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DPT 631 > The GI System > Flashcards

The GI System Flashcards

1
Q

What are the functions of the GI system?

A

Ingest food
Breakdown nutrients
Segmental propulsion
Digestion
Absorption
Defecation

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2
Q

What are some screening tools for the GI system?

A

Colonoscopy
Cologuard
Nutrition

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3
Q

T/f: young people should regularly get colonoscopies

A

False, not unless their is a family hx

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4
Q

What is Cologuard?

A

Non-invasive, effective, and affordable prescription based at home colon cancer screening test that look s for both abnormal DNA and blood in your stool for adults over 45 at average risk

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5
Q

What are the pros of Cologuard?

A

Noninvasive
Convenient
No special prep
High accuracy
Covered by insurance
Early detection when it’s more treatable and can improve outcomes and potentially reduce mortality

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6
Q

What are the cons of Cologuard?

A

False positives
Lower sensitivity for precancerous polyps (false negatives)
A positive test requires a follow colonoscopy
Not for high risk individuals
Testing frequency is every 3 years if negative
Limited scope

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7
Q

What is involved in the prep for a colonoscopy?

A

Clear liquid diet prior to the test

Drink large volume of laxative to clear the bowels

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8
Q

T/f: there is an option for sedation with a colonoscopy

A

True

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9
Q

What goes into the gut during a colonoscopy to provide a better view of the colon?

A

CO2

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10
Q

T/f: biopsy and polyp removal can be done during a colonoscopy as needed

A

True

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11
Q

How long does a colonoscopy usually take?

A

30-60 minutes

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12
Q

How long do you have to wait for recovery from a colonoscopy

A

Until the sedative wears off

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13
Q

How often should colonoscopies be done?

A

Every 10 years if negative or 5 if positive

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14
Q

What are important nutritional factors to consider on a nutrition label?

A

Trans fats
Sodium
Calorie:protein ratio

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15
Q

What should the calorie:protein ratio be?

A

No more than 10:1

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16
Q

What supplements might someone on a vegan diet have to take?

A

B12 and iron

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17
Q

What are common causes of GI trauma?

A

MVA and athletics

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18
Q

What are solid organs?

A

Spleen>liver>kidney

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19
Q

What are hollow organs?

A

Intestine, bladder

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20
Q

What is the difference between solid and hollow organs?

A

They sound different on percussion

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21
Q

What should we look for with GI trauma?

A

Pain, tenderness, and vomiting

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22
Q

What is Blumberg’s sign?

A

Rebound tenderness

Pain with lifting off after pushing down on the abdomen and lifting the hand off

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23
Q

How do we test for Blumberg’s sign?

A

In supine, select a site away from the painful area and place your hands in the abdomen

Push down slow and deep, hold, and the lift up quickly (positive would have pain at this moment)

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24
Q

Does Blumberg’s sign tell us the structures involved?

A

Nope, it is non-descriptive and can be anywhere in the gut

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25
Q

T/f: GI symptoms can be produced by eating, swallowing, or not eating

A

True

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26
Q

What are some s/s of gastric issues?

A

Epigastric pain with radiation to the back
Blood or dark, tarry stool
Fecal incontinence/urgency, diarrhea/constipation
Nausea, vomiting, bloating
Weight loss, loss of appetite
(+) Blumberg’s sign

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27
Q

If a pt has Melina (black, tarry stools), and hat does this indicate?

A

An upper GI bleed

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28
Q

If a pt has blood red stools, what does this indicate?

A

Colon-rectal tumor

Colon diverticulitis

Hemorrhoids

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29
Q

If a pt had silvery stools, what does this indicate?

A

Pancreatic cancer

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30
Q

If a pt has pencil thin ribbon stools, what does this indicate?

A

Distal colon/anal cancer

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31
Q

What is gastroesophageal reflux disease (GIRD)?

A

Chronic digestive condition where stomach acid or occasionally stomach contents flows back (reflux) into the esophagus

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32
Q

What is dyspepsia?

A

Indigestion

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33
Q

What is pyrosis?

A

Heartburn

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34
Q

What position should we avoid for pts with GERD?

A

Lying flat

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35
Q

What are the causes of GERD?

A

Obesity
Pregnancy
Hiatal hernia
Smoking
Foods and drinks
Meds

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36
Q

How does obesity cause GERD?

A

Weight can put pressure on the abdomen

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37
Q

How does pregnancy cause GERD?

A

Hormonal changes

Abdominal pressure

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38
Q

How does a hiatal hernia cause GERD?

A

Weakening of the LEs

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39
Q

How does smoking cause GERD?

A

Weakening LEs and increased acid production

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40
Q

What are problematic foods and drinks for GERD?

