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KN JD NPTE: OTHER SYSTEMS > OTH: GI System > Flashcards

OTH: GI System Flashcards

1
Q

Upper GI contains

A

Mouth, esophagus, stomach

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2
Q

Middle GI contains

A

Small intestine (duodenum, jejunum, ileum)

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3
Q

Lower GI contains

A

Large intestine (cecum, colon, rectum)

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4
Q

What are the accessory organs of the GI system?

A

Salivary glands, liver, pancreas

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5
Q

Neural control is achieved by ___. The ___ and ___ plexuses extend length of GI wall. ____ (mediated by __ N.) reflexes control secretions and motility of GI tract.

A

ANS
sympathetic and parasympathetic
Vasovagal (Vagus)

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6
Q

Major GI hormones include

A

Cholecystokinin, gastrin, secretin

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7
Q

N+V: nausea signals stimulation of ___ vomiting center. Can be triggered by food, drugs, ___oxia, shock, inflammation of __ __, distention, irritation of __ __, __ sickness. Prolonged vomiting leads to __ and ___ imbalance, resulting in ___ aspiration and mucosal/GI damage.

A

Medullary
Hypoxia, abdominal organs, GI tract, motion sickness
Fluid and electrolyte, pulmonary

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8
Q

Diarrhea: Dehydration, ___ imbalance, dizziness, thirst, weight __. Triggers: ___ organisms ( ____, rotavirus, ____), dysentery, ___ enteropathy, ___ ___ syndrome, ____thyroidism, neoplasm, diverticulitis

A

Electrolyte, loss

Infectious (E. Coli, Salmonella), diabetic, irritable bowel, hyper

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9
Q

Constipation: From diet lacking in ___ and ___, inadequate ___ consumption, __ age, ___ lifestyle, drugs (___and ___ meds). ____thyroidism, diverticula disease, __ __ syndrome, __, __ (2 NM conditions), tumors, __ obstruction, rectal __

A

Bulk, fiber, fluid
Increasing age, sedentary, CCB and anticholinergics
HYPOthyroidism, IBS, PD, SCI
Bowel, lesions

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10
Q

What is obstipation? Who gets this?

A

Intractable constipation- fecal impaction, likely inability fart, retention of hard dry stools in rectum/colon
- post-op pts, long-term opiates, SCI
(Needs to be removed)

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11
Q

RED FLAGS: constipation can cause ___ pain, tenderness in ___, ___, __ regions

A

Abdominal, anterior hip, groin, thigh

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12
Q

Constipation may develop as result of __ __ and __ (i.e. LBP)

A

Muscle guarding

Splinting

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13
Q

Dysphasia can result from CNS lesions (3 listed), strictures, ___ scarring, swelling, __, and __

A

stroke, PD, Alzheimer’s
Esophageal
CA, scleroderma

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14
Q

What is achalasia?

A

Lower esophageal sphincter fails to relax (food gets trapped in esophagus)

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15
Q

Abdominal pain can result from (3 listed)

Visceral pain in epigastric, periumbilical, lower abdomen —> what spinal levels are these associated with?

A
  1. Inflammation 2. Ischemia 3. Mechanical stretching
    Epigastric: T3-T5 symp distribution
    Periumbilical: T10 sympathetic
    Lower abdomen: T10-L2 sympathetic
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16
Q

RED FLAGS: Referred GI pain patterns —> where?

  1. Esophagus
  2. Midthoracic spine (nerve roots)
  3. Visceral pain from liver, diaphragm, pericardium
  4. Visceral pain from colon, appendix, pelvic viscera
A
  1. Midback
  2. Esophageal
  3. Shoulder
  4. Pelvis, low back, sacrum
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17
Q

What is heartburn? What increases it?

A

Painful burning sensation, reflux

From increased abdominal pressure: pregnancy, tight clothing, bending over, lying down after large meal

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18
Q

4 causes of GI bleeds

A
  1. Erosive gastritis
  2. Peptic ulcer
  3. Prolonged use of NSAIDs
  4. Chronic alcohol
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19
Q

How do you determine occult blood?

