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Chp. 9

Fundamentals of Disease

Oral neoplasms new growth that commonly occurs on the floor of the oral cavity, tongue, and inferior oral labia.
Labial carcinoma associated with pipe and cigar smoking
Carcinomas associated with tobacco and dipping: carcinoma of the buccae, tongue, or palate
Leukoplakia A premalignant sign of an oral neoplasm
Dx of an oral neoplasm are confirmed with: Bx
Oral neoplasms respond well to: surgery and radiation therapy
Signs/symptoms of an esophageal malignancy include: dysphagia, vomiting, halitosis, WT gain, aphagia
Dx for an esophageal malignancy includes: UGI AKA barium swallow
The Px for an esophageal malignancy is poor because: metastasis usually occurs before detection
Esophagitis an inflammation of the esophagus
GERD Gastroesophageal reflux disease - caused by esophagitis
GERD is caused by: an incompetent cardiac sphincter , which allows the stomach contents to regurgitate up the esophagus
Signs/symptoms of GERD: dyspepsia, eructation, dysphagia, halitosis, hematemesis, thoracodynia
Signs/symptoms of GERD may follow: eating, drinking, bending over and lying down
GERD is more common with: obesity and pregnancy
Dx of GERD: confirmed with an EGD (esophagealgastroduodenoscopy)
Tx for GERD: nonirritatin diet, antacids, antiulcer drugs (Pepcid)
Hiatal Hernia (HH) A protrusion of the stomach through the diaphragm AKA diaphragmatic hernia
Signs and symptoms of a HH include: dyspepsia, postprandial dyspepsia, SOB, also may cause GERD
Dx for a HH: CXR and UGI
Tx for a hiatal hernia includes: avoid spicy foods, ETOH, and caffeine, WT loss for obese patients, abdominal supports, hernioplasty (surgical repair)
Acute gastritis: inflammation of the stomach frequently accompanied by hematemesis
Gastritis is usually caused by irritants such as: NSAIDS, caffeine, tobacco, spicy food, ETOH, infection
Dx of gastritis: confirmed with a gastroscopy and Bx
Signs and symptoms of gastritis include: LUQ abdominal pain, hematemesis
Tx for gastritis: removal of irritants, antacids, antiulcer drugs
PUD peptic ulcer disease of the stomach or duodenum
Primary symptom of PUD: abdominal pain, relieved temporarily by antacids and food
Causes of PUD: poorly controlled stress, excessive production of HCl, NSAIDs (such as ASA, Motrin and Naprosyn), Helicobacter pylori (bacteria)
Tx of PUD: stress mangement, reduction of irritants, antiulcer drugs (Nexium), antacids, antibiotic therapy (amoxcillian)
A complication associated with PUD is: ulcer perforation and hemorrhage
Signs of perforation include: extreme ab. pain, hematemesis, melena; requires surgery
Dx of PUD: confirmed with a barium swallow
peritonitis A complication of ulcer perforation
Ulcer perforation requires: surgery
Gastroenteritis: inflammation of the stomach and small intestine
Causes of gastroenteritis: bacteria (e.coli, salmonella, listeria), chemical toxins, lactose, food allerigies
Signs and symptoms of gastroenteritis include: colicky dysentery, N+V, pyrexia, diarrhea
Dx of gastroenteritis: stool CX
Tx of gastroenteritis: IV hydration, antibiotics,antiemetics, antidiarrheals, GI antispasmodics
Salmonella food poisoning caused by an enterobacteria; can cause gastroenteritis 6 to 48 hours after ingestion of tainted food
Dx of salmanoellosis: stool CX
Symptoms of salmonellosis can last up to: 2 weeks
The primary complication of salmonellosis is: dehydration
Prevention of salmonellosis includes: Proper refrigeration of foods, Thorough cooking of foods, Prevent cross contamination of food, Proper frequent hand washing.
