AMSN - GI
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| What are the three accessory organs of the GI system? | 1. Liver
2. Pancreas
3. Biliary System
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| What is the function of the GI system? | Digestion and absorption (the movement of nutrients into the blood system)
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| What is the Cullen's sign? | Bruise around the umbilicus - this indicates abdominal bleeding.
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| How long should you listen to bowel sounds for? | 2-5 minutes per each quadrant.
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| What is the normal frequentcy of bowel sounds that should occur in a minute? | 5-35x per minute
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| When can you state that there is an absence of bowel sounds? | No activity for a FULL 5 minutes.
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| What site is the best location for listening to bowel sounds? | RLQ
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| What is Bilirubin? | product of RBC breakdown
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| What is the normal range of total Bili? | 0.3 - 1.3 mg/dl
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| What is the normal range of direct Bili? | 0.1 - 1.3 mg/dl
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| What is the normal range of indirect Bili? | 0.1 - 1.0 mg/dl
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| What does an elevated direct bili value indicate? | RBC destruction is accelerated but the liver is able to convert.
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| What does an elevated indirect bili value indicate? | Liver is unable to do its work of converting - more indicative of liver dysfunction.
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| What is the normal range of AST? | 7 - 40 U/L
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| What is the normal range of ALT? | 5 - 36 U/L
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| What is the normal range of LDH? | 92 - 200 U/L
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| What does elevated pancreatic enzymes indicate? | damage to the organ
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| What is the normal range of Amylase? | 25 - 125 U/L
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| What is the normal range of Lipase? | 14 -280 U/L
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| What is the normal range of prothrombin time? | 12 - 15 seconds
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| CEA is typicall elevated with? | Colorectal cancers
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| Dyspepsia is a condition that can lead to? | Peptic ulcer
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| What is dyspepsia? | Imbalance between protective mucosa and the effects of acid, pepsin or can be the direct effects of drugs.
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| What is a Peptic ulcer? | It is a discontinuity of the mucosa i.e. erosin in any part of the upper GI tract (esophagus, stomach, duodenum)
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| What can cause stress ulcer? | 1. long term hospital stays
2. trauma
3. extensive sugeries
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| Pain related to duodenal ulcers mostly occur when? | 1. at night
2. 2-4 hours after meals
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| Zollinger Ellision syndrome? | "hypergastremia" caused b a pancreatic tumor that secretes an elevated level of gastrin.
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| Where and when is pain commonly seen with patients with gastric ulcers? | High in the epigastic area and occurs with eating.
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| Peptic ulcers are typically seen where? | 80% found in the duodenum.
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| What is the tx for peptic ulcers? | treat mild pain with antacids, omit causative agents such as ASA, NSAIDS.
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| What complications can occur with peptic ulcers? | bleeding, perforation (emergent - tx with antibiotics, fluids. This requires surgical repair)
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| What is GERD? | reflux of gastric contents into the esophagus.
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| What causes GERD? | 1. obesity
2. hiatal hernia
3. gastric emptying
4. incompetent lower esophageal sphincter
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| What are the symptoms of GERD? | 1. dyspepsia
2. heartburn
3. hoarse voice
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| Tx for GERD? | H2 blockers, PPI, meal timing
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| What is used to diagnosis GERD? | History, UGI, Endoscopy
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| What complications can occur with GERD? | Barrett's Esophagus
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| Why is Barrett's esophagus a concern? | The consistent reflux can lead to metaplasia of the cells of the esphogus which can lead to cancer
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| What pt's are at high risk for GI bleed? | 1. chronic renal failure
2. diabetes
3. COPD
4. liver disease
5. PUD
6. Heart disease
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| What causes UGI bleed? | erosive ulcerations or lesions, varices.
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| Mallory Weiss Tear? | UGI bleed associated with ETOH consumption and the use of ASA.
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| What are the symptoms of GI bleed? | 1. frank bloo in stool or melena
2. coffee ground emesis
3. volume loss (elevated HR, decrease BP and H&H)
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| Tx for GI bleed? | 1. fluid/blood replacement
2. correct the cause
3. pain control
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| Melena indicates what type of bleed? | slow bleed or further up in the GI tract
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