GI & GU Systems Flashcards

1
Q

Name the regions:

A
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2
Q

What organs will you find in the RUQ?

A

liver

gall bladder

duodenum

right kidney

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3
Q

What organs comprise the upper GU tract?

What organs comprise the lower GU tract?

A

kidneys

pelvicalcyceal system: urine collection which includes the ureters, bladder, and urethra

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4
Q

Describe the appearance of hematemesis.

A

coffee ground emesis

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5
Q

What is the medical term for “pain with swallowing”?

A

odynophagia

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6
Q

What are the symptoms for GI disorders?

A

Abdominal Pain
Indigestion, N/V
Early satiety when eating / loss of appetite
Dysphagia/odynophagia
Change in bowel function (diarrhea/constipation)
Jaundice/Liver disease

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7
Q

What region does urinary and renal disorders present on the patient?

A

suprapubic

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8
Q

What are the symptoms of urinary and renal disorders?

A

Dysuria, urgency, or frequency
Hesitancy, decreased stream (males)
Polyuria or nocturia
Urinary incontinence
Hematuria
Kidney or flank pain
Ureteral colic

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9
Q

KNOW

What should you discuss with your kidney disease patient? (4)

A

History of kidney dysfunction
History of dialysis – last treatment, location and any problems with AV fistula
Medications
Daily urine production

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10
Q

Define Ch.L.O.R.I.D.E.

A

Character of pain: ask patient to describe in own words
Location: have patient report location of the pain
Onset: timing of the pain (acute vs. chronic)
Radiation: Does the pain radiate?
Intensity or Severity of pain (1-10 scale)
Duration: how long has this pain been going on/lasts?
Exacerbating or alleviating factors: what worsens or improves pain?

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11
Q

What are some other GI symptoms?

A

heartburn
acid reflux/regurgitation
N/V
anorexia (loss of appetite)
early satiety

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12
Q

Name 3 GU functional adjuncts:

A

Ileal conduit

PD catheter

vascath

(depicted in clockwise order)

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13
Q

What is the medical term for “difficulty swallowing (solids, liquids, or both) Intermittent or persistent”?

A

dysphagia

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14
Q

If patient is unable to pass gas and is distended with N/V , what may be our diagnosis?

A

bowel obstruction

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15
Q

How do you quantify an acute vs. chronic symptom?

A

acute is up to 2 weeks

chronic is beyond 2 weeks

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16
Q

The inability to excrete ingested water because of the hypovolemic stimulus to the release of antidiuretic hormone is what?

A

hyponatremia

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17
Q

What results if free water losses are not replaced?

A

hypernatremia

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18
Q

What can occur is there if a GI loss of potassium in the stool?

A

hypokalemia

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19
Q

What can occur with the GI loss of bicarbonate in the stool?

A

metabolic acidosis

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20
Q

What are the symptoms of GI bleeding? (2)

A

Melena: black tarry stools (signifies upper GI bleed)
Hematochezia: bright red blood (signifies lower GI bleed)

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21
Q

Odynophagia is painful swallowing and usually is infectious in nature. True or false?

A

true

Typical infections include: herpes, candida, or CMV infections in an immunocompromised patient (malignancy or AIDS)

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22
Q

What is characterized by the yellowish discoloration of skin and sclerae from > levels of bilirubin?

A

jaundice

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23
Q

What is polyuria?

A

increase in 24 hour urine volume

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24
Q

What is severe pain that originates at the costovertebral angle and radiates to lower quadrants of the abdomen, upper thigh, or genitals?

A

Ureteral colic

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25
Q

KNOW

What causes urinary incontinence? (9)

A

Pregnancy and childbirth
Changes with aging, Hysterectomy
Painful bladder syndrome (interstitial cystitis)
Prostatitis
Enlarged prostate
Prostate cancer
Bladder cancer or bladder stones
Neurological disorders
Obstruction

26
Q

Where do you listen for bruits during an abdominal exam?

A

Listen over aorta, renal, iliac, and femoral arteries

27
Q

What is boborygmi?

A

“stomach growling”

28
Q

What is the normal rate of clicks & gurgles sounds when listening to the bowels?

A

5 - 34 /minute

29
Q

Bruits confined to systole are abnormal. True or false?

A

false

They are normal.

