Diseases of the Gastrointestinal System Chapter 9
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| Oral neoplasms(new growth) commonly occur on the | 1.Floor of the oral cavity(mouth) 2.Tongue 3.Interior oral labia(lip)
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| Labial carcinoma is often associated with | pipe and cigar smoking
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| Carcinomas of the buccae(cheeks), tongue, or palate(oral roof) are commonly associated with | chewing tobacco or dipping(snuff)
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| A premalignant sign of an oral neoplasm(new growth) is | leukoplakia (white patches that appear on the mucous membranes of the oral cavity
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| Dx of an oral neoplasm(new growth) is confirmed with a | Bx(biopsy)
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| Oral neoplasms(new growth) respond well to | surgery & radiation therapy
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| Signs & symptoms of an esophageal malignancy include | 1.Dysphagia(difficult swallowing) 2.Vomiting 3.Halitosis(bad breath) 4.WT(weight) loss 5.Aphagia(inability to swallow)
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| Dx for an esophageal malignancy includes an | UGI(Upper GastroIntestinal) AKA barium swallow
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| The Px(prognosis) for an esophageal malignancy is poor because | metastasis(spread) usually occurs before detection
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| Esophagitis is an | inflammation of the esophagus
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| Esophagitis is commonly caused by | GERD(GastroEsophageal Reflux Disease)
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| GERD(GastroEsophageal Reflux Disease) is commonly caused by an incompetent | cardiac sphincter(lower esophageal sphincter)
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| The incompetent cardiac sphincter(lower esophageal sphinclter) allows stomach contents to | regurgitate(reflux/back flow) up the esophagus
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| Signs & Symptoms of GERD(GastroEsophageal Reflux Disease) include | 1.Dyspepsia(indigestion) 2.Eructation(belching) 3.Dysphagia(difficult swallowing) 4.Halitosis(bad breath) 5.Hematemesis(vomiting blood) 6.Thoracodynia(chest pain)
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| The signs & Symptoms of GERD(GastroEsophageal Reflux Disease) may be exacerbated(make worse) by | 1.Eating 2.Drinking 3.Bending over 4.Lying Down
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| GERD(GastroEsophageal Reflux Disease) is more common with | obesity & pregnancy
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| Dx of GERD can be confirmed with an | EGD(EsophagoGastro Duodenoscopy)
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| Tx (treatment) for GERD includes | 1.Nonirritating diet(bland) 2.Antacids(mylanta) 3.Antiulcer drugs(Pepcid)
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| A HH (Hiatal Hernia) is a | protrusion of the stomach through the diaphragm(primary muscle of ventilation)
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| A HH (Hiatal Hernia) is AKA a | diaphragmatic hernia
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| Signs & symptoms of a HH (Hiatal Hernia) include | 1.Dyspepsia (indigestion) 2.Postprandial dyspepsia(indigestion after meals) 3.SOB (shortness of breath)
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| A HH (Hiatal Hernia) may cause the cardiac sphincter(lower esophageal sphincter) to become incompetent causing | GERD(GastroEsophageal Reflux Disease)
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| Dx for a hiatal hernia(HH) is confirmed with a | CXR(Chest X-ray) & UGI (Upper GastroIntestinal) AKA barium swallow
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| Tx for hiatal hernia(HH) include | 1.Avoidance of spicy foods, ETOH(alcohol), & caffeine 2.WT(weight) loss for obese patients 3.Abdominal supports 4.Hernioplasty(surgical repair of the hernia
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| Gastritis is an | inflammation of the stomach frequently accompanied by hematemesis(vomiting blood)
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| Gastritis can be caused by irritants such as | 1.*NSAIDs(non-steriodal Anti-Inflammatory Drugs) such as ASA(Aspirin),Motrin(ibuprofen) & Aleve(naproxen) 2.Caffeine 3.Tobacco 4.Spicy foods 5.Alcohol(ETOH) 6.Infection
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| Dx of gastritis is confirmed with a | gastroscopy(viewing the stomach with a lighted instrument) and Bx(biopsy)
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| Signs & Symptoms of gastritis include | 1.LUQ (left upper quadrant) abdominal pain 2.Hematemesis(vomiting blood)
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| Tx for gastritis includes | 1.Removal of irritants 2.Antacids(Maalox, Tums, Rolaids) 3.Antiulcer drugs(Pepcid, Zantac)
