Term
| acute abdominal pain is described as |
|
Definition
| Recent onset of severe pain (sudden) |
|
|
Term
| chronic abdominal pain is described as |
|
Definition
| Occurring over weeks or months |
|
|
Term
| the nature of abdominal pain is |
|
Definition
| a result of mechanism responsible or part that is causing the pain |
|
|
Term
| Distention or spasm of hollow viscus causes |
|
Definition
| “visceral” type pain originating from pain receptors located in the organs (viscera) of the abdomen. Pain poorly localized and described as dull |
|
|
Term
| Peritoneal irritation causes |
|
Definition
| “parietal pain”, sharp and well localized |
|
|
Term
| When considering RUQ pain, areas affected could be the |
|
Definition
Chest cavity
Liver
Gallbladder
Stomach
Bowel
Right kidney |
|
|
Term
| LUQ pain could involve the following organs |
|
Definition
Pancreas
Left kidney
Spleen
Heart or chest cavity |
|
|
Term
| When considering classic presentation in those with GI issues, the following group of people may not present with classic symptoms: |
|
Definition
| infants, elderly and debilitated |
|
|
Term
| Obtain a consult or refer GI disorders that presents with |
|
Definition
Blood in the stool
Weight loss
Anemia
Dysphagia (BAWD) |
|
|
Term
GI, ie PUD
CNS, ie motion sickness
Systemic, ie pregnancy, food poisoning
Iatrogenic, ie meds, bulemia
are all common causes of |
|
Definition
|
|
Term
| n/v do not require lab studies if |
|
Definition
| no systemic S & S and duration <24 hours |
|
|
Term
| how long should the pt withhold solids after n/v ceases? |
|
Definition
|
|
Term
| list a few medications that may relieve n/v |
|
Definition
Phenergan – generalized N&V
Bismuth Subsalicylate – generalized N&V
Transdermal scope – motion sickness |
|
|
Term
| if n/v persist for greater than 24hrs, it is appropriate to |
|
Definition
| consult a specialist or physician |
|
|
Term
| Functional constipation is the most common and has |
|
Definition
|
|
Term
| common causes of constipation include |
|
Definition
Slow transit
Pelvic floor dysfunction |
|
|
Term
| Diseases of the colon which are associated with constipation are |
|
Definition
|
|
Term
| Endocrine disorders which cause constipation are |
|
Definition
|
|
Term
| neurological disorders associated with constipation are |
|
Definition
| parkinsons, spinal cord lesion |
|
|
Term
| medications which cause constipation are |
|
Definition
| anticholinergics, calcium channel blockers, diuretics, antacids |
|
|
Term
| list several ways to treat constipation |
|
Definition
Increase fluid, fiber, exercise
Bulk forming agents
Stool softeners – short term |
|
|
Term
| When should a person with constipation be referred? |
|
Definition
| if change in bowel pattern, unresponsive to tx, or blood in stool |
|
|
Term
| when dealing with diarrhea, all solids should be stopped for |
|
Definition
| 12-24 hours, give rehydrating solution |
|
|
Term
| If diarrhea symptoms occure for less than 48hrs and no other systemic symptoms are present then |
|
Definition
| no lab studies are needed |
|
|
Term
| donnatol is used for________ related to diarrhea |
|
Definition
|
|
Term
| use Kaopectate or Pepto Bismol for tx of |
|
Definition
|
|
Term
| What are the common bacteria that cause diarrhea which last for greater than one week? |
|
Definition
| Salmonella, Shigella or Campylobacter |
|
|
Term
| When managing diarrhea, if fecal leukocytes, occult blood, fever with watery diarrhea or symptoms > 1 wk then ___________ should be the treatment |
|
Definition
|
|
Term
| if fecal leukocytes or blood is present stools then do not |
|
Definition
| administer antimolity drugs (tx of diarrhea) |
|
|
Term
| Ulceration of the GI mucosa in areas bathed by acid pepsin is called |
