Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ACLS > CEN study set 4, GI, GU, OB-GYN > Flashcards

CEN study set 4, GI, GU, OB-GYN Flashcards

(79 cards)

Start Studying
1
Q

At the completion of this section, the learner will be able to:

A

Prioritize treatments for patients with esophageal emergencies
Recognize signs of gastritis
Verbalize discharge instructions for patients with hepatitis
Differentiate between symptoms of small bowel obstructions and large bowel obstructions
Identify the abdominal organ most frequently injured in traumatic situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The CEN exam contains ten questions on gastrointestinal emergencies which involve the following topics:

A

Acute Abdomen, e.g. peritonitis, appendicitis, Bleeding, Cholecystitis, Cirrhosis, Diverticulitis, Esophageal varices, Esophagitis, Foreign bodies, Gastritis, Gastroenteritis, Hepatitis, Hernia, Inflammatory Bowel Disease, Intussusception,
Obstructions, Pancreatitis, Trauma, Ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a Mallory-Weiss tear?

A

small tears in the junction of the esophagus and stomach caused by violent retching and vomiting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe the treatment and bleeding of a Mallory-Weiss tear

A

Bleeding is usually self limiting

In rare cases, may need fluid resuscitation and injection of epinephrine to control bleeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is Boerhaave’s syndrome

A

Rupture of the esophageal wall secondary to violent retching and vomiting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is involved in the treatment of Boerhaave’s syndrome

A

IV fluids
Antibiotics
Surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

explain Esophageal varices

A

bleeding from distended blood vessels in the esophagus and stomach, usually secondary to liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

explain the treatment of Esophageal varices

A 
Treat hypovolemic shock with intravenous fluids and blood products
 Vasopressin (Pitressin) or sandostatin (Octreotide) - may be given with nitroglycerin to prevent cardiac ischemia
 Vitamin K (aquaMEPHYTON) to reverse underlying coagulopathies of liver disease
 Endoscopic procedures to control bleeding
 Sengstaken-Blakemore tube or Minnesota tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the causes of Esophagitis

A

Gastroesophageal Reflux Disorder (GERD), Achalasia impaired motility of the lower 2/3 of the esophagus, Esophageal infections, drugs that inflame the esophagus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some causes of Gastritis

A

Helicobacter Pylori infection, ingestion of noxious substances, stress, tobacco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the symptoms of Esophagitis

A

Pain
Burning in the chest
Worse with activities that increase intra-abdominal pressure
Worse 30 - 60 minutes after eating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the symptoms of Gastritis

A 
Epigastric pain relieved by eating food
 Nausea and vomiting (hematemesis)
 Diarrhea
 Anorexia
 Intestinal gas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some of the treatments of gastritis and esophagitis

A

cholinergics, dopamine antagonists, antacids, histamine H2 receptor antagonists, proton pump inhibitors, and acid protective agents such as carafate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do cholinergics treat esophagitis and gastritis?

A

such as bethanechol (Urecholine), increase lower esophageal sphincter pressure and promote gastric emptying.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how are dopamine antagonists used to treat esophagitis and gastritis?

A

such as metoclopramide (Reglan), move food through the gastrointestinal system faster.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the mechanism of action of antacids that make it useful in the treatment of esophagitis and gastritis

A

such as aluminum and magnesium (Maalox), neutralize stomach acid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what do proton pump inhibitors do that make them useful in the treatment of gastritis and esophagitis?

A

Proton pump inhibitors, such as lansoprazole (Prevacid), shut down the acid pump in the stomach.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what do Histamine (H2)-receptor antagonists do that make them useful in the treatment of gastritis and esophagitis?

