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GI cards

Gastrointestinal System

QuestionAnswer
Abnormal condition characterized by the inability of a muscle, particularly the cardiac sphincter of the stomach, to relax achalasia
abnormal condition characterized by the absence of hydrochloric acid in the gastric secretions achlorhydria
surgical joining of two ducts or blood vessels to allow flow from one to the other anastomosis
general ill health and malnutrition marked by weakness and emaciation cachexia
oncofetal glycoprotein antigen found in colonic adenocarcinoma and other cancers; also found in nonmalignant conditions carcinoembryonic antigen (CEA)
partial or complete separation of the wound edges dehiscence
difficulty in swallowing dysphagia
state in which the patient’s viscera protrude through a disrupted wound evisceration
an increase in the seriousness of a disease or disorder exacerbation
vomiting blood hematemesis
infolding of one segment of the intestine into the lumen of another segment intussusception
a white patch in the mouth or on the tongue leukoplakia
space within an artery, vein, intestine, or tube lumen
abnormal, black tarry stool containing digested blood melena
blood that is hidden or obscured from view occult
sign or symptom specific to a disease or condition pathognomonic
a decrease in the severity of a disease or any of its symptoms remission
excessive fat in the feces steatorrhea
combining form meaning a mouth or opening stoma
ineffective and painful straining with defecation tenesmus
twisting of the bowel on itself, causing intestinal obstruction volvulus
contrast medium used for upper GI study barium
test used to detect any abnormal structural conditions of the upper GI tract upper GI series
how quickly must the gallon of Golytely be taken if used for upper GI series? 2 hours
what color does barium turn stool? white, or light in color
why is it important for a patient to increase fluid intake after UGI series? to expel all the barium and prevent constipation
in this test stomach contents are aspirated to determine the amount of acid produced by the parietal cells in the stomach tube gastric analysis
how is a sample for tube gastric analysis collected? via NG tube
diagnostic test using an endoscope to directly examine the esophagus, stomach, and duodenum EGD
some issues that can be detected or address by EGD tumors, varices, mucosal inflammations, hiatal hernias, polyps, ulcers, H. pylori, strictures, obstructions
how long must a patient remain NPO following an EGD? until gag reflex returns
what are the signs and symptoms of espophageal, gastric, or duodenal perforation? abdominal pain and tenderness, guarding, bleeding from mouth, melena, hypovolemic shock
a more thorough version of the upper GI which can detect anatomical abnormalities such as hiatal hernia, left atrial dilation, aortic aneurysm, paraesophageal tumors barium swallow
this can be used in place of barium in cases where GI bleed is present or suspected gastrografin
this test is used to reproduce the symptoms of esophageal reflux and can be used to differential esophageal pain from angina pectoris berstein test (esophageal function study)
how is a positive berstein test determined? the patient experiences a recurrence of pain when HCl is instilled into the esophagus
what should be suspected if occult blood is detected in the stool? benign or malignant GI tumor
this study allows visualization of the lower GI tract and the collection biopsy specimens of tumors, polyps, or ulcerations of the anus, rectum, and sigmoid colon sigmoidoscopy
test used to detect structural abnormalities (polypes, tumors, diverticula, and positional abnormalities) of the lower GI using barium as a contrast medium barium enema
what is a possible complication of failure to expel all barium quickly from the GI tract impaction
use of a fiberoptic scope to examine the entire colon colonoscopy
this diagnostic test is used to test for the presence of bacteria, ova, and parasites stool culture
what solutions can be used in an enema for the purpose of collecting a stool specimen for culture normal saline or tap water
stool cultures should be taken before the administration of this contrast medium barium
accumulation of fluid and albumin in the peritoneal cavity ascites
a hand flapping tremor in which the patient stretches out an arm and hyperextends the wrist with the finger separated, relaxed, and extended asterixis
a complex of longitudinal, tortuous veins at the lower end of the esophagus esophageal varices
