Immune and GI systems Flashcards
(210 cards)
1
Q
What is the primary central gland of the immune system?
A
thymus
produces lymphocytes (primary immune cells)
2
Q
(true/false) The thymus is not fully developed until puberty.
A
FALSE - thymus is fully developed at birth and then reaches maximal size at puberty
Decreases in size and is slowly replaced by adipose tissue as a person ages.
3
Q
What is the function of the spleen?
A
- Filters antigens from the blood
- produces leukocytes, monocytes, lymphocytes, and plasma cells in response to infection
- Produces RBC and WBC while in embryo
Only produces lymphocytes after birth unless severe anemia exists
4
Q
definition
Classification of diagnoses characterized by immune system responses directed against the body’s normal tissues; self-destructive processes impair the body functioning
A
autoimmune diseases
5
Q
What is HIV?
A
A virus that weakens the immune system and destroys cells that fight disease and infection
- CD4+ helper cells, resulting in CD4+ T lymphocytopenia (major immune system defect)
6
Q
What are the stages of HIV?
A
Stage 1: flu-like illness within 2-4 wks after exposure/infection
stage 2 (clinical latency): asymptomatic HIV infection or chronic HIV infection that can last a decade or longer
Stage 3 (AIDS): most severe phase; mass destruction of cells resulting in the immune system not being able to fight off disease or illness
7
Q
How is HIV spread?
A
Body fluids
Rare: during pregnancy, birth, or breastfeeding
8
Q
(true/false) HIV can be transmitted through saliva, tears or sweat.
A
FALSE (unless blood is present)
9
Q
(true/false) AIDS can be contracted through respiratory inhalation, skin contact, or human waste
A
FALSE
10
Q
What is the regular range of CD4?
A
500-1200 cells/mm
11
Q
What is used to diagnose AIDS?
A
- CD4 cell count < 200 cells/mm or if they develop opportunistic illnesses - have a high viral load and are very infectious
- presence of acute symptoms secondary to immune system deficiency (AIDS-Related Complex (ARC))
12
Q
What is AIDS-related complex (ARC)?
A
presence of acute symptoms secondary to immune system deficiency
13
Q
What are the s/s of HIV?
A
- flu-like symptoms that resolve within a few weeks
14
Q
(true/false) Getting tested is the only way to diagnose HIV.
A
true
15
Q
What are the s/s of AIDS?
A
- presence of opportunistic infections
- malignancies
- neural conditions
- deconditioning
- anxiety and depression
16
Q
What opportunistic infections that are considered as AIDS-defining conditions?
A
- PNA
- candidiasis
- cytomegalovirus
- toxoplasmosis
17
Q
What is the most common malignancy caused by AIDS?
A
Kaposki’s sarcoma and non-hodgkins lymphoma
18
Q
What neuro conditions can be seen with AIDS?
A
- AIDS dementia complex
- focal encephalitis
- meningitis
- herpes zoster
19
Q
(true/false) Some patients with AIDS may exhibit a brief, early, nonspecific viral HIV infection and then remain asymptomatic for years.
A
True
20
Q
(true/false) antibiotics cure HIV infections
A
FALSE (no cure for HIV)
21
Q
Those with HIV will progress to having ____ if not treated.
A
AIDS
22
Q
What medication does not cure HIV but does keep those with HIV healthy for many years if taken consistently and correctly?
A
Antiretroviral therapies (ARTs)
Antiviral drugs reduce the amount of virus (viral load) in the system
23
Q
What does a retrovirus do?
A
Replicates in reverse fashion (RNA code is transcribed into DNA)
24
Q
What are common side affects of ARTs?
A
- N/V
- diarrhea
- HA
- dizziness
- fatigue
- pain
- rash
25
(True/false) a person experiencing an acute episode of HIV can participate in exercise testing.
FALSE - no exercise testing during acute infections
## Footnote
Avoid intense exercise with symptomatic individuals due to possible immune suppression occurring
26
What does staphylococcus aureus commonly begin as?
localized infection through skin portal
## Footnote
Bacterial invasion and spread is through the bloodstream or lymphatic system to almost any body location
27
What do staphylococcus aureus infections produce on the skin?
Pus formation and abscess
28
# Diagnosis
- swollen, painful red bumps that can quickly progress to an abscess with pus/drainage inside
- area around abscess is warm to the touch
- fever
- possibility to produce life-threatening infections in the body
MRSA
29
(true/false) MRSA can be treated and reappear in the same individual
true
30
(true/false) Vancomycin-resistant staphylococcus aureus (VRSA) can be a life-threatening infection
true
31
- fever
- chills
- swollen lymph nodes
- HA
- muscle and joint aching
- fatigue
- bulls-eye rash
| Within 3-30 days of tick bite
Lyme disease
32
What are the symptoms of lyme disease if left untreated?
| Days to months after tick bite
- severe HA and neck stiffness
- arthritis, joint pain and swelling
- palpitations and/or irregular heartbeat (lyme endocarditis)
- inflammation of brain and spinal cord
- nerve pain
- shooting pain
- N/T in hands and feet
- palsy
- issues with short-term memory
33
What is it called when symptoms of lyme disease linger for months or years after treatment of an acute infection?
| 10% of cases
Post-lyme disease syndrome (PLDS)
34
What is the cause of PLDS?
unknown- individuals are asymptomatic in the absence of clinically detectable infection
35
What are symptoms of PLDS?
