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Chp. 9
Fundamentals of Disease
| Question | Answer |
|---|---|
| Oral neoplasms | new growth that commonly occurs on the floor of the oral cavity, tongue, and inferior oral labia. |
| Labial carcinoma | associated with pipe and cigar smoking |
| Carcinomas associated with tobacco and dipping: | carcinoma of the buccae, tongue, or palate |
| Leukoplakia | A premalignant sign of an oral neoplasm |
| Dx of an oral neoplasm are confirmed with: | Bx |
| Oral neoplasms respond well to: | surgery and radiation therapy |
| Signs/symptoms of an esophageal malignancy include: | dysphagia, vomiting, halitosis, WT gain, aphagia |
| Dx for an esophageal malignancy includes: | UGI AKA barium swallow |
| The Px for an esophageal malignancy is poor because: | metastasis usually occurs before detection |
| Esophagitis | an inflammation of the esophagus |
| GERD | Gastroesophageal reflux disease - caused by esophagitis |
| GERD is caused by: | an incompetent cardiac sphincter , which allows the stomach contents to regurgitate up the esophagus |
| Signs/symptoms of GERD: | dyspepsia, eructation, dysphagia, halitosis, hematemesis, thoracodynia |
| Signs/symptoms of GERD may follow: | eating, drinking, bending over and lying down |
| GERD is more common with: | obesity and pregnancy |
| Dx of GERD: | confirmed with an EGD (esophagealgastroduodenoscopy) |
| Tx for GERD: | nonirritatin diet, antacids, antiulcer drugs (Pepcid) |
| Hiatal Hernia (HH) | A protrusion of the stomach through the diaphragm AKA diaphragmatic hernia |
| Signs and symptoms of a HH include: | dyspepsia, postprandial dyspepsia, SOB, also may cause GERD |
| Dx for a HH: | CXR and UGI |
| Tx for a hiatal hernia includes: | avoid spicy foods, ETOH, and caffeine, WT loss for obese patients, abdominal supports, hernioplasty (surgical repair) |
| Acute gastritis: | inflammation of the stomach frequently accompanied by hematemesis |
| Gastritis is usually caused by irritants such as: | NSAIDS, caffeine, tobacco, spicy food, ETOH, infection |
| Dx of gastritis: | confirmed with a gastroscopy and Bx |
| Signs and symptoms of gastritis include: | LUQ abdominal pain, hematemesis |
| Tx for gastritis: | removal of irritants, antacids, antiulcer drugs |
| PUD | peptic ulcer disease of the stomach or duodenum |
| Primary symptom of PUD: | abdominal pain, relieved temporarily by antacids and food |
| Causes of PUD: | poorly controlled stress, excessive production of HCl, NSAIDs (such as ASA, Motrin and Naprosyn), Helicobacter pylori (bacteria) |
| Tx of PUD: | stress mangement, reduction of irritants, antiulcer drugs (Nexium), antacids, antibiotic therapy (amoxcillian) |
| A complication associated with PUD is: | ulcer perforation and hemorrhage |
| Signs of perforation include: | extreme ab. pain, hematemesis, melena; requires surgery |
| Dx of PUD: | confirmed with a barium swallow |
| peritonitis | A complication of ulcer perforation |
| Ulcer perforation requires: | surgery |
| Gastroenteritis: | inflammation of the stomach and small intestine |
| Causes of gastroenteritis: | bacteria (e.coli, salmonella, listeria), chemical toxins, lactose, food allerigies |
| Signs and symptoms of gastroenteritis include: | colicky dysentery, N+V, pyrexia, diarrhea |
| Dx of gastroenteritis: | stool CX |
| Tx of gastroenteritis: | IV hydration, antibiotics,antiemetics, antidiarrheals, GI antispasmodics |
| Salmonella | food poisoning caused by an enterobacteria; can cause gastroenteritis 6 to 48 hours after ingestion of tainted food |
| Dx of salmanoellosis: | stool CX |
| Symptoms of salmonellosis can last up to: | 2 weeks |
| The primary complication of salmonellosis is: | dehydration |
| Prevention of salmonellosis includes: | Proper refrigeration of foods, Thorough cooking of foods, Prevent cross contamination of food, Proper frequent hand washing. |
| Gastric malignancies are more common in: | men over age 55 |