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| PUD (Peptic Ulcer Disease) is an | ulcer(erosion/worn away) of the stomach and/or duodenum(1st section of the small intestine)
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| The primary symptom of PUD(Peptic Ulcer Disease) is | abdominal pain
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| PUD (Peptic Ulcer Disease) abdominal pain is relieved temporarily by | antacids(Maalox, Tums) and food
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| Causes of PUD(Peptic Ulcer Disease) include | 1.Poorly controlled stress 2.Excessive production of HCl(HydroChloric Acid) 3.NSAIDs(Non-Sterodial Anti-Inflammatory Drugs) such as ASA(aspirin),Advil(ibuprofen) and Naprosyn(naproxen) 4.H.(Helicobacter) pylori(bacteria)
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| Tx of PUD(Peptic Ulcer Disease) includes | 1.Stress management(regular exercise) 2.Reduction of irritants 3.Antiulcer drugs(Nexium,Zantac,Pepcid) 4.Antacids(Tums,Gaviscon,Maalox) 5.Antibiotic therapy(amoxicillin) **PUD is not treated by drinking milk**
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| A complication associated with PUD (Peptic Ulcer Disease) is | ulcer perforation(rip or tear) and hemorrhage (rapid flow of blood)
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| Signs of perforation include | 1.Extreme abdominal pain 2.Hematemesis(vomiting blood) 3.Melena(black, tarry, pungent/aromatic stools)
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| A complication of ulcer perforation is | peritonitis(inflammation of the abdominal lining)
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| Ulcer perforation requires | surgery
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| Dx of PUD(Peptic Ulcer Disease) can be confirmed with a | barium swallow(Upper GastroIntestinal) UGI
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| Gastroenteritis is an | inflammation of the stomach and small intestine(bowel)
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| Causes of gastroenteritis include | 1. Bacterial infections such as E.Coli(escherichia), salmonella & Listeria 2.Chemical toxins(poisons) 3.Lactose(Milk sugar) intolerance 4.Other food allergies
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| Signs & symptoms of gastroenteritis include | 1.Colicky(spasm-like) dysentery(painful small bowel) 2.N&V(nausae & vomiting) 3.Pyrexia(fever) 4.Diarrhea(soft watery stool)
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| Dx of gastgroenteritis is confirmed with a | stool CX(culture)
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| Tx of gastroenteritis include | 1.IV(IntraVenous) hydration 2.Antibiotics(Cipro) 3.Antiemetics(phenergan/anti-vomiting) 4.Antidiarrheals(Imodium) 5.GI antispasmodics(Bentyl)
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| Salmonellosis is food poisoning caused by an enterobacteria called | salmonella
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| Salmonellosis can cause gastroenteritis 6 to 48 hours after | ingestion of tainted food
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| Dx of salmonellosis can be confirmed by a | stool CX(Culture)
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| Symptoms of salmonellosis can last up to | 2 weeks
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| The primary complication of salmonellosis is | dehydration(hypovolemic shock)
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| Prevention of salmonellosis include | 1.Proper refrigeration of foods 2.Thorough cooling of foods 3.Prevent cross contamination of food 4.Proper frequent hand washing
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| Gastric malignancies are more common in | men(2 to 1) over age 55
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| Signs and symptoms of gastric malignancy include | 1.Anorexia(loss of appetite) 2.Dyspepsia(indigestion) 3.N&V(nausea & vomiting) 4.PA(Pernicious Anemia) caused by vitamin B/12 deficiency 5.Achlorhydria(no hydrochloric acid(HCl) in the stomach
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| Dx of a gastric malignancy is confirmed with a | gastroscopy(viewing the stomach with a lighted instrument) and Bx(biopsy)
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| Risk of gastric malignancies increases with | H.(Helicobacter) pylori infection of the stomach >The consumption of dried,smoked,salted,or preserved foods(especially meats), and a diet dificient in fresh fruits and vegetables >Chronic gastritis(inflammed stomach)>Family history of gastric malignancy
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| Tx for a gastric malignancy includes | 1.Chemotherapy(antineoplastics) 2.Radiation therapy 3.Surgery
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| Px(prognosis) for a gastric malignancy is good if | detected before metastasis(spread) Only 1 in 5 survive 5 years after metastasis
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| Appendicitis is an | inflammation of the appendix
