Lower G.I. problems

Question 1

appendicitis

Answer 1

Inflammation of appendix

Question 2

cause of appendicitis

Answer 2

apPendix is obstructed leads to inflammation

Question 3

complications of appendicitis

Answer 3

Gangrene
Abscess formation
Peritonitis

Question 4

s/sx of appendicitis

Answer 4

Classic pain-RLQ in Periumbilical area
rebound pain/tenderness – severe
Sudden pain relief
dull steady pain, 4 to 6 hours – localizes RLQ
Fever, nausea, anorexia

Question 5

what does sudden pain Relief in appendicitis indicate

Answer 5

May indicate rupture

Question 6

what is the peak incidence time for appendicitis?

Answer 6

10 to 12 years old

Question 7

diagnosis of appendicitis

Answer 7

Increase WBC
Abdominal sonogram
Exploratory lap

Question 8

peritonitis

Answer 8

Inflammation of peritoneum
Serous membrane that lines abdominal cavity, and covers visceral organs

Question 9

what occurs from the fluid shift of peritonitis?

Answer 9

Hypovolemic shock, sepsis
Paralytic ileus, intestinal obstruction

Question 10

causes of peritonitis

Answer 10

Perforated ulcer, pancreatitis
Ruptured gallbladder, spleen, bladder, appendix

Question 11

s/sx appendicitis

Answer 11

sudden and severe
abdominal pain, tenderness
Rigid, board like abdomen
N/V
Fever, increased WBC
increased heart rate
Decreased blood pressure

Question 12

What is a key indicator of appendicitis?

Answer 12

Hard, rigid abdomen

Question 13

Irritable bowel syndrome – IBS

Answer 13

chronic condition
Alterations in bowel pattern due to changes in intestinal motility

Chronic and frequent constipation and diarrhea – IBSC, IBSD

Question 14

s/sx IBS

Answer 14

vary by individual
Abdominal distention, fullness, bloating
Intermittent, abdominal pain
bowel urgency
Intolerance to sorbitol, lactose, gluten
Non-bloody stool – excess mucus

Question 15

how is abdominal pain in IBS exacerbated?

Answer 15

stress

Question 16

how is abdominal pain in IBS relieved?

Answer 16

Defecation

Question 17

t/f emotional stress can exacerbate IBS

Answer 17

True

Question 18

t/f IBS cannot cause, psychological stress and problems

Answer 18

False

Question 19

Cause of IBS

Answer 19

generally unknown**
Can be triggered by stress, food, hormone changes, GI infections, menses-women

Question 20

Inflammatory bowel disease – IBD

Answer 20

Group of life-changing, chronic illnesses
Chronic inflammation of intestines

Question 21

Who is inflammatory bowel disease more common in

Answer 21

Women
Caucasians
Jewish descent
Smokers

Question 22

cause of IBD

Answer 22

Autoimmune activated by infection

Question 23

Crohn’s disease Patho

Answer 23

Lymph structures of G.I. tract are blocked
tissue becomes engorged an inflamed
Deep linear, fissures and ulcers develop in a Patchy pattern in the bowel wall

Question 24

what are the fissures in ulcers that develop in a Patchy pattern

Answer 24

skip lesions
Cobblestone appearance

Question 25

Complications of Crohn’s disease

Answer 25

malnutrition Anemia Scar tissue/obstruction Fistulas Cancer

Question 26

s/sx Crohn’s disease

Answer 26

Crampy lower abdominal pain – RLQ Watery diarrhea Systemic: weight, loss, fatigue, no appetite, fever, malabsorption of nutrients Palpable, abdominal mass RLQ Mouth ulcers

Question 27

ulcerative colitis

Answer 27

Inflammation of mucosa of rectum, and colon

Question 28

Who is ulcerative colitis more common in

Answer 28

Third decade of life Caucasian European descent Ashkenazy, Jewish Occasionally African-Americans

Question 29

Who is ulcerative colitis rare in?

Answer 29

Asians

Question 30

Patho of ulcerative colitis

Answer 30

Inflammation begins in rectum and extends in a continuous segment that may involve entire colon Leads to large ulcerations Necrosis of epithelial tissue – crypt abscess Colon and rectum Try to repair damage with new granulation tissue– tissue is fragile and bleeds easily

Question 31

s/sx ulcerative colitis

Answer 31

Abdominal pain Bloody diarrhea Systemic: weight loss, decreased appetite, fever

Question 32

complications of ulcerative colitis

Answer 32

Hemorrhage Perforation Cancer Malnutrition Anemia Strictures

Question 33

what does ulcerative colitis put patients at risk for?

Answer 33

Fissures Abscesses Toxic megacolon Colorectal carcinoma Liver disease PH/fluid and electrolyte imbalance VTE, DVT

Question 34

diverticulosis Patho

Answer 34

development of diverticula Small pouches in lining of Colon that bulge outward through weak spots

Question 35

t/f diverticulosis can be congenital, but not acquired

Answer 35

False, can be both

Question 36

Cause of diverticulosis

Answer 36

Low fiber diet with chronic constipation

Question 37

Where does diverticulosis occur?

Answer 37

Descending colon

Question 38

does diverticulosis involve inflammation?

Answer 38

No

Question 39

s/sx diverticulosis

Answer 39

Usually asymptomatic Discovered accidentally with presentation of acute diverticulitis

Question 40

diverticulitis

Answer 40

Inflammation of one or more diverticula from retained fecal material

Question 41

s/sx diverticulitis

Answer 41

LLQ abdominal pain Fever, increased WBC constipation, diarrhea Acute passage, large quantity of Frank blood

Question 42

can diverticulitis resolve spontaneously?

Answer 42

Yes

Question 43

complications of diverticulitis

Answer 43

Perforation Obstruction Peritonitis