GI Disease Flashcards

Question

Referral pain patterns- To low back

Answer 1

Mid Abdominal pain caused by disturbances of the small intestine centered around the umbilicus (T9-T11 nerve distribution) can refer to low back at the same anatomical level L3-L4.

Answer 2

* Heart * Esophagus * Liver * Duodenum * Gallbladder * Pancreas * Stomach * Corresponds to T3 to T5 Sympathetic nerve distribution

Answer 3

* Pancreas * Small Intestine * Appendix or * Proximal Colon * Corresponds to T9-T11 Sympathetic nerve distribution The umbilicus is in level with the disk located between L3-L4 vertebral bodies.

Answer 4

* Colon * Large intestine * Uterus * Bladder * Corresponds to T10-L2 Sympathetic N distribution

Answer 5

* Pain associated with large intestine and colon, * May occur in the lower abdomen across either or both abdominal quadrants

Answer 6

Occurs in Mid line or left of the epigastrium just below the xiphoid process but may be referred to the L shoulder or mid thoracic spine. Posterior pain may radiate or lateralize from the spine away from the mid line. Sensory n distribution is from T5-T9

Answer 7

False- Do not attempt to reduce your own hernia you could cause strangulation.

Answer 8

Sac herniates through the internal inguinal ring: can remain in the canal or pass into the scrotum (men) can extend to labia in women

Answer 9

* Pain with straining * Soft swelling that increases with increased intraabdominal pressure. * May decrease when lying down

Answer 10

Most common. 60% of all hernias More common in infants

Answer 11

Congenital or Acquired

Answer 12

When the appendix is located somewhere else other than the end of the cecum. In 50% of the cases the appendix is retrocecal (behind the cecum) or retrocolic (behind the colon)

Answer 13

Blumberg's sign or Rebound Tenderness- assesses appendicitis or generalized peritonitis- press your finger gently but deeply over the R lower quadrant for 15-30 seconds

Answer 14

Pinch-an-Inch test- Used to avoid the discomfort of classic rebound tenderness/ Blumberg's sign. assesses apendicitis and generalized peritonitis Usually the rebound is the most painful in appendicitis! Can do a pinch an inch. Take a pinch of skin and let it go – it will recreate that rebound without putting extra pressure on a burst or about-to-burst appendix.

Answer 15

* A typical grouped pruritic papulovesicles associated with skin reactions from gluten sensitivity. * Usually occurs on the buttocks, elbows or knees. * Can affect children but more common in adults between age 30-40. * It is almost always a sign of celiac disease and usually resolves in 3-6 months with gluten free diet A herpes virus can also cause a rash that looks like this.

Answer 16

Ulcerations of mucosal lining of esophagus, stomach, and duodenum Pt says: “I’ve got a peptic ulcer” we ask “where?” Most common sites for peptic ulcer (in picture) Corresponding pain pattern that goes with them. Must be confirmed with some type of test. Usually a gastroscope.

Answer 17

* Peptic ulcers * May also treat epigastric distress (dyspepsia)

Answer 18

Leakage of gastric acid into esophagus, gastroesophageal reflux (GERD)

Answer 19

* Neutralize stomach acid, breaking it down into salt and water * Have a carbonate or hydroxide base combined with aluminum, magnesium, sodium, or calcium * Aluminum may give some protection against Helicobacter pylori * Biggest adverse effect is constipation * Antacids should not be taken within 2 hours of orally administered drugs that need gastric juices to dissolve them, such as warfarin, digoxin, iron supplements, and certain antibiotics (tetracyclines, fluoroquinolones, ketoconazole)

Answer 20

* Histamine receptors that diminish stomach parietal cells secretion of gastric acid * Can decrease damage from NSAIDs * Used for short and long-term management of peptic ulcer and GERD * Generally well tolerated * Headache and dizziness may occur \*\* This is one of 2 classes of drugs for people who have had to take tums all the time. Tagamet and Pepcid were like a miracle drug when it first came out. Most of the time people do not have any trouble of this Most of these are available over the counter at about half the pharma dose

Answer 21

* Inhibit the enzyme responsible for secreting gastric acid * H+, K+-ATPase, known as the “proton pump” * Can decrease acid secretion 80-95% and may have some protective effect against H. Pylori, making this the **drug class of choice for long-term management** These are like the Cadillac of gastric acid control drugs Note on drug classes: Insurance formularies usually determine which class a person can take. These are not equivalent, but insurance companies still treat them as such. But if person is not responding to one type, MD can write an override for a different formulary. pts can tell you very well if it is working or not.

Answer 22

* May have acid rebound when discontinued * May have ↑ risk of C. Difficile Rebound effect: If pt decides to just quit, they may have acid rebound because their body has adjusted to what the meds do.

Answer 23

* Several treatment protocols, all use multidrug therapy * Usually consists of mixture of antibiotics and PPIs * Administered for 10-14 days, * Maintenance on a PPI MDs get their own concoctions that they like. Figuring out the connection between H. pylori and ulcers has been wonderful!

Answer 24

* **Reglan –** a dopamine receptor that is useful to stimulate GI motility * **Cytotec** – prostaglandin, treatment of ulcers * **Carafate, Sulcrate** – ulcer treatment, coats the stomach mucosa * You’re probably familiar with… Anti-diarrheal agents Laxatives and cathartics Emetics, antiemetics

Answer 25

Shows the proximity of the iliopsoas and why abscess there can disturb viscera.

Answer 26

Direct Inguinal Indirect Inguinal Umbilical Femoral Incisional

Answer 27

Upper and Lower Could stick together or fibrosis there. Get Strictures that make it hard to swallow. * We may have to have a gastroscope to stretch them out Lower: – get reflux (increasingly common – more aware of it and more weight)

Answer 28

1. Celiac Artery 2. Superior Mesenteric Artery 3. Inferior Mesenteric Artery

Answer 29

Water, vitamins, and electrolytes are more absorbed in large intestine

Answer 30

If has not been examined, send for referral. If it has been examined, we should understand that MSK intervention will not be terribly effective. We should be looking more at pt ed, general conditioning, etc.

Answer 31

People who have had gut surgery are at very high risk for abdominal hernias. Pts often do not understand how fragile the ab wall could be after surgery Too often the MD says you can go back to your life with no limitations (without asking what the pt normally does) Often we need to be very specific about what not to lift with pt (give them an example of the max weight they can lift that they encounter in daily life and is something they are familiar with)

Answer 32

Post partum women can find they have weakness in fascia next to the rectus abdominus that can cause a hernia.

Answer 33

Senosis here (from hypertrophic sphincter) can be treated with a scope that puts in a stent (or we can just stretch it with the scope).

Answer 34

dr. T said that sometimes when a pt is recovering from or experiencing some sort of gastointenstinal upset, they drink water to help replace the lost liquid, but they may still feel poorly. She has found that just reccomending a sports dring with electrolyts can make a big difference and help them feel better (recover faster).

GI Disease Flashcards

(61 cards)