A

Histamine (H2)-receptor antagonists, such as ranitidine (Zantac), block acid production.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Acid-protective agents, such as sucralfate or Carafate do what

A

provide a thick protective coat over the lower esophagus and stomach.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

discharge instructions for the treatment of gastritis and esophagitis might include:

A

Avoid irritating substances (NSAIDs, alcohol)
Avoid foods which decrease pressure on lower esophagus (chocolate, fatty foods, onion, garlic, peppermint, spearmint, tea and coffee).
Avoid medications which relax the lower esophagus (anticholinergics, beta-blockers, calcium channel blockers, diazepam, morphine sulfate, nicotine, nitrates, progesterone, estrogen and theophylline)
Eat small meals
Elevate HOB on 6 - 8” blocks
Encourage weight loss and smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Regardless of site of ulcer, typical pain is described as

A

“squeezing”, “indigestion”, “gnawing”, “colicky”, “aching” or “feeling of fullness” that is often epigastric and may radiate through to the mid back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the common demographic or age group affected by Duodenal ulcers and what causes and relieves pain?

A

Common between the ages of 30 and 55

•Pain starts prior to meals and is relieved by food or antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the common age group affected by gastric ulcers and when does the pain usually start?

A

Common between the ages of 55 and 70.

•Pain usually occurs after eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

