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PHCC Disease digest
PHCC digest-DISEASE
| Question | Answer |
|---|---|
| Where do oral neoplasms commonly occur ? | floor of oral cavity, tongue, inferior labia |
| Carcinoma of the lip is often associated with what? | pipe and cigar smoking |
| Carcinoma of the labiae, buccae, tongue or palate are commonly associated with what? | chewing tobacco , dipping or snuff |
| What is a pre-malignant sign for oral cancer ? | leukoplakia white patches that appears on the mucous membranes of the oral cavity |
| What is the treatment for oral cancer? | surgery and radiation therapy |
| What are the s/s esophagus malignancy? | dysphagia ( difficulty swallowing), vomiting, halitosis, weight loss, inability to eat, ( prognosis is poor because of metastasises that occurs before detection |
| What is esophagitis? | inflammation of the esophagus commonly caused by GERD. ( gastroesophageal reflux disease) |
| What commonly causes GERD ? | an incompetent cardiac sphincter ( lower esophageal sphincter), this allows the stomach contents to regurgitate up the esophagus |
| What are the s/s for GERD ? | chest discomfort ( similar to that experienced with heart disease(MI)), hematemesis ( vomiting blood), ( the pain may follow eating, drinking, bending over , lying down) |
| What is the Tx for esophagitis? | non-irritating diet (bland), antacids ( Mylanta), antiulcer drugs (pepcid) |
| What is a Hiatal Hernia? | a protrusion of the stomach through the diaphragm aka diaphragmatic hernia |
| What are the s/s Hiatal Hernia? | dyspepsia, postpiandial heartburn, SOB ( the Hiatal Hernia may cause the cardiac sphincter to become incompetent causing GERD |
| What are the Tx for a Hiatal Hernia? | avoidance of spicy foods, alcohol & caffeine, weight loss for obese patients, abdominal supports, surgery ( hernioplasty, herriorrhaphy) |
| What is gastritis? | inflammation of the stomach |
| What usually causes gastritis? | NSAIDs (ASA, ibuprofen), caffeine, tobacco, spicy foods, alcohol (ETOH), infection. |
| What are the s/s for gastritis? | LUQ pain, hematemesis |
| What is the Tx for gastritis? | removal of irritants, antacids , anti-ulcer drugs |
| What is PUD? | peptic ulcer disease, an ulcer of the stomach and/or duodenum |
| What are s/s for PUD? | abdominal pain ( relieved temporarily by antacids and food) |
| What are the causes for PUD? | poorly controlled stress, excessive production of HCl, bacterial infection ( a complication associated with PUDs is ulcer perforation ( hemmorrhage)) |
| What are the s/s for PUD? | extreme abdominal pain, hematemesis, melena ( a complication of ulcer peroration is peritonitis), The perforated ulcer needs surgery |
| What is the Tx for PUD? | stress management, reduction of irritants, antiulcer drugs, antacids, antibiotic therapy ( do not Tx with milk) |
| What is gastroenteritis? | inflammation of the stomach and small intestine |
| What are the causes for gastroenteritis? | bacterial and viral infection ( E coli, Salmonella, Listeria), chemical toxins, lactose intolerance, other foods allergies |
| What are the s/s for gastroenteritis? | colicky (spams-like) abdominal pain ( dysentery), N&V, diarrhea , pyrexia |
| What is the Tx for gastroenteritis? | replace lost fluids(IV), antibiotics, anti-emetics, anti-diarrheas, anti-spasmodic |
| What is Salmonellosis? | a food poisoning caused by an enter-bacteria, this causes gastroenteritis 6-48 hours after ingestion of tainted food |
| How is Salmonellosis Dx, how long can s/s stay around, and how can it be prevented? | Dx= a stool culture, s/s = up to 2 weeks, prevention= refrigeration of food, preparation of foods, through cooking of foods, prevent cross contamination of food, proper hand washing. |
| Stomach cancer commonly occurs in men over 40, and painless, what are the s/s for it? | anorexia, heartburn, general stomach distress,pernicious anemia(PA)<B12, achlorhydria ( research suggest that the consumption of preserved, salted cured foods and a diet low in fresh fruits and veggies are assoc. w/stomach cancer.prognosis = poor |
| What is an appendicitis and the s/s? | an inflammation of the appendix, s/s = N&V, pyrexia, leukocytosis, right inguinal (lilac) rebound tenderness |
| What is the treatment for an appendicitis? | appendectomy |
| What are the complication from an untreated appendicitis? | gangrene, appendorrhexis, peritionitis |
| Malabsorption Syndrome is what? | The inability to absorb fat from the small intestine. |
| Malabsorption Syndrome causes the stool to become or look like what? | unformed, fatty, pale, pungent floaters |
| What is a complication of Malabsorption Syndrome? | inability to absorb fat soluble vitamins ( D,E,A,K) ( Vitamin K deficiency causes bleeding tendencies = Vitamin K is used in blood clotting= the person with this syndrome will have to have inject-able vitamin supplements of D,E,A,K |