excess formation of gases in the stomach or intestine flatulence
a type of brain damage caused by liver disease and consequent ammonia intoxication hepatic encephalopathy
inflammation of the liver caused by viruses, bacteria, and noninfectious causes of liver inflammation hepatitis
yellow discoloration of the skin, mucous membranes, and sclera of the eyes, caused by greater than normal amounts of bilirubin in the serum jaundice
an obstruction or closing off occlusion
a procedure in which fluid is withdrawn from the abdominal cavity paracentesis
tissue of an organ as distinguished from supporting or connective tissue parenchyma
small, dilated blood vessels with a bright red center point and spiderlike branches spider telangiectases
stools that contain fat steatorrhea
this system includes the liver, gall bladder, cystic, hepatic, and common bile ducts and the pancreatic duct biliary system
bile travels through the hepatic duct to the _________ for storage gall bladder
this organ is responsible for fat metabolism, production of clotting factors, cholesterol and albumin manufacture, blood filtration, conversion of ammonia to urea liver
this organ is a sac located on the right inferior surface of the liver gallbladder
the storage organ for bile gallbladder
the three enzymes present in pancreatic juice protease, lipase, amylase
pancreatic juice aids in the digestion of what three substances? proteins, fats, and carbs
what is the purpose of the sodium barcarbonate in the pancreatic juice? to neutralize stomach acids
Elevated levels of this cause jaundice, which is the most common sign of a liver disorder bilirubin
normal levels of total bilirubin 0.1 to 1.0 mg per dl
normal values of aspartate aminotransferase(AST) 0 to 35 iu per L
liver enzyme that becomes elevated in MI, hepatitis, cirrhosis, hepatic necrosis, hepatic tumor, acute pancreatitis, acute renal disease and acute hemolytic anemia aspartate aminotransferase (AST)
normal values of alanine aminotransferase(ALT) 4 to 36 IU per L
liver enzyme that becomes elevated in hepatitis, cirrhosis, hepatic necrosis, hepatic tumors, and hepatotoxic drugs alanine aminotransferase(ALT)
normal values of lactic dehydrogenase 100 to 190 IU per L
liver enzyme that becomes elevated in MI, pulmonary infarction, hepatic disease, pancreatitis, hemolytic anemia and skeletal muscle disease lactic dehydrogenase(LDH)
normal values of alkaline phosphatase 30 to 120 IU per ml
liver enzyme that becomes elevated in obstructive disorders of the biliary tract, hepatic tumors, cirrhosis, hyperparathyroidism, metastatic tumor in bones, and healing fractures alkaline phosphatase
normal values of Gamma glutamyltransferase(Gamma GT) male or female over 45:8 to 38 U per L; female under 45:5 to 27 U per L
liver enzyme that becomes elevated in liver cell dysfunction, hepatitis, cirrhosis, hepatotoxic drugs, MI, and congestive heart diseases Gamma glutamyltransferase (Gamma GT)
normal value for prothrombin time 11.0 to 12.6 seconds
an elevation in this lab value indicates an increased clotting time that can be caused by liver disease (inability to synthesize clotting factors) or vitamin K deficiency PT
this lab value can assess the functional status of the liver by measuring the products that are synthesized there, specifically albumin serum protein test
low values in this laboratory study can be the result of nephritic syndrome, ascites, or inadequate protein in diet as well as liver dysfunction serum proteins
in liver dysfunction, blood levels of this chemical can rise leading to hepatic encephalopathy ammonia
normal values for serum ammonia 10 to 80 ug per dl
serum ammonia measurements may be affected by these prescription drugs antibiotics
a diet high in this substance stimulates emptying of the gallbladder fat
in this diagnostic study, radiographic dye is injected intravenously, concentrated by the liver, and secreted into the bile duct intravenous cholangiography
this diagnostic study allows radiographic visualization of the hepatic and common bile ducts if the cystic duct is patent intravenous angiography
in this diagnostic study, the common bile duct is directly injected with dye operative cholangiography
this diagnostic test is used to identify retained stones in a postoperative cholecystectomy patient t tube cholangiography
diagnostic study used to detect structural changes in the liver; uses gamma ray radiation radioisotope liver scanning
in this diagnostic procedure a needle is inserted directly into the liver to remove tissue needle liver biopsy
