GI Reviews
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| The larger glandular organ in the body, which function as an accesory orhgan of the digestion is? | The Liver
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| Digestion begin? | In the mouth where food and saliva begins the breakdown of starches
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| Define Digestion | The physical and mechanical breakdown of the food into absorbble subsatncews and is completed in the small intestines
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| Describe digestion in the small intestines | -Carbohydrate are hydrolysed to monosaccharides -Fats to Fatty Acids -Proteins into amino acids
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| Enzymes used in Digestion | Ptyalin, Pepsin, Trypsin, Lipase, protease, and Amylase
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| Wher is each enzyme produce? | -Ptyalin(Amylase)found in the mouths saliva:produce by the adrenalin gland, Pepsin found in the stomach, Trypsin is a Protease produced by the pancrease
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| MOst common clinical sign of infection | Diarrhea
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| Primary diagnostic Tests | Stool Culture
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| Crohn's Disease | A form of irritale bowel disease(IBD) that causes inflamation of the digestive tract. Ussualy occurs in the terminal ileum but can occurs any where in the digestive tract
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| Chron's Disease Clinical Manifestetation | The principal symptoma are diarrhea and abdominal pain. Diarrhea is ussually non-bloody, weight loss,malnutrition, dehydration, electrolyte imbalance, anemia, increaseperistalsis and pain.
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| this class of GI medications in general should be taken on a regular schedule, 1 to 3 hours after each meal and at bedtime | antacids
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| to provide maximum benefit, an antacid treatment should elevate gastric pH above... | 5
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| to prevent reactions with other medications, you should allow ___ ______ between antacid administration and the administration of other medications | 1 hour
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| these antacids are slow acting, contain significant amounts of sodium, and commonly cause constipation | aluminum hydroxides
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| these antacids are rapid acting and release carbon dioxide in the stomach, causing belching and flatulence | calcium carbonates
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| these antacids are rapid acting and can also act as saline laxatives, causing diarrhea, and are contraindicated in patients with obstruction, appendicitis, or undiagnosed abdominal pain | magnesium hydroxides
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| this antacid has a rapid onset, increases flatulence and abdominal pressure, and can induce systemic alkalosis | sodium bicarbonate
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| magnesium hydroxide is usually administered in combination with _______ _________ to prevent diarrhea | aluminum hydroxide
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| this gastric protectant agent is administered with meals, and can cause diarrhea and abdominal pain | misoprostol (cytotec)
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| this gastric protectant agent should be taken on an empty stomach and may cause constipation | sucralfate (carafate)
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| this glass of gastrointestinal medications supresses the secretion of gastric acid by blocking histamine at the receptor site; used for long tem management of GERD | H2 Receptor Antagonists
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| this H2 receptor antagonist passes the blood-brain barrier, and can also cause hypotension and dysrhythmias | cimetidine (tagamet)
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| this H2 receptor antagonist does not cross the blood brain barrier and rarely produces side effects | ranitidine (zantac)
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| common H2 receptor antagonists | cimetidine (tagamet), famotidine (pepsid), nizatidine (axid), and ranitidine (zantac)
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| common proton pump inhibitors | esomeprazole (nexium), lansoprazole (prevacid), omeprazole(prilosec) pantoprazole (protonix), rabeprazole (aciphex)
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| dual therapy for H pylori infection usually includes either zantac or prilosec in combination with | clarithromycin (biaxin)
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| triple therapy for H. pylori includes what components? | two antibacterial agents and a proton pump inhibitor
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| this class of medications stimulates the motility of the GI tract and increases the rate of gastric emptying without stimulating gastric, biliary, or pancreatic secretions | GI stimulants
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| at what time of day are GI stimulants generally administered? | 30 minutes before meals and at bedtime
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| when are GI stimulants contraindicated? | mechanical obstruction, perforation, or GI hemorrhage
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| this GI stimulant can cause parkinson's like symptoms | reglan (metoclopramide)
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| commonly used GI stimulants | bethanechol chloride (urecholine, duvoid), dexpanthenol (ilopan), metoclopramide (reglan), neostigmine methylsulfate (prostigmin)
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| these two medications are used to treat hepatic encephalopaty | lactulose(cholac), neomycin (mycifradin)
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| this medication for hepatic encephalopathy lowers colonic pH, causing ammonia to be pulled into the bowel and excreted in the feces and improves protein tolerance in patients with advanced hepatic cirrhosis | lactulose (cholac)
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| this medication for hepatic encephalopathy reduces the number of colonic bacteria thus reducing ammonia production | neomycin (mycidfradin)
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| these 5 classes of medications are used in the treatment of inflammatory bowel disease | antimicrobials, 5-aminosalicylates, corticosteroids, immunosuppressants, immunomodulators