A

Stool sample lab test

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20
Q

Inflammation of liver from viral or bacterial infection, chemical agents (alcohol, drugs, toxins)

A

Hepatitis

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21
Q

autoimmune hepatitis, ___ cirrhosis, metabolic disorders (___ disease) are all causes of hepatitis

A

Biliary, WILSONNNNNN’s

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22
Q

Hepatitis A: __ __ hepatitis
Transmission: ?
Acute or chronic?
Prevention?

A

Acute infectious
Oral-fecal routine (contaminated food/water, person-to-person)
ACUTE (mild—> severe)
Prevention: hand hygiene, sanitation, immunization

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23
Q

Hepatitis B: ___ hepatitis
Transmission?
How long does it last?
Prevention?

A

Serum
Blood, body fluids, body tissues, blood transfusion, oral/sexual contact with contaminated person, contaminated needles
Mild (few weeks)- chronic (yrs)
Prevention: disposable needles, screen blood donors, health care worker pxns, immunization (EDUCATION)

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24
Q

Hepatitis C?
Transmission? What is most common?
Acute or chronic?

A

Same transmission as B (body fluids)
Needle sharing most common
Can be acute OR chronic

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25
Q

Hepatitis D
How do you get it?
What is prognosis?

A

Dependent on having Hep B

Poor prognosis- pts often with fulminant liver failure

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26
Q

Sx of hepatitis: initial stage (___)- low grade fever, anorexia, N+V, diarrhea, fatigue, malaise, headache, ___ tenderness, myalgia, arthralgia

A

Preicteric

Abdominal

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27
Q

What is second stage of hepatitis? (2 names)

A

Jaundice/icteric

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28
Q

What are symptoms of jaundice?

A

Fever, jaundice, enlarged liver with tenderness, abatement of earlier symptoms, dark or amber colored urine

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29
Q

What are the elevated lab values of hepatitis?

A

Hepatic transaminases, bilirubin

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30
Q

Chronic HBV and HCV may lead to what?

A

Chronic liver infection (necrosis, cirrhosis, failure)

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31
Q

Viral hepatitis is leading cause of ? Common reason for what?

A

Liver CA

Liver transplant

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32
Q

Cirrhosis is a result of ?

A

Chronic hepatitis

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33
Q

Cirrhosis sx?

___, ___ edema, ____ contracture, ___ erythema, angiomas, ___megaly, ____megaly, ____(abdominal)

A 
Jaundice
Peripheral
Dupuytren’s
Palmar
Hepatomegaly, splenomegaly
Ascites
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34
Q

Tx?

A

Lasix, paracentesis to drain fluid

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35
Q

Late complication of cirrhosis may be __ __

A

Hepatic encephalopathy

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36
Q

What are 3 other changes (neuro) with cirrhosis?

A

Personality changes, intellectual impairment, slurred speech

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37
Q

What is asterixis?

A

Liver flap- myoclonus of hand with wrist in extension, seen with late cirrhosis, characteristic of hepatic encephalopathy, drug OD, WILSON’s disease

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38
Q

What is lactulose (cirrhosis)

A

Increase in BM and excrete ammonia in stool

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39
Q

What is cholelithiasis?

A

Gallstones present in gallbladder

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40
Q

What does cholelithiasis lead to?

A

If block common bile duct, biliary colic can occur

41
Q

cholelithiasis/gallstones pain radiates to where?

A

RUQ pain with radiation to R SCAP

42
Q

What is cholecystitis?

A

Partial or complete obstruction of common bile duct resulting in inflammation of gallbladder

43
Q

Where is pain/where is it referred with cholecystitis? Other symptoms?

A

Pain in RUQ, radiates to R scap

N+V, low grade fever

44
Q

What is Murphy’s sign? What does it indicate?

A

Palpate near R subcostal margin as pt takes deep breath

Pain indicates cholecystitis

45
Q

3 causes of acute pancreatitis

A
  1. Gallstones
  2. Alcoholism
  3. Substance abuse
46
Q

Acute pancreatitis pain- where? Radiates where?