how should a patient be positioned following needle liver biopsy? on right side for 2 hours, then flat for 12 to 14 hours
fiberoptic scope inserted through the GI tract into the duodenum used to diagnose pancreatic dysfunction, evaluate obstructive jaundice, remove common bile duct stones and place biliary and pancreatic duct stents endoscopic retrograde cholangiopancreatography (ERCP)
laboratory values of this increase 12 hours after onset of pancreatic disease, but return to normal within 48 to 72 hours amylase
normal amylase values 25 to 125 U per L
laboratory values of this are elevated in acute pancreatitis lipase
normal lipase values 0 to 110 U per L
this procedure is used to establish a diagnosis of pseudocyst, pancreatitis, and pancreatic abcess ultrasound
a noninvasive but accurate imaging study used to diagnose pancreatic inflammation, tumor, cyst formation, ascites, aneurysm, and cirrhosis of the liver CT scan
incurable sores of the mouth and lips ranging in size from 0.5 to 3cm cold sores, canker sores, aphtous ulcers
medical treatment for cold sores, canker sores, and aphthous ulcers antiinflammatory agents, topical agents, debriding agents
anti inflammatory agent commonly used in cold sores, canker sores, and aphthous ulcers
when and how often should amlexanox (aphthasol) be applied? as soon after noticing symptoms as possible; 4x per day following oral hygiene
dental decay caused by dental plaque, poor nutrition, acids, and heredity dental caries
patient teaching for dental caries should include proper nutrition and proper oral hygiene techniques
infection of the oral cavity by the fungus Candida; more frequent in leukemia, diabetes, antibiotics use, and steroids candidiasis (thrush)
treatment for candidiasis nystatin, amphotericin B, hydrogen peroxide rinse (50%) or saline rinse, ketoconazole
side effects of amphotericin B (fungizone) headache, hypotension, NVD, nephrotoxicity, hypokalemia
nystatin oral suspensions or lozenges should be continued for how long following resolution of symptoms? 48 hours or until cultures are negative
what common GI medications should not be administered within two hours of ketoconazole? H2 antagonists or antacids
topical analgesic overdose is toxic to which two target organs? brain and heart
GERD is caused by what? backflow of stomach content
what are the two most frequent complaints leading to a diagnosis of GERD? retrosternal pain after meals and regurgitation
GERD and this condition have very similar symptoms angina pectoris
what lifestyle changes can reduce symptoms of GERD? stop smoking, no strenuous exercise, sleep with head elevated, eat smaller meals, quit drinking, don’t eat close to bedtime, limit caffeine
what causes achalasia? spasm of the cardiac sphincter
what are some signs and symptoms of achalasia? difficulty swallowing, regurgitation, chest pain, nocturnal cough, weight loss
treatment of achalasia focuses on what two outcomes? dilation of cardiac sphincter and reduction of esophageal pressure
inflammation of the lining of the stomach gastritis
common causes of gastritis alcohol, smoking caffeine, bacteria, viruses, aspirin, nsaids, stress, chemotherapy, radiation therapy, food allergies
signs and symptoms of acute gastritis epigastric pain, nausea, vomiting, headache, anorexia
diagnostic tests appropriate for gastritis occult blood, CBC, gastroscopy
treatment for gastritis antiemetics, antacids, H2 antagonists, antibiotics, fluid and electrolyte replacement
ulceration of the mucous membranes of the deeper structures of the GI tract peptic ulcer disease
the two most common sites of peptic ulcers stomach(gastric), duodenum
the two most common causes of peptic ulcers chronic hyperacidity or mucous reduction
this bacteria is found in over 70% of those with gastric ulcers and 95% of those with duodenal ulcers H. pylori
this class of medications can cause gastric injury and lead to the development of peptic ulcers NSAIDS
complications of peptic ulcer disease hemorrhage and perforation, gastric outlet obstruction
diagnostic tests appropriate for peptic ulcer disease CBC, Upper GI series, esophagogastroduodenoscopy, biopsy, H. pylori
medications used to manage peptic ulcer disease antacids, H2 antagonists, antibiotics, mucosal healing agents, proton pump inhibitors, Prostaglandin E analogue
removal of the entire antrum (lower stomach) to eliminate the main stimuli for acid production antrectomy
part of the stomach is removed and the remaining portion of the stomach is connected to the duodenum gastroduodenostomy