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| this class of medication is used to prevent or treat secondary infection associated with inflammatory bowel disease | antimicrobials
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| these two classes of medications are used to decrease gastrointestinal inflammation in inflammatory bowel disease | 5-aminosalicylates, corticosteroids
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| this class of medication is used to suppress the immune system in inflammatory bowel disease | immunosuppressants
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| this class of medication reduces inflammation and interrupts the movement of leukocytes, which reduces inflammatory response in the treatment of inflammatory bowel disease | immunomodulators
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| the antimicrobial most commonly used in the treatment of inflammatory bowel diseases | metronidazole (flagyl)
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| 5-aminosalicylates that are commonly used in the treatment of inflammatory bowel disorders | sulfasalazine(azulfidine), mesalamine (rowasa), olsalazine (dipentum)
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| corticosteroids commonly used in the treatment of inflammatory bowel disorders | cortisone, prednisone, budesonide (entocort), hydrocortisone
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| immmunosuppressants commonly used in the treatment of inflammatory bowel disorders | azathioprine (imuran), cyclosporine (neoral), mercaptopurine
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| immunomodulators commonly used in the treatment of inflammatory bowel disease | infliximab (remicade), natalizumab (tysabri)
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| common side effect of antiemetics | drowsiness
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| this type of laxative absorbs water into feces and helps produce large, soft stools; contraindicated in bowel obstruction | bulk-forming laxatives
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| this type of laxative stimulates motility of the large intestin | stimulant cathartic
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| this type of laxative attracts water into the large intestine to produce bulk and stimulate peristalsis | saline (osmotic) cathartics
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| this type of laxative interferes with the absorption of fat soluble vitamins and softens stool | lubricant
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| these medications inhibit absorption of water in the large intestine resulting in softer stool | stool softerners
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| commonly used bulk forming laxatives | fibercon, citrucel, metamucil
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| commonly used stimulant cathartics | bisacodyl, castor oil
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| commonly used stool softeners | docusate calcium (surfak), docusate sodium (colace)
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| commonly used lubricant laxative | mineral oil
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| when should opoids not be used to control diarrhea? | poisons, infections, or bacterial toxins
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| these medications relax the smooth muscle of the GI tract | antispasmodics
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| opioids used to treat diarrhea | codeine, difenoxin with atropine (motofen), diphenoxylate with atropine (lomotil), loperamide (imodium), tincture of opium
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| commonly used antispasmodic | dicyclomine hydrochloride (antispas, bentyl)
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| this sphincter prevents reflux of gastric contents into the esophagus | cardiac (lower esophageal) sphincter
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| this sphincter regulates the rate of stomach emptying into the small intestin | pylorlic sphincter
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| the chief coenzyme of gastric juice which converts proteins into proteases and peptones | gastrin
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| this part of the small intestine contains the openings of the bile and pancreatic ducts | duodenum
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| digests starch to maltose | amylase
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| reduces maltose to monosaccharide glucose | maltase
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| splits lactose into galactose and glucose | lactase
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| splits nuclec acids to nucleotides | nucleose
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| reduces sucrose to fructose and glucose | sucrase
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| activates trypsinogen to trypsin | enterokinase
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| these play a vital role in the synthesis of some B vitamins and vitamin K | intestinal bacteria
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| prevents contents of the large intestine from entering the ileum | ileocecal valve
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| this organ synthesizes glucose, amino acids, and fats | liver
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| this organ stores 200 to 400 mL of blood and also filters the blood | liver
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| stores and concentrates bile and contracts to force bile into the duodenum during the digestion of fates | gallbladder
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| the cystic duct joins the hepatic duct to form | common bile duct
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| the presence of fatty materials in the duodenum stimulates the liberation of this, which causes contraction of the gallbladder and relaxation of the sphincter of Oddi | cholecystokinin
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| secretes sodium bicarbonate to neutralize the acidity of the stomach contents that enter the duodenum | pancreas
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| examination of the upper GI tract under fluoroscopy after the patient drinks barium sulfate | barium swallow (upper GI seies)
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| after a barium swallow test, the client should be instructed to | increase po fluid until stools resume their normal color
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| a fluoroscopic and radiographic examination of the large intestine after the rectal instillation of barium sulfate | barium enema (lower GI series