30
Q

How do you assess for peritoneal inflammation? (3)

A
  1. Ask patient to cough
  2. Map tenderness with 1 finger
  3. Assess for rebound tenderness (press fingers down slowly then release quickly)
31
Q

What do you note when performing abdominal exam during light and deep palpation of the 4 quadrants?

A

tenderness

guarding (muscles contract as pressure is applied)

masses

32
Q

How do you assess for costovertebral angle tenderness (CVA tenderness)? (3)

A

On pt’s back:

  • Place ball of one hand in the costovertebral angle and strike it with the ulnar surface of your other fist
  • Use enough force to cause a perceptible but painless jar or thud in a normal person.
  • Pain is suggestive of pyelonephritis (kidney infection)
33
Q

What are the risk factors for a AAA?

A

> 65 years of age

smoker

male

family history of AAA

34
Q

What is ascites?

A

Ascites is fluid within the abdomen usually as result of end stage liver disease (cirrhosis) or malignancy.

35
Q

In a patient with ascites, during an abdominal exam where will you hear tympany/dullness?

A

Ascites fluid typically sinks with gravity, whereas gas filled loops of bowel float to the top, percussion gives a dull note in dependent areas of the abdomen.

36
Q

What are mechanical causes of bowel obstructions? (3)

A

adhesions

hernias

tumors

37
Q

On PE, very high pitched bowel sounds indicate what?

A

full stomach

38
Q

What is formed in the liver and therefore is a measure of hepatic function?

A

albumin

39
Q

What is the normal range for albumin?

A

3.5 - 5.5 g/dL

40
Q

What is AST and ALT?

A

Aspartate Aminotransferase

Alanine Aminotransferase

Both found in multiple tissues of the body (ie: liver, kidney, heart, skeletal muscle), but ALT predominantly in the liver.

41
Q

What are normal values for AST / ALT?

A

7 - 40 U/L for both

42
Q

What enzyme is found in the liver, biliary tract epithelium, and bone?

A

alkaline phosphatase

43
Q

What is the normal value for alkaline phosphatase?

A

25-85 IU / L

44
Q

What labs are used to detect and monitor pancreatic disease?

A

amylase

lipase

45
Q

What lab can indicate a dysfunction of metabolism?

A

bilirubin

46
Q

What lab test assesses the extrinsic pathway of clot formation?

What are normal values for this test?

A

PT (Coumadin therapy)

10 - 15 seconds

47
Q

What test assesses the intrinsic pathway of clot formation?

what are the normal values?

A

PTT (Heparin therapy)

25-38 seconds

48
Q

PTT measures what blood factor that may be altered due to hepatocellular disease?

A

Factor VII

49
Q

What test detects presence of this organism in patients with gastric or duodenal ulceration or inflammation?

A

Helicobacter pylori

50
Q

What test:

  • measures the amount of urea nitrogen in the blood
  • is directly related to metabolic function of the liver and excretory function of the kidneys?
A

BUN

51
Q

What are normal values for BUN?

A

7-21

52
Q

What test:

  • rises later than BUN suggesting a more chronic disease process
  • depends on muscle mass which fluctuates very little
A

serum creatinine

53
Q

If creatinine value doubles, what does this suggest?

A

50% reduction in GFR

54
Q

What are normal creatinine values?

A

0.5 - 1.5 mg/dL

55
Q

What lab test measures GFR?

A

creatinine clearance

56
Q

At what levels of K do you need to be concerned about cardiac dysrhythmias?

A

K < 2.5 mEq/L

K > 5.9 mEq/L

57
Q

What nuclear medicine is injested in an upper GI series test?

A

barium

58
Q

What anesthetic drugs do you use for upper endoscopies?

A

propofol

fentanyl

59
Q

What procedure is perfomed to treat conditions of the bile ducts and main pancreatic duct, including biliary stones, strictures, certain malignancies, and other disorders?

A

Endoscopic retrograde cholangiopancreatography (ERCP)

60
Q

What anesthetic drug do you use for colonoscopies?

A

propofol only

61
Q

What can CT scans assess for within the GI? (4)

A

infection/inflammation

cancer

kidney/bladder stones

AAA

62
Q

When may be a cystoscopy be recommended?

A

Urinary tract infections
Hematuria
Incontinence or overactive bladder
Abnormal cells found in urine sample
Need for a bladder catheter
Painful urination, chronic pelvic pain, or interstitial cystitis
Urinary blockage from prostate enlargement, stricture, or narrowing
Stone in the urinary tract
Unusual growth, polyp, tumor, or cancer