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Lower GI patho

Diseases of the small and large intestine

What are the primary causes of intestinal obstruction? Post-operative adhesions, malignancy, Crohn's disease, hernia, foreign bodies, congenital conditions
What response is there when the bowel dilates? Increased digestive fluids
Presentation of early small bowel obstruction Diarrhea due to incr digestive fluids
Distention leads to compression of mucusal lymphatics and movement of ___ into the lumen, leading to ____ fluid, dehydration
What is the risk with strangulated bowel? gangrene, rupture leading to sepsis, death
What is the presentation of proximal small bowel obstruction? colicky pain leading to nausea (bile)
What is the presentation of distal small bowel obstruction? Crampy pain every 4-7 minutes, progressive over days
What is the presentation of strangulated bowel? Constant intense pain
What are the signs and symptoms of small bowel obstruction? hyerpactive bowel sounds (early), hypoactive (late), nausea, diarrhea (early), constipation (late), fever/tachycardia (late), previous abdominal surgery, radiaition or malignancy
What is the treatment of small bowel obstruction? Bowel rest, NG tube to take off fluid and gas
What are the aggressive factors r/t peptic ulcers? H. pylori, NSAIDS/aspirin, cigarette smoking, alcohol, corticosteroids
What are the protective factors of the stomach as relates to peptic ulcer? mucus, bicarb, blood flow, elaboration of protaglandins, epithelial regenrative capacity
What are the steps contributing to formation of gastric ulcer? Ischemia, shock, stress, 2) delayed gastric emptying due to injury, 3) duodenal gastric reflux, 4) decreased retrograde motility impairs neutralization by pancreatic alkaline secretions
What is the pathophysiology of Crohn's disease? Most commonly affects terminal ileum, begins as ulcerations, progresses to fistulas
What is the presentation of Crohn's disease? "irritable bowel", bloody, mucus diarrhea, pain, pernicious anemia if ileum involved
What areas are affected by chronic ulcerative colitis? chronic inflammation of the colon, usually rectum and sigmoid
What is the etiology of chronic ulcerative colitis? genetic, infectious, immune (antibodies, cytotoxic t cells)
What is the pathophysiology of chronic ulcerative colitis? antigen activates macrophages to release interleukins and tumor necrosis factor causing damage to the lining.
What is the term for urge to defecate without contents (like dry heaves)? tenesmus
What is the presentation of chronic ulcertaive colitis? rectal bleeding and diarrhea, rectal pain, urgency, cramps, tenesmus, wt loss, fatigue, fever, night sweats
How long does it take for gangrene and perforation to occur in an acute abdomen condition? In 6 hours
Acute pain may require ___ surgery
Chronic pain is treated ___ medically
What are common causes of large bowel obstruction infection, inflammation, cancer, mechanical obstruction (impaction or vovulus)
Who are high risk patients for large bowel obstruction? chronic constipation, long term cathartic use, straining at stool, change in caliber of stool
What is the presentation of large bowel obstruction prior to perforation? vague visceral abdominal cramps, peritonitis, belts/pants no longer fit
What is the presentation of Irritable Bowel Syndrome? pain relieved by defecation, change in stool frequency, change in stool consistency, mucus in stool, bloating
What is the cause of diverticular disease? low fiber diet, loss of collagen with age
What is the presentation of diverticulitis? Abdominal pain, tenderness in LLQ, infection, performation, tears, obstruction
What is the presentation of polyps? blood in stool, rectal bleeding, constipation or diarrhea, pain or obstruction
Created by: suec56