A

Acute band-like pain radiating to back, worse in supine

47
Q

Symptoms of acute pancreatitis?

PXN for pt?

A

Hypotension, tachycardia, N+V

NPO**

48
Q

Chronic pancreatitis is pain where?

A

Epigastric and LUQ

49
Q

Sx of chronic pancreatitis? (6)

A
  1. Anorexia
  2. N+V
  3. Constipation
  4. Flatulence
  5. Wt loss
  6. Steatorrhea
50
Q

What is GERD?

A

Reflux of gastric contents from stomach —> esophagus, causes heart burn

51
Q

Why does GERD occur?

A

Failure of lower esophageal sphincter to regulate food flow from esophagus into stomach from increased gastric pressure

52
Q

Over time, gastric acids (ph ?) damages esophagus. Heartburn is common ___ after eating and lying down at night.

A

<4

20-30 min

53
Q

RED FLAGS: Atypical GERD pain may present as ____ pain. May sometimes be mistaken for ___ with ___ pain. Respiratory symptoms may include (3).

A

Head/neck
heart attack, chest
1. Cough 2. Hoarseness 3. Irritation

54
Q

Complications of GERD? (2)

A

Strictures

Barrett’s esophagus (precancerous)

55
Q

PT interventions for GERD? (2)

A
  1. Positional changes from full supine to more upright

2. Contraindication: Valsalva (when is it ever not…)

56
Q

Hiatal hernia: protrusion of ___ upward through ___, or displacement of stomach ___ junction upward into ___.

A

Stomach, diaphragm

Gastroesophogeal, thorax

57
Q

Sx of hiatal hernia?

A

Heartburn from GERD

58
Q

Gastritis of the stomach: from 5 causes

A
  1. Severe burns
  2. NSAIDs
  3. corticosteroids
  4. Allergy
  5. Infection
59
Q

Symptoms of gastritis? 3

A

Anorexia, N+V, pain

60
Q

Chronic gastritis: from ____ (bacteria), __ CA, ___ anemia, autoimmune disease (__ and __)

A

H. Pylori
Stomach
Pernicious
thyroid, addson’s

61
Q

Pts taking NSAIDs long-term should be monitored for what?

A

Stomach pain, bleeding, N+V

62
Q

What is peptic ulcer disease?

A

Ulcerative lesions of upper GI tract

63
Q

Causes of peptic ulcer disease? (5)

A
  1. H. Pylori
  2. Aspirin
  3. NSAIDs
  4. Excess secretion of gastric acids
  5. Stress
64
Q

Sx of peptic ulcer disease:

___ pain, __, __, __ (3 sensations), hemorrhage, dizziness, weakness, ____ ___

A

Epigastric
Gnawing, burning, cramping
Circulatory shock

65
Q

Pain from peptic ulcer is located where? Radiates where?

A

Posterior wall of stomach —> radiates to back and possibly R shoulder

66
Q

Gastric/small bowel resection, CF, celiac, Chron’s, chronic pancreatitis, and pernicious anemia can all lead to

A

malabsorption syndrome

67
Q

Red flags for malabsorption syndrome:

  1. ____ anemia
  2. Easy ____/___ due to decreased Vitamin _
  3. Muscle __ and __
  4. Bone loss, pain, predisposition for __
  5. __, tetany, ___
  6. spasms due to decreased ___
  7. Peripheral __
A
  1. Iron-deficiency
  2. Bruising/bleeding
  3. Weakness/fatigue
  4. Fx
  5. Neuropathy, paresthesias
  6. Electrolytes
  7. Edema
68
Q

Inflammatory bowel disease (IBD)- from 2 chronic inflammatory intestine disorders ?

A
  1. Chron’s

2. Ulcerative colitis

69
Q

Sx of IBD? What’s common in peds?