| What is diverticulitis? | the inflammation of diverticula ( these are blister like pouches or sacs that develop in the large intestine) |
| What are the s/s of diverticulitis? | lower , left cramp like abdominal pain = complication = ileus w/ abscesses |
| What is the treatment for diverticulitis? | antibiotics ( Augmentin), modified diet ( no nut or seeds) |
| What is Crohn's Disease ? | a chronic idiopathic ( possibly autoimmune) inflammatory disease of the entire GI track. ( IBD = inflammatory bowel disease) |
| What are risk factors for Crohn's Disease? | runs in families with a diagnosis between the ages of 20-40. The onset & relapse is associated w/ smoking and poorly controlled stress. |
| What are the s/s of Crohn's Disease? | appendicitis like pain, alternating bloody diarrhea and constipation, melena, N/V, weight loss ( periods of exacerbation & remission are common with some cases ending in perforation and obstruction ( illus) |
| What is the treatment for Crohn's disease | Imuran ( immunosuppressive), Corticosteroids to control inflammation ( Prednisone), Antibiotics (ampicillin)= this disease increases the risk of colon malignancies |
| What is Chronic Ulcerative Colitis (UC)? | a serious idiopathic ( possibly autoimmune) inflammation usually affecting the colon and rectum ( IBD) |
| What are risk factors for UC? | exacerbation caused by poorly controlled stress, runs in families ( 10-30%), usually occurs in young adults , especially women and usually begins between the ages of 15-20. |
| What are s/s of UC? | sudden diarrhea with pus and blood, cramp-like pain in the lower abdomen, anemia from chronic blood loss. |
| What is the Tx for UC? | Lialda ( med used to treat UC), stress management, Diet modification ( avoid caffeine, raw vegs., legumes, whole grains, nuts and seeds, mild sedation ( librium), Corticosteroids ( hydrocortisone), Psychological counseling, colostomy. |
| Where are most malignancies of the large bowel found? | in the rectum or sigmoid colon |
| How is a malignancies of the large bowel Dx? | Digital rectal exam ( DRE), sigmoidoscopy or colonoscopy, Bx ( if detected early colorectal malignancies respond well to surgical treatment |
| What are the early s/s of colorectal malignancies? | change in bowel habits, abdominal discomfort, occult blood in stool or melena, anemia |
| How can colorectal malignancies be found and what are the rick factors? | early detection =regular physical exams, regular stool guaiac (Hemoccult) test & risk factors=long standing UC, polps(familial polyposis), diet rich in meat and fat and low in fiber, deficient Ca in diet < 700mg/day |
| How can colorectal malignancies be decreased by 90% | if colonoscopies are routinely performed after the age of 50 or if there is a previous Hx of polyps |
| What is a Intestinal (Bowel) obstruction? | an ileus |
| what is paralytic ileus? | an obstruction caused by a reduction of peristalic activity |
| What is a volvulus? | an obstruction caused by the bowel twisting on itself( like a garden hose) |
| What is a intussusception? | an obstruction caused when the intestine telescope on itself |
| Bowel obstructions can also be caused by what? | adhesions |
| What are the s/s of an ileus? | 1)severe abdominal pain 2) distended abdomen 3) vomiting |
| What is the Tx for intussusception? | surgery ( resection) to remove the obstruction |
| What is IBS ? | Irritable Bowel Syndrome |
| What are the s/s of an ileus? | 1)severe abdominal pain 2)distended abdomen 3)vomiting |
| What is the Tx for an ileus? | surgery (resection) to remove the obstruction |
| What does IBS stand for? | Irritable Bowel Syndrome |
| What are the s/s of IBS? | 1) diarrhea 2)constipation 3) abdominal pain 4) flatulence (flatus) |
| What is the difference between IBS and other intestinal disorders ? | There are no lesions present at time of exam |
| What causes IBS? | the motility ( peristalsis) and intestinal wall muscle spasms (colic) |
| What is the treatment for IBS? | 1) increasing fiber (fruit,vegs. whole grains) 2)avoid caffeine,fatty foods, spicy foods, alcohol, citrus, cabbage and beans 3)stress management 4)GI antispasmodics (Bentyle) 5)Antidiarrheals (Kaopectate) 6)sedatives (Ativan) |
| What is Viral Hepatitis? | inflammation of the liver caused by a family of viruses = Hepatitis A,B,C,D&E |
| How is HAV transmitted? | in urine and feces and is the least serious |
| What is the s/s for 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 AKA icterus |
| What is jaundice? | yellowish-orangeish discoloration to the skin or sclera |
| What is the prognosis for HAV? | good w/ no permanent liver damage and a lasting immunity |