a process where the jejunum is anastomosed to the stomach to provide a second outlet for gastric contents and the vagus nerve is severed gastrojejunostomy and vagotomy
removal of the entire stomach and the esophagus is joined to the jejunum total gastrectomy
a procedure in which an incision in the pylorus is opened and then closed to permit the stomach to relax pyloroplasty
treatment of H. pylori usually includes H2 receptor antagonist or Proton Pump Inhibitor with two antiinfectives for 1
antiinfectives used for the treatment of H. pylori amoxicillin, clarithromycin, metronidazole, doxycycline
which antiinfective used in the treatment of H. pylori is contraindicated during pregnancy tetracycline (doxycycline)
which antiinfective used for the treatment of H. pylori is contraindicated in those with a history of seizures or neurological problems? metronidazole (flagyl)
which antiinfective used for the treatment of H. pylori can cause ventricular dysrhythmias and blood disorders? clarighromycin (biaxin)
which antiinfective used in the treatment of H. pylori can cause albuminuria and neurotoxicity? metronidazole (flagyl)
which antiinfective used in the treatment of H. pylori can cause discoloration and softening of the teeth and bones tetracycline(doxycycline)
what food groups and medications should be avoided when administering tetracycline? milk and dairy products, calcium, antacids, magnesium, sodium bicarb, and other iron supplements
Antacids usually contain one of these three ingredients aluminum, magnesium, calcium
some commonly used Histamine H2 antaonists cimetidine, famotidine (pepsid), nizatidine, ranitidine(zantac)
IV dosage of H2 antagonists should be administered slowly to prevent what possible side effect? bradycardia
some commonly used Proton pump inhibitors esomeprazole(nexium), lansoprazole(prevacid), omeprazole(prolosec), rabeprazole(aciiphex)
what time of day should proton pump inhibitors be administered? morning
these two classes of GI medications reduce the secretion of gastric acid H2 antagonists and proton pump inhibitors
degenerative disorder of the liver from generalized cellular damage cirrhosis
what are some common health problems related to cirrhosis? impaired digestion and metabolism, reduction in protein synthesis, impaired coagulability, fluid-electrolyte imbalances, ascites
what would you expect laboratory values of liver enzymes to be in a patient with cirrhosis elevated
what would you expect lab values of serum albumin to be in a patient with cirrhosis? decreased
what would you expect lab values of serum ammonia to be in a patient with cirrhosis? elevated
what would you expect lab values of glucose to be in a patient with cirrhosis? decreased
what would you expect the prothromin time to be in a patient with cirrhosis prolonged
removal or aspiration of fluid from the peritoneum? paracentesis
yellowish discoloration of tissues caused by abnormally high level of bilirubin in blood? jaundice
other than yellow discoloration in the eyes and skin, what are some other symptoms of elevated bilirubin clay colored stool, deep orange urine color
what substances would you expect to be restricted in a patient with cirrhosis? fluid, sodium, alcohol, fat, protein
one way valve moving fluid from peritoneal cavity to superior vena cava peritoneal jugular shunt (laveen)
possible complications of a peritoneal jugular shunt hemodilution, pulmonary edema, CHF, wound infection, peritonitis, septicemia, shunt occlusion
signs and symptoms of hepatic encephalopathy inappropriate behavior, disorientation, flapping tremors, twitching extremeties, stupor, coma
what dietary treatment can help reduce blood ammonia levels? protein restriction
inflammation of the liver resulting from several types of viral agents, exposure to toxic substances or lengthy alcohol abuse hepatitis
signs and symptoms of hepatitis RUQ pain, NVD, pruritis, jaundice, dark urine, clay colored stools, hepatomegaly
the treatment for hepatitis is… no treatment, palliative care and transmission prevention only
Hepatitis B vaccine should not be given to patients with anaphylactic reaction to this substance yeast
formation of stones in the gallbladder cholelithiasis
risk factors for cholelithiasis overweight, women, pregnant or multiple pregnancies, birth control, diabetes
common causes of cholecystitis obstruction, gallstone, tumor
obstruction of the any of the biliary ducts causes… spasms
obstruction of the bile duct leads to bile stasis which causes… infection and necrosis
