaneous

36
Q

Complications of diverticular disease

A

Perforation, obstruction, peritonitis
- depends on severity, if they pop

37
Q

GI tx

A

Often diet, sometimes surg
- may r/t constipation

38
Q

Treating H. pylori

A

Need several abx, gastric acid inhibition
- combo drugs to dec resistance, like acid
- need 10-14d tx
- very $$$ so adherence is prob

39
Q

Pharm target for GI

A

dec gastric acid production
- Block H2 receptors (which produce GA) or inhibit proton pump (pump makes gastric acid)
- occur in parietal cells of stomach