Gastric malignancies are more common in: men over age 55
Signs and symptoms of a gastric malignancy include: anorexia, dyspepsia, N+V, PA (pernicious anemia caused by B12 deficiency), achlorhydria
Dx of a gastric malignancy: gastroscopy and Bx
Risk of gastric malignancies increases with: H. pylori, dried,smoked,salted or preserved foods, chronic gastritis, family Hx
Tx for a gastric malignancy includes: chemo, radiation, surgery
Appendicitis: inflammation of the appendix
Signs and symptoms of appendicitis include: N+V, pyrexia, leukocytosis, right inguinal rebound tenderness
Tx for appendicitis: appendectomy
Complications of appendicitis: gangrene, appendorrhexis, peritonitis
Malabsorption syndrome is the: inability to absorb fat from the small intestine
Malabsorption syndrome causes the stool to become: unformed, fatty, pale, pungent, floaters
A complication of malabsorption syndrome is: the inability to absorb the fat soluble vitamins A, D, E, + K
Vitamin K deficiency can cause bleeding tendencies
Tx for malabsorption syndrome: INJ A, D, E, K supplements
Diverticulitis an inflammation of diverticula - blister-like pouches or sacs that develop in the large intestine
The primary symptom of diverticulitis: LLQ cramp-like abdominal pain
A complication of diverticulitis is bowel obstruction and abcesses
Dx of diverticulosis: BE (barium enema)
Tx for diverticulitis: antibiotics, fiber, decrease gas causing foods
Crohn's Disease AKA RE (regional enteritis) chronic, idiopathic IBD
CD may be exacerbated by: poorly controlled stress
Signs and symptoms of CD: appendicitis like pain, bloody diarrhea and constipation, melena, anorexia, N+V, WT loss
Dx of CD: colonoscopy and Bx
Periods of exacerbation and remission are common with some cases of CD ending in: perforation or ileus
Tx of CD: immunosuppressant meds, SAIDS, antibiotics, avoiding trigger foods
Ulcerative Colitis: idiopathic IBD affecting the colon and rectum, increases risk of colon malignancies
UC usually occurs in young adults, especially women, and usually begins between ages: 15 and 20
Signs and symptoms of UC: sudden diarrhea w/ pus and blood, cramps in the lower abdomen, anemia
Dx of UC colonoscopy and BaE )barium enema)
Tx for UC: Lialda, stress management, diet, mild sedation, corticosteriods, psych. counseling, colostomy
Most malignancies of the large bowel are found in the : rectum or sigmoid colon
Dx of carcinoma of the colon and rectum is made with: DRE, sigmoid/colonoscopy, Bx
Colorectal malignancies detected early respond well to: surgical treatment
Early signs and symptoms of carcinoma of the colon and rectum include: change in bowel habits, abdominal discomfort, occult blood in stools or melena, anemia
Early detection of colorectal malignancies can occur with: physical exams, regular stool guaiac tests (Hemoccult)
Risk factors for colorectal malignancies include: long standing UC, polyps, a diet rich in red meat and fat, deficient Ca
A bowel obstruction is AKA: ileus
An ileus caused by a reduction of peristaltic activity is called a: paralytic ileus
volvus an ileus caused by the bowel twisting on itself
intussusception An ileus caused when the intestine telescopes on itself
An ileus can also be caused by: adhesions
Signs and symptoms of an ileus: severe abdominal pain, distended abdomen, vomiting and constipation
Dx of an ileus: abdominal CT
Tx for an ileus: laparoscopic bowel resection
IBS usually affects women between their: late teens and early 40's
Signs/symptoms of IBS: sudden diarrhea, constipation, abdominal pain, flatulence
The difference between IBS and other intestinal disorders: no lesions present on examination
IBS is a disorder of: motility and intestinal wall muscle spasms
