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Dse of Digestive Sys
Diseases of the Digestive System
Question | Answer |
---|---|
Oral neoplasms commonly occur where? | 1. Floor of the oral cavity 2. Tongue 3. Inferior oral labia |
Pipe and cigar smoking is often associated with what type of carcinoma? | Labial carcinoma |
Carcinomas of the buccae,tongue, or palate are typically associated with? | Chewing tobacco or dipping |
A premalignant sign of an oral neoplasm is? | Leukoplakia |
How is Dx of an oral neoplasm confirmed? | Biopsy(Bx) |
Oral neoplasms respond well to what types of treatment? | Surgery and radiation therapy |
Signs and Symptoms of an esophageal malignancy include? | 1. Dysphagia 2. Vomiting 3. Halitosis 4. WT Loss 5. Aphagia |
Methods of Diagnosis for esophageal malignancy include? | Upper Gastrointestinal(UGI)-AKA Barium Swallow |
Why is the prognosis(Px)for esophageal malignancy poor? | The disease usually metastasizes prior to detection |
What is the name for inflammation of the esophagus? | Esophagitis |
Esophagitis is commonly caused by? | GERD(Gastroesophageal Reflux Dse) |
What causes GERD? | An incompetent Cardiac Sphincter which allows stomach contents to regurgitate up the esophagus |
Signs and Symptoms of GERD? | 1. Dyspepsia 2. Eructation 3. Dysphagia 4. Halitosis 5. Hematemesis 6. Thoracodynia |
Signs and Symptoms of GERD may be exacerbated by? | 1. Eating 2. Drinking 3. Bending over 4. Lying Down |
GERD is more common with which conditions? | 1. Obesity 2. Pregnancy |
How is Dx of GERD confirmed? | EGD (Esophagogastroduodenoscopy) |
Tx for GERD includes? | 1. Non-irritating diet 2. Antacids 3. Antiulcer drugs |
What is a Hiatal Hernia(HH)? | A protrusion of the stomach through the diaphragm |
A Hiatal Hernia is AKA? | Diaphragmatic Hernia |
Signs and Symptoms of a Hiatal Hernia? | 1. Dyspepsia 2. Postprandial dyspepsia 3. SOB |
A Hiatal Hernia may cause the cardiac sphincter to become incompetent causing what? | GERD |
Dx of a Hiatal Hernia is typically confirmed with? | 1. CXR 2. UGI(Barium Swallow) |
Treatment for a Hiatal Hernia include? | 1. Avoidance of spicy foods,ETOH,and Caffeine 2. WT Loss (for obese patients) 3. Abdominal Supports 4. Hernioplasty |
What is inflammation of the stomach frequently accompanied by hematemesis? | Gastritis |
Name the list of irritants which can cause Gastritis? | 1. NSAIDS 2. Caffeine 3. Tobacco 4. Spicy Food 5. Alcohol 6. Infection |
Dx of Gastritis is confirmed by? | 1. Gastroscopy 2. Bx |
Signs and Symptoms of Gastritis include? | 1. LUQ Abdominal pain 2. Hematemesis |
Tx of Gastritis includes? | 1. Removal of irritants 2. Antacids 3. Anti-ulcer Drugs |
How do Antacids work? | Neutralize the Hydrochloric Acid in the stomach |
What is the purpose of Anti-ulcer drugs? | To decrease the amount of acid produced in the stomach |
What is Peptic Ulcer Disease(PUD)? | An ulcer(erosion)of the stomach and/or duodenum |
What is the primary symptom of PUD? | Abdominal Pain |
What can temporarily relieve the pain caused by PUD? | 1. Antacids 2. Food |
Name the causes of PUD? | 1. Poorly controlled stress 2. Excessive production of HCl 3. NSAIDs 4. H. Pylori |
Tx of PUD includes? | 1. Stress Management 2. Reduction of irritants 3. Anti-ulcer drugs 4. Antacids 5. Antibiotic therapy *Not Tx by drinking milk* |
Identify the complications of PUD? | 1. Ulcer Perforation 2. Hemorrhage |