A

Fatty/fried foods

Chocolate

Caffeine

Alcohol

Spicy foods

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41
Q

What are problematic meds for GERD?

A

NSAIDS

BP meds

Muscle relaxers

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42
Q

What are the s/s of GERD?

A

Chest pain
Heartburn (usually after eating)
Nausea
Bloating, gas, belching
Certain food intolerances
Difficulty swallowing
Regurgitation of food/sour liquid
Sensation of a lump in your throat
Disrupted sleep
Chronic cough
New/worsening asthma
Laryngitis

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43
Q

How do we test for GERD?

A

Endoscopy

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44
Q

What is the treatment for GERD?

A

Avoiding trigger foods

Eating smaller meals (grazer)

Reducing weight

Elevating head at night

Breathing exercises to strengthen abdominals and diaphragm for diaphragmatic breathing
Meds like PPIs to decrease stomach acid

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45
Q

What is a peptic ulcer?

A

Break in the protective mucosal lining of the stomach

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46
Q

What are the two types of peptic ulcers? What is the difference between between them?

A

Gastric (usually symptomatic sooner after eating)
Duodenal (usually symptomatic later after eating)

47
Q

What factors affect risk for peptic ulcers?

A

Genetic factors (familiar tendencies and type O blood)
Environmental factors (smoking, ETOH, and NSAIDS)

48
Q

Do genetics or environmental factors play a bigger role in risk for peptic ulcers

A

Environment factors

49
Q

What percent of all PT pts taking NSAIDS have gastritis?

A

50%

50
Q

What percent of those on long term NSAIDS develop a peptic ulcer?

A

15%

51
Q

T/f: most people with a peptic ulcer have no symptoms and are unaware of their ulcers

A

True

52
Q

Secondary ulcers can develop from what two kinds of stress?

A

Psychological and physiological

53
Q

T/f: gastric mucosal changes occur with 72 hours in 89% of pts with burns over 35% of their body

A

True

54
Q

What is a risk for developing serious ulcer complications?

A

Bleeding or perforation of the stomach

55
Q

Why should we encourage pts to take meds with foods?

A

To prevent peptic ulcers

56
Q

What meds have a small but significant increase in risk for gastric cancer and depletes vitamin B12?

A

PPIs (proton pump inhibitors)

57
Q

T/f: ulcers can result from a hx of H pylori

A

True

58
Q

What is a key symptom of h pylori?

A

Dull, gnawing/burning sensation into the midline of T6-12 and radiating to suprascapula

59
Q

What OTC solution can provide temporary relief from ulcer pains?

A

Antacids

60
Q

T/f: remission from ulcers may be weeks

A

True

61
Q

Why are NSAIDS are problem?

A

Bc they are often used for pathology that is not an “-itis” and will therefore not help

62
Q

What will muscle with an “-itis” feel like?

A

Gritty, sandy, wet leather

Like it’s gelding it get stuck

63
Q

How is an ulcer typically diagnosed?

A

Based on clinical symptoms

64
Q

What values may be decreased in ulcers?

A

Hemoglobin/hematocrit

65
Q

If a pt presents with signs of anemia, what pathology could be responsible?

A

An ulcer

66
Q

What is the H pylori breath test?

A

A test for h pylori that can ID up to 90% of people have its H pylori

Involves swallowing a substance containing urea with carbon atoms and waiting 10 minutes then breathing into a bag that measures the CO2 levels exhaled

67
Q

What is a positive h pylori breath test?

A

Hen the pt exhales, the measured CO2 is greater than normal

68
Q

T/f: Pts must stop taking antibiotics and bismuth-containing meds like Pepto Bismol and Tums at least 2 weeks b4 taking the H pylori breath test

A

True

69
Q

What will present like an ulcer but will not respond to PPIs or Tums?

A

An H pylori infection

70
Q

What are the treatments for an ulcer?

A

To remove the irritant (stop eating/drinking aggregating foods/drinks)
Meds to restore the mucosa
Anti-microbials (for h pylori)
Avoiding coffee

71
Q

T/f: no known dietary changes have been found to reduce gastric acid secretion

A

True

72
Q

What is the fxn of the appendix?

A

Houses the good bacteria of the gut and repopulates the gut with the bacteria it needs to digest and absorb nutrients following sickness

73
Q

What things can cause appendicitis?

A

Obstruction
Infection
Inflammation

74
Q

T/f: All pts with appendicitis must get it removed

A

False, but in some cases it must be removed bc if it bursts it can lead to sepsis

75
Q

Where is the pain with appendicitis?

A

In the RLQ

76
Q

What are the s/s of appendicitis?