- MSK pain
- fatigue
- impaired cognition
- difficulty sleeping
- unexplained numbness
36
(true/false) An extended course of antibiotics has been proven beneficial for treatment of PLDS.
false
## Footnote
treatment is symptomatic-based (analgesics, antidepressants, and psychotherapy) and most patients recover with time
37
# Diagnosis
- rash with the site of bite being black or crusted
- caused by a tick
- fever and chills
- muscle aches
- confusion
- N/V
- neuro changes
Rocky mountain spotted fever
38
What are possible complications of rocky mountain spotted fever?
- encephalitis
- inflammation of heart and lungs
- heart failure
- kidney failure
- serious infection in fingers in toes (possible amputation)
- death (if untreated)
39
Complications of rocky mountain spotted fever can be avoided if treatment is started within ___ days of developing symptoms
5 days
40
(true/false) MRSA can be contracted via indirect and direct contact to infected person
true
41
Plasma makes up ___% of of total blood volume
55%
| 91% water, 7% protein, 2-3% other small molecules
42
RBCs make up ___% of the total blood volume
45%
43
What is the function of erythropoietin?
hormone that regulates RBC production
44
How long do most RBCs last?
120 days
45
(true/false) RBC count varies with age, activity, and environmental conditions
true
46
Leukocytes make up __% of total blood volume
1%
47
Where are leukocytes produced?
bone marrow
| Along with RBCs
48
# definition
The normal function and generation of blood cells in bone marrow
hematopoiesis
49
What regulates production, differentiation, and function of blood cells?
Cytokines and growth factors acting on blood-forming cells
50
What is ESR?
Rate of RBCs to clot
51
What is indicated when ESR is elevated?
presence of inflammation
52
What are the normal values of ESR?
Male: <15 mm/hr
Female: <20 mm/hr
53
What is hemostasis?
Termination of blood flow by mechanical or chemical processes
## Footnote
- vasospasm
- platelet aggregation
- thrombin and fibrin synthesis
54
What does blood clotting require?
1. platelets (produced in bone marrow)
2. Von Willebbrand's factor (produced by endothelium of BVs)
3. clotting factors from the liver using vitamin K
55
What is fibrinolysis?
clot dissolution that prevents excess clot formation
56
Atherosclerosis, DM, elevated blood lipids, and cholestrol have a (decreased/increased) platelet function.
increased platelet function
57
(true/false) A person with a hypocoagulopathy disorder has no limitations for exercise.
FALSE: strenuous exercise contraindicated due to risk of increased hemorrhage
58
# Diagnosis
Condition of inadequate blood flow to the body tissues that is associated with hypotension, inadequate cardiac output, and changes in peripheral blood flow resistance
shock
59
What causes hypovolemic shock?
Hemorrhage, vomiting, or diarrhea
60
What s/s is progressive shock associated with?
- restlessness and anxiety
- weakness
- lethargy
- pallor with cool and moist skin
- decreased body temperature
61
# diagnosis
- fatigue and weakness with minimal exertion
- DOE
- pallor or yellow skin of the face, hands, nails, or lips
- tachycardia
- bleeding gums, mucus membranes, or skin w/o trauma
- possible hypoxic damage to the liver and kidney
- possible heart failure
anemia
62
(true/false) patients with anemia have a normal exercise tolerance.
FALSE- decreased tolerance
## Footnote
Use RPE scale and closely monitor vital signs
63
# diagnosis
Group of inherited, autosomal recessive RBC disorders; Hgb and the size and shape of RBCs are abnormal
sickle cell disease
## Footnote
Types: HbSS, HbSC, HbS, beta thalassemia, HgSD, HbSE, HbSO
64
# diagnosis
Hgb is released from the abnormal RBCs into the plasma resulting in decreased oxygen delivery into the tissues
- results from bone marrow aplasia, hemolysis, folate deficiency, splenic involvement
Chronic hemolyic anemia (sickle cell anemia)
65
- pain caused by clots in joints, organs, and/or bone
- acute abdominal pain from visceral hypoxia
- swelling in the hands and feet
- persistent HA
- dizziness
- convulsions
- coma
- nystagmus
- chest pain
- dyspnea
- coughing
- tachypnea
sickle cell crisis
66
# definition
rapid drop in hemoglobin levels
anemic crisis
67
# definition
characterized by severe anemia associated with acute viral, bacterial, or fungal infection. Results in an increased risk of infection
aplastic crisis
68
What is the MOA of hydrooxyurea?
stimulates Hgb production
69
(heat/cold) therapy is contraindicated with sickle cell anemia.
Cold therapy is contraindicated due to vasoconstriction and sickling
70