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| Signs & Symptoms of the appendicitis include | 1.N&V(Nausea & vomiting 2.Pyrexia(fever) 3.Leukocytosis(elevated WBCs) 4.Right inguinal(Iliac) rebound tenderness
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| Tx for appendicitis is an | appendectomy(surgical/excision removal of the appendix
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| Complications of appendicitis include | 1.Gangrene(putrification(rot) 2.Appendorrhexis(rupture of the appendix) 3.Peritonitis(inflammation of the abdominal lining)
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| Malabsorption syndrome is the | inability to absorb fat from the small intestine(small bowel)
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| The inability to absorb fat causes the stool(feces) to become | 1.Unformed(loose) 2.Fatty 3.Pale 4.Pungent(aromatic) 5.Floaters
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| A complication of malabsorption syndrome is | the inability to absorb the fat soluble vitamins A,D,E & K
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| Vitamin K deficiency can cause | bleeding tendencies
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| Tx for malabsorption syndrome includes | injectable vitamin A,D,E & K supplements
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| Diverticulitis is an inflammation of | diverticula(blister like pouches or sacs that develop in the large intestine(large bowel/colon)
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| The primary symptom of diverticulitis is | LLQ(Left Lower Quadrant) cramp-like abdominal pain
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| A complication of diverticulitis is | bowel obstruction(ileus) and abcesses (collections of pus)
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| Dx of diverticulosis is confirmed with a | BE(Barium Enema) AKA lower GI
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| Tx for diverticulitis includes | 1.Antibiotics(Augmentin) 2.Increase fiber in diet(whole grains, leafy green vegetables/fruits) 3.Decrease intake of gas forming foods(legunes/beans & peas) & cabbage
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| CD(Crohn's Disease) is AKA | RE(regional enteritis)
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| CD(Crohn's Disease) is a | chronic, idiopathic(unknown autoimmune/attacking itself) IBD (inflammatory bowel disease)
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| CD (Crohn's Disease) runs in | families
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| CD(Crohn's Disease) is usually diagnosed between the ages of | 20 and 40
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| CD(Crohn's Disease) may be exacerbated(made worse) by | poorly controlled stress
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| Signs & symptoms of CD(Crohn's Disease) include | 1.Appendicitis-like pain 2.Alternating bloody diarrhea(loose watery stool) and constipation(difficult defecation) 3.Melena(black, tarry, pungent/aromatic stool) 4.Anorexia(loss of appetite) 5.N&V(Nausea & Vomiting) 6.WT(weight) loss
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| Dx of CD(Crohn's Disease) is confirmed with a | colonoscopy(viewing the colon with a lighted instrument) and Bx(biopsy)
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| Periods of exacerbation and remission are common with some cases ending in | perforation(tear or rip) or lieus(bowel obstruction)
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| Tx of CD(Crohn's Disease) includes | 1.Immunosuppressant medications(Imuran & Humira) 2.SAIDs(steroidal anti-inflammatory drugs) (prednisone) 3.Antibiotics(Ampicillin) 4.Avoiding trigger foods
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| Chronic Ulcerative Colitis(UC) is an | idiopathic(unknown possible autoimmune) IBD (Inflammatory Bowel Disease) usually afffecting the colon and rectum
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| Chronic UC(Ulcerative Colitis) increases the risk of | colon malignancies
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| UC (Ulcerative Colitis) may be exacerbated (made worse) by | poorly controlled stress
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| UC(Ulcerative Colitis) runs in | families (10-30%)
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| UC (Ulcerative Colitis) usually occurs in young adults, especially women, and usually begins between ages | 15 and 20
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| Signs & symptoms of UC(ulcerative colitis) include | 1.Sudden diarrhea with pus and blood 2.Cramplike pain in the lower abdomen 3.Anemia(erythrocytopenia and/or deficiency of hemoglobin)from chronic blood loss
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| Dx of UC(ulcerative colitis) is confirmed with a | colonoscopy (viewing the colon with a lighted instrument) and BaE(Barium enema(BE)
