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Cert - GI
AMSN - GI
| Question | Answer |
|---|---|
| What are the three accessory organs of the GI system? | 1. Liver 2. Pancreas 3. Biliary System |
| What is the function of the GI system? | Digestion and absorption (the movement of nutrients into the blood system) |
| What is the Cullen's sign? | Bruise around the umbilicus - this indicates abdominal bleeding. |
| How long should you listen to bowel sounds for? | 2-5 minutes per each quadrant. |
| What is the normal frequentcy of bowel sounds that should occur in a minute? | 5-35x per minute |
| When can you state that there is an absence of bowel sounds? | No activity for a FULL 5 minutes. |
| What site is the best location for listening to bowel sounds? | RLQ |
| What is Bilirubin? | product of RBC breakdown |
| What is the normal range of total Bili? | 0.3 - 1.3 mg/dl |
| What is the normal range of direct Bili? | 0.1 - 1.3 mg/dl |
| What is the normal range of indirect Bili? | 0.1 - 1.0 mg/dl |
| What does an elevated direct bili value indicate? | RBC destruction is accelerated but the liver is able to convert. |
| What does an elevated indirect bili value indicate? | Liver is unable to do its work of converting - more indicative of liver dysfunction. |
| What is the normal range of AST? | 7 - 40 U/L |
| What is the normal range of ALT? | 5 - 36 U/L |
| What is the normal range of LDH? | 92 - 200 U/L |
| What does elevated pancreatic enzymes indicate? | damage to the organ |
| What is the normal range of Amylase? | 25 - 125 U/L |
| What is the normal range of Lipase? | 14 -280 U/L |
| What is the normal range of prothrombin time? | 12 - 15 seconds |
| CEA is typicall elevated with? | Colorectal cancers |
| Dyspepsia is a condition that can lead to? | Peptic ulcer |
| What is dyspepsia? | Imbalance between protective mucosa and the effects of acid, pepsin or can be the direct effects of drugs. |
| What is a Peptic ulcer? | It is a discontinuity of the mucosa i.e. erosin in any part of the upper GI tract (esophagus, stomach, duodenum) |
| What can cause stress ulcer? | 1. long term hospital stays 2. trauma 3. extensive sugeries |
| Pain related to duodenal ulcers mostly occur when? | 1. at night 2. 2-4 hours after meals |
| Zollinger Ellision syndrome? | "hypergastremia" caused b a pancreatic tumor that secretes an elevated level of gastrin. |
| Where and when is pain commonly seen with patients with gastric ulcers? | High in the epigastic area and occurs with eating. |
| Peptic ulcers are typically seen where? | 80% found in the duodenum. |
| What is the tx for peptic ulcers? | treat mild pain with antacids, omit causative agents such as ASA, NSAIDS. |
| What complications can occur with peptic ulcers? | bleeding, perforation (emergent - tx with antibiotics, fluids. This requires surgical repair) |
| What is GERD? | reflux of gastric contents into the esophagus. |
| What causes GERD? | 1. obesity 2. hiatal hernia 3. gastric emptying 4. incompetent lower esophageal sphincter |
| What are the symptoms of GERD? | 1. dyspepsia 2. heartburn 3. hoarse voice |
| Tx for GERD? | H2 blockers, PPI, meal timing |
| What is used to diagnosis GERD? | History, UGI, Endoscopy |
| What complications can occur with GERD? | Barrett's Esophagus |
| Why is Barrett's esophagus a concern? | The consistent reflux can lead to metaplasia of the cells of the esphogus which can lead to cancer |
| What pt's are at high risk for GI bleed? | 1. chronic renal failure 2. diabetes 3. COPD 4. liver disease 5. PUD 6. Heart disease |
| What causes UGI bleed? | erosive ulcerations or lesions, varices. |
| Mallory Weiss Tear? | UGI bleed associated with ETOH consumption and the use of ASA. |
| What are the symptoms of GI bleed? | 1. frank bloo in stool or melena 2. coffee ground emesis 3. volume loss (elevated HR, decrease BP and H&H) |
| Tx for GI bleed? | 1. fluid/blood replacement 2. correct the cause 3. pain control |
| Melena indicates what type of bleed? | slow bleed or further up in the GI tract |