A

Abdominal pain, frequent attacks of diarrhea (that sucks), fecal urgency, wt loss
- stunted growth in peds

70
Q

Symptoms of malabsorption syndrome: anorexia, wt loss, abdominal ___, pain and ___, ___, ___ (greasy poop)

A

Bloating, cramps, indigestion, steatorrhea

71
Q

Deficiency of ___ enzyme with malabsorption syndrome

A

Pancreatic lipase

72
Q

Chronic IBD can lead to __ and __

A

Anxiety, depression

73
Q

IBD red flag: jt pain (reactive arthritis), skin rashes —> referral to where?

A

Low back

74
Q

Complications of IBD include (2)

A

Intentional obstruction, corticosteroid toxicity

75
Q

Nutritional deficiencies are common with IBD due to what?

A

Intentional absorption disrupted

76
Q

Granulomatous inflammation anywhere in the GI. What type of lesions with this?

A

CHRON’S — skip lesions

77
Q

Ulcerative and exudative inflammation of large intestine and rectum. What kind of lesions with this condition?

A

ULCERATIVE CHOLITIS: NO skip lesions

78
Q

Ulcerative cholitis: 3 symptoms

A

Blood diarrhea, mucus, pus

79
Q

IBS has abnormal increased motility of __ ?

Aka __, ___, __ colon

A

Large and small intestines

Spastic, nervous, irritable

80
Q

Tx for IBS

A

Stress reduction, meds for anxiety, regular physical activity

81
Q

Pouch like herniation of mucosal layer of colon

A

Diverticular disease

82
Q

Where is diverticular disease common

A

Sigmoid colon

83
Q

Sx of diverticular disease:

  1. Pain
  2. Cramping in ___
  3. N+V
  4. Slight __
  5. Increased __
A
  1. LLQ
  2. Fever
  3. WBC
84
Q

Diverticular disease: pts may complain of ___ pain. What is important part of tx?

A

Back pain

Regular exercise

85
Q

Appendicitis:

Inflammation of vermiform appendix: becomes swollen, gangrenous, perforated. Pain characteristics?

A

Abrupt onset, located epigastric or periumbilical area

86
Q

What is Rebound Tenderness? Also called what? Used for what condition?

A

pain in response to depression of abdominal wall at site distant from painful area — aka blumberg’s sign
+Appendicitis, peritonitis

87
Q

What is McBurney’s point? What does it indicate if positive?

A

Point tenderness at McBurney’s point: site of appendix, 1.5-2 inches above ASIS RLQ.
+ appendicitis

88
Q

what is Rovsing’s sign? + is what?

A

pain RLQ with pressure on LLQ

+ appendicitis

89
Q

What is psoas sign? + for what?

A

pain RLQ with hip extension from inflammation of peritoneum overlying psoas
+ appendicitis

90
Q

What is obturator sign? + for what?

A

RLQ pain with R hip IR and flexion to 90 with 90 knee flexion
+indicative of inflammation of sheath of obturator N
+ appendicitis

91
Q

What is merkle’s sign? + for what?

A

Pain in RLQ when pt drops from standing on toes to heels with jarring landing
+ appendicitis

92
Q

WBC level indicative of appendicitis perforation? Tx?

A

Elevations in WBC >20,000 indicates surgery needed

93
Q

Inflammation of peritoneum from bacterial infection

A

Peritonitis

94
Q

Sx of peritonitis:

  1. Abdominal __
  2. Severe __ pain
  3. ___ from reflex guarding
  4. ___ ___ (test +)
  5. Decreased or absent __ __
  6. ___cardia
A
  1. Distention
  2. Abdominal
  3. Rigidity
  4. Rebound tenderness
  5. Bowel sounds
  6. Tachycardia
95
Q

4 things found with peritonitis

A
  1. Fever
  2. Elevated WBC
  3. Electrolyte imbalance
  4. Hypotension
96
Q

Peritonitis can lead to (4)

A
  1. Toxemia
  2. Shock
  3. Circulatory failure
  4. Resp distress
97
Q

Tear/ulceration of lining of anal canal

A

Rectal fissure

98
Q

Hemorrhoids: vericosities in ___/__ caused by vein congestion, internal or external. Symptoms?

A

Lower rectum/anus

Itching, pain

KN JD NPTE: OTHER SYSTEMS (12 decks)

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