A

RLQ pain
(+) McBurney’ point
Nausea, vomiting, night sweats
Guarding of rectus abdominis
(+) psoas sign
(+) obturator sign
Low grade fever
(+) rebound tenderness
Position of relief with knees to chest

77
Q

What is a (+) McBurney’s point?

A

Laying in supine, palpate 1/3 bw the ASIS and umbilicus applying vertical pressure causes pain with pushing down

78
Q

What is a (+) obturator sign?

A

In supine, raise the pts R LE with the knee flexed and rotate the LE into IR at the hip

This causes pain in the abdomen with appendicitis

79
Q

What is a (+) psoas sign?

A

In L SL, hypertend the R LE to put the psoas on stretch

This will cause pain the abdominal region with appendicitis

80
Q

When would there be a HIGH grade fever in a case of appendicitis?

A

If there is a perforation is associated with appendicitis

81
Q

What is the modality of choice for appendicitis?

A

US imaging

82
Q

What is celiac disease?

A

A chronic systemic autoimmune disorder triggered in genetically susceptible individuals by gluten proteins (wheat, barely, rye)

83
Q

To develop celiac disease, one must have what?

A

A genetic predisposition and antigen exposure

84
Q

Most people that think they have celiac disease, actually have what?

A

A gluten sensitivity

85
Q

Is there a more rapid and dramatic response to gluten proteins in celiac disease or gluten sensitivity?

A

Celiac disease

86
Q

What nutritional deficits may result from a gluten free diet?

A

Calcium and iron deficiency

87
Q

Are males or females more likely to have celiac disease?

A

More females

88
Q

How is celiac disease diagnosed?

A

With serologic tests (tTg antibody test and IgA anti-endomysial antibody test)

89
Q

What does the tTG antibody test test for?

A

Tissue transglutaminasen (an enzyme in every tissue that joins proteins) to test for celiac disease

90
Q

What does the IgA anti-endomysial antibody (EMA) test test for?

A

Celiac disease

91
Q

How long does the onset of celiac disease usually take?

A

6-24 months after gluten is introduced to the diet but can be much later in life

92
Q

What are the s/s of celiac disease?

A

Short stature (dec pituitary release of GH)

Osteoporosis (calcium malabsorption)

Infertility

Asthenia

Diarrhea, abdominal distension pain

Vomiting, weight loss

Hypotension

Intense pruritic (itchy) rash over buttocks, face, scalp, elbows, knees

93
Q

There is an increased risk of what if a pt with celiac disease doesn’t follow a gluten free diet?

A

Colon cancer

94
Q

What are the s/s of anemia?

A

Decreased hemoglobin and hematocrit

Change in fingernail beds

Pale skin color

Fatigue

Decreased DBP

diminished RBC production due to low iron stores

Calcium depletion

Iron absorption issues

95
Q

Changes in the fingernail beds is usually due to what?

A

Endocrine or oxygenation issues

96
Q

T/f: turmeric is good for the GI system

A

True

97
Q

T/f: cooking in an iron skillet an help add iron to the diet

A

True

98
Q

What is the only known substance to inhibit the absorption of both heme and non heme iron?

A

Calcium

99
Q

What is the difference bw heme and non heme iron?

A

Heme iron comes from animal products

Non heme iron comes from plant products

100
Q

What kind of iron is better absorbed by the gut?

A

Heme iron

101
Q

What are the top 10 causes of anemia?

A

Abnormal uterine bleeding (heavy menstrual flow)

Use of Aspirin or other NSAIDs long term

Colon cancer

Angiodysplasia

Donating blood

Stomach cancer

Peptic ulcer disease

Celiac disease

Gastrectomy

Heliobacter pylori infection

102
Q

What populations need more iron?

A

Those who are pregnant or lactating

103
Q

Does iron need increase or decrease with age up until about 59 yo?

A

Increase

104
Q

T/f: nutritional deficits can have effects on exercise

A

True

105
Q

What factors are highly correlated with increased risk of cancer reoccurance?

A

Nutrition
Weight
Body composition

106
Q

T/f: cancer dx and obesity create an increased risk together for type 2 DM

A

True

107
Q

A diet high in what component can increase GI cancer risk via direct mucosal damage and synergistically with H pylori?

A

Sodium

108
Q

Colorectal risk increases with diets which in what foods?

A

Red meat
Processed meat
Saturated fats

109
Q

T/f: it is important to stay active with a cancer dx

A

True

110
Q

T/f: lean mass is lost when taking anti-obesity meds (AOMs)

A

True

111
Q

What makes up lean mass?

A

Muscle, water, bone, organs, and other body tissues

112
Q

T/f: most people on AOMs are not exercising enough (<150 min/week)

A

True

113
Q

Muscle mass and strength can be preserved if _____ is included in daily life when taking AOMs?

A

Exercise

DPT 631 (5 decks)

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