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| Tx for UC(ulcerative colitis) includes | Lialda(mesalamine)*Stress management*Diet modification(no caffeine, raw veggies, legumes/beans& peas, whole grains,nuts,seeds)*Mild sedation(librium)*Corticosteroids(hydrocortisone)*Psychological counseling*Colostomy(artifical opening into the colon)
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| Carcinoma of the Colon & Rectum (malignancies) are found in the | rectum & sigmoid colon
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| Dx of carcinoma of the colon & rectum is made with | 1.DRE(Digital(finger) Rectal Exam) 2.Sigmoidoscopy or colonoscopy(viewing of the sigmoid colon or entire colon w/ a lighted instrument) 3.Bx(biopsy)
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| Colorectal malignancies detected early respond well to | surgical treatment
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| Early signs & symptoms of carcinoma of the colon and rectum include | 1.change in bowel habits 2.abdominal discomfort 3.occult(hidden) blood in stools or melena(black, tarry pungent/aromatic stool) 4.Anemia(erythrocytopenia and/or deficiency of hemoglobin)
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| Early detection of colorectal malignancies can occur with | 1.Regular physical examinations 2.Regular stool guaiac(Hemoccult) tests
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| Risk factors for colorectal malignancies include | 1.long-standing UC(Ulcerative Colitis) 2.Polyps(premalignant lesions of the colon) 3.A diet rich in red meat and fat and low in fiber 4.Deficient Ca(Calcium) in diet (less than 700mg/day)
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| Each year _______ Americans die from colorectal malignancies | 72,000
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| Deaths from colorectal malignancies can be decreased by 90% if | Colonoscopies are routinely performed after age 50 or if there is a previous hx(history)of polyps
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| ACS (American Cancer Society) suggests the following at age 50 | -Colonoscopy every 10 years -Sigmoidoscopy every 5 years -BaE(Barium Enema) every 5 years -Virtual colonoscopy every 5 years -If no access to these test, stool guaiac(Hemoccult) every year
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| A bowel obstruction is AKA | ileus
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| An ileus caused by a reduction of peristaltic (bowel contraction) activity is called a | paralytic ileus (stool blockage)
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| An ileus (bowel obstruction) caused by the bowel twisting on itself is called a | volvulus (garden hose kinks)
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| An ileus caused when the intestine telescopes on itself is called | intussusception (telescoped inside itself)
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| An ileus can also be caused by | adhesions (tissue sticking together)
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| Signs & Symptoms of an ileus (bowel obstruction) include | 1. Severe abdominal pain 2. Distended(stretched out) abdomen 3. Vomiting & constipation(difficult defecation)
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| Dx(diagnosis) of an ileus(bowel obstruction) is confirmed with an | abdominal CT (computerized tomography)
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| Tx (treatment) for an ileus(bowel obstruction) usually involves | laparoscopic(lighted instrument to view the abdomen) bowel resection(surgical removal of bowel)
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| IBS stands for | Irritable Bowel Syndrome
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| IBS usually affects women between their | late teens & early 40s
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| Signs & symptoms of IBS(Irritable Bowel Syndrome) include | 1.Sudden diarrhea 2.Constipation 3.Abdominal paid 4.Flatulence (flatus) {gas expelled through the anus)
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| Symptoms of IBS(Irritable Bowel Syndrome) tend to worsen with | poorly controlled stress
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| The difference between IBS(Irritable Bowel Syndrome) and other intestinal disorder is that | no lesions are present on examination
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| IBS(Irritable Bowel Syndrome) is a disorder of | motility(peristalsis) and intestinal wall muscle spasms(Adult colick)
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| Tx for IBS (Irritable Bowel Syndrome) includes | >Increasing fiber in diet >Avoiding caffeine, fatty food, spicy foods, alcohol(ETOH), citrus, cabbage,lagumes(beans, peas) >Stress management >GI antipasmodies(Bentyl) >Antidiarrheals(Kaopectate) >Sedatives(Xanax)
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| Cirrhosis is a | chronic degeneration (deterioration) of the liver
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| Cirrhosis can be caused by | 1)Alcohol(ETOH) 2)HBV(Hepatitis B Virus) or HCV(Hepatitis C Virus) 3)Drugs such as Tylenol(acetaminophen), Motrin(ibuprofen) & antihyperlipidemics(lipitor)