a hormone secreted by the small intestine each time the person eats fatty food which stimulates the release of bile cholecystokinin
if the gallbladder ruptures or becomes grossly infected, _________ can result peritonitis
a gallstone that has become lodged in and obstructs the common bile duct choledocholithiasis
chronic cholecystitis is treated with low fat diet
the drug of choice for pain control in cholelithiasis demerol
this treatment for cholelithiasis involves the use of shockwaves to break up stone extracorporeal shock wave lithotripsy
this treatment for a gallstone lodged in the common bile duct involves the insertion of an endoscope through the mouth and into the duodenum to capture the stone endoscopic sphincterotomy
the preferred method of gallbladder removal endoscopic cholecystectomy
indications for an open cholecystectomy extreme inflammation, infection, or large gallstones
a biliary drainage tube left in place after cholecystectomy to keep the duct open and drain bile until the inflammation of the common bile duct has resolved t tube
t tube should drain less than this much in an 8 hour period 50ml
possible complications of cholecystectomy jaundice, hemorrhage, peritonitis
indication that bile is being deposited normally into the GI tract following cholecystectomy normal stool and urine color
inflammation of the pancreas pancreatitis
common causes of pancreatitis trauma, disease, inflammatory bowel disease, heredity, alcohol, drugs, refeeding after prolonged fasting or anorexia
possible complications of pancreatitis necrosis, hyperglycemia, hypercalcemia, hemorrhage, peritonitis, abcess, renal failure, sepsis, pleural effusion, blood coagulopathies
signs and symptoms of pancreatitis mid upper abdominal pain, NVD, flatulence, frothy, foul smelling stool, jaundice
cullens sign, turners sign, chvosteks sign, and trousseaus sign are all signs of pancreatitis
elevated serum and urine amylase, lipase, and AST-ALT levels, bilirubin levels, WBC’s, glucose with decreased calcium, potassium, and magnesium would be indicative of pancreatitis
the most common cause of chronic pancreatitis alcoholism
when the pancreatic duct is not obstructed what is the treatment for pancreatitis diet restriction, then gradual advancement, pain control, enzyme replacement, pancreatectomy or transplant
most common entry point of intestinal infections into the body the mouth via contaminated food or water
long term use of antibiotic can lead to the death of normal flora and overgrowth of opportunistic bacteria such as… C. difficile
most common sign of intestinal infection diarrhea
primary test for intestinal infection stool culture
treatment for diarrhea fluid and electrolyte replacement
IBS is often related to.. psychological problems
most common symptom of IBS abdominal pain associated with change in bowl habits
IBS is diagnosed by… ruling out other GI disorders
In IBS, anticholinergic drugs are used… to relieve abdominal cramps
In IBS, dietary fiber, milk of magnesia, and mineral oil are used to treat constipation
in IBS, antianxiety drugs are used to treat distress, panic, and depression
how many grams per day of dietary fiber should a person with IBS consume? 20
inflammation of the colon and rectum characterized by alternating periods of exacerbation and remission ulcerative colitis
the hallmark symptom of ulcerative colitis diarrhea containing pus and blood
10 to 20 liquid stools per day, containing blood, mucus, and pus would be indicative of which inflammatory bowel disease? ulcerative colitis
hallmark sign of this inflammatory bowel disease is a cobblestone appearance in parts of the GI tract crohns disease
severe cases of crohns disease are treated with corticosteroids
patients on long term corticosteroid therapy should be monitored for infection
anticholinergics are contraindicated in patients with glaucoma, hemorrhage, tachycardia, myasthenia gravis
in this procedure the entire colon and rectum are removed and the stoma is located in the right lower quadrant ileostomy
this procedure is done to allow the intestine to repair itself following inflammatory disease, injury, or intestinal surgery temporary colostomy
colostomy placed when there is a debilitating intestinal disease or cancer requiring removal of the colon and rectum permanent
in this “ostomy” material discharged is liquid to semiliquid and contains digestive enzymes ileostomy
in this “ostomy” fecal material discharges is liquid to semi liquid requiring frequent emptying to keep the patient dry and to control odor ascending colostomy