|
Definition
|
|
Term
| what are the common areas affected by PUD? |
|
Definition
| stomach, duodenum and esophagus |
|
|
Term
| What causes the vast majority (80-90%) of PUD? |
|
Definition
|
|
Term
| Chronic NSAID use is responsible for a small percentage of |
|
Definition
|
|
Term
| List a few factors that may aggravate PUD |
|
Definition
Physiological stress – severe trauma, burns, shock
Psychological stress
Alcohol and nicotine use |
|
|
Term
| hWhat percentage of the pop. is affected by PUD? |
|
Definition
|
|
Term
| What is the primary location of the ulcer in PUD? |
|
Definition
|
|
Term
| In PUD, 5% of gastric ulcers are |
|
Definition
|
|
Term
| PUD pain is described as ______ and typically_______ at night |
|
Definition
| gnawing and burning and wakes people |
|
|
Term
| PUD pain begins ________ after meals and but is relieved by________ in duodenal ulcers |
|
Definition
|
|
Term
| gastric ulcer pain is usually increased by |
|
Definition
|
|
Term
| people with gastric ulcers will usually experience |
|
Definition
|
|
Term
| gastric ulcers are associated with what unpleasant symptoms |
|
Definition
| Dyspepsia (bloating, nausea, anorexia, excessive flatulence) |
|
|
Term
| dx of duodenal ulcers can be fairly easily by obtaining careful hx of |
|
Definition
|
|
Term
| physical assessment findings in PUD is usually limited to |
|
Definition
|
|
Term
| When completing a physical exam on a person with PUD, ensure that a rectal exam and __________testing are done as well |
|
Definition
|
|
Term
| C-urea breath test or fecal antigen test can be used to test for h pylori in PUD if |
|
Definition
| PPIs have not been given in the previous week |
|
|
Term
| Endoscopies should be given to those with PUD when/to |
|
Definition
Pts over 50
indicated after 2 weeks of treatment if no improvement
To locate bleeding site in those with diagnosed or suspected blood loss |
|
|
Term
|
Definition
| relief of symptoms, healing, prevention of recurrence |
|
|
Term
| Pharmacological tx of PUD should include |
|
Definition
| PPI and Clarithromycin, amoxicillin or Flagyl X 14 days |
|
|
Term
| pts with gastric ulcers; be sure to |
|
Definition
|
|
Term
| reflux of stomach and duodenal contents into the esophagus leading to a spectrum of clinical manifestations predominated by inflammation of the esophagus |
|
Definition
|
|
Term
| what is the cause of GERD? |
|
Definition
| relaxation of the lower esophageal sphincter (LES) which allows reflux of gastric acid and pepsin into the distal esophagus |
|
|
Term
| Narcotics, benzodiazepines, calcium channel blockers, alcohol, nicotine, chocolate and peppermint cause |
|
Definition
| lower esophageal sphincter relaxation |
|
|
Term
| Daily prevalence rate of heartburn, the major symptom of GERD, has been estimated to be |
|
Definition
| 10% in a normal adult population |
|
|
Term
| GERD can lead to what dental problem? |
|
Definition
|
|
Term
|
Definition
| Acute or chronic inflammation of the gallbladder |
|
|
Term
| About 90% of cholecystitis is related to presence of |
|
Definition
| pigmented or cholesterol calculi |
|
|
Term
| cholecystitis occurs subsequent to |
|
Definition
| bile stasis, bacterial infection, or ischemia |
|
|
Term
| Risk factors for cholesterol stone formation |
|
Definition
Age
Gender – female
Maternal family hx
Obesity
High triglycerides and other metabolic diseases
Rapid weight loss
Estrogen therapy
Oral contraceptive use
Pima Indian descent/Scandinavians |
|
|
Term
Gallbladder hypomotility
is related to |
|
Definition
Prolonged fasting
Pregnancy
Oral contraceptive use |
|
|
Term
| s/s of gallbladder disease include |
|
Definition
