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Nursing 201 Pathophys > Lower GI Inflammatory Disorders and GI Malabsorption > Flashcards

Lower GI Inflammatory Disorders and GI Malabsorption Flashcards

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1
Q

What is appendicitis?

A

Inflammation of the appendix due to obstruction of the opening of the appendix

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2
Q

What are the signs and symptoms of appendicitis?

A

Periumbilical pain shifting to the lower right quadrant
- Guarding
- Tenderness/rebound tenderness
Anorexia
Nausea and vomiting

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3
Q

What tests can be used to diagnose appendicitis?

A

Gold standard: CT/Ultrasound
Physical examination
Increased white blood cell count
Urinalysis

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4
Q

What is the treatment for appendicitis?

A

Laparoscopic appendectomy

NO LAXATIVES

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5
Q

What are the complications of appendicitis?

A

Rupture –> Peritonitis
Abscesses

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6
Q

What is diverticulosis?

What is the main cause of diverticulosis?

What is diverticulitis?

A

Diverticulosis is the formation of multiple, non-inflamed pockets in the bowel (diverticula)

Diverticulitis is the inflammation of these diverticuli

Diverticulosis is caused by low fibre intake

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7
Q

What are the signs and symptoms of diverticulitis?

A

Acture lower left quadrant pain
Palpable masses
- Diverticula becomes swollen and can be felt on the abdominal surface
Systemic infection symptoms
Altered bowel movements
- Change in size
- Presence of mucus and/or blood

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8
Q

What are some diagnostic tests for diverticulitis?

A

CT with contrast
Blood tests
Physical exam
History

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9
Q

What is the treatment for diverticulitis?

A

General:
- High-fibre diet
- Increase activity and weight management
- Stool softeners
- Clear liquid diet

Acute:
- Rest colon
- Inflammation management
- Oral antibiotics
- NBM
- Nasogastric suction
- Surgery if abscess or obstruction

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10
Q

What are the complications of diverticulitis?

A

Diverticular bleeding
Abscess
Perforation into peritoneum
- Peritonitis if uncontained

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11
Q

What is peritonitis?

What are the primary and secondary causes of peritonitis?

A

Inflammation of the peritoneum

Primary cause: Organisms invading the abdomen (Uncommon - intact gut)
Secondary cause: Rupture/perforations/Trauma (Most common)

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12
Q

What are the signs and symptoms of peritonitis?

A

Severe abdominal pain
- Tenderness over-involved area
- Rebound tenderness
Distension
Spasm
Fever

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13
Q

What are some diagnostic tests for peritonitis?

A

Abdominal X-ray and ultrasound
Blood tests
Peritoneoscopy
Aspiration if ascites present (less common)

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14
Q

What is the treatment for peritonitis?

A

Antibiotics
Pain relief
IV Fluids
Nasogastric suction
- Remove the bowel contents so they don’t leak into the peritoneum
Surgery
- Flush antibiotics into the peritoneum and leave antibiotics in the peritoneal space (Peritoneal lavage)

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15
Q

What are the complications of peritonitis?

A

Sepsis
Hypovoloaemic shock

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16
Q

What are two examples of inflammatory bowel diseases?

A

Two examples of inflammatory bowel diseases are Chron’s disease and Ulcerative colitis

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17
Q

What is Chron’s disease?

What causes Chron’s disease?

A

A chronic inflammatory bowel disease that usually affects the ileum and the colon but can affect all parts of the GI tract

Chron’s disease is of unknown origin

18
Q

What are the signs and symptoms of Chron’s disease?

A

Diarrhea
Weight loss
Abdominal pain
Fever
Fatigue

19
Q

What is ulcerative colitis?

What causes ulcerative colitis?

A

Inflammation of the colon with the development of mucosal and sub-mucosal ulcers

Ulcerative colitis is of unknown origin

20
Q

What are the signs and symptoms of ulcerative colitis?