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| the diet restrictions before a barium enema study include | low residue diet for 1-2 days, clear liquid diet day before and laxative the evening before, NPO after midnight
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| requires the passage of a NG tube into the stomach to aspirate gastric contents for analysis of acidity, appearance, and volume | gastric analysis
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| how long should a patient be NPO before gastric analysis | 8 to 12 hours
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| upper GI endoscopy is also known as | esophagogastroduodenoscopy(EGD)
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| following sedation, an endoscope is passed down the esophagus to view the gastric wall, sphincters, and duodenum | EGD
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| how long should a patient remain NPO following EGD | 1 to 2 hours
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| use of a rigid scope to examine the anal canal | anoscopy
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| before anoscopy, proctoscopy, and sigmoidoxcopy enemas are given until | returns are clear
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| following endoscopic examinations, guarding of the abdomen, increased fever and chills, pallor, abdominal distensiona and pain, restlessness, tachycardia, and tachypnea are signs of | colonoscopy
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| following endoscopic examinations, guarding of the abdomen, increased fever and chills, pallor, abdominal distensiona and pain, restlessness, tachycardia, and tachypnea are signs of | bowel perforation; peritonitis
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| performed with a fiberoptic laparoscope that allows direct visualization of organs and structures within the abdomen | laparoscopy (peritoneoscopy)
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| performed to detect gallstones and to assess the ability of the gallbladder to fill, concentrate its contents, contract, and empty | cholecystography
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| before colecystography, patient should be assessed for allergies to | iodine or seafood
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| examination of the hepatiobiliary system performed via a flexible endoscope inserted into the esophagus to the descending duodenum | endoscopic retrograde cholangiopancreatography (ERCP)
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| transabdominal removal of fluid from the peritoneal cavity for analysis | percutaneous transhepatic cholangiography
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| transabdominal removal of fluid from the peritoneal cavity for analysis | paracentesis
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| why should a patient void before paracentesis is performed? | to move the bladder out of the way of the paracentesis needle
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| how is a patient positioned for parcentesis? | to move the bladder out of the way of the paracentesis needle
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| needle inserted through the abdominal wall to the liver to obtain a tissue sample for biopsy and microscopic evaluation | liver biopsy
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| these laboratory values should be checked before a liver biopsy is performed | PT, PTT, INR
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| patient should like on this side for this long after a liver biopsy | right side, two hours
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| urea breath test detects the presence of ________, which is the bacteria that causes perptic ulcer disease | heicobacter pylori
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| __________ is released during liver damage or biliary obstruction | alkaline phosphatase, (bilirubin is also an acceptable answer)
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| prothrombin time is _________ with liver damage | prolonged
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| _________________ assesses the ability of the liver to deanimate protein byproducts | serum ammonia
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| liver enzymes are ______________ with liver damage | elevated
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| an increase in _________ indicates pancreatitis or biliary obstruction | cholesterol
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| increased values of amylase and lipase indicate __________ | pancreatitis
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| normal bowel sounds occur every __ to ___ seconds | 5 to 15
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| how long must you listen before assuming that bowel sounds are absent? | 5 minutes
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| backflow of gastric and duodenal contents into the esophagus | gastroesophageal reflux
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| causes of GERD | incompetent lower esophageal sphincter, pyloric stenosis, or motility disorders
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| also known as esophageal or diaphragmatic hernia | hiatal
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| inflammation of the stomach or gastric mucosa | gastritis
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| in chronic gastritis, a deficiency of this vitamin may develop | B12
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| ulceration in the mucosal wall of the stomach, pylorus, duodenum, or esophagus | peptic ulcer
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| the proper order for performing an abdominal assessment | inspect, auscultate, percuss, palpate
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| chronic gastritis is distuinguished from acute gastritis by the following symptoms in addition to nausea, vomiting, and anorexia | belching, heartburn after eating, sour taste in mouth, vitamin B12 deficiency
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| ulcers are named according to their _____ | location
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| most common sites of peptic ulcers | stomach and duodenum
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| mucosal barrier protectants should be administered... | 1 hour before meals
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| pain with gastric ulcers is usually located in ___________ and occurs ________ after meals | mid or left epigastric, 30 to 60 minutes
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| pain with duodenal ulcers is usually located in ___________ and occurs _________ after meals | midepigastric, 1.5 to 3 hours
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