in this “ostomy” fecal material is semi formed, can be irrigated daily to reduce number of bowel movements transverse colostomy
in this “ostomy” fecal material is semi formed to formed
in this “ostomy” fecal material is formed sigmoid colostomy
a pink or red stoma is healthy
a dusky blue stoma indicates ischemia
a brown black stoma indicates necrosis
the four types of hernias inguinal, femoral, umbilical, and ventral (incisional)
most common type of hernia inguinal
inguinal hernias are more frequent in which gender? male
this type of hernia occurs more often in women and easily becomes strangulated femoral
this type of hernia occurs when the rectus muscle is weak and is most common in children umbilical
this type of hernia is due to weakness in the abdominal wall at the site of a previous incision ventral(incisional)
if the protruding structures of a hernia can be replaced into the abdominal cavity via manipulation, it is referred to as reducible
a hernia that cannot be manually manipulated and replaced into the abdominal cavity irreducible
a hernia where blood supply and intestinal flow are occluded strangulated
edema of the hernia and constriction of the muscular opening causing it to be irreducible incarcerated
two methods for hernia repair approximating adjacent muscles or use of synthetic mesh
in this type of hernia the stomach prolapses through the diaphragmatic esophageal hiatus hiatal hernia
following hernia repair, the patient should be encouraged to breathe deeply but discouraged from coughing
most intestinal obstructions occur here ileum
90% of obstruction are due to these two pathologies adhesions and incarcerated hernias
the most common form of non mechanical bowel obstruction paralytic ileus
inflammation of the vermiform appendix located at the tip of the cecum appendicitis
hallmark sign of appendicitis rebound tenderness
treatment of choice for acute appendicitis appendectomy
the presence of pouchlike herniations through the muscular layer of the colon diverticulosis
the inflammation or infection of one or more diverticula diverticulitis
signs and symptoms of diverticulitis pain in left lower quadrant, fever
test of choice for diverticulitis ct scan with oral contrast
diverticulitis or osis caused by muscular atrophy is treated by low residue diet, stool softeners, and bedrest
diverticulitis or osis caused by increased intracolonic pressure and muscle thickening is treated by high fiber diet of bran, fruits, and vegetables
inflammation of the abdominal peritoneum peritonitis
how is peritonitis related to diverticular disease rupture of diverticula can cause leakage into the peritoneum
hallmark symptom of peritonitis severe abdominal pain
this finding on xray is indicative of peritonitis trapped air under the diaphragm
treatment for peritonitis surgical removal of irritant, antibiotics, NG intubation
patient with peritonitis should be placed in this position semifowler’s
laxatives are used to prevent constipation or to prepare the bowel for radiologic or endoscopic procedures
types of laxatives bulk forming, osmotic cathartics, saline laxatives, stimulants, stool softeners
laxatives should generally be administered at this time of day bedtime
during laxative therapy patient should intake more or less fluid than normal? more
varicosities of the lower recrum and anus resulting in congestion of the anal and rectal veins hemorrhoids
an abnormal opening on the cutaneous surface near the anus fistula
a linear ulceration or laceration of the skin of the anus anal fissure
opening of the fistula tract, incising the fistula with a partial anus division fistulotomy
removal of the fistula tract fistulectomy
small reddish appearing lumps at the edge of the anus hemorrhoids
procedural treatment of hemorrhoids ligation, sclerotherapy, cryotherapy, infrared photocoagulation
conservative treatment for hemorrhoids stool softeners, topical creams, analgesic ointments, sitz baths
surgical treatment for hemorrhoids laser excision, hemorrhoidectomy
usually occur as a result of trauma caused by hard stool the overstretches the anal lining and is aggravated by defecation fissures
these can form a local crypt abcess and are common in crohn’s disease fistulas
act on the chemoreceptor trigger zone to inhibit nausea and vomiting phenothiazines
act as antiemetics by diminishing motion sickness dimenhydrate, scopolamine, meclizine
decreases nausea and vomiting by its effects on gastric emptying metoclopramide
block the effects of serotonin at the 5HT3 receptor sites to reduce nausea and vomiting dlasetron, granisetron, ondansetron
Created by: ewoff85