Signs of a perforation include? | 1. Extreme Abdominal Pain 2. Hematemesis 3. Melena |
A complication of ulcer perforation includes? | Peritonitis |
How is an ulcer perforation treated? | With Surgery |
Dx of Peptic Ulcer Disease is made by? | Barium Swallow |
What is Gastroenteritis? | An inflammation of the stomach and small intestine |
Identify the causes of Gastroenteritis? | 1. Bacterial Infections (E.coli,Salmonella,listeria) 2. Chemical Toxins 3. Lactose Intolerance 4. Other Food Allergies 4. |
Signs and Symptoms of Gastroenteritis include? | 1. Colicky dysentery 2. N&V 3. Pyrexia 4. Diarrhea |
Dx of Gastroenteritis is confirmed with? | Stool Cx (culture) |
How is Gastroenteritis treated? | 1. IV hydration 2. Antibiotics 3. Antiemetics 4. Antidiarrheals 5. GI Antispasmodics |
What is Salmonellosis? | A food poisoning caused by an enterobacteria called salmonella |
How soon after ingestion of salmonellosis tainted food does gastroenteritis occur? | 6 to 48 hrs after |
How is Dx of Salmonellosis confirmed? | Stool Cx |
How long can the symptoms of Salmonellosis last? | Up to 2 weeks |
The main complication of Salmonellosis is? | Dehydration |
Prevention of Salmonellosis includes? | 1. Proper refrigeration of foods 2. Thorough cooking of foods 3. Prevent cross contamination of food 4. Proper frequent hand washing |
Gastric malignancies are more common in? | Men over age 55 |
What are the signs and symptoms of Gastric Malignancy? | 1. Anorexia 2. Dyspepsia 3. N&V 4. PA(Pernicious Anemia)caused by Vit B-12 deficiency 5. Achlorhydria(No HCl in the stomach) |
Dx of Gastric Malignancy is confirmed by? | 1. Gastroscopy 2. Bx |
What factors increase the risk of Gastric Malignancies? | 1. H. pylori infection of stomach 2. Consumption of dried,smoked,salted,or preserved foods 3. Diet deficient in fresh fruits and vegetables 4. Chronic Gastritis 5. Family History of gastric malignancy |
What are the treatment options for Gastric Malignancies? | 1. Chemotherapy 2. Radiation therapy 3. Surgery |
Prognosis is good for Gastric malignancy if detected before? | Metastasis |
Inflammation of the appendix is? | Appendicitis |
Signs and Symptoms of Appendicitis include? | 1. N&V 2. Pyrexia 3. Leukocytosis 4. Right inguinal rebound tenderness |
How is Appendicitis treated? | By Appendectomy |
Identify complications of appendicitis? | 1. Gangrene(putrifaction or rot) 2. Appendorrhexis(rupture of appendix) 3. Peritonitis(Inflamm of abdominal lining) |
What Dse is known as the inability to absorb fat from the small intestine? | Malabsorption Syndrome |
The inability to absorb fat causes the stool to become? | 1. Unformed 2. Fatty 3. Pale 4. Pungent 5. Floaters |
What is a complication of Malabsorption Syndrome? | Inability to absorb the fat soluble vitamins: A, D, E, and K |
Deficiency of Vit K can cause? | Bleeding tendencies |
How is Malabsorption Syndrome treated? | Injectable vitamin A, D, E,and K supplements |
What is Diverticulitis? | Inflammation of the diverticula |
What are diverticula? | Blister-like pouches or sacs that develop in the large intestine |
The primary symptoms of Diverticulitis is? | LLQ cramp-like abdominal pain |
Complications of Diverticulitis are? | 1. Bowel Obstruction(Ileus) 2. Abscesses(collection of pus) |
How is Diagnosis of Diverticulitis confirmed? | By Barium Enema(AKA: Lower GI) |
Treatment of Diverticulitis includes? | 1. Antibiotics 2. Increase fiber in diet 3. Decrease intake of gas forming foods |
