PPNP 2.0 Flashcards
Intestinal Obstruction
Partial or complete obstruction of the intestinal lumen of the small or
large bowel
* Abdominal surgery with adhesions
* Congenital abnormalities of the bowel
* Carcinoma (primary, metastatic)
- Fluid & electrolyte losses associated
with colonic obstruction < small bowel
risk factor of intestinal obstruction
- Abdominal surgery with adhesions
- Congenital abnormalities of the bowel
- Carcinoma (primary, metastatic)
Most common causes of Peptic Ulcer:
- NSAIDs- inhibiting prostagladin synthesis, which is essential for gastric protection.
Reducing the level of prostaglandins over a prolonged period of time leaves the gastric mucosa susceptible to damage, and overtime ulcers can begin to develop. - Aspirin – most ulcerogenic among the NSAID
- H. pylori
- Gastrin release due to infection → increased amount of gastric acid (HCl)
- Most cases are caused by the organism; oral-faecal mode of transmission
- Spiral shape of H. pylori allows them to penetrate your stomach lining - protected by
mucus hence body’s immune cells are not able to reach them
(A rare cause of PUD is Zollinger-Ellison syndrome, which is a gastrin secreting tumor that increases gastric acid production.)
Cholecystitis
Acute inflammation of the gallbladder associated with abdominal pain, leukocytosis, and fever
Obstruction of the cystic duct occurs in almost all cases, suggesting
that stasis of bile in the gallbladder is important in the pathogenesis
of the disease.
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
levels may be elevated in cholecystitis or with common bile duct
(CBD) obstruction
Amylase may also be mildly elevated in cholecystitis
Alkaline phosphatase level may be elevated (25% of patients with
cholecystitis)
__________________ and _______________
levels may be elevated in cholecystitis or with common bile duct
(CBD) obstruction
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST)
Viral Hepatitis
Inflammation of the liver parenchyma
- Can be caused by hepatotropic viruses, autoimmune disorders,
reactions to drugs and toxins, other infectious disorders - Viral hepatitis – usually applied to diseases caused by hepatitis
- A, B, C, D and E
- Difficult to differentiate between the different types without the
serologic tests; cannot rely on patient’s presenting symptoms only to differentiate which type
Liver Cirrhosis
Characterised by diffuse hepatic
fibrosis surrounding nodules of
liver tissue → permanent
alteration of hepatic blood flow
and liver function
Extensive fibrosis → distorts
liver architecture → formation
of regenerative nodules
Common symptoms of PUD
70% of PUD patients are asymptomatic
1) bloating & abdominal fullness
2) nausea
3) ANEMIA
- fatigue
- pallor
- shortness of breath
4) melena
5) hematemesis
6) peritonitis
-abdominal pain and rigidity
- tachycardia
7) perforation into peritoneal space
PUD
Sometimes asymptomatic
often burning epigastric pain
pain from duodenal ulcers
- 2-3 hours after meal and at night
pain frorm gastric ulcers
- 15-30 mins after meal
Food to avoid for PUD
- CAFFEINE
- Alcohol
- Increase fatty foods
The pain associated with PUD is typically described as
gnawing, burning, aching, or a hunger-like pain
bowel sounds for PUD
Clients with PUD often present with hypoactive or hyperactive bowel sounds due to the abnormal movement and function of the gastrointestinal (GI) system. Bleeding gastric ulcers can cause hyperactivity of the GI system. The absence of bowel sounds indicates an emergency.
modifiable risk factor of PUD
Modifiable risk factors include smoking, alcohol or caffeine intake, and NSAID use.
General risk factor
1) Inflammatory bowel disease
2) Family history
3) Diet: likes to eat out?? spicy food??
low fibre, high fat
4) Weight, overweight
5) Lack of exercise
6) Alcohol and smoking
7) Diabetes
Investigations done for H.pylori
1) oesophagogastroduodenoscopy
2) Esophagogastroduodenoscopy
3) c-urea breath test