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| Dx of cirrhosis is confirmed with a | liver Bx(Biopsy)
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| Signs & Symptoms of advanced cirrhosis include | Tremors(shakiness) >Somnolence(alot of sleep) >Mental confusion >Gynecomastia(male breasts) >Lose chest hair >Testicular atrophy(sm) >Splenomegaly >Hepatomegaly(Lg liver) >Dialated abdominal veins >Tendency 2 hemorrhage >Pedal(ankel/feet) edema
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| More signs & symptoms of advanced cirrhosis include | >Esophageal varices(vericose veins) >Jaundice >Ascites(accumulation of fluid in the abdomen) >Hepatic coma(unconscious with no response to stimuli)
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| Dx of cirrhosis is confirmed with | LFTs(Liver Function Test) & liver Bx(Biopsy)
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| LFTs (Liver Function Test) include | 1.SGOT(AST) 2.SGPT(ALT) 3.Alkaline phosphatase(Alk.Phos. or ALP) 4.LDH(LD) 5.Bilirubin
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| Viral hepatitis is an inflammation of the liver caused by a family of viruses called | hepatitis A,B,C,D & E
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| The HAV(hepatitis A Virus) is the least serious & is usually transmitted in | feces(stool)
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| Signs & Symptoms of the HAV(hepatitis A virus) can occur | 2-7 weeks after exposure & usually lasts 2 months
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| Signs & symptoms of the HAV(hepatitis A virus) include | >Fatique,Anorexia(loss of appetite), RUQ(right Upper Quadrant) abdominal pain, Cephalalgia(head pain), diarrhea, darkened urine(bilirubin in urine), Nausae, pale stools, myalgias(muscle pain), low grade pyrexia(fever), Jaundice
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| Px for the HAV(hepatitis A virus) is good with no permanent | liver damage & a lasting immunity
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| A vaccine (Havrix, Vaqta) is now available for | immunization(inoculation) against the HAV(hepatitis A virus)
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| HBV (hepatitis B virus) can lead to | chronic hepatitis & cirrhosis
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| Signs & symptoms of the HBV(hepatitis B virus) are similar to the | HAV(Hepatitis A virus)
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| Signs & symptoms of the HBV(hepatitis B virus) can occur | 2 to 6 months after exposure
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| Transmissions of the HBV(hepatitis B Virus) is the same as the | HIV(Human Immunodeficiency Virus)
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| The HIV & HBV are transmitted | 1.Parenterally(needle/IV) 2.Sexually 3.Perinatally(during gestation/pregnancy, parturition/birth & breast feeding
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| Parenteral transmission usually refers to | needle sticks & exposure to certain body fluids
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| Potentially hazardous body fluids include | >blood or anything with blood in it >Synovial(joint) fluid >Pleural(lung) fluid >CSF(CerebroSpinal Fluid) during a LP(Lumbar Puncture) >Peritoneal(abdominal) fluid >Amniotic fluid(water breaks) >Breast milk
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| Carriers of the HBV(hepatitis B Virus) can be | asymptomatic(no symptoms)
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| Damage from the HBV can cause fulminating hepatitis where the patient can suddenly become | comatose & die
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| A lasting immunity can be achieved for the HBV (hepatitis B Virus) by | vaccination(Hepatovax, Engerix B, Recombivax HB) or contracting the disease and recovering completely
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| Some people will not completely recover from the HBV(hepatitis B virus) and will be | carriers of the disease
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| Tx for the HBV(hepatitis B virus) includes | antiviral therapy
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| Signs & symptoms of the HCV(Hepatitis C Virus) are similar to the | HBV(hepatitis B virus)
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| The HCV(hepatitis C virus) is | insidious(slow to develop)(most dangerous)
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| The incubation period for HCV(hepatitis C virus) may take up to | 20-30 years to damage the liver significantly
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| 70% of people with the HCV(hepatitis C virus) are | asymptomatic(no symptoms)
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| 80% of people with the HCV(hepatitis C virus) will develop | cirrhosis(degeneration of the liver) and/or liver cancer
