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Pathophysiology for Nursing > Unit 3 Module 1: Gastrointestinal > Flashcards

Unit 3 Module 1: Gastrointestinal Flashcards

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1
Q

Liver failure: hyper or hypoalbumin

A

hypoalbumin

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2
Q

Pre or intrahepatic or obstructive: hemolysis

A

prehepatic

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3
Q

Most common segment affected in Crohn’s

A

terminal ilium

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4
Q

cholecystitis

A

inflammation of the gallbladder

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5
Q

t/f: Pancreatitis is a common disorder that is easily treated with bowel rest, fluids and pain medication.

A

false, can be fatal

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6
Q

Hepatitis A etiology

A

food handlers – fecal-oral route, shellfish

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7
Q

Local diverticulitis symptoms

A

LLQ pain, blood in stool, constipation

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8
Q

Crohn’s or UC: colon cancer

A

UC

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9
Q

Asterixis

A

Encephalopathy sign

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10
Q

Mechanisms of injury in viral hepatitits

A

direct cellular injury

induction of an immune response

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11
Q

Crohn’s or UC: malnutrition

A

both

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12
Q

Pre or intrahepatic or obstructive: jaundice, urine and stool changes

A

obstructive and intrahepatic

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13
Q

Crohn’s or UC: tenesmus

A

UC - urgent need to go to the bathroom, but can’t go

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14
Q

How much blood from the intestines flows into the liver per minute

A

1 L

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15
Q

t/f: Pancreatitic cancer incidences are on the rise

A

true

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16
Q

t/f: Pancreatic cancer is typically dxed early when patients present with jaundice

A

false

The head of the pancreas is involved in 60% of cases. Because of it’s proximity to the CBD, patients often don’t present until they are jaundiced. It is often too late by that time and it has metastasized by then. The incidence of pancreatic cancer has tripled. 5% survival rate at 5 years.

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17
Q

Risk factors of colon cancer

A

age, family/genetics, diet, ulcerative colitis

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18
Q

Crohn’s or UC: pinpoint mucosal hemorrhages

A

UC

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19
Q

Causes of paralytic ileus

A

This is nonmechanical obstruction. Pain meds, ICU, surgery

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20
Q

Is appendicitis a problem of youth or aging?

A

youth

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21
Q

Types of intestinal obstructions

A

complete
incomplete
mechanical - something outside the bowel (tumor or adhesions) or in lumen of bowel
nonmechanical - slowing or stopping of peristalsis

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22
Q

Gallstone pancreatitis occurs because there is a stone located in the

A

pancreatic duct

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23
Q

Liver failure: low or high blood pressure

A

low (third spacing instead of intravascular)

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24
Q

Sequelae of appendicitis

A

gangrene/necrosis
peritonitis
wall off infection –> abcess formation
septicemia

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25
Q

Borborygmi

A

Hyperactive bowel sounds above obstruction and no sounds below

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26
Q

Primary affected region in ulcerative colitis

A

begins in rectum and proceeds to cecum

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27
Q 
Which has a chronic state: SATAAAAA
pancreatic cancer
cholecystitis
gastritis
pancreatitis
A

chronic cholecystitis: GB becomes fibrotic and contracted.

Chronic pancreatitis: usually from chronic alcoholism. Very painful situation and often malnourished.

Chronic gastritis: bringing this forward from the other section.

There is not a chronic pancreatic cancer—patients usually die within 6 months to 1 year of diagnosis.

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28
Q

NASH

A

Nonalcoholic steatohepatitis: fatty liver disease.

Connected to type 2 diabetes, hyperlipidemia, metabolic syndrome

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29
Q

What is Laënnec cirrhosis?

