Test2 Flashcards
BMI
< 18.5 is underweight
- 5–24.9 normal weight
- 0–29.9 overweight
30.0–39.9 obesity
≥ 40.0 morbid obesity
Metabolic Syndrome
3 or more of the following:
- visceral obesity (>40 men, >35 women)
- insulin resistance >100 or treated
- low HDL <40 men <50 women
- high triglycerides >150
- HTN >130/85 or treated
Gynoid Obesity
Android Obesity
Pear
Apple-more at risk for metabolic syndrome, heart disease, DM, gout, HTN, CA
Obese-risk for RHF (pulmonary HTN, sudden cardiac death, L.Ventricular hypertrophy, DVT, Afib, HTN, venous stasis, cardiomyopathy, streatohepatitis, gallstones, stress incontinence, hypogonadism, gynecomastia, cellulitis
Barium Swallow
NPO for 8 hours
Feces will be gray afterwards
disorders of esophogus, stomach, duodenum
Barium Enema
NPO 12 hr
drink laxative
clear liquids for 24 hours
Endoscopy
(Esophagogastroduodenoscopy (EGD))
numb throat
can get all the way to beginning of small intestine
NPO 6-8 h prior
can see, take biopsies
POST: gag reflex
Colonoscopy
clear liq 24 h
NPO from midnight til procedure
bowel prep (Golytely)
Post: air and discomfort; walk to get air out
Left Sims
50 yo
Complication=perforation
LFT’s
Bilirubin
Ammonia level (encephalopathy)
AST/ALT
Endoscopic Capsule
NPO 6h prior and 2h post
Can show small intestine
Can’t direct angle of camera
Drugs for N/V
Zofran (ondansetron) (serotonin agonist)
Compazine (phenothiazine)-also anti-psychotic
Phenergan (antihistamine)
Esophogeal Stricture
Causes:
esophagitis
Baretts
tumor
scar tissue
GERD
Tx-dilation with balloon
Esophogeal Varices
Dilated veins in lower portion of esophagus (like hemorhoids)
Complication of Cirrhosis of liver
Any liver diagnosis increase risk of varices bc of increased pressure
Hemorrhage
Dx-Barium swallow, EGD
PUD
Gastric Ulcer-pain 1-2 h after meal, burning, gaseous, high in epigastrum
Duodenal Ulcer-pain 2-4 h post meal, midepigastric region beneath xiphoid process, back pain
Complications: hemorrhage, perforation, gastric outlet obstruction
Cause=erosion from HCl and pepsin
Tx-H2 blockers, PPIs, antibiotics (for H.pylori), antacids, anticholinergics
Constipation Meds
Bulk forming-Metamucil
Stool Softeners-Docusate
Osmotic Solutions-Milk of Mag, Golytely
Stimulants-Ducolax, Correctol, Ex-Lax
if these don’t work-enemas
order to dis-impact rectal resevoir manually
foods that constipate: cheese, bread
IBS
Diarrhea
Constipation
Abdominal Distention
Excessive Flatulence
Bloating
Continual Defication Urge
Sensation of Incomplete Evacuation
(NOT: anemia (GI Bleed), fever (infection), persistent diarrhea, rectal bleeding, severe constipation, wt loss)
IBD
(inflammatory bowel disease)
Auto-immune disease
Ulcerative Colitis
(colon/rectum so stool will be bloody)
Crohn’s Disease
(segments of GI tract-so stool may be dark or bloody)
GOAL: decrease inflammation
More common in whites, Jewish pop.
Meds: Sulfasalazine (anti-inflammatory), Antimicrobials (flagyl, cipro, biaxin), Prednisone (anti-inflm), immunosuppressants (cyclosporine, imuran), anti diarheals (Imodium, Lomotil)
Diverticulitis
Complications:
perforation, bowel obstruction, bleeding
Hepatits
hepatic cell necrosis (viral, med OD-tylenol, alcoholism)
cholestasis may occur (flow of bile from liver)
liver cells can regenerate
icteric/anicteric (yellow)
hepatomegaly, lymphadenopathy, splenomegaly
stool-grayish-lots of enzymes are released from the liver
pruritis can accompany jaundice-accumulation of bile salts beneath the skin
complications: liver failure, cirrhosis, CA
AST/ALT/Bilirubin
Hep A, B, C
A-fecal-oral, found in feces 2 wks prior, 1 wk post, can give blood again; vaccine
B-sexually transmitted-blood/body fluids, can live on dry surface for 7 days; interferon-3 months; vaccine
C-percutaneously-IV drug, blood transfusions, hemodialysis, occupational, perinatal (blood to blood); interferon with ribavirin
Cirrhosis
liver is fibrous, thick, firm
alcoholic, post-necrotic (from hepatitis)
need high calorie low fat diet
peripheral edema, ascites, hepatic encephalapthy
80% of Liver CA comes from cirrohosis
ERCP
endoscopic retrograde cholangiopancreatography
complication is pancreatitis
procedure is used to retrieve gallstones
a stone/obstruction of the common bile duct is one of the 2 most common causes of pancreatitis (the other being alcohol consumption)
Vomiting-Alkalosis
loss of HCl from the stomach-alkalosis
Symptom of alkalosis=tingling fingertips and lightheadedness
Diarrhea
hypokalemia
dehydration-hypernatremia
metabolic acidosis with severe diarrhea
Pancreatitis
colelithiasis
alcohol intake
causes: hypercalcemia, ETOH, gallstones, viral
S/S = elevation of serum amylase and lipase, pain, flushing, N/V, edema, low grade fever, tachy, abd tenderness, abd distention
Can see with ERCP
Tx=NG tube on suction, pain meds (percocet, dilauded), NPO