| postparandial fullness, heartburn, nausea, flatulence, regurgitation of bitter fluid, vomiting;usu following a fatty meal |
|
|
Term
| abdominal guarding, rebound tenderness in right hypochondrium, palpable tender sausage shaped mass in RUQ during acute attack are physical symptoms present in |
|
Definition
|
|
Term
| Positive Murphy’s sign, seen in gallbladder disease is described as |
|
Definition
| inspiratory arrest secondary to extreme tenderness when subhepatic area is palpated during deep inspiration |
|
|
Term
| what test is used most often to dx cholecystitis? |
|
Definition
|
|
Term
| What population is most affected by appendicitis? |
|
Definition
| males between 10 and 30 years of age |
|
|
Term
| What age group has the highest complication and morbidity rates when dx with appendicitis? |
|
Definition
| children adolescents and people over 55 yrs of age |
|
|
Term
| what is the leading cause of abdominal surgery? |
|
Definition
|
|
Term
| review the following s/s of appendicitis |
|
Definition
Acute onset of periumbilical or epigastric pain which ranges from mildly diffuse to severe
Anorexia, nausea and vomiting (usually subsequent to pain onset)
Shifting of pain to right lower quadrant (McBurney’s point) after several hours, aggravated by walking or coughing
Occasional radiation of pain into testicles
Spasm of abdominal muscles
Constipation usual, diarrhea rarer
Elderly clients may present with mild symptoms of unexplained weakness, anorexia, tachycardia, and abdominal distention with little pain |
|
|
Term
| if the appendic perforates, the following symptoms may be present |
|
Definition
Sudden cessation of pain
Abdominal rigidity
Generalized abdominal tenderness
High fever
Vomiting
Dehydration
Decreased bowel sounds
Shock |
|
|
Term
| Positive psoas and obturator signs are present in |
|
Definition
|
|
Term
| with appendicitis, a rectal exam may reveal |
|
Definition
| tenderness in the right perirectal area |
|
|
Term
| A normal CRP after 24hrs, does not indicate |
|
Definition
|
|
Term
| leukocytosis with increased band cells will be present in |
|
Definition
|
|
Term
| gastroenteritis is defined as |
|
Definition
| Acute inflammation of the GI mucosa |
|
|
Term
| what is the second leading cause of morbidity in the US |
|
Definition
|
|
Term
| Epidemic outbreaks of bacterial enteritis occur in groups of persons who have ingested |
|
Definition
|
|
Term
| what are the most common causes of gastroenteritis |
|
Definition
| viruses, bacteria, and parasites |
|
|
Term
| who are at highest risk of mortality due to gastroenteritis? |
|
Definition
| Very young, elderly and those with chronic disease |
|
|
Term
| gastroenteritis is a _______ disease |
|
Definition
|
|
Term
| s/s of acute gastroenteritis include |
|
Definition
Abrupt onset of nausea and vomiting
Explosive flatulence
Crampy abdominal pain
Frequent watery diarrhea
Myalgia
Headache
Fever
Generalized weakness |
|
|
Term
gastroenteritis:
dizziness, difficulty in swallowing and other neuro deficits are indication of ________and require __________ |
|
Definition
| botulism and immediate referral |
|
|
Term
| pts with gastroenteritis will not have rebound tenderness spasm except when it is caused by |
|
Definition
|
|
Term
gastroenteritis:
fecal leukocytes need to be done when there |
|
Definition
| fever > 102, bloody diarrhea, abdominal pain, profuse watery diarrhea and dehydration or frail, elderly or immuno-compromised |
|
|
Term
gastroenteritis:
Fever, chills, rigors, night sweats and weight loss indicate penetrating diarrhea and require |
|
Definition
|
|
Term
| in gastroenteritis, antibiotics can be used with_____,_____,and ___. |
|
Definition
| with fecal leukocytes, occult blood, fever with watery diarrhea |