A

Alcoholic cirrhosis

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30
Q

Most common location of diverticulitis

A

sigmoid colon

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31
Q

Etiology of mechanical obstruction

A

adhesions, tumors, hernia, fecal impactions, strictures, volvulus (twisting) and intusseption (folding over), vascular disorders

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32
Q

Diverticulosis vs. diverticulitis

A

osis: outpouchings
itis: inflamed outpouching

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33
Q

Name conditions that can cause fistulas

A

Crohn’s, ulcerative colitis, diverticulitis

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34
Q

Stages of viral hepatitis

A
  • prodromal (exposure to jaundice, about 2 weeks)
  • icteric (2-6 weeks with jaundice, dark urine, clay stools, enlarged liver)
  • recovery (resolution of jaundice)
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35
Q

Hep C’s three C’s

A

chronic, cirrhosis, cancer

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36
Q

fulminant hepatitis

A

rapid progression from onset of symptoms to encephalopathy within 2-3 weeks - plurality from hep A and B

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37
Q

Crohn’s or UC: skip lesions

A

Crohn’s

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38
Q

Hepatorenal syndrome

A

blood redistributed and kidneys don’t get enough blood

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39
Q

Systemic symptoms of appendicitis

A

temp, WBC > 10k, N/V, bowel changes

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40
Q

Is jaundice an early or late symptom of cirrhosis?

A

late

41
Q

t/f: pancreatitis Stimulates the exocrine function of the pancreas leading to overproduction of pancreatic enzymes.

A

false

42
Q

Pre or intrahepatic or obstructive: jaundice, normal urine and stool

A

prehepatic

43
Q

Pre or intrahepatic or obstructive: liver can’t conjugate or excrete

A

intrahepatic

44
Q

cholangitis

A

inflammation of the common bile duct

45
Q

When should colonoscopy vs. Cologuard be performed?

A

> 45 years, colonoscopy every 10 years and higher risk, Cologuard for lower risk

46
Q

Skin changes with liver disease

A

petiecchiae, ecchymosis, pruritis, spider angiomas, peripheral edema, jaundice

47
Q

cholelithiasis

A

gallstones

48
Q

t/f: Pancreatitis causes right upper quadrant pain associated with meals high in fat.

A

false, this is gallstones

49
Q

Is there a chronic state of Hep A?

A

No. self limiting, usually not fatal. Usually highly symptomatic and body clears it.

50
Q

DNA or RNA? Hep A, B, C

A

RNA: A, C
DNA: B

51
Q

Liver failure: low or high cholesterol

A

low

52
Q

Most colon cancer arises from…

A

Polyps

53
Q

Which type of obstruction requires a lysis of adhesions?

A

mechanical

54
Q

Complications of bowel obstruction

A

perforation, peritonitis, fluid and electrolyte imbalance, acid/base disturbances, hypovolemic shock

55
Q

Top 5 complications of ulcerative colitis

A

Hemorrhage, perforation, nutritional deficiency, colon cancer, toxic megacolon

(also abscess, peritonitis, fistulas)

56
Q

Pre or intrahepatic or obstructive: ^^ both conjugated and unconjugated bilirubin

A

intrahepatic

57
Q

Diagnostic tools for obstruction

A

X ray and CT

58
Q

How does liver failure cause encephalopathy?

A

Impaired conversion of ammonia to urea

59
Q

process of Inflammation of the liver

A

inflammatory cells, edema (hepatomegaly), chronic –> necrosis

60
Q

Pre or intrahepatic or obstructive: ^^ conjugated bilirubin

A

obstructive

61
Q

What is HBsAg

A

The marker that you have Hep B

62
Q

Hep C etiology

A

needles and blood transfusions

63
Q

Which hepatitis can cause chronic hepatitis

A

B, C, D (C is most common)

64
Q

IBD etiology

A

Unknown, believed to be autoimmune

65
Q

Pain pattern of appendicitis

A

epigastric or periumbilical pain with 1-2 episodes of nausea
increasing pain localizes to RLQ
pain with palpation and rebound tenderness
pinpoint area of pain

66
Q

Which hepatitis has vaccines?