Crohn's Disease(AKA Regional Enteritis) is? | A chronic, idiopathic, inflammatory bowel disease |
True or False: Crohn's Disease(CD) typically runs in families? | TRUE |
What is the Age range where Crohn's Disease is usually made? | Between 20-40 |
Signs and Symptoms of Crohn's Dse include? | 1. Appendicitis-like pain 2. Alternating bloody diarrhea and constipation 3. Melena 4. Anorexia 5. N&V 6. WT Loss |
Confirmation of a Crohn's Diagnosis is made by? | 1. Colonoscopy 2. Bx |
Periods of exacerbation and remission are common with CD and some cases end in? | Perforation(rip/tear) or Ileus(bowel obstruction) |
Tx of CD includes? | 1. Immunosuppresant Medications 2. SAIDs(prednisone) 3. Antibiotics |
What is Chronic Ulcerative Colitis(UC)? | An idiopathic inflammatory bowel disorder which usually affects the colon and rectum |
UC increases the risk of what type of malignancies? | Colon |
Ulcerative Colitis may be exacerbated by? | Poorly Controlled Stress |
True or False: UC usually does not run in families? | False-It is hereditary |
Most cases of UC occur in? | Young Adults(especially women)between ages of 15-20. |
Identify the Signs and Symptoms of UC? | 1. Sudden diarrhea with pus and blood 2. Cramp-like pain in lower abdomen 3. Anemia from chronic blood loss |
Diagnosis of UC is confirmed by? | 1. Colonoscopy 2. Barium Enema(AKA: Lower GI) |
Identify the treatments for UC? | 1. Lialda(mesalamine) 2. Stress Management 3. Mild Sedation 4. Corticosteroids 5. Psychological counseling 6. Colostomy |
Where are most malignancies of the large bowel located? | Rectum or Sigmoid Colon |
How is Dx of Colorectal malignancies confirmed? | 1. DRE(Digital Rectal Exam) 2. Sigmoidoscopy or Colonoscopy 3. Bx |
If detected early, Colorectal malignancies respond well to what type of treatment? | Surgery |
Early Signs and Symptoms of colorectal carcinoma include? | 1. Change in bowel habits 2. Abdominal discomfort 3. Occult(hidden)blood in stool or Melena 4. Anemia |
What two methods aid in early detection of colorectal malignancy? | 1. Regular Physical Exam 2. Regular Stool Guaiac(hemoccult)tests |
List the risk factors for colorectal malignancies? | 1. Long-standing UC 2. Polyps 3. A diet rich in red meat and fat/Low in fiber 4. Deficient Calcium in the diet |
What is the prevalence of death from colorectal cancer? | 2nd most common cause of death from cancer(Lung Ca is #1 most common) |
ACS(American Cancer society)recommends the following at age 50? | 1. Colonoscopy every 10yrs 2. Sigmoidoscopy every 5yrs 3. BaE(barium enema)every 5yrs 4. Virtual Colonoscop every 5yrs 5. Stool Guaiac Test every year |
A bowel obstruction is AKA? | Ileus |
What is a paralytic ileus? | Ileus caused by a reduction of peristaltic activity |
What is it called when an ileus is caused by the bowel twisting on itself? | A Volvulus (kinked like a garden hose) |
What is an intussusception? | An ileus caused when the intestine telescopes on itself(a sock turned partially inside out) |
An ileus can also be caused by adhesions which are? | Areas of tissue which are sticking together |
Signs and Symptoms of an ileus include? | 1. Severe abdominal pain 2. Distended abdomen 3. Vomiting and Constipation |
How is diagnosis of ileus confirmed? | Abdominal CT |
Identify what is involved in the Tx of an ileus? | Laparoscopic bowel resection |
Spastic colon is AKA? | Irritable bowel syndrome(IBS) |
