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kol- Med Surg 320 Spring > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

type of breast cancer that is not a “true cancer” - cannot invade tissue: lobular carcinoma in situ or inflammatory breast cancer?

A

lobular carcinoma

Note: inflammatory breast cancer is found late in disease process, often times no lump and will not show up on mammo

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2
Q

what does lump feel like w/ infiltrating ductal carcinoma?

A

irregular, uneven borders

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3
Q

brachy vs tele therapy- internal or external?

+ which one are we concerned about our exposure to?

A 
brachy = internal device :  Patient emits radiation while as long as device is emitting radiation
tele= external
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4
Q

sealed vs unsealed radiation - which has body fluids that emit radiation?

A

Unsealed: Any body fluids are also radioactive
Sealed: Only the patient emits radiation - not excreted into bodily fluids

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5
Q

stomatitis vs mucositis?

A

◦ Stomatitis = irritation in mouth only

◦ Mucositis = irritation in entire GI Tract

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6
Q

type of diet that increases risk of colorectal cancer?

A

high fat, low fiber

heavy alcohol use

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7
Q

SCREENING - when do we start?
colon cancer average risk vs high risk=
breast cancer average risk vs high risk=

A

colon high risk = <45
colon low risk = >45

breast high risk= <40 + MRI + 10 years younger than 1st deegree relative tested + for BC
low risk= annual mammo >40

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8
Q

Colorectal cancer TESTING
colonoscopy looks for?
FOBT looks for? What does it tell us?

A

colonoscopy look for precancerous POLYPS
FOBT looks for blood = bleeding , follow w/ colonoscopy

NOTE: *if test negative on FOBT does not mean you do NOT have cancer, just means no blood

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9
Q

most common type colon cancer (think cellular level) and most common cause

A

> Most are adenocarcinomas

>Polyps form first and can transform into CRCs

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10
Q

3 main assessments for colonrectal cancer:

A
  • Rectal bleeding
  • Anemia
  • Changes in stool
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11
Q

colon cancer bleeding:

what does color of blood tell us- mahogany vs bright red?

A

Mahogany (bleeding further up) vs Bright red (bleeding lower down)

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12
Q

Gross blood most common with tumors on _______ side of colon/rectum

A

left

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13
Q

partial vs complete bowel obstruction (sounds and see)

A

• Partial bowel obstruction

  • ->Visible peristaltic waves
  • -> Tinkling bowel sounds

• Complete bowel obstruction
–> Absence of bowel sounds

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14
Q

anemia is more associated with right or left sided colon cancer?

A

right

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15
Q

blockage w/ colon cancer usually in what colon sections?

A

transverse, descending

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16
Q

rectosigmoid cancer characterized by

A
  • Hematochezia (poo blood)
  • Straining
  • Narrowing of stools
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17
Q

colostomy w/ 2 openings

-What does top drain? what does bottom drain?

A

Colostomy w/ mucous fistula
= 2 different stomas
‣ mucous fistula= bottom = drains mucous
‣ top fistula= drains stool

18
Q

MATCH THE STOOL TYPE

ASCENDING
TRANSVERSE
DESCENDING
ILEOSTOMY

solid, pasty, liquid

A

Ileostomy= liquid

Ascending colon= liquid

Transverse colon= pasty

Descending colon= solid stool

19
Q

deficient b12 w/ which 2 GI conditions?

A

Crohn’s and Chronic Gastritis

20
Q

Hematemesis w/ which diseases

A

acute gastritis

gastric ulcer

21
Q

blood in stool w/ which diseases

A

acute gastritis
duodenal ulcer
colon cancer
ulcerative colitis

22
Q

Barrett’s esoph- cells go from ______ to ______

A

squamous to columnar

columnar tolerate acid better but increase cancer risk

23
Q

random thing: which GI disease we have studied can lead to cardiac disease and pneumonia?

A

GERD

24
Q

hiatal hernia is risk factor for which GI disease?

A

GERD

25
Q

meds causing LED/ GERD

A 
◦ Nitrates
◦ NSAIDS
◦ Oral contraceptives
◦ CCB’s
◦ sedatives
‣ Avoid these medications is not always possible!
26
Q

random thing: we are concerned about gastric neuropathy related to diabetes w/ which disease process?

A

GERD

27
Q

GERD- elevated HOB how many inches?

A

6-12

6 is average, 12 is for adult film level elevation

28
Q

on a patho level what is difference b/w acute gastritis and peptic ulcer?

A

gastritis = inflammation of mucosa

peptic ulcer = lesion of mucosa

29
Q

2 random drugs leading to peptic ulcers

A

glucocorticoids and theophylline

30
Q

pH exam for what GI disease?

A

GERD

usually used EGD

31
Q

peptic ulcers:

bowel sounds early vs late

A

Hyperactive bowel sounds (early)

• Hypoactive bowel sounds (late)

32
Q

definitions: crohn’s vs UC

A 
crohns= Chronic inflammatory disease of the small intestine, colon, or both with periods of remission and exacerbation
UC= Chronic inflammation of the rectum and sigmoid colon with periods of remission and exacerbation
33
Q

tenesmus is unque to which 2 disease processes

A

UC, Crohn’s

34
Q

UC >10 years = increase chance of developing….

A

colon cancer

35
Q

UC - monitor for what 2 vital signs in particular

A

Fever & Tachycardia&raquo_space; may be sign of worsening or complication: sepsis, bleeding, electrolyte imbalance, dehydration

36
Q

steatorrhea unique to what disease process

A

crohns

37
Q

4 ways to differentiate crohns s/s from UC

A

-Diarrhea- **Steatorrhea (fatty diarrhea)
-Abdominal pain- **Constant, RLQ and around umbilicus.
(Can be in the LLQ if the colon is also affected.)
-Fever: Secondary to **when a patient has a fistula, abscess, or severe inflammation.
-Weight loss: **Secondary to malabsorption, Anorexia, increased catabolism,…

38
Q

Definitions: diverticulosis vs diverticulitis

A
  • Diverticulosis = pouch-like herniations of mucosa through muscle wall of gut (usually occurs in the colon)
  • Diverticulitis = Inflammation of diverticula (herniation)
39
Q

usual sxs of diverticulitis

A 
Abdominal Pain (LLQ), nausea, constipation 
Perforation --> Peritonitis
40
Q

s/s of peritonitis

A 
• Abdominal pain
• Rigid Board-like abdomen
• Fever
• Tachycardia
• Low blood pressure
(signs of poor perfusion and infection)

(diverticulitis, colon cancer)

41
Q

diverticulosis vs itis interventions (esp consider fiber)

A

-Diverticulosis
High Fiber 25-25 g
Fluids
avoid Foods with seeds

-Diverticulitis
Avoid fiber
Antibiotics
Analgesic
Opioids
IV fluids
Bowel rest
Rest
Avoid increased abdominal pressure

kol- Med Surg 320 Spring (43 decks)

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