A
  • A (endemic regions, surfers/swimmers, MSM)
  • B (broad, esp healthcare workers and exposure to blood) - offers some protection for D
  • not for C
67
Q

If an obstruction pt has bowel movements, describe

A

watery or ribbonlike

68
Q

Pre or intrahepatic or obstructive: ^^ unconjugated bilirubin

A

prehepatic

69
Q

Crohn’s or UC: colectomy with ileostomy

A

UC

70
Q

Hepatitis specific symptoms

A

jaundice, RUQ pain

71
Q

What benefit is there for testing stool for DNA over testing just for occult blood?

A

Stool DNA testing can pick up on precancerous DNA mutations which is superior to looking for hidden blood which is a symptom of colon cancer. The procedure is similar to occult blood testing as both take a sample of stool for testing. Both can be done at home and then sent into the lab.

72
Q

Hep G details

A

sparse

73
Q

Which of the 5 F’s is not supported by science

A

Fair – Native Americans have a higher risk

74
Q

Pre or intrahepatic or obstructive: bilirubinuria

A

intrahepatic and obstructive (only conjugated is water soluble)

75
Q

t/f: Patients with cholecystitis always have gallstones

A

false

Cholecystitis can be caused by gallstone or by “acalculous” where no stones are found. Acalculous cholecystits can be caused by trauma, DM, fasting, dehydration, opioid use, or hormone replacement therapy.

76
Q

t/f: Pancreatitis can result in the release of pancreatitc enzymes into the peritoneal cavity or into the general circulation.

A

true

77
Q

Portal hypertension

A

blood backs up in the portal vein (valveless) – causes collateral circulation in GI tract, rectum, esophagus

78
Q

Liver failure: impaired [fat or protein] absorption

A

fat - bile salts are responsible for fat absorption. Steatorrhea - floating stool.

79
Q

4 extraintestinal symptoms of systemic IBD

A

SEAL: stones (gall and kidney), eye inflammation, arthritis, lesions (skin and mouth)

80
Q

Hepatitis causes

A

viral (alphabet), drugs/toxins/alcohol, fatty, autoimmune

81
Q

3 reasons liver failure causes clotting issues

A
  • poor absorption of fat soluble vitamins (like K)
  • splenomegaly hoardes/destroys platelets
  • decreased coagulation factors
82
Q

Liver failure: hyper or hypoglycemic

A

hypoglycemic

83
Q

t/f: The head of the pancreas is most often involved in pancreatic cancer

A

true

84
Q

choledocholithiasis

A

stones in the common bile duct

85
Q

Dx of appendicitis

A

physical exam, ultrasound, CT scan

86
Q

Hep E is similar to which other hepatitis?

A

A. Waterborne, fecal-oral, no chronic form

87
Q

Crohn’s or UC: cobblestoning

A

Crohn’s

88
Q

Most colon cancer occurs in…

A

rectum and sigmoid colon. Can be ascending colon and cecum – harder to dx/screen.

89
Q

Crohn’s or UC: bloody diarrhea

A

UC

90
Q

Hep D is paired with which other hepatitis?

A

B. It can also be chronic

91
Q

t/f: There’s a 4-5% 5 year survival for pancreatic cancer

A

true

92
Q

Causes of diverticulosis

A

age, lack of fiber, lack of physical activity, neglecting urge to defecate, constipation

93
Q

Hepatitis B etiology

A

transmitted by blood and body fluids

94
Q

Crohn’s or UC: weight loss

A

Crohn’s

95
Q

Crohn’s or UC: extraintestinal symptoms

A

both

96
Q

Crohn’s or UC: weight loss

A

both

97
Q

Hepatitis nonspecific symptoms

A

nausea, fatigue, anorexia, arthralgia, myalgia, pruritus

98
Q

Hepatitis nonspecific symptoms

A

nausea, fatigue, anorexia, arthralgia, myalgia, pruritus

99
Q

Systemic diverticulitis symptoms

A

n/v, temperature, elevated wbc

Pathophysiology for Nursing (16 decks)

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