Tx for IBS: fiber, avoiding caffeine, ETOH, fat, spicy food, citrus, cabbage, and legumes, stress management, GI antispasmodics, antidiarrheals, sedatives
Cirrhosis: chronic degeneration of the liver
Cirrhosis is caused by: ETOH, HBV/HCV, drugs
Dx of cirrhosis: liver Bx
Signs/symptoms of advanced cirrhosis: tremors, somnolence (sleepiness), confusion, gynecomastia (breast growth in males), loss of chest hair, testicular atrophy, splenomegaly/hepatomegaly, dilated abdominal veins, hemorrhage, pedal edema, esophageal varcies, jaundice, ascites, hepatic coma
Dx of cirrhosis: LFTs and liver Bx
LFTs include: SGOT (AST), SGPT (ALT), Alk.Phos (ALP), LDH (LD), bilirubin
Viral hepatitis is an inflammation of the liver caused by a family of viruses called: hepatitis A, B, C, D, and E
The HAV is the least serious and is usually transmitted in: feces
Signs and symptoms of the HAV can occur: 2-7 weeks after exposure and usually last 2 months
Signs/symptoms of the HAV: fatigue, anorexia, RUQ pain, cephalalgia, diarrhea, dark urine, nausea, pale stools, myalgia, low pyrexia, jaundice
Px for HAV: is good with no pernament liver damage and lasting immunity
HBV can lead to: chronic hepatitis and cirrhosis
Signs and symptoms of the HBV are similar to the: HAV
Signs and symptoms of the HBV can occur: 2-6 months after exposure
Parenteral transmission usually refers to: needle sticks and exposure to certain body fluids
Potentially hazardous body fluids include: blood, synovial fluid, pleural fluid, CSF during an LP, pertioneal fluid, amniotic fluid and breast milk
Damage from the HBV can cause fulminating hepatitis where the patient can suddenly become: comatose and die
A lasting immunity can be achieved for the HBV by vaccination or: contracting the disease and recovering completely
Tx for HBV: antiviral therapy
The HCV is: insidious
The incubation period for HCV is: 20-30 yrs to damage the liver
80% of ppl with HCV will develop: cirrhosis
The HCV is transmitted: parenterally, sexually, perinatally
Tx for HCV: antiviral therapy, liver transplant
Hepatic malignancies are usually secondary tumors that: metastasize from the colon, rectum, stomach, pancreas, esophagus, lung, and breast
Hepatocarcinoma is a primary malignancy commonly associated with: ETOH, HBV, HCV
Signs and symptoms of a liver malignancy include: WT loss, RUQ abdominal mass and pain
Dx of a liver malignancy is confirmed with: AFP and liver Bx
Cholecystitis: an inflammation of the gallbladder
Cholecystitis is caused by: an obstruction due to chloelithiasis
Increased incidence of cholelithiasis includes: postpartum, BCPs, DM, cirrhosis, pancreatitis
Signs and symptoms of cholelithiasis include: Right rib cage pain radiating to the right shoulder, especially after eating a meal rich in fat, chills, pyrexia, N+V, jaundice
Dx of chloelithiasis: GB ultrasound, hepatobiliary scan (HILDA), ERCP, EUS, MRC
Tx for cholelithiasis: laparoscopic cholecystectomy before perforation occurs, Laparoscopic cholelithectomy if stones are present in the common bile duct
Pancreatitis: inflammation of the pancreas
Pancreatitis is commonly associated with alcoholism in men and: GB disease in women
Pancreatitis can cause: pancreatic enzymes to activate prematurely
These activated pancreatic enzymes will : digest the pancreas
Pancreatic enzymes include: Trypsin, Chymotrypsin, Lipase, Amylase
High levels of these pancreatic enzymes will confirm the diagnosis of pancreatitis especially the enzyme: amylase
Signs and symptoms of pancreatitis: severe ab. pain, N+V, jaundice
Risk factors for a pancreatic malignancy include: male gender, smoking, high protein/fat diets, alcohol, DM
Signs and symptyoms of a pancreatic malignancy include: severe ab. pain, anorexia, WT loss, clay colored stools, jaundice
Dx of a pancreatic malignancy is confirmed with a: CT, MRI, PET and Bx
Created by: RBarnes86