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Chapter 42
from the powerpoint in D2L
Question | Answer |
---|---|
Six predisposing factors for oral cancer | 1) tobacco use 2) excessive alcohol intake 3) diet low in fruits/vegetables 4) chronic irritation 5) constant overexposure to sun 6) recurrent herpectic lesions |
What are some s/s of oral cancer? | nonhealing sores, bleeding sores, persistent patches in mouth, hard raised lesions, lumps, crusts, eroded areas, unexplained bleeding, persistent pain, difficulty chewing, swallowing, speaking or moving tongue |
s/s of GERD | heartburn, chest pain, sore throat, hoarseness, frequent throat clearing, globus hystericus (lump in throat), water brash, regurgitation, coughing, loss of dental enamel |
What is pyrosis? | heartburn |
What is dyspepsia? | upper abdominal pain/discomfort |
Three esophageal complications of GERD | 1) the effect of gastric acid on esophageal mucosa 2) esophagitis (inflammation) 3) Barrett's esophagus (precancerous lesion) |
What are some respiratory complications of GERD? | cough, bronchospasm, laryngosapasm, possible asthma, bronchitis, pneumonia |
What is GERD? | Chronic symptoms or mucosal damage due to reflux of gastric contents into the lower esophagus |
What is the most common upper GI problem in adults? | GERD |
Four goals of drug therapy for GERD | 1) decrease volume and acidity of reflux 2) improve lower esophageal sphincter function 3) increase esophageal clearance 4) protect the esophageal mucosa |
What do proton pump inhibitors (PPI) do for the patient with GERD? | They reduce the amount of acid produced by the stomach |
What do histamine-2 (H2) antagonists (receptor blockers) do for the GERD patient? | They reduce the amount of acid produced by the stomach |
What do antacids do for the GERD patient? | Antacids neutralize acid |
What do promotility (GI stimulants) do for the patient with GERD? | Promotility drugs treat reflux by increasing lower esophageal sphincter (LES) tone and enhancing emptying of food from the stomach |
How do cytoprotective drugs help the patient with GERD? | they work by forming a material that adheres to the lining of the esophagus, providing a protective barrier against stomach acid. If irritation is already present, the barrier will coat the damage and allow it to heal. |
What is the goal of cholinergic drugs in the GERD patient? | To improve lower esophageal sphincter function |
Source of 50% of upper GI bleeds? | Stomach/Duodenum-peptic ulcers |
What are the two types of upper gastrointestinal (UGI) bleeding? | Obvious and Occult |
What are the two types of obvious UGI bleeding? | hematemesis and melena |
hematemesis | bright red or "coffee ground" emesis |
melena | black tarry stools |
How do you detect occult blood? | guaiac test |
The longer the passage of blood through the intestines, the _______ the stool color | darker |
clinical important bleeding can result in: | decreased BP, increased pulse, decrease in hemoglobin by more than 2g/dL |
What would you assess if you suspect an upper GI bleed? | BP, pulse, signs of shock, medications, previous episodes, liver disease |
What could a tense, rigid, boardlike abdomen indicate? | perforation or peritonitis |
What labs would you expect to be monitoring for an upper GI bleed? | CBC, electrolytes, LFTs, guaiac stools |