Flashcards in GI Drugs Take 1 Deck (33):
1
what kinds of drugs that can mess with LES function (ie lower the tone)?
anti-cholinergic
anti-muscerinic
2
what is the vicious cycle of GERD/
esophageal damage causes reduced esophageal peristalsis causes compromised integrity of LES causes more gastric contents and more esophageal erosion
3
how do H2RAs work?
blocks H2 receptor in the stomach and it blocks acid production (75-80% acid reduction)
4
how much acid reduction do PPis give you?
85-90%, shuts down acid production
5
what are pro-ulcerative substances?
gastric acid (inc. by histamine, gastrin, ACh)
Pepsin (proteolytic enzyme)
6
what are protective gastric substances?
gastric mucus
bicarb
prostaglandins (increases mucous and bicarb and mediates gastric repair)
7
what do you do when a pt isn't getting relief from a PPI?
try a different one
8
where does non-hodgkins lymphoma typically go to?
stomach cancer
9
what deficiency can duodenal resection cause?
folate
iron
Ca
10
what deficiency can terminal ileum cause?
B12
bile salts
11
what deficiency can extensive SB resection cause?
diarrhea
weight loss
electrolyte nutrient malabsorption
12
what is an ileus?
a functional gut problem
neurogenic failure or loss of peristalsis in the absence of mechanical obstruction
13
what is the MCC of ileus?
post operative
(other causes could be peritoneal inflammation or extreme illness)
14
how does an ileus present?
mild abd pain (diffuse)
N/V
distention
hypoactive or absent BS
15
why is the pelvic MRI good for colorectal cancer?
it can tell you if there is presacral nerve involvement
16
what is the rectal coil?
enhances images that are taken in the area
-it is large! it doesn't feel good!
17
who is most commonly affected by constipation?
women and elderly
18
what is the MCC of constipation?
inadequate fiber and fluid intake
poor bowel habits
19
what is functional constipation?
normal transit (35 hrs) but have trouble pushing it out
idiopathic, eating problems
20
what is slow transit?
takes more than 3 dys to have a BM
21
what is evacuation disorder?
functional outlet obstruction
paradoxical contraction of anal sphincter and/or pelvic floor
22
what is ROME criteria?
helps to define functional constipation
->3mo of sxs
-onset >6 mo
->2 of (straining, hard stools, incomplete evacuation, anorectal blockage, manual maneuvers, t have IBS
23
what is a common secondary cause of constipation?
medications
24
when would you suspect obstructing colonic lesion?
new onset sxs
25
what are alarm sxs for constipation pt?
bleeding
wt loss
anemia
heme (+)
family hx of colon cancer
26
how do you assess ppls stool?
bristol stool form scale
(type 1-type 7)
type 8 is mucous like, bubbly, foul
27
what is a rectocele?
vaginal wall or bladder is protruding into rectum
28
what is a SITZ mark study?
ingest capsule w radio plaque markers,
f/up imaging to evaluate for pattern of retained markers
29
what is anorectal manometry?
measures function of the anal sphincter
30
when might you need to get a subtotal colectomy in a constipation pt?
colonic inertia
nothing works
31
what is an internal hemorrhoid?
supepithelial vascular cushion protects seal of anus
-arise from rectal artery and veins
32
what is an external hemorrhoid?
arise from inferior hemorroidal veins (below dentate line)
-squamous epithelium
33