IBS typically affects? | Women between their late teens and early 40's |
Signs and Symptoms of IBS are? | 1. Sudden Diarrhea 2. Constipation 3. Abdominal Pain 4. Flatulence *Symptoms tend to worsen with poorly controlled stress* |
What is the difference between IBS and other intestinal disorders? | No lesions are present on examination (with IBS) |
IBS is a disorder of? | 1. Motility 2. Intestinal wall muscle spasms(involuntary) |
How is IBS treated? | 1. Increasing fiber in diet 2. Avoiding caffeine,fatty foods,spicy foods,ETOH,citrus,cabbage,and legumes 3. Stress Management 4. GI Antispasmodics 5. Antidiarrheals 6. Sedatives |
What is the name for chronic degeneration of the liver? | Cirrhosis |
Identify the causes of Cirrhosis? | 1. Alcohol(ETOH) 2. HBV(Hepatitis B Virus)or HCV(Hep.C Virus) 3. Drugs such as Tylenol and Antihyperlipidemics(lipitor) |
How is Dx of Cirrhosis confirmed? | Liver Bx |
Signs and Symptoms of advanced Cirrhosis include? | 1. Tremors 2. Somnolence 3. Mental Confusion 4. Gynecomastia(breast development in males) 5. Loss of chest hair 6. Testicular Atrophy 7. Splenomegaly 8. Hepatomegaly |
Signs and Symptoms of advanced Cirrhosis(cont'd)? | 9. Dilated abdominal veins 10. Tendency to hemorrhage 11. Pedal Edema 12. Esophageal Varices 13. Jaundice 14. Ascites 15. Hepatic Coma |
What components are used to confirm Dx of Cirrhosis? | 1. LFT's(Liver Function Tests) 2. Liver Bx |
What Blood tests are considered LFT's? | 1. SGOT(AST) 2. SGPT(ALT) 3. Alkaline phosphatase(Alk.Phos. or ALP) 4. LDH(LD) 5. Bilirubin |
What is Viral Hepatitis? | An inflammation of the liver caused by a family of viruses called Hepatitis A,B,C,D,and E |
How is Hepatitis A transmitted? | Through Feces(stool) *HAV is LEAST serious type* |
How soon after exposure to HAV do signs and symptoms occur? | Usually 2-7 weeks after exposure and typically lasts 2 months |
Name the signs and symptoms of HAV? | 1. Fatigue 2. Anorexia 3. RUQ abdominal pain 4. Cephalalgia 5. Diarrhea 6. Darkened Urine 7. Nausea 8. Pale Stools 9. Myalgias 10. Low Grade Pyrexia 11. Jaundice |
Prognosis for HAV is good because? | There is no permanent liver damage and there is a lasting immunity |
What are the names of available HAV immunizations? | 1. Havrix 2. Vaqta |
The Hepatitis B Virus(HBV)can lead to what conditions? | 1. Chronic Hepatitis 2. Cirrhosis |
Signs and Symptoms of HBV typically appear how long after exposure? | 2 to 6 months |
Signs and Symptoms of HBV are similar to? | HAV |
Identify the modes of transmission for HBV? | 1. Parenterally 2. Sexually 3. Perinatally |
Parenteral transmission usually refers to? | Needle sticks and exposure to certain body fluids |
Potentially hazardous body fluids include? | 1. Blood or anything with blood in it 2. Synovial(joint)fluid 3. Pleural(lung)fluid 4. CSF(cerebrospinal fluid)during a LP(lumbar puncture) 5. Peritoneal(abdominal)fluid 6. Amniotic fluid 7. Breast milk |
True of False: Carriers of HBV can be Asymptomatic? | TRUE |
Fulminating Hepatitis where the patient can suddenly become comatose and die may occur as a result of? | Damage from the HBV |
How can a lasting immunity be achieved for HBV? | 1. Vaccination 2. Contracting the disease and recovering completely |
True or False: Everyone can completely recover from HBV, and therefore there are no carriers of the disease? | FALSE-Only some people will not completely recover from HBV and will be carriers |