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| The HCV(hepatitis C virus) is the #1 reason for a person to need a | liver transplant
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| The HCV(hepatitis C virus) is transmitted | 1.Parenterally(needle sticks & certain body fluids) 2.Sexually 3.Perinatally(during gestation/pregnancy, parturition/birth) (NOT FOUND IN BREAST MILK)
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| Everyone should be tested for the HCV(hepatitis C virus) who received a blood transfusion before | July 1992
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| Tx for the HCV(hepatitis C virus) includes | 1.Antiviral therapy 2.Liver transplant
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| Hepatic(liver) malignancies(cancer) are usually secondary tumors that | metastasize(spread) from the colon, rectum, stomach, pancreas, esophagus, lung and breast
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| Hepatocarcinoma is a primary malignancy commonly associated with | alcohol(ETOH), HBV(hepatitis B virus) and HCV(hepatitis C virus)
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| Signs & Symptoms of a liver malignancy include | WT(weight) loss, RUQ(Right Upper Quadrant) abdominal mass and pain
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| Dx of a liver malignancy is confirmed with an | AFP(AlphaFeta-Protein) blood test and liver Bx(biopsy)
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| The Px for a liver malignancy is | poor
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| Cholecystitis is an | inflammation of the gall bladder
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| Cholecystitis is commonly caused by an obstruction due to | cholelithiasis(gall stones) AKA biliary calculi(stones in the bile duct)
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| The biliary obstruction can lead to | hepatic(liver) damage
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| Increased incidence of cholelithiasis includes | 1.Postpartum(after birth) women 2.Use of BCPs(Birth Control Pills) 3.DM(diabetes mellitus) 4.Cirrhosis(chronic degeneration of the liver) 5.Pancreatitis(inflammation of the pancreas)
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| Signs & symptoms of cholelithiasis(biliary calculi/bile duct stones) include | 1.right rib cage pain radiating to the right shoulder, especially after eating a meal rich in fat 2.Chills 3.Pyrexia(fever) 4.N&V(Nausea & vomiting) 5.Jaundice(yellowing of skin and/or sclerae
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| Dx of cholelithiasis is confirmed with | 1.GB(Gall Bladder) ultrasound 2.Hepatobiliary scan(HIDA) 3.ERCP(Endoscopic Retrograde CholangioPancreatography) 4.EUS(Endoscopic Ultra Sound) 5.MRC(Magnetic Resonance Cholangiogram)
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| Tx for cholelithiasis includes | 1.Laparoscopic cholecystectomy(excision of the gall bladder) before preforation(rip/tear) occurs 2.Laparoscopic cholelithectomy(excision of gall stones) if stones are present in the common bile duct
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| Pancreatitis is an | inflammation of the pancreas
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| Pancreatitis is commonly associated with | alcoholism in men and GB(gall bladder) disease in women
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| Pancreatitis can cause pancreatic | enzymes to activate prematurely(enzymes activate while still in the pancreas)
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| These activated pancreatic enzymes will start to | digest(dissolve) the pancreas
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| Pancreatic enzymes include | 1.Trypsin 2.Chymotrypsin 3.Lipase 4.Amylase
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| High levels of these pancreatic enzymes will confirm the diagnosis of pancreatitis especially the enzyme | amylase
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| Signs & symptoms of pancreatitis include | 1.Severe abdominal pain 2.N&V(nausea & vomiting) 3.Jaundice(yellowing of skin/sclerae)
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| Pancreatitis can result in | death
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| Risk factors for a pancreatic malignancy include | 1.male gender 2.smoking 3.high protein & high fat diets 4.alcohol(ETOH) 5.DM(diabetes mellitus)
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| Signs & symptoms of a pancreatic malignancy include | 1.severe abdominal pain 2.anorexia(loss of appetite) 3.WT (weight) loss 4.Clay-colored stools(grey) 5.Jaundice(yellowing of skin/sclerae)
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| Dx of pancreatic malignancy is confirmed with a | CT(Computerized Tomography) or MRI(Magnetic Resonance Imaging) or PET (Positron Emission Tomography and Bx(biopsy)
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| The Px(prognosis) for a pancreatic malignancy is | very poor due to early metastasis(spreading)
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