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Intestinal Disorders

QuestionAnswer
Appendicitis Inflammation of vermiform appendix. RLQ pain, rebound tenderness, N/V, fever. Surgical emergency.
McBurney's Point Location of maximal tenderness in appendicitis (RLQ, 2/3 from umbilicus to ASIS).
Appendicitis Sx Epigastric/periumbilical pain migrating to RLQ, anorexia, nausea, fever, leukocytosis.
Appendicitis Care NPO, IV fluids, prep for surgery (appendectomy), semi-Fowler's position, no heat/laxatives.
Peritonitis Inflammation of peritoneum. Medical emergency from perforation, infection. Rigid abdomen, fever.
Peritonitis Sx Acute illness, board-like abdomen, high fever, diminished BS, rebound tenderness, leukocytosis.
Peritonitis Care NPO, NG tube, IV fluids/ABX, semi-Fowler's, prep for surgery, monitor for shock/sepsis.
Ulcerative Colitis Chronic inflammation of rectum/colon. Bloody diarrhea, tenesmus, lower abdominal pain.
UC Risk Factors Genetics, immunologic, environmental. Higher in Ashkenazi Jews, women 15-35y.
UC Complications GI bleeding, dehydration, electrolyte imbalance, anemia, increased CRC risk.
UC Labs ↓Hgb/Hct, ↑WBC/CRP/ESR, ↓Na/K/Cl, ↓albumin. MRE for imaging.
UC Treatment 5-ASAs (aminosalicylates), glucocorticoids, antidiarrheals, nutrition, bowel rest, surgery.
Ileostomy Surgical opening (stoma) in ileum for fecal drainage after colon removal. In RLQ. Empty at 1/3-1/2 full, change q4-7d. Monitor stoma color (pink/red).
Ileostomy Output Initially loose/dark green. Becomes paste-like, yellow-brown. High output risk of dehydration.
Crohn's Disease Chronic transmural inflammation, often terminal ileum. RLQ pain, diarrhea, malabsorption.
Crohn's Sx Severe diarrhea (5-6x/day), steatorrhea, RLQ pain, weight loss, fatigue, anemia, fistulas.
Crohn's Labs ↓Albumin, ↑ESR/CRP, anemia (B12/folate deficiency), possible lactose intolerance.
Crohn's Nutrition High-calorie, high-protein, low-residue diet. TPN if severe. Avoid caffeine/alcohol.
Diverticulosis Pouch-like herniations in colon wall. Often asymptomatic. Caused by low fiber, increased pressure.
Diverticulitis Infection/inflammation of diverticula. LLQ pain, fever, N/V. Risk of abscess/perforation.
Diverticulitis Care NPO/clear liquids, IV ABX (flagyl/cipro), bowel rest, no laxatives/enemas, then high-fiber diet.
Created by: Wasurenboh
 

 



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