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3512 > week 8: upper GI and accessory organ disorders > Flashcards

week 8: upper GI and accessory organ disorders Flashcards

1
Q

what is GERD

A

stomach acid leaks back into esophagus

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2
Q

what are complications of GERD

A

barretts epithelium, respiratory issues (aspiration), esophagitis, dental decay, hemmorhage

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3
Q

where do GERD symptoms stem from

A

tissue injury and too much stomach acid

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4
Q

whats the difference between a sliding hartal hernia and a parasophageal hernia

A

sliding: herniated portion of stomach just kind of slides out

paraesophageal: pouch of stomach kind of rolls out

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5
Q

what are the symptoms of a hiatal hernia similar to

A

GERD
if LES is normal there are no symptoms

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6
Q

how does a CPAP help with Gerd

A

makes sleep apnea better and for some reason helps with GERD

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7
Q

when are GERD symptoms usually worse

A

when a person is eating or lying down

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8
Q

which drugs help with GERD

A

antacids, PPIs, H2 receptor blockers

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9
Q

which drugs make GERD worse

A

oral contraceptives, anticholinergic drugs, sedatives, NSAIDS, nitrates, CCB
all lower LES pressure

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10
Q

what are long term complications of PPI;s

A

PPIs long term lead to more risk of infection because stomach acid kills bacteria

also leads to inflammation of the kidney and inability to absorb calcium = bone fracture

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11
Q

what is a fundoplication

A

wrap fundus/herniated part of hernia around a band and secure it and it’ll eventually fall off

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12
Q

what is post op priorities when a person has a fondoplicaiton

A

preventing respiratory complications (raise HOB, early ambulation, Deep breathe and cough, support incision, pain control)

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13
Q

what does normal NG tube drainage look like

A

it’ll go from dark brown to yellowish green, if it goes back to dark brown that could mean GIB

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14
Q

what is a sign that fondification is too tight

A

inability to bleach, dysphagia, aerophagia (air swallowing)

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15
Q

what are the first signs/symptoms of oesophageal tumours

A

dysphagia

then it’ll move on to odynophagia, hoarseness and weight loss

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16
Q

what are the non surgical interventions for oesophageal tumours

A

nutritional and swallowing therapy
chemo and radiation
esophageal dilation

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17
Q

what is the main surgical intervention for an esophageal tumour

A

esophagectomy
- basically removing a part of esophagus

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18
Q

what is the highest priority post-procedure thing for esophagectomy

A

respiratory care (DB + C, turning, pain support)

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19
Q

what is an important thing to note about an NG tube

A

don’t reposition, measure the length

20
Q

what is an anastomotic leak and why is it so serious

A

it is when GI fluid leaks out of esophagus sutures into mediastinum (after an esophagectomy)

it could lead to sepsis/peritonitis

21
Q

what are symptoms of anastomotic leak

A
  • fever, increased chest tube drainage, early signs of shock (high pulse, low BP)
22
Q

what is a blumberg sign

A

rebound tenderness

23
Q

what is steatorrhea

A

increased fat excretion of stools usually due to inflammation of the gall bladder

24
Q

what is extra-corporeal shock wave lithotripsy and why does it help with gall stone management

A

it uses ultrasound shock waves to break up stones so that they can pass

25
Q

what is a percutaneous transhepatic biliary catheter

A

a stent inserted to divert bile from liver into the duodenum

26
Q

what is the gold-standard method for treating cholecyctotis

A

laparoscopic cholecystectomy

27
Q

why would a patient have gaseous pain after a cholecystectomy

A

because they need to fill the abd wall with 3-4L of CO2 to lift the wall and visualise the internal organs

28
Q

what is a Jackson-pratt drain

A

small drain that sits near where the gall was
used for an open approach cholecyctectomy

29
Q

why would one use an open approach cholecystectomy

A

used in severe biliary obstruction where surgeon needs to look around and figure out the cause

30
Q

what does pancreatitis pain look like

A

starts in LUQ, radiates to back, L flank and L shoulder

31
Q

what are the pain causes of pancreatitis

A

gall bladder stones and ahcolol use

32
Q

what is the primary nutritional intervention for pancreatitis

A

NPO to give pancreas a rest

33
Q

what are signs of hypocalcemia

A

muscle spasms and cramps

34
Q

why do you need to monitor respiratory status with pancreatitis

A

pancreatic juice can migrate to peritoneum and cause atelectasis

monitor for cough and fever, look for crackles in the lungs

35
Q

what are the signs of peritonitis

A

fever, loss of appetite, abd pain, change in mental status

36
Q

what are the two main vasoactive meds to treat an active bleed d/t liver cirrhosis

A

octreotide, vasopressin

37
Q

what is a TIPS procedure

A

blood flow from portal vein shunted to hepatic vein

38
Q

which medication helps with confusion with liver cirrhosis

A

lactulosewhy

39
Q

why do you need to use drugs sparingly with liver cirrhosis

A

because they get metabolised in the liver

40
Q

why do you need moderate protein intake when managing and preventing confusion in a liver cirrhosis patient

A

because ammonia competes with protein in the gut

41
Q

what is the goal of pooping with lactulose

A

2-3 soft stools per day

42
Q

what should you monitor with lactulose

A

monitor for hypokalaemia, dehydration, asterisks and fetor hepaticus

43
Q

which medication helps with itchy skin due to liver cirrhosis

A

sertraline

44
Q

where would you experience pain with hepatitis

A

right upper quadrant pain

45
Q

what is the main drug management with hepatitis B and C

A

antiviral drugs

46
Q

what is the primary patient education with antiviral drugs

A

avoid large crowds and sick people because it can suppress the immune system

3512 (19 decks)

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