describe the pain usually associated with cholecystitis

A

RUQ tenderness, guarding and rigidity, aggravated by taking a deep breath
Typically follows ingestion of fried ro fatty foods or ingestion of a large meal.
Murphy’s sign (inability to inhale deeply during palpation under the right costal margin near the liver).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
define Murphy's sign
inability of the patient to inhale deeply during palpation under the right costal margin
26
what is cholecystitis
acute or chronic inflammation of the gallbladder, usually caused by a gallstone that cannot pass
27
what are some of the signs and symptoms of cholecystitis?
pain, fever with infection, jaundice and dark urine
28
what is used to diagnose cholecystitis?
Elevated white blood cell count, serum and urine bilirubin and ALT. Thickened gallbladder wall, gallstones and pericholecystic fluid on ultrasound.
29
what is the method used in the treatment of cholecystitis?
``` IV fluids Antiemetics and analgesics NPO/Gastric tube Antibiotics Cholecystectomy after infection has subsided ```
30
what are the clinical manifestations of pancreatitis?
Pain - Rapid onset epigastric through to the back aggravated by eating, alcohol intake, walking or lying supine but relieved by leaning forward or assuming fetal position Abdomen tender to palpation Abnormal labs include elevated WBC, serum amylase, serum glucose and serum triglycerides.
31
what are some Complications associated with pancreatitis
Pleural effusion and acute respiratory distress syndrome (ARDS), Pancreatic abscess and sepsis, Retroperitoneal bleeding and hypovolemia, hypocalcemia
32
how does pancreatitis lead to PE and ARDS?
Pancreatic inflammation can lead to activation of the inflammatory response with capillary permeability can lead to fluid accumulation in the lungs (ARDS) and pleural effusions.
33
Pancreatic abscess and sepsis will manifest as
The infection can lead to pancreatic abscesses and sepsis. Symptoms may include a worsening fever, increasing abdominal pain and indications of sepsis.
34
why does pancreatitis cause retroperitoneal bleeding and hypovolemia
Autolysis caused by release of pancreatic enzymes can cause bleeding from the pancreas and other abdominal structures. Signs and symptoms include hypotension, tachycardia, a diminishing hematocrit, abdominal distension, bruising of the flanks and umbilicus
35
pancreatitis can cause hypo_______. What are the symptoms of this condition?
Symptoms include tetany and serum calcium levels below 8 mg/100 dL.
36
how are Nitroglycerin or papaverine used to treat pancreatitis
relaxation of the smooth muscles
37
how are Antispasmodics such as dicyclomine (Bentyl or propantheline bromide (Pro-Banthine) used to treat pancreatitis
Decrease vagal stimulation and release of pancreatic enzymes
38
how are Carbonic anhydrase inhibitors such as acetazolamide or Diamox used to treat pancreatitis?
reduction on volume and concentration of pancreatic juices
39
how are antacids effective in the treatment of pancreatitis?
neutralize gastric secretions
40
how do Carbonic anhydrase inhibitor such as acetazolamide (Diamox) treat pancreatitis?
Reduction in volume and concentration of pancreatic juices)
41
how do Histamine H2-receptor antagonists such as cimetidine (Tagamet) and ranitidine (Zantac) help with the treatment of pancreatitis?
decreases hydrochloric acid which can diminish pancreatic secretions
42
how does calcium gluconate help with the treatment of pancreatitis?
it helps to alleviate hypocalcemia
43
how do corticosteroids help with the treatment of pancreatitis?
treatment of sepsis
44
how does glucagon help with the treatment of pancreatitis?
reduces the pancreatic inflammation and decreases serum amylase as well as suppressing pancreatic secretions
45
how is hepatitis A transmitted and what are two notable details
transmission is through the fecal/ oral route. It causes epidemic and there is a vaccine available
46
how is hepatitis B transmitted and what are two notable details
Parenteral/Sexual/ occupational exposure/ perinatal/human bites Can be acute (< 6 months) or chronic (> 6 months) • Vaccine available
47
how is hepatitis C transmitted and what are two notable details
Parenteral/occupational exposure/deviant sexual practices, perinatal 50% become chronic • May be asymptomatic at first
48
how is hepatitis E transmitted and what are two notable details
Similar to Hepatitis A | • Rare in the USA, more common in Asia, Mexico and Africa
49
what are the indications of liver dysfunction (10)
Elevated ammonia levels/decreased urea levels treated with lactulose Decreased albumin and calcium levels with generalized edema and ascites, treated with albumin administration and removal of fluid from the peritoneum Lack of clotting factors leading to petechiae, easy bruising and bleeding, treatedwith vitamin K Elevated serum and urine bilirubin, decreased fecal bilinogens. Clay colored stools and dark colored urine which foams when shaken. Jaundice Steattorhea Liver enzymes (ALP, SGOT, SGPT and GGT) elevate. Albumin decreases PT and PTT climb
50
what liver enzymes are elevated with liver dysfunction?
Liver enzymes ALP, SGOT, SGPT and GGT elevate.
51
what are the clinical manifestations of mild hepatitis
malaise, fatigue, anorexia, nausea and vomiting, right upper quadrant pain, joint pain
52
what are the clinical manifestations of severe cases of liver dysfunction
jaundice, clay colored stools, dark colored urine
53
treatment of liver dysfunction include what
``` Acute cases must run their course Severity of chronic cases may be diminished with: Interferon-alpha Pegylated interferon Adefovir dipivoxil Lamivudine Riboflavin ```
54
what is Steatorrhea
Chunky yellow foul | smelling fatty stools which float in toilet water
55