What is the treatment for HBV? | Antiviral therapy |
Signs and Symptoms of Hepatitis C Virus are similar to? | HAV and HBV |
Which Hepatitis virus is considered insidious? | HCV |
The incubation period may take up to how long to damage the liver significantly? | 20-30 years |
What percentage of people with HCV are asymptomatic? | 70% |
What percentage of people with HCV will develop cirrhosis and/or liver cancer? | 80% |
Which Hepatitis Virus is the #1 reason for a person to need a liver transplant? | Hepatitis C Virus(HCV) |
Identify the means of transmission for HCV? | 1. Parenterally 2. Sexually 3. Perinatally(But NOT Breast milk) |
What group of people should be tested for HCV? | Those who received a blood transfusion prior to July 1992 |
How is HCV treated? | 1. Antiviral therapy 2. Liver Transplant |
Hepatic malignancies are typically secondary tumors that metastasize from what sites? | 1. Colon 2. Rectum 3. Stomach 4. Pancreas 5. Esophagus 6. Lung 7. Breast |
What is the name of a primary malignancy which is commonly associated with ETOH,HBV,and HCV? | Hepatocarcinoma |
Identify the signs and symptoms of a liver malignancy? | 1. WT Loss 2. RUQ Abdominal Mass 3. RUQ Abdominal Pain |
What methods are used to confirm Dx of liver malignancy? | 1. Alphafetoprotein Blood Test(AFP) 2. Liver Bx |
What is the prognosis for liver malignancy? | Poor |
What is the name for a condition of inflammation of the gall bladder? | Cholecystitis |
How is Cholecystitis commonly caused? | Obstruction due to cholelithiasis(gall stones) |
Cholelithiasis is AKA? | Biliary Calculi |
What factors increase the incidence of cholelithiasis? | 1. Postpartum women 2. Use of BCP's 3. DM 4. Cirrhosis 5. Pancreatitis |
Name the signs and symptoms of Cholelithiasis? | 1. Right rib cage pain which radiates to the right shoulder(esp. after high-fat meal) 2. Chills 3. Pyrexia 4. N&V 5. Jaundice |
Confirmation of Cholelithiasis Dx is made by? | 1. GB ultrasound 2. Hepatobiliary scan(HIDA) 3. ERCP (Endosopic Retrograde Cholangiopancreatogrophy) 4. EUS (Endoscopic Ultrasound) 5. MRC (Magnetic Resonance Cholangiogram) |
Identify the treatments for Cholelithiasis? | 1. Laparoscopic cholecystectomy (before perforation occurs) 2. Laparoscopic Cholelithectomy(if stones are present in CBD) |
What is Pancreatitis? | Inflammation of the pancreas |
Pancreatitis is commonly associated with what in men? | Alcoholism |
Pancreatitis is commonly associated with GB disease in who? | Women |
What disease can cause pancreatic enzymes to activate prematurely? | Pancreatitis |
What does activated pancreatic enzymes do to the pancreas? | Digests(dissolves)the pancreas |
List the pancreatic enzymes? | 1. Trypsin 2. Chymotrypsin 3. Lipase 4. Amylase |
What can confirm the diagnosis of pancreatitis? | High levels of pancreatic enzymes (especially Amylase) |
What are the signs and symptoms of pancreatitis? | 1. Severe Abdominal Pain 2. N&V 3. Jaundice |
True or False: Pancreatitis can result in death? | TRUE |
Risk factors for a pancreatic malignancy include? | 1. Male gender 2. Smoking 3. High protein and High fat diets 4. Alcohol 5. DM |
Identify the signs and symptoms of a pancreatic malignancy? | 1. Severe Abdominal Pain 2. Anorexia 3. WT Loss 4. Clay-colored Stools 5. Jaundice |
Dx of a pancreatic malignancy is confirmed with? | 1. CT or MRI or PET 2. Bx |
Why is the Px for pancreatic malignancy very poor? | Due to early metastasis |