Medical Conditions Flashcards
Ascites
Ascites is the buildup of an abnormal amount of fluid inside the abdomen (belly). This is a common problem in patients with cirrhosis (scarring) of the liver. Approximately 80% of patients with cirrhosis of the liver develop ascites.
Symptoms: Most people who develop ascites develop a large belly and experience a rapid gain in weight. Some people also develop swelling of the ankles and shortness of breath.
Diagnosis: Ascites is diagnosed based on physical exam, medical history, blood tests, ultrasound or CT scan, and paracentesis. Paracentesis is a procedure in which a needle is inserted through the abdominal wall (after local anesthesia) and fluid is removed. This fluid is examined for signs of infection, cancer, or other medical problems.
Hiatal hernia
A part of the stomach bulges upward through the diaphragm.
Symptoms: respiratory symptoms such as pneumonitis, chronic bronchitis, and asthma.
GERD
Reflux is aggravated by increased intra-abdominal pressure from excessive coughing, straining, bending, vomiting, obesity, pregnancy, trauma, ascites, reclining after eating, lifting heavy objects, and strenuous exercise.
Lifestyle modifications:
• Head of bed elevated 6 inches
• Decreased fat intake
• Smoking cessation
• Weight reduction for obese patients
• Avoidance of recumbent positions for 3 hours postprandially
• Small, frequent meals
• Avoidance of alcohol, chocolate, caffeine
• Avoidance of tight, waist-constricting clothing
Peptic Ulcer Disease (PUD)
A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum.
Causes: Infection with Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs (NSAIDs)
Treatment**: Goals are accomplished through triple therapy, a combination of two antibiotics and acid-reducing medications for 10-14 days. Triple therapy often requires more than one round of treatment to eradicate H. pylori completely.
Dumping syndrome
Complication that may develop after gastic bypass surgery. Impairment of the normal stomach reservoir causes a large volume of particles to be dumped rapidly into the small intestine. These hyperosmolar contents draw water into the lumen and stimulate bowel motility, causing nausea and vomiting. Vasomotor symptoms may also occur: tachycardia, postural hypotension, profuse sweating, weakness, flushing, and syncope. Patients may experience intestinal symptoms but not vasomotor symptoms, or vice versa. A late phase may occur 1 to 3 hours postprandially. Less common than the early phase, its symptoms include perspiration, hunger, nausea, anxiety, tremors, and weakness.
Diverticulitis
When the musculature of the bowel walls weakens, diverticula (pouchlike herniations protruding from the muscular layer of the colon) often develop, resulting in the condition diverticulosis. It develops as the result of long-term, low-fiber eating habits and increased intracolonic pressure such as that created with straining to have a bowel movement. Usually this condition remains undetected until the diverticula become infected and inflamed from trapped fecal material and colon bacteria; the condition is then known as diverticulitis.
Treatment:
• Eat high-fiber foods
• Add more fiber gradually to allow the intestinal tract to adapt. This approach minimizes side effects such as abdominal distress, bloating, flatulence, cramps, and diarrhea, which are usually temporary.
• There is no evidence-based research indicating that nuts and seeds or popcorn worsen diverticular symptoms.
• Care should also be taken to consume adequate amounts of fluid—at least 8 to 12 cups per day
Renal (kidney) disease
Causes: Usually uncontrolled hypertension or diabetes. Heart disease can be the primary disease with renal failure as secondary to heart disease. Genetics are a cause of a small percentage of renal disease (polycystic kidney disease). A traumatic loss of fluid (blood loss or volume depletion, dehydration) can cause acute renal failure which may or may not become chronic renal failure.
Renal calculi (kidney stones)
Formation of kidney stones depends on simultaneous occurrence of low urine volume from inadequate fluid intake, alkaline urine pH, excessive urinary excretion of calcium, oxalate, and/or uric acid. Some stones are hereditary, others caused by recurrent UTIs.