| What is Havrix and Vagta? | vaccines against HAV |
| What can HBV lead to in an infected person? | chronic hepatitis and cirrhosis ( chronic degeneration of liver cells) (degeneration = example if 100 cells are dying only 80 are reproduced ) |
| How is HBV transmitted? | The same way as HIV. 1)parenterally 2)sexually 3)perinatally |
| What does parental transmission usually refer to ? | transmission via needle sticks and certain body fluids |
| What are he potentially hazardous body fluids for HIV and HBV ? | 1)blood or anything w/ blood in it 2)synovial fluids (joints) 3)pleural fluids (aspirated fluid form lungs) 4)CSF ( cerebral spinal fluid) obtained form a lumbar puncture (LP) 5)Peritoneal fluid ( aspirated from the abdomen 6) amniotic fluid |
| What are the s/s of HBV? | the same as HAV or asymptomatic or can occur suddenly and process rapidly called fulminating hepatitis where the patient can become comatose and die |
| How can lasting immunity from HBV be achieved? | through either the vaccine (Ergerne) or contacting the disease and completely recovering ( some carriers will not completely recover and therefore become carriers of the disease ) |
| What is the Tx for HBV? | antivirals |
| What are the s/s for HCV? | the same are HBV , however the incubation period may take up to 20-30-years of damage to the liver significantly before any s/s. |
| 70 % of HCV people are what and 80% of people with HCV develop what? | 70% are asymptomatic and 80 % develop cirrhosis and/or liver cancer |
| HCV is the #1 reason for what? | liver transplants |
| How is HCV transmitted? | the same way as HIV and HBV 1)parenterally, 2) sexually 3) perinatally ( HOWEVER, not found in breast milk) |
| Everyone should be tested for HCV if they received a blood transfusion before what year? | 1992 |
| What is the Tx for HCV? | 1)antiviral therapy 2) liver transplant |
| What is Cirrhosis of the liver? | a chronic degeneration of the liver |
| What causes Cirrhosis of the liver? | 1) alcohol abuse 2) HBV or HCV 3) drugs (APAP and ibuprofen) |
| What are the s/s of advanced cirrhosis | tremors,somnolence(sleepiness),mental confusion,gynecomastia,loss of chest hair, testicular atrophy,splenomegaly,hepatomegaly 'hobnailed liver",dilated abdominal veins,tend to hemorrhage,pedal edema,esophageal varies,jaundice,ascites,coma |
| A malignancy of the liver is commonly caused form metastasis from what part of the body? | the breast, colon or pancreas |
| What are secondary tumors of the liver? | tumors that do not originate in the liver |
| What is the prognosis of carcinoma of the liver? | poor |
| What is cholecystitis ? | inflammation of the ball bladder |
| What causes cholecystitis? | an obstruction caused by a cholelithiasis (biliary calculus *biliary refers to bile). the obstruction can lead to liver damage |
| Who has or what causes the increased incidence of cholelithiasis? | 1)postpartum women 2)use of BCPs 3)DM 4)cirrhosis 5)pancreatitis |
| What are the s/s of cholecystitis? | 1)right rib cage pain, radiating to the right shoulder, especially after eating a meal rich in fat 2)chills 3)pyrexia 4)N&V 5)jaundice |
| What is the Tx for cholecystitis? | 1)cholecystectomy before perforation occurs 2)cholecystectomy if stones are present in the common bile duct |
| What is pancreatitis? | inflammation of the pancreas |
| What is pancreatitis commonly associated with ? | alcoholism in men & GB disease women (GB = gall bladder) |
| Pancreatitis can cause the pancreatic enzymes to activate prematurely causing the enzymes to do what? | to digest (dissolve) the pancreas |
| What are pancreatic enzymes? And what is important about amylase? | 1)Trypsin 2)Chymotrypsin 3)Lipase 4) Amylase (high levels of these pancreatic enzymes enzymes will confirm the Dx of pancreatitis, especially the enzyme amylase) |
| What are the s/s for pancreatitis? | 1)severe abdominal pain 2) N&V 3) jaundice (pancreatitis can lead up to death) |
| What is a pancreatic malignancy called? | adenocarcinoma and the prognosis is very poor and the occurrence is more frequently in men than women |
| What are the s/s pancreatic malignancy? | 1)severe abdominal pain 2)anorexia 3)weight loss 4)clay-colored stools 5)jaundice |
| Pancreatic malignancy have been associated with what? | 1)cigarette 2)high protein & high fat diet 3) alcohol abuse 4)DM |
| What is SGOT = AST or SGPT = ALT or alk. Phos (ALP)= alkaline phosphatase or bilirubin | LFT (liver function test) |
| What does UGI stand for? | upper gastrointestinal =barium swallow |
| What is another name for lower GI? | barium enema( BaE, BE)? |
| What does EGD stand for? | esophagogastroduodenoscope |
| UGI,Lower GI, EGD, colonoscopy and GB ultrasound are all what? | GI diagnostic tests |
Created by:
wgolon
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