what are the symptoms of appendicitis
Pain starts umbilical, then localizes to McBurney's point in the RLQ. Pressure on the LLQ results in pain in the RLQ Rovsing's sign. Flexion of the knees decreases pain Pain may be in the RUQ in pregnant women Elevated WBC Fever Vomit ing Enlarged appendix on ultrasound or CT scan.
56
what is involved in the treatment for appendicitis?
surgery
57
what are the symptoms of peritonitis?
``` Pain Diffuse abdominal pain which worsens with movement or coughing. Relieved with flexion of the knees Tenderness to palpation Rigid (washboard) abdomen. Fever/sepsis Decreased bowel sounds Dehydration/electrolyte imbalances Respiratory difficulties ```
58
what is involved in the treatment of peritonitis?
NPO/Surgery IV fluids and antibiotics Analgesics/Antiemetics/Antipyretics
59
what is diverticulitis and what are the clinical manifestations
Inflammation of the diverticula of the colon, usually the sigmoid colon. Clinical manifestations Generalized abrupt onset aching cramping pain which localizes to the LLQ. Fever and WBC Abdominal tenderness
60
what is involved in the treatment of diverticulitis
NPO/gastric tube to rest bowel IV fluid replacement Antibiotics Surgery for ruptured diverticuli
61
what is pyloric stenosis and where is it found in the body
Marked hypertrophy and hyperplasia of the pylorus muscle and narrowing of the gastric antrum. The pylorus is found between the stomach and the small intestine.
62
what is intussusception? Where does it usually present?
telescoping of the bowel within itself. Most common near the ileocecal valve or a Merkel's diverticulum in adults, may occur near a colon tumor or polyp
63
what demographic is most effected by pyloric stenosis?
95% occur during the first 3 - 12 weeks of life.
64
what are the symptoms of pyloric stenosis
Projectile vomiting - Poor weight gain - Continual hunger and constipation - Jaundice - Gastric peristalsis prior to emesis - Mobile, hard, "olive" shaped mass over pylorus - Elevated bilirubin, hypochloremia, and hypokalemia
65
what are the symptoms of intussusception?
Colicky pain associated with peristalsis. Child may sleep for 15 - 30 minutes, then scream with pain and pull legs to abdomen for 15-30 minutes, then fall back asleep - Lethargy and fever which worsen due to increased ischemia of the bowel. - Mucusy bloody stool that may look like grape jelly - Vomiting food, mucus or fecal matter - Increased bowel sounds during painful episodes - Tender, palpable "sausage-shaped" mass over the site of the intussusceptions in the right lower and middle abdomen
66
Treatment for bowel obstruction
``` IV fluids for fluid and electrolyte imbalance. Antiemetics and analgesics Rest the bowel (NPO and gastric tube) Barium enema - Intussusception Surgery - Volvulus Pyloric stenosis Indications of perforation ```
67
what are some clinical manifestations of regional ileitis?
``` Abdominal distension - Anemia - Weight loss - Low-grade fever - Nausea and Vomiting - Dehydration and fluid/electrolyte imbalances - Abdominal cramping and tenderness - Flatulence - 3 - 4 semi-soft stools daily with no blood, some fat is present and stools are foul smelling ```
68
what is Ulcerative colitis?
Chronic inflammatory disease affecting only the large intestine commonly in the sigmoid and rectal areas. • Affects only the mucosal and sub-mucosal layers
69
what are the clinical manifestations of Ulcerative colitis?
Abdominal distension • Anemia • Weight Loss • Fever • Nausea and Vomiting • Dehydration and fluid/electrolyte imbalances • Abdominal cramping typically in the left lower quadrant • Diarrhea (5 - 25 stools/day) with blood, mucus and pus but no fat • Rectal Bleeding
70
regional ileitis and Ulcerative colitis are categorized as what?
functional bowel syndromes
71
what are the potential complications of functional bowel syndromes such as ulcerative colitis and regional ileitis?
``` Fistulas (with regional ileitus) Intestinal obstructions Malnutrition Bowel perforation Toxic megacolon ```
72
Most frequently injured abdominal organ | Associated with fractures of ribs 10 - 12 on the left.
spleen
73
what are the signs and symptoms of an injured spleen?
LUQ pain (referred to left shoulder) LUQ bruising Hypovolemia Signs of peritoneal irritability
74
what are the signs and symptoms of an injured liver and what rib fx are associated with it locally?
RUQ pain (referred to right shoulder) RUQ bruising Hypovolemia Rigid abdomen/rebound tenderness
75
Which of the following lab values is likely to be decreased in a patient with cirrhosis of the liver? a) Serum bilirubin b) Serum ammonia c) Blood urea nitrogen d) Partial thromboplastin time
c) Blood urea nitrogen
76
Which of the following presentations is most consistent with a patient who has pancreatitis? a. Epigastric pain that radiates to the umbilical region b. Epigastric pain that radiates midline through to the back c. Left upper quadrant pain that radiates to the left shoulder d. Right upper quadrant pain that radiates to the right shoulder
b. Epigastric pain that radiates midline through to the back
77
Which of the following conditions will likely go directly to the operating room from the emergency department? a. Pancreatitis b. Cholecystitis c. Ulcerative colitis d. Boerhaave's syndrome
d. Boerhaave's syndrome
78
The emergency nurse knows a patient with end stage cirrhosis of the liver has understood their discharge instructions if they state that they will minimize their intake of: a) Starch b) Protein c) Carbohydrates d) Fresh fruits and vegetables
b protein
79
what is renal colic?
accumulation of materials within the renal pelvis into a stone which typically exits out the genitourinary system causing significant discomfort.

ACLS (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions