Medical 2 Flashcards
How many people in Canada have symptoms of GERD (gastroesophageal reflux disease)
10-20%
What are some risk factors of GI disorders?
Age
Previous illness
Surgery
Family history
Medications
Cigarettes
Drugs or alcohol
What is role of the portal veins?
Portal veins transport veins transport venous blood from the GI system to the liver for processing of nutrients that have been absorbed.
Name the 3 sections of the small intestine and it’s purpose.
Duodenum, jejunum, and ileum function to absorb 90% of nutrients.
What are the common symptoms of a GI tract disease?
Pain, fluid losses (diarrhea/vomiting), bleeding, and alterations in bowel habits
What is esophageal varices?
Increased pressure in the blood vessels of the distal esophagus due to liver damage or cirrhosis
What is Mallory-Weiss Syndrome?
Tears in the esophageal lining caused by severe vomiting and may lead to hemorrhage.
What causes hemorrhoids?
Swelling and inflammation of the blood vessels surrounding the rectum.
What causes peptic ulcer disease (PUD)? And with are the risk factors?
The protective layer is eroded allowing the acid to eat the mucosal lining of the stomach
Major risk factors are helicobacter pylori infection and NSAID use
What causes cholecystitis?
Obstruction of the cystic duct from the gallbladder to duodenum, usually by a gallstone can cause inflammation of the gallbladder.
Patient may show a positive Murphy sign (rebound tenderness in the right upper quadrant as the diaphragm descends)
What are the Five F risk factors for cholecystitis?
Fat, Fair (White), Female, Fertile, Forty
What causes Diverticulitis?
Feces may become trapped in the diverticula (bulges in the colon wall). Bacteria will grow causing inflammation and infection
Pain from diverticulitis is most common in the left lower quadrant
What causes Ulcerative Colitis?
Generalized inflammation of the colon
What is Crohn disease?
A disease in which the immune system attacks the GI tract, most commonly affecting the ileum
What’s the biggest difference between Ulcerative Colitis and Crohn’s disease?
Ulcerative Colitis affects the colon, Crohn Disease may affect any part of the GI Tract
What is Acute Gastroenteritis and what are it’s symptoms?
Gastroenteritis is caused by several infectious conditions and presents with nausea, diarrhea, vomiting, cramps, and chills.
May run its course in 2-3 days or several weeks
What are the types of Hepatitis, what does hepatitis do, what are the symptoms?
Hep A (fecal-oral)
Hep B (blood-blood)
Hep C (blood-blood)
Hep D (blood-blood)
Hep E (fecal-oral)
Acute Hepatitis causes damage to the liver.
Symptoms: abdominal pain, vomiting, fever, and jaundice
What do you have to do before palpating the abdomen?
Auscultate for bowel sounds
What are Orthostatic vital signs? What can they determine?
When a patient has suffered significant fluid loss, 10-20%, you will note a 20 mmHg systolic and 10 mmHg diastolic change in blood pressure when the patient is sitting vs. standing
What are the 4 types of abdominal pain?
Somatic Pain- localized pain, felt deeply
Rebound Tenderness- felt on rebound of palpation, increases with movement
Visceral Pain- difficult to localize, described as burning cramping or aching
Referred Pain- originates in the abdomen and causes pain in distant locations
What are normal bowel sounds?
Soft gurgles occurring 5-30x per minute
What is the main airway concern for the GI patient?
Potential for aspiration or obstruction of the airway due to vomit or blood
What does shortness of breath with a GI problem indicate?
The patient needs oxygen, GI bleeding may cause significantly decreased hemoglobin. Oxygen saturation may read high but the patient still needs oxygen.
What equipment can be used to protect from bodily fluids?
Gloves, Gowns, Eye pro, Mask
Towels and Wash rags
Extra linens
Absorbent pads
Emesis basin
Disposable basin
How much of the body’s blood flows through the kidneys each minute?
1/4
What are the parts of the kidney?
Hilum- concave medial side
Renal Fascia- dense tissue anchoring the kidney to the abdominal wall
Cortex- light coloured outer region
Medulla- includes cone shaped renal pyramids and inward tissue
Renal pelvis- flat funnel shaped tube that fills the sinus
What is a nephron and how many are there?
The main structural and functional units of the kidney that form urine, each kidney contains approximately 1.25 million nephrons
What affect does Aldosterone and Antidiuretic hormone (ADH) have on reabsorption?
Aldosterone- increases the rate of sodium and chloride ion reabsorption (water follows salt)
Antidiuretic hormone- Increases water reabsorption when solute concentration in the blood is too high
What is the Micturition Reflex?
Spinal reflex causes contractions of bladder smooth muscle causing the urge to void.
What is Polynephritis?
Inflammation of the kidney linings caused by an upper urinary tract infection. If untreated may lead to sepsis.
What are the risk factors of kidney stones?
Diet, hydration, personal or family history, and hypertension
Types of Kidney stones?
Calcium oxalate (calcium stones account for 80%)
Calcium phosphate
Uric acid/ Cystine
Struvite stones
Define the terms Polyguria, Anuria, Oligura
Polyguria- increased urinary output
Anuria- complete stop of urine production
Oliguria- decreased urinary output
What is an AKI
An Acute Kidney injury is a sudden decrease in the rate of filtration through the glomeruli causing toxins to accumulate in the blood. Classified into 3 types, prerenal, intrarenal, postrenal. (approximately 1/8 will require long term dialysis)
What is CKD?
Chronic Kidney Disease is progressive and irreversible loss of function developed over months or years, more than half caused by diabetes or hypertension. May also be caused by congenital diseases such as pyelonephritis.
What is dialysis? What are the 2 types?
Dialysis is a technique for filtering toxic wastes from blood or removing excess fluids.
There are 2 types:
Peritoneal- large amounts of dialysis fluid are infused into the peritoneal cavity, remain there for 4-6 hours for equilibrium to occur.
Hemodialysis- Blood is circulated through a dialysis machine that functions similarly to normal kidneys
Patients requiring chronic dialysis every 2-3 days
What problems may be associated with dialysis?
Accidental disconnection of the machine
Air embolism
Bleeding from a fistula or shunt
Malfunction of machine
Rapid shift in fluid may cause hypotension, potassium Imbalance, or disequilibrium syndrome
What is Disequilibrium Syndrome and what are it’s signs and symptoms?
Increase of Intracranial pressure from water moving into the CSF through osmosis as a consequence of dialysis.
Patient may experience nausea, vomiting, headache, and confusion
What is Pheochromocytoma?
A tumour in the adrenal gland, usually in the medulla
Fewer than 10% of tumours are malignant (cancerous)
