GI
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| RUQ pain | -cholecystitis, hepatitis, pancreatitis, perforated ulcer,right renal pain
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| RLQ pain | apendicitcitis,abd aortic disection or rupture,ruptured ectopic prego,PID, irinary +calculus, hernia,ovarian or testicular torsion,rt ovarian cyst
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| LUQ pain | -pancreatits, gastritis, left renal pain
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| LLQ pain | diverticulitis, aortic dissection or rupture, ruptured extopic pregnancey,left ovarian cyst,PID,urinary calculus,hernia,ovarioan or testicular tosion
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| Epigastric pain | -gastritis,esophagitis,pancreatitis,cholecystis, aortic aneurysm,myocardial ischemia
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| Diffuse pain | -intestinal obstruction,preforation,peritonitis
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| Visceral pain | -walls of hollow organs due to inflammation,distention, ischemia.*not localized-DULL,CRAMPY,DIFFUSE
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| Somatic pain | Localized-sharp or stabbing/guarding-caused by bacteria, chemicals,
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| Referred pain | originates in a region other than where it is felt
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| Sudden onset= | perforation of organ
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| Gradual onset | blockage of organ
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| Diaphram | high pitch sounds
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| Cullens sign | discoloration over the umbilicus-late sign
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| Turners sign | discoloration over flanks-late sign
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| Ascites | sign of CHF
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| Upper GI bleeding | within the GI tract proximal to the ligament of Treitz-where duodenum and jejunum meet
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| Orthostatic hypotension | 10-20 mmHg drop in systolic and 10-20 increase in pulse
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| Mallory-Weiss syndrome | mucosal tear in the distal esophagus-bleeding is arterial-occurs afterviolent vomiting,forced coughing, trauma
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| Esophageal Varies | Swollen veins of esophagus-35% mortality rate if vessel ruptures,DUE to portal hypertention(primary cause)-Cirrosis,, high pressure causes esophageal veins to dilate
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| Esophageal S/S | painless bleeding,shock,dysphagia(swallowing)burning or tearing,clotting time increases sue to back up in spleen, plts are destroyed,liver is not producing proteins
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| Esophageal TX | IV fluid 20cc/kg,Sengstaken-blkemore tube, sclerotherapy(thrombus forming frug into vein itself
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| Acute Gastroenteritis | Inflammation of the stomach/intesine-causes hemorrhage and erosion of mucosal/sub mucosal layer-sdestruction of villi=H2o and nutrients not absorbed=diarrhea
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| Acute gastroenteritis causes | alcohol,ASA,NSAID, ingestion of chemicals, infections
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| " S/S | N/V,bloody/MUCUS diarrhea, melena,abd cramps,dehydration,Hypokalemia,acidosis or alkalosis
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| Chronic Gastritis | Inflammation of gastric lining-due to infections, passed on by fecal -oral route, infected food or water-S/S same as acute G
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| Peptic Ulcers | breakdown of gastric or duodenal mucosal defence-caused by imbalance between production of acid->males -Caused by Helieobacter pylori,NSAIDs,cigs,alcohol,
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| Duodenal Ulcer | -prox duodenum(small intestines)2-3xs more common that gastric ulcers,25-50yr,genetic-PAIN AT NIGHT/EMPTY STOMACH-blocked pancreatic duct can cause this-relieved by food for 2-3hrs
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| Gastric Ulcer | only in the stomach,>50,PAIN AFTER MEAL/FULL STOMACH,no pain at night,because of acid production
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| Zollinger ellison syndrom | gastrin secreting tumors(signals stomach to produce acids
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| HCL | converts pepsinogen to its active form to breakdown protein
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| Peptic ulcers S/S | rigid boardlike abd,sudden intense steady epigastric pain,RUQ, radiates to back, dimished bowel sounds,hemorrhage :TX:H2blockers-Zantac/pepcid,Antacids, antibiotics
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| Drugs that block or decrease gastric acid secretion | H2 receptor antagonists, Tagamet,Zantac,Pepcid, Axid
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| Antacids | Aluminim, magnesium, calcium,sodium bicarbonate
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| Lower GI consist of | Jejunum,Ileum,large intestine, rectum,anus
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| most common cause of lower GI bleeding is | Diverticulosis
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| Lower GI bleeding S/S | Cramp,N/V,stool changes,bright red blood , distention or ecchymosis
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| Ulcerative COlitis | Idiopathic inflammatory bowel disprder (IBD)-unknown origion, ulcers along mucosal layer of colon.75% involve rectum or rectosimoid portion,inflammation starts at rectum extends proximally-20-40yrs,immune system overreacts to intestinal bacteria
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| Pancolitis | when the entire large intestine is involved
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| Proctitis | when only the rectum is involved
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| Ulcerative S/S | bloody diarrhea,contains mucus,N/V,fever, weightloss,abd cramping,limited to lower quadrants,lyte abn,perforation,ecchymosis,distention
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| Crohn's Disease | (IBD),runs in families,white males,can occur from mouth to rectum,affects Ileum,colon-hypertrophy and fibrosis of muscles undersubmucosal layer-diameter decreases causing fissures.
