Week 2 Pre-Learning: GI Tract - Lower Disorders 2

Question 1

What is appendicitis?

Answer 1

• inflammation of the appendix due to obstruction by fecalith or if bowels become twisted

Question 2

How does appendicitis occur in the body? (3)

Answer 2

1. Obstruction causes increased pressure within the appendix, leading to ischemia and necrosis
2. Inflammation can increase permeability of appendix, causing localized peritonitis
3. As pressure increases, appendix can rupture, leading to generalized peritonitis (life-threatening)

Question 3

What are the clinical manifestations of appendicitis? (9)

Answer 3

Initially:
- Periumbilical pain, persistent and continuous
Eventually:
- pain will localize to the McBurney point
Also look for:
- anorexia
- nausea
- vomiting
- localized tenderness
- rebound tenderness
- muscle guarding
- low grade fever

Question 4

Where is the McBurney point?

Answer 4

halfway between umbilicus and right iliac crest

Question 5

What is peritonitis? (2)

Answer 5

• the inflammation of the peritoneal membranes from chemical irritation or bacterial infection
• inflammation from chemical irritation can increase permeability of intestinal wall and lead to bacterial peritonitis (occurs within hours)

Question 6

What are common causes of peritonitis? (8)

Answer 6

• perforated ulcer
• ruptured galbladder
• panceatitis
• Ruptured spleen
• hemorrhage
• perforated appendix
• IBD
• intestinal obstruction

Question 7

What are the clinical manifestations of peritonitis? (8)

Answer 7

• severe generalized abdominal pain
• tenderness over involved area
• rebound tenderness
• rigid abdomen
• septicemia
• hypovolemic shock
• paralytic ileus
• fever/leukocytosis

Question 8

In class, what is the response to peritonitis?

Answer 8

• increased vasodilation and cap. permeability

Question 9

What is gastroenteritis?

Answer 9

• inflammation of the mucosa of the stomach and small intestine due to an infection (viral, bacterial, or parasitic)

Question 10

What are the clinical manifestations of gastroenteritis? (6)

Answer 10

• N+V+D
• abdominal cramping
• abd. distension
• fever
• increased WBC
• Blood/mucus in stool (common with bacterial)

Question 11

Should patients be NPO with gastroenteritis?

Answer 11

yes, until vomiting resolves
- most cases are self-limiting but can be dangerous for older adult or chronically ill (risk of dehydration)