A

Blood in stool
- Brown blood = Old
- Red/Large amount of blood = Invasion or erosion of a blood vessel into the bowel
Diarrhea
Rectal bleeding
Abdominal pain

21
Q

What is the treatment for inflammatory bowel diseases?

A

Medication
Nutritional management/Dietary adjustments
- Ensure adequate caloric intake
Inflammation management
- Steroids
- Antibiotics if infected
Stress management
Smoking cessation
Surgery depending on the type of inflammatory bowel disease

22
Q

What are the complications of inflammatory bowel diseases?

A

Haemorrhage
Strictures
- Tightening bands around bowels
Perforation
Dilatation
Fissures
- Crack
Fistulae
- A tract from one lumen to another
- Increased risk of rectal and intestinal cancers

23
Q

How is Chron’s disease diagnosed?

A

Often through biopsy

24
Q

What is the surgical intervention for Ulcerative colitis?

A

Total or partial colectomy with the formation of an ileal pouch or ileostomy (AKA proctocolectomy)

25
Q

When is surgery advocated for in managing Chron’s disease?

What is the usual management for Chron’s disease without surgery?

A

Conservative surgery to repair strictures, obstructions and fissures/fistulas without bowel removal

Conservative management with medication and diet

26
Q

What is coeliac disease?

What causes coeliac disease?

A

Coeliac disease is an immune-mediated response to gluten ingestion

It is caused by genetic predisposition

27
Q

What are some diagnostic tests for coeliac disease?

A

Gold standard: Small intestine biopsy before and after gluten
Serology for Immunoglobulin A
Genotyping for antigens

28
Q

What is the treatment/management of coeliac disease?

A

Gluten-free diet
Corticosteroids

29
Q

What is GI Malabsorption syndrome?

A

Impaired absorption of fats, carbs, proteins, minerals and vitamins

30
Q

What are some causes of GI malabsorption syndrome?

A

Biochemical & Enzymatic
- e.g. Lactase deficiency
Lymphatic/vascular
- e.g. Ischaemia, heart failure
Infectious
- e.g. parasites
Small intestine mucosal disruption/surface area loss
- e.g. Inflammatory bowel diseases, coeliac disease

31
Q

What are some gastrointestinal signs and symptoms of GI malabsorption?

A

Diarrhoea
Flatulence
Weight loss
Fatty stools

32
Q

What are some haematological symptoms of GI malabsorption?

A

Anaemia
Tendency to haemorrhage

33
Q

What are some musculoskeletal symptoms of GI malabsorption?

A

Bone pain
Osteoporosis
Weakness
Wasting

34
Q

What are some neurological symptoms of GI malabsorption?

A

Altered mental state
Paraesthesia
Peripheral neuropathy
Night blindness

35
Q

What are some skin-related symptoms of GI malabsorption?

A

Bruising
Dermatitis
Brittle Nails
Hair thinning

36
Q

What are some cardiovascular symptoms of GI malabsorption?

A

Hypotension
Tachycardia
Peripheral oedema

37
Q

What are some tests that can help diagnose GI malabsorption syndrome?

A

Stool tests
Blood tests
Hydrogen breath tests
CT scans
Endoscopy with small bowel biopsy

38
Q

What is the treatment on GI malabsorption based on?

A

The treatment for GI malabsorption is based on the cause, but early identification can help prevent complications

39
Q

What is the cause of irritable bowel syndrome?

A

It is unknown. May be related to food allergies? May be related to stress?

40
Q

What are the signs and symptoms of irritable bowel syndrome?

A

Abdominal pain
Altered bowel patterns
- Diarrhoea
- Constipation
Distension
Flatulence
Urgency
Fatigue
Sleep disturbances

41
Q

What are some tests for irritable bowel syndrome?

A

Patient history and description of symptoms
Tests aimed at differential diagnoses

42
Q

What is the treatment for irritable bowel syndrome?

A

Dietary management
Psychological
Medication

Nursing 201 Pathophys (29 decks)

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