|
|
Term
| Diarrhea that last greater than two weeks is likely caused by______ and _________ should be used for tx |
|
Definition
|
|
Term
| _________is most common cause of Traveler’s diarrhea |
|
Definition
|
|
Term
| traveler's diarrhea is ________ but antibiotics may shorten the course by ____ |
|
Definition
| self-limiting and 1-2 days |
|
|
Term
| though antibiotics are okay, the best medication to use for traveler's diarrhea is |
|
Definition
|
|
Term
| prevention of traveler's diarrhea includes |
|
Definition
Avoid untreated water and ice
Avoid raw fruits and vegetables
Avoid undercooked meat
Avoid unpasteurized milk |
|
|
Term
| travelers diarrhea may last 1-2wks if it is caused by |
|
Definition
|
|
Term
|
Definition
| abdominal pain and alternate bouts of constipation and diarrhea |
|
|
Term
|
Definition
|
|
Term
| abdominal discomfort in IBS is relieved by |
|
Definition
|
|
Term
| abdominal discomfort in IBS is associated with |
|
Definition
| diarrhea, constipation or mucus in stool |
|
|
Term
| symptoms of IBS often starts in |
|
Definition
|
|
Term
| mild abdominal tenderness, normal or mildly hyperactive bowel sounds are present in |
|
Definition
|
|
Term
| what is the management/tx plan for IBS? |
|
Definition
High fiber diet. Esp with constipation
Bulking agents |
|
|
Term
|
Definition
| dominant symptom (pain, constipation, diarrhea |
|
|
Term
| dx of hepatitis would include what labs? |
|
Definition
|
|
Term
| What are the acute and prior infection serologic markers for Hep A? |
|
Definition
Acute: IgM anti-HAV
Prior: IgG anti-HAV |
|
|
Term
| Acute infection of Hep B serologic markers include |
|
Definition
| + HBsAg, + IgM anti-HBc,-anti-HBs |
|
|
Term
| chronic Hep B serologic markers include |
|
Definition
| : HBsAg, IgG antiHBc, and -anti-HBs |
|
|
Term
| prior Hep B infection serologic markers present include |
|
Definition
|
|
Term
| what serologic markers are present in Hep C infected pts? |
|
Definition
| HCV-RNA, anti-HCV (usually within 2 wks of active infection |
|
|
Term
| review tx plan for those infected with hepatitis |
|
Definition
Treatment of symptoms
Educate to abstain from alcohol and any hepatotoxic drugs
No strenous activities or contact sports until recovery
Universal precautions |
|
|
Term
| Serum amylase is elevated 3X normal in |
|
Definition
|
|
Term
| what serologic finding is specific for pancreatitis dx? |
|
Definition
| Serum lipase three fold elevation |
|
|
Term
| what is the most useful scan for pancreatitis dx? |
|
Definition
|
|
Term
| pancreatitis should be referred to a |
|
Definition
|
|
Term
| in jaundice, an elevated ALT and AST indicate |
|
Definition
|
|
Term
| in viral hepatitis, ALT is usually |
|
Definition
|
|
Term
| in alcoholic hepatitis, AST is |
|
Definition
|
|
Term
| Alkaline phospatate is primarily found in the ____ and _____. |
|
Definition
| liver (ALP-1) and bone (ALP-2) |
|
|
Term
| With rapid bone growth (adolescence, fetus) there are elevated |
|
Definition
|
|
Term
| What other areas are ALP found? |
|
Definition
| placenta, fetus,intestines,and kidneys |
|
|
Term
| Gamma-glutamyl transferase (GGT) levels may be used to determine the cause of an elevated |
|
Definition
|
|
Term
| only ALP will be elevated in |
|
Definition
|
|
Term
| ). Both ALP and GGT are elevated in disease of the |
|
Definition
| bile ducts and in some liver diseases |
|
|
Term
| If the GGT level is normal in a person with a high ALP,, the cause is most likely |
|
Definition
|
|
Term
| if a pt has Hep B immunity from vaccination, then what serologic marker is present? |
|
Definition
|
|
Term
| If a pt has Hep immunity from prior infection, what serologic markers are present? |
|
Definition
|
|
