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Mary's Tests - Spring 2016 > Patho Exam #2 February 2016 > Flashcards

Patho Exam #2 February 2016 Flashcards

1
Q

Pharyngoesophaeal (upper sphincter)

A

what prevents air from entering the esophagus

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2
Q

Gastoesophageal (lower sphincter)

A

what prevents gastric acid from forming.

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3
Q

Achalasia

A

failure of the lower esophageal sphincter to relax due to the absence of a vagal nerve. Can lead to cancer, esophageal erosion and difficulty passing food

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4
Q

Esophageal diverticulum

A

out pouching that causes food to get trapped and inflammation to occur. May cause belching

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5
Q

Esophageal lacerations is also called

A

Mallory Weiss Syndrome

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6
Q

Mallory Weiss Syndrom (esophageal lacerations)

A

can occur with vomiting blood and cause GI bleeding. Seen in alcoholism. May go away over time.

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7
Q

Most common disorder of the esophagus is..

A

GERD

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8
Q

GERD is…

A 
Persistent reflux (backflow) of acidic contents in stomach that can cause erosion and mucosal damage
Regurgitation of gastric contents into esophagus.

Exposure of the esophageal mucosa to gastric acid and pepsin

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9
Q

Characteristics of GERD

A

Can lead to erosion and mucosal damage, scarring, strictures, cancer

Acid reflux - Often occurs after big evening meal & at night. May have belching or burning sensation.

Heartburn (main symptom) - Recumbent position, bending over. Also caused by increased abdominal pressure

Common during pregnancy, >40 years, overweight

Felt as pain or burning in retrosternal area & may radiate to throat, shoulder, back. People may be worried about heart attack since these symptoms are very similar.

Effortless regurgitation of acidic fluid into mouth, especially post-meal and at night.

May cause resp. sxs: wheezing, cough, hoarseness

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10
Q

What is the cause of GERD.

A

Weak lower esophageal sphincter (LES) and increased intra-abdominal pressure, reflux of stomach contents into esophagus & mucosal injury

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11
Q

Foods that cause GERD

A

Fatty foods, spicy foods, alcohol, caffeine, large meals, recumbent position after eating, meds that decrease the CNS

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12
Q

Medications to treat GERD

A

PPI and H2 blockers

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13
Q

What penetrates the gastric mucosal barrier?

A

Alcohol and aspirin

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14
Q

What is the mucosal barrier?

A

It prevents acid from penetrating and is covered in a hydrophobic lipid bilayer.

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15
Q

Prostaglandins do what?

A

increase blood flow, mucous and ion secretion

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16
Q

What interferes with prostaglandins

A

NSAIDS and aspirin

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17
Q

What is inflammation of the gastric mucosa

A

Gastritis

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18
Q

What is acute gastritis

A

This can be caused by a local irritant such as alcohol or bacterial virus (bacteria) This causes upset stomach and is transient (resolves on its own)

S/S: heartburn, vomiting, GI bleeding, stomach upset

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19
Q

What is an example of chronic gastritis

A

H Pylori

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20
Q

Chronic gastritis occurs when there is

A

changes in the epithelial lining and inflammatory changes

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21
Q

H. Pylori is gram positive or negative?

A

NEGATIVE

treat with what meds?? amoxicillin, clarithromycin, metronidazole, tetracycline. May also add peptobismol or kaopectate to disrupt the cells walls and prevent microorganisms from adhering to gastric epitherlium

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22
Q

H. Pylori causes..

A

disruption in the gastric mucosa, inflammatory responses, gastric atrophy, PUD, increases cancer risk,

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23
Q

What meds can be used to treat H Pylori

A

PPI and H2RA.

USUALLY 2 ANTIBIOTICS

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24
Q

What is PUD

A

it is attributed to an imbalance in the cell destructive and cell protective effects. It causes exposure to pepsin and gastrin. Scar tissue replaces damaged muscle