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| Increased levels of suppressor T-cells means | inflammatory process
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| Diverticulitis | -complication of diverticulosis-small outpuching of tissue that push thru outermost layer of intestine(muscle)-inflammation of diverticula secondary to infection due to obstructed fecal matter
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| Diverticulitis S/S | LLQ pain, most in sigmoid colon, fever, WBC high,melena,comstipation,diarrhea
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| Divertiluitis pathology | 1.stool passes sluggish,colon responds withmuscle spasms,by raising pressure causes herniation through openings in muscles forming diverticula,poop gets trapped,bacteria develops,infection and inflammation
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| Hemorrhods | small masses of swollen veins-occur in anus and rectum
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| Internal hemorrhoids | involve inferior hemorrhoidal plexus, bleeds during defication
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| Bowel obstruction | partial or complete-due to hernias,intussusception (overlaps) and volvulus (twisting on itself) Adhesions-most common area is the small intestines
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| Adhesions | union or normally seperated tissue by fibrous band of new tissue-develops due to abd surgery and inflammation-develop die to abd sx and inflammation
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| Bowel obstr S/S | fever,DIFFUSE VISCERAL pain,peritonitis, shock, ecchymosis, decreased bowel sounds
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| Appendicitis | inflammation of vermiform appendix,kids n young adults-caused by obstruction of lumen by fecal material,inflames lymphoid tissue
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| Appendicitis S/S | low grade fever,pain begins periumbilical,then localizes to RLQ (MCBURNEYS point),once ruptured diffuse pain-peritonitis
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| Gallbladder | stores 30-50cc of bile produced by liver-excreted into the duodenum
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| Cholecystitus | inflammation of the gallbladder
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| Cholelithiasis | formation of gallstones-causes 90%of cases-2 types:
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| Cholesterol Based gallstones | most common,associated w/obese,middle aged,women,whom are fertile 4F's
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| Bilirubin based gall stones | formed by breakdown of hemoglobin in RBC's
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| Sphincter of Oddi | allows entrance of bile from the liver to the intestines
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| Formation of stones patho | bile from liver travels thru the common bile duct thru Sphincter of Oddie, it closes when intestines had enough bile, excess bile goes to gall bladder,if bile becomes supersaturated with bilirubin or cholesterol the bile salts erode the membrane and cause
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| back up and inflammation occurs-prostoglandins release,leads to reduced blood flow
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| Chronic Cholecystiitus | bacterial infection
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| Acalculus Cholecsistis (no stones) | burns,sepsis,DMI,multiple organ failure
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| Cholecystitus S/S | RUQ pain, MURPHEYS SIGN(reffered pain to RT shoulder,colicky,pain after meal high in fat (increases bile release),N/V,warm skin,DARK URINE/light stools TX:DEMORAOL or STADOL-NOT MORPHINE!!
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| Pancreatitis | inflammation of pancreas-most common cause is alcoholism,mechanical and vascular causes,ifectious dx-30-40% mortality due to sepsis and shock >3 s/s =severe pancreatitis
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| mild pancreatitis | epigastric pain,N/V,elevated amylase and lipase
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| Severe pancreatitis | refractory hypotensive shock and bloos loss,jaundice,respiratory failure
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| pancreas | acini cells produce enzymes involved in digestion,produces bicarbonate juice to buffer acidic juice from stomach
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| Islets of Langerhans | Beta cells (75%)insulin,Alpha (20%) glucagon,Delta (5%)somastatin
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| Hepatitis | injury to liver cells either by inflammation or infection
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| Viral Hepatitis | (A,B,C,D,E) 60-70% of all cases
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| Alcoholic hepatitis | 20-30%
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| Kuffer cells (in liver) | breakdown RBC's, bacteria
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| Liver Fx | digestive,storage,Detox,production of bile 60-1000ml per day, carbohydrate metabolism, amino acid metabo-proteinmetabo,synthesis of plasma proteins
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| Bile Salts | made of cholesterol n other stuff,used in small intestines for emulsification and absorbption, reabsorbed in ileum and carried back to liver
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| Hepatitis A | spread by fecal0oral,rarely causes hepatic inj,TX.immune globulin
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| Hepatitis B | serum hepatitis,blood borne
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| Hepatitis C | most common blood borne infection,blood borne,needle sticks,less severe than HBV,TX:imunoglobs,ribavirin(antiviralmed)
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| Endogenous Interferon | critical against ciral infections,produced by invaded cells,doesnt kill, prevents virus from moving and reproducing
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| Hepatitis D | occurs in pts with HBV,sexually transmitted and needle sharing,TX:prevention of HBV
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| Hepatitis E | waterborne infection,chronic hep does not develop,mortlity high for pregos
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| Hepatitis S/S | Sudden onset of Malaise,muscle aches,weak,anorexia,N/V,weightloss, diarrhea,constipation,clay colored stool,jaundice,dark urine,photophobia,cough
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| Cirrhosis | Chronic,irreversable degenerative Dx of the liver,most common cause alcohol, viral hep B or C-slow developing-bld backs up in portal system causing portal HTN due to obstructed liver
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Created by:
rebeccabelleth
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