| Signs and symptoms of a gastric malignancy include: | anorexia, dyspepsia, N+V, PA (pernicious anemia caused by B12 deficiency), achlorhydria |
| Dx of a gastric malignancy: | gastroscopy and Bx |
| Risk of gastric malignancies increases with: | H. pylori, dried,smoked,salted or preserved foods, chronic gastritis, family Hx |
| Tx for a gastric malignancy includes: | chemo, radiation, surgery |
| Appendicitis: | inflammation of the appendix |
| Signs and symptoms of appendicitis include: | N+V, pyrexia, leukocytosis, right inguinal rebound tenderness |
| Tx for appendicitis: | appendectomy |
| Complications of appendicitis: | gangrene, appendorrhexis, peritonitis |
| Malabsorption syndrome is the: | inability to absorb fat from the small intestine |
| Malabsorption syndrome causes the stool to become: | unformed, fatty, pale, pungent, floaters |
| A complication of malabsorption syndrome is: | the inability to absorb the fat soluble vitamins A, D, E, + K |
| Vitamin K deficiency can cause | bleeding tendencies |
| Tx for malabsorption syndrome: | INJ A, D, E, K supplements |
| Diverticulitis | an inflammation of diverticula - blister-like pouches or sacs that develop in the large intestine |
| The primary symptom of diverticulitis: | LLQ cramp-like abdominal pain |
| A complication of diverticulitis is | bowel obstruction and abcesses |
| Dx of diverticulosis: | BE (barium enema) |
| Tx for diverticulitis: | antibiotics, fiber, decrease gas causing foods |
| Crohn's Disease | AKA RE (regional enteritis) chronic, idiopathic IBD |
| CD may be exacerbated by: | poorly controlled stress |
| Signs and symptoms of CD: | appendicitis like pain, bloody diarrhea and constipation, melena, anorexia, N+V, WT loss |
| Dx of CD: | colonoscopy and Bx |
| Periods of exacerbation and remission are common with some cases of CD ending in: | perforation or ileus |
| Tx of CD: | immunosuppressant meds, SAIDS, antibiotics, avoiding trigger foods |
| Ulcerative Colitis: | idiopathic IBD affecting the colon and rectum, increases risk of colon malignancies |
| UC usually occurs in young adults, especially women, and usually begins between ages: | 15 and 20 |
| Signs and symptoms of UC: | sudden diarrhea w/ pus and blood, cramps in the lower abdomen, anemia |
| Dx of UC | colonoscopy and BaE )barium enema) |
| Tx for UC: | Lialda, stress management, diet, mild sedation, corticosteriods, psych. counseling, colostomy |
| Most malignancies of the large bowel are found in the : | rectum or sigmoid colon |
| Dx of carcinoma of the colon and rectum is made with: | DRE, sigmoid/colonoscopy, Bx |
| Colorectal malignancies detected early respond well to: | surgical treatment |
| Early signs and symptoms of carcinoma of the colon and rectum include: | change in bowel habits, abdominal discomfort, occult blood in stools or melena, anemia |
| Early detection of colorectal malignancies can occur with: | physical exams, regular stool guaiac tests (Hemoccult) |
| Risk factors for colorectal malignancies include: | long standing UC, polyps, a diet rich in red meat and fat, deficient Ca |
| A bowel obstruction is AKA: | ileus |
| An ileus caused by a reduction of peristaltic activity is called a: | paralytic ileus |
| volvus | an ileus caused by the bowel twisting on itself |
| intussusception | An ileus caused when the intestine telescopes on itself |
| An ileus can also be caused by: | adhesions |
| Signs and symptoms of an ileus: | severe abdominal pain, distended abdomen, vomiting and constipation |
| Dx of an ileus: | abdominal CT |
| Tx for an ileus: | laparoscopic bowel resection |
| IBS usually affects women between their: | late teens and early 40's |
| Signs/symptoms of IBS: | sudden diarrhea, constipation, abdominal pain, flatulence |
| The difference between IBS and other intestinal disorders: | no lesions present on examination |
| IBS is a disorder of: | motility and intestinal wall muscle spasms |
| Tx for IBS: | fiber, avoiding caffeine, ETOH, fat, spicy food, citrus, cabbage, and legumes, stress management, GI antispasmodics, antidiarrheals, sedatives |
