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internal med unit 3 > the gastrointestinal system 1 & 2 > Flashcards

the gastrointestinal system 1 & 2 Flashcards

1
Q

mouth, esophagus, stomach, and duodenum

A

upper GI tract

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2
Q

small intestine
large intestine

A

lower GI tract

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3
Q

what organ accomplishes digestion and absorption of nutrients

A

small intestine

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4
Q

what organ absorbs water and electrolytes, storing waste products of digestion until elimination?

A

large intestine

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5
Q

true or false: gut immune system has 70% to 80% of the body’s immune system

A

true

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6
Q

what is the muscular aspect of diarrhea?

A

electrolyte imbalance

endocrine disorder

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7
Q

what is the neurogenic aspect of diarrhea?

A

diabetic enteropathy

hyperthyroidism

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8
Q

diarrhea is caused by what medication?

A

antibiotics

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9
Q

constipation is caused by what medications?

A

opioids

diuretics

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10
Q

peptide ulcer disease

A

a break in the lining of the stomach or duodenum of 5 mm or more owing to a number of different causes

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11
Q

what are three types of peptic ulcer diseases?

A

gastric ulcer

duodenal ulcer

stress ulcer

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12
Q

what are the most common causes of PUD?

A

NSAIDs, low dose aspirin, and H. pylori bacterial infection (90%)

psychologic stress, diet, caffeine, tobacco use, and alcohol consumption

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13
Q

to prevent PUD, you must maintain a balance between the mucosal defenses and contributing insults. What are the defenses and insults?

A

defenses: mucous and bicarbonate layer, an epithelial barrier, prostaglandins, and adequate mucosal blood flow

contributing insults:
acid, pepsin, alcohol, bile salts, and drugs

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14
Q

what are the most common contributing insults to PUD?

A

NSAID use and H. pylori

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15
Q

how is PUD often discovered if there is no symptoms?

A

bleeding

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16
Q

what is a classic symptom of PUD and where is the pain referred?

A

burning, gnawing, or cramping near the xiphoid or radiating to the back

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17
Q

how can pain for PUD be relieved?

A

eating

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18
Q

what is hematemesis? and what disease is a sign of?

A

vomiting blood

PUD

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19
Q

what is hematochezia? and what disease is it a sign of?

A

bleeding per rectum

PUD

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20
Q

what is melena? and what is it a sign of?

A

dark, tarry stools secondary to blood

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21
Q

what is a perforation and where does it happen?

A

sudden severe pain

thoracic spine from T6-T10 with radiation to the right upper quadrant

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22
Q

what are some prevention and treatments for PUD?

A

medication modification
antibiotics for H. pylori
lifestyle changes
probiotics
endoscopy

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23
Q

where does perforate and hemorrhage refer pain?

A

back pain

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24
Q

where does ulcer pain radiate to?

A

mid thoracic back and right shoulder

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25
Q

what reduces the risk of GI bleeding?

A

moderate exercise training

26
Q

what is a hiatal hernia?

A

esophageal hiatus of the diaphragm becomes enlarged, allowing the stomach to pass through the diaphragm into the thoracic cavity

27
Q

what is the most common hiatal hernia?

A

sliding

28
Q

What is a rectal fissure?

A

a rectal or anal fissure is an ulceration or tear of the lining of the anal canal, usually on the posterior wall

29
Q

how does an acute rectal fissure occur?

A

excessive tissue stretching or tearing, such as childbirth or passage of a large, hard bowel movement through the area

30
Q

what are some symptoms of a rectal fissure?

A

sharp pain
burning

accompanied by defecation, bleeding, spasms, mucus, and itching

31
Q

when do anal fissures heal?

A

within 1-2 months

32
Q

how do anal fissures get treated?

A

combination of bran and bulk of laxatives or stool softeners, sitz baths, and emollient suppositories

33
Q

what are hemorrhoids?

A

varicose veins of a pillow-like cluster of veins that lie just beneath the mucous membranes lining the lowest part of the rectum and anus

34
Q

what are PT implications for hemmorhoids?

A

spasms in sphincter, pelvic floor pain, and trigger points in pelvic and glut muscles

35
Q

true or false: hemorrhoids are not associated with an increase in intraabdominal pressure

A

false: it is

36
Q

what are internal hemorrhoids?

A

occur in the lower rectum

37
Q

how are internal hemorrhoids noticed?

A

when a small amount of bleeding occurs during passage of stool, especially if straining occurs during a bowel movement

38
Q

what are external hemorrhoids?

A

located under the skin around the anus bleed (bright red blood) if the hemorrhoid is injured or ulcerated

39
Q

why external hemorrhoids painful?

A

they form in nerve-rich tissue outside the anal canal

40
Q

how can external hemorrhoids be treated?

A

with local application of topical medications, sitz baths, high fiber diet, and avoidance of constipation and other causes of intra-abdominal pressure

41
Q

what is diverticulosis?

A

the presence of outpouchings in the wall of the colon or small intestine

the mucosa and submucosa herniate through the muscular layers of colon

42
Q

what is diverticulitis?

A

inflammation/infection of the diverticula with possible complications such as perforation, abscess formation, obstruction, fistula formation, and bleeding

43
Q

what are some risk factors of diverticular disease?

A

constipation
physical inactivity
eating red
obesity
smoking
NSAID, chronic steroids, and immunosuppressants

44
Q

what is uncomplicated diverticular disease?

A

when diverticula become blocked, bacteria that are trapped inside begin to proliferate, causing infection and inflammation

45
Q

what is complicated diverticular disease?

A

a fistula may develop with the bladder

46
Q

what is pneumaturia and fecaluria? what is it associated with?

A

air in the urine

urine in the stool

and it is associated with complicated diverticular disease

47
Q

what are some medical management recommendations for diverticular disease?

A

CT imaging
test to see elevated WBCs
colonoscopy

lifestyle change
surgery

48
Q

when should you get a colonoscopy for diverticular disease?

A

4-6 weeks after resolution of the initial attach, avoid in the acute stage

49
Q

what medications should you take for diverticular disease?

A

antibiotics and pain control

50
Q

what are some PT implications of diverticular disease?

A

avoid activities that increase intra-abdominal pressure to avoid further herniation

physical activity and exercise have protective effect and lowers the risk of diverticulitis and diverticular bleeding

51
Q

where is diverticular disease refer pain to? and where does pain regularly occur?

A

referred pain in hip or thigh

back pain

52
Q

what is appendicitis?

A

an inflammation of the vermiform appendix that results to necrosis and perforation with peritonitis

53
Q

when does appendicitis mostly occur?

A

peak incidence between the ages of 15-19

54
Q

does appendicitis happen in males or females more?

A

males

55
Q

what is appendicitis primarily caused by? and is it secondarily caused by?

A

primarily: obstruction of the lumen

secondarily: bacterial infection

56
Q

one third of appendicitis is caused by what occurence?

A

obstruction that prevents normal drainage

57
Q

what happens if normal drainage in the appendix is obstructed?

A

the intraluminal pressure rises and eventually exceeds the venous pressure causing ischemia, necrosis, and perforation

58
Q

what quadrants manifest abdominal pain for appendicitis?

A

epigastric
peri-umbilical
right lower quadrant

59
Q

what does high fever indicate for adults with appendicitis?

A

perforation

60
Q

where does pain shift for appendicitis?

A

right lower quadrant over the site at Mcburney point

61
Q

what is the WBC count for appendicitis?

A

> 20,000

62
Q

clients with appendicitis may present symptoms in what specific areas?

A

right thigh
groin (testicular)
pelvic
referred pain in the hip

internal med unit 3 (11 decks)

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