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25
What is PUD often associated with
Stress, trauma, h pylori, caffeine, alcohol, warfarin use, blood group O, older adult >60, NSAID or ADA drugs
26
duodenal ulcers are more common than
gastric ulcers
27
duodenal ulcers occur with
h. pylori and NSAID ingestion- can occur at any age and is usually chronic in nature. Theses ulcers heal more slowly
28
Duodenal ulcer S/S
dull, gnawing pain, hematemesis, melena Empty stomach feeling 2-3 hours after eating. May be relieved by food or antacids pain is usually...epigastric
29
What tests would you run to diagnose a Duodenal ulcers.
Gastroscopy/duodenoscopy and biopsy for H pylori, barium xrays, Labs (hgb & hct)
30
Gastric ulcers differ from duodenal ulcers in that it
is common most after eating
31
Peptic ulcers are found in what regions
stomach, esophagus and duodenum
32
Name two stress ulcers
Cushings: caused from increased intracranial pressure. There is an increase of gastric acids related to stimulation of vagus nerve and is seen in head injuried Curling Ulcer: caused from major trauma like sepsis, spinal cord injuries, surgery. Patients often have NG tube that turns bright red. There is an increase in bile salts entering stomach
33
Cell destructive efforts for UGI disorders to prevent recurrence of lesions..
take patients off of NSAIDS, advise against smoking, take patient off of steroids
34
What is the first line drug mainly used in most situations for ulcers
PPIs
35
Antacids contain compounds incorporating:
Aluminum, Magnesium and Calcium They neutralize the acids in the stomach and act locally
36
Medication examples of antacids..
Aluminum hydroxide/ magnesium hydroxide--Maalox Alum. Hydroxide, magnesium hydroxide, simethicone--Mylanta
37
Simethicone (Mylicon)
antiflatulent- reduces gas, distention, and abd. discofort
38
Nursing implications of antacids:
it binds with other drugs and prevents absorption. Give 1 to 2 hours before or after other meds and at night
39
H2RA drug
blocks basal secretion of gastric acid and secretion stimulated by histamine, acetylcholine and gastrin; decreased amount, acidity and pepsin content of gastric juices
40
Histamine causes strong stimulation of..
gastric acid secretions
41
H2 recepts when stimulated increase
production of HCl acid from parietal cells
42
H2 blockers are used from prevention or treatment for
PUD, GERD, Esophagitis, GI bleed
43
Drugs that are H2 blockers are
Famotide (Pepcid), ranitidine (Zantac), cimetidine (Tagamet) and nizatidine (Axid)
44
Adverse Effects of H2 blockers:
hypotension, rash, diarrhea, headache, constipation
45
H2 blockers can cause patients to develop
pneumonia due to the decreased gastric acid production which increases normal flora in the stomach
46
PPI drugs prevent
pumping of gastric acid into the stomach. They inhibit daytime and nocturnal HCL acid secretions
47
Adverse effectos of PPI
minimal
48
PPI drugs include:
``` omeprazole (prilosec) pantoprazole (protonix) iansoprazole (Prevacid) esomeprazole (nexium) rabeprazole (aciphex) ```
49
Sucralfate
works locally in the stomach and binds to normal and ulcerated mucosa to form a protective barrier
50
Sucralfate prevents and treats what type of ulcer
duodenal
51
Does sucralfate inhibit acid secretion?
NO!!!! it acts locally!
52
Sucralfate should be given..
2 hours beofre or after other drugs since it can prevent the drugs actions from occuring
53
Misoprostol (cytotec)
Synthetic prostaglandin E- protects gastric mucosa
54
Misoprostol (cytotec) should be taken with what to prevent ulcers
NSAIDS to prevent ulcers
55
Do not use misoprostol in these individuals
pregnancy women since it may induce abortions
56
Antiemetic drugs act on the a vomiting center in the medulla called
CTZ (chemoreceptor trigger zone), cerebral cortex, vestibular apparatus or combination
57
Receptors involved in activation of chemoreceptor trigger zones (CTZ)
serotonin, dopamine and muscarinic
58
receptors involved in signals from pharynx and gi tract from vagal pathways
serotonin and dopamine
59
receptors involved in vestibular appartatus
histamine and muscarinic
60
Phenothiazides block
dopamine receptor sites in CTZ
61
Adverse effects of phenothiazides:
sedation, cognitive impairment, extrapyramidial reactions (parkinsons with involuntary movements)
62
phenothiazides work on motion sickness
false
63
Phenothiazide drugs:
Chlorpromazine (thorazine). prochlorperazine (compazine), **promethazine(phenergan)treats psych disorders
64
I love you
Happy Valentines Day!
65
What do stimulant cathartics do?
Pull water into bowel
66
What are examples of stimulant cathartics? (4)
Bisacodyl (Dulcolax), caster oil, Sennocide (Serocat)
67
What is a side effect of stimulant cathartics?
May cause electrolyte imbalance (works quick and strong)
68
What blocks prostaglandin?
Corticosterods (Antiemetic)
69
What are examples of Corticosterods (Antiemetic)? (2)
methylprednizone (medril) and dexamethazone (decradron)
70
Cholestyramine, Questran Drug
lowers cholesterol levels in the blood and improves itching related to liver disease. It binds to bile acids in th intestines and prevents their absorption AE: constipation, bloating, belching, gallstones, diarrhea
71
Lovastatin
"used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as "statins." It works by reducing the amount of cholesterol made by the liver." WebMD
72
Niacin
Vitamin B3- can be used in combo with statins Can treat high cholesterol and triglyceride levels and slows the narrowing of the arteries.
73
Nicotinic
used to prevent or treat niacin deficiency. Niacin deficiency can cause demetia, redness/swelling.
74
Gemfibrozil
used with diet to treat high cholesterol and triglyceride levels in people with pancreatitis. do not take if you have liver disease or gallbladder disease
75
Hctz
used for high blood pressure and prevents the body from absorbing too much salt
76
Doxazosin
can be used to treat high BP. do not take if there is liver disease or a blockage in the stomach.
77
Captopril
used to treat high blood pressure and heart disease. ACE inhibitor.
78
Losartan
It can treat high blood pressure. It can reduce the risk of stroke in patients with high blood pressure and an enlarged heart. It can also treat kidney disease in patients with diabetes.
79
amlodipine
calcium channel blockers that widens blood vessels and increases blood flow. used for hypertension, angina, and coronary heart disease
80
Norvasc
calcium channel blocker used for hypertension
81
hydralazine
Hydralazine apparently lowers blood pressure by exerting a peripheral vasodilating effect through a direct relaxation of vascular smooth muscle.
82
clonidine
alpha agonist hypotensive agent- vasodilator

Mary's Tests - Spring 2016 (10 decks)

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