| Cirrhosis: | chronic degeneration of the liver |
| Cirrhosis is caused by: | ETOH, HBV/HCV, drugs |
| Dx of cirrhosis: | liver Bx |
| Signs/symptoms of advanced cirrhosis: | tremors, somnolence (sleepiness), confusion, gynecomastia (breast growth in males), loss of chest hair, testicular atrophy, splenomegaly/hepatomegaly, dilated abdominal veins, hemorrhage, pedal edema, esophageal varcies, jaundice, ascites, hepatic coma |
| Dx of cirrhosis: | LFTs and liver Bx |
| LFTs include: | SGOT (AST), SGPT (ALT), Alk.Phos (ALP), LDH (LD), bilirubin |
| Viral hepatitis is an inflammation of the liver caused by a family of viruses called: | hepatitis A, B, C, D, and E |
| The HAV is the least serious and is usually transmitted in: | feces |
| Signs and symptoms of the HAV can occur: | 2-7 weeks after exposure and usually last 2 months |
| Signs/symptoms of the HAV: | fatigue, anorexia, RUQ pain, cephalalgia, diarrhea, dark urine, nausea, pale stools, myalgia, low pyrexia, jaundice |
| Px for HAV: | is good with no pernament liver damage and lasting immunity |
| HBV can lead to: | chronic hepatitis and cirrhosis |
| Signs and symptoms of the HBV are similar to the: | HAV |
| Signs and symptoms of the HBV can occur: | 2-6 months after exposure |
| Parenteral transmission usually refers to: | needle sticks and exposure to certain body fluids |
| Potentially hazardous body fluids include: | blood, synovial fluid, pleural fluid, CSF during an LP, pertioneal fluid, amniotic fluid and breast milk |
| Damage from the HBV can cause fulminating hepatitis where the patient can suddenly become: | comatose and die |
| A lasting immunity can be achieved for the HBV by vaccination or: | contracting the disease and recovering completely |
| Tx for HBV: | antiviral therapy |
| The HCV is: | insidious |
| The incubation period for HCV is: | 20-30 yrs to damage the liver |
| 80% of ppl with HCV will develop: | cirrhosis |
| The HCV is transmitted: | parenterally, sexually, perinatally |
| Tx for HCV: | antiviral therapy, liver transplant |
| Hepatic malignancies are usually secondary tumors that: | metastasize from the colon, rectum, stomach, pancreas, esophagus, lung, and breast |
| Hepatocarcinoma is a primary malignancy commonly associated with: | ETOH, HBV, HCV |
| Signs and symptoms of a liver malignancy include: | WT loss, RUQ abdominal mass and pain |
| Dx of a liver malignancy is confirmed with: | AFP and liver Bx |
| Cholecystitis: | an inflammation of the gallbladder |
| Cholecystitis is caused by: | an obstruction due to chloelithiasis |
| Increased incidence of cholelithiasis includes: | postpartum, BCPs, DM, cirrhosis, pancreatitis |
| Signs and symptoms of cholelithiasis include: | Right rib cage pain radiating to the right shoulder, especially after eating a meal rich in fat, chills, pyrexia, N+V, jaundice |
| Dx of chloelithiasis: | GB ultrasound, hepatobiliary scan (HILDA), ERCP, EUS, MRC |
| Tx for cholelithiasis: | laparoscopic cholecystectomy before perforation occurs, Laparoscopic cholelithectomy if stones are present in the common bile duct |
| Pancreatitis: | inflammation of the pancreas |
| Pancreatitis is commonly associated with alcoholism in men and: | GB disease in women |
| Pancreatitis can cause: | pancreatic enzymes to activate prematurely |
| These activated pancreatic enzymes will : | digest the pancreas |
| Pancreatic enzymes include: | Trypsin, Chymotrypsin, Lipase, Amylase |
| High levels of these pancreatic enzymes will confirm the diagnosis of pancreatitis especially the enzyme: | amylase |
| Signs and symptoms of pancreatitis: | severe ab. pain, N+V, jaundice |
| Risk factors for a pancreatic malignancy include: | male gender, smoking, high protein/fat diets, alcohol, DM |
| Signs and symptyoms of a pancreatic malignancy include: | severe ab. pain, anorexia, WT loss, clay colored stools, jaundice |
| Dx of a pancreatic malignancy is confirmed with a: | CT, MRI, PET and Bx |
Created by:
RBarnes86
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