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CPNP EXAM PREP > GI > Flashcards

GI Flashcards

1
Q

Acute inflammation of gastric causing abdominal pain, nausea, vomiting, diarrhea, increased bowel sounds, sick feeling

A

Gastroenteritis

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2
Q

What is the most common cause of gastroenteritis

A

Viral

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3
Q

What are viral pathogens that cause

gastroenteritis

A

Rotavirus 50%
Adenovirus
Norovirus

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4
Q

This virus can cause gastroenteritis year-round and is more commonly in older children and adults

A

Norovirus

Caused by fecal oral route through contaminated food or water

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5
Q

This virus can cause gastroenteritis is seen in children 2 to 4 years old

A

Adenovirus

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6
Q

Rotavirus

A

50% of cases of gastroenteritis
Acute fever, emesis, watery no blood diarrhea

less than five years

Last 3 to 8 days, highly contagious
Fecal oral spread

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7
Q

Bacterial causes of gastroenteritis

A

Salmonella
Shigella
Campylobacter
E.coli

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8
Q

Common parasitic cause of gastroenteritis

A

Giardia lambia

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9
Q

What stool is associated with Campylobacter bacterial gastroenteritis

A

Odorous

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10
Q

What symptoms are associated with Shigella bacterial gastroenteritis

A

Fever spikes, bloody stool, febrile seizures

6m-3yrs

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11
Q

E.Coli has what type of stool associated in bacterial gastroenteritis

A

Mild loose stool

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12
Q

Giardia lambia

A

Flagellate protozoan parasitic causes of gastroenteritis
Found in contaminated food and water
Abdominal pain, flatulence, bloating, watery greasy foul smelling stool

Intermittent symptoms or a asymptomatic 1-4 week

Need stool culture to identify

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13
Q

Giardia lambia parasitic gastroenteritis treatment?

A

Albendazole, metronidazole

X7-10 days

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14
Q

When are diagnostic test done for gastroenteritis

A

Symptoms greater than 72 hours or presence of bloody stool

Stool guaiac + bacterial
Culture
Stool wbc
Ova and parasites

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15
Q

What pathogens of gastroenteritis are excluded from school

A

Rotavirus, E. coli, shigella

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16
Q

E. coli and shigella need what to return to school

A

Two negative stools

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17
Q

Moderate oral rehydration

A

50 mL / hr

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18
Q

Severe oral rehydration

A

100 mL/hr

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19
Q

When her antibiotics given in gastroenteritis

A

If 72 hours or labs are done

Or 8-10 stools /day

20
Q

Antibiotic management for gastroenteritis

A

Bactrim (trimethoprim/sulfamethoxazole) x5 days

Azithromycin 2nd line

Not given in salmonella

21
Q

Early sign of dehydration

A

Normal vital signs decreased output

22
Q

Blood pressure, heart rate, cap Refill, turgor, fontanel normal
Urine decrease slightly, normal mentation

A

Mild dehydration 3 to 5%

23
Q

Moderate dehydration percentage & symptoms

A 
6-9% 
Normal blood pressure, cap Refill
Heart rate increased
Turgor decreased
Urine <1mL/kg/h
Sunken fontanel
24
Q

Severe dehydration percentage and symptoms

A

> 10%

BP normal/decreased
HR decreased 
>3s cap Refill 
Turgor decreased 
Fontanel decreased 
Cool mottled 
Normal to lethargic to comatose mentation
25
Q

Affects anywhere in the G.I. tract chronic inflammation of the intestine triggered by pathogen

A

Crohn’s disease

Large uncontrolled inflammatory response wants a free radicals proteases, platelet activating factor causing tissue destruction is released

26
Q

Cobblestone appearance of the G.I. tract

A

Crohn’s disease

Scattered areas of the affected ileum colon or G.I. tract

27
Q

Symptoms of crohns

A 
Diarrhea 
Bloody stool
Malabsorption 
Pain with no diarrhea 
Decreased wt
Pain RLQ 
Food related pain 
Cobblestone intestinal tract

Family hx increases

28
Q

Severe frequent diarrhea with blood pain in left lower quadrant

A

Symptoms of ulcerative colitis

More diarrhea because decrease H2O absorption of the large intestine which is the main goal of that organ

29
Q

Inflammation of the colon or large intestine

A

Ulcerative colitis

30
Q

Ulcer created along the lumen of the large intestine spots in the mucosa tissue is eroded away, circumferential and continuous

A

UC

31
Q

Causes of ulcerative colitis

A

Diet/stress is a secondary cause
Auto immune origin —-T cells destroy lining

Family history plus environmental
>females
teens to 30s
Whites/Eastern European Jews

32
Q

Diagnostics for IBD

A

Stool-cal protein neutrophils in poop show inflammation in the intestinal lining

Upper G.I. shows IBD changes in extent

Endoscopy/colonoscopy with biopsy is the gold standard

CBC w/diff microcytic anemia; increase white blood cells, ESR, CRP

33
Q

Treatment for IBD

A

Referral to G.I.
Nutritional therapy to increase growth

Anti-inflammatory agents
Sulfasalazine,mesalamine

Immunosuppressant
Corticosteroids, cyclosporine,azathroprine

Biologics
Inflixamab,adalimimab

Surgery Ileocecectomy/ ostomy=CD
Coloectomy=UC

34
Q

Episodic/continuous abdominal pain occurs at least weekly ,at least x2 a month With no other cars

A

Functional abdominal pain, chronic abdominal pain, recurrent abdominal pain

35
Q

What age group is most common to have functional abdominal pain

A

School aged 8 to 15 years

13 to 17%

36
Q

Functional abdominal pain risk factors

A

School-aged
Male
Certain personality traits: maladaptive coping, protective parents, common absence from school due to pain

37
Q

Management of functional abdominal pain

A

Pain is real even with no organic cause reinforce normal behavior, decrease hectic lifestyle and hurried meals, identify stress, pain diary , no medication as needed

38
Q

Symptoms of functional abdominal pain

A 
Cranky dull pain
No radiation
Peri umbilical
No relief
Not related to food
No nighttime awakenings
Normal weight
Interferes with activity
Diffuse tenderness
No guarding
39
Q

How to calculate dehydration

Weight 7kg
Now 6.5 kg

A

Pre-illness Weight - illness weight
/ pre-illness weight x100

7 kg-6.5 =500 g
0.5/7=0.07x 100=7%

40
Q

Most common symptom of a pinworm infection

A

Anal itching

41
Q

Pinworms transmission

A

I don’t worm lives in rectum comes out at night to lay eggs on the perianal skin and dies causing itching; scratching and then finger to mouth contact transfers eggs into the intestines because children swallow them and then once they reach the duodenum they develop into mature worms and repeat the cycle

Easily float in air can be swallowed by others

42
Q

Worm like thread seen on toilet or underwear

A

Pinworms

Enterobius vermicularis

43
Q

Medication for pinworm

A

Pyrantel pamoate 11 mg/kg one dose

Albendazole 400mg POx1 repeat in 2 weeks

44
Q

Tight anal canal with no stool in vault

A

Hirschsprung’s disease

45
Q

Impacted stool with fissure and large dilated rectum

A

Constipation

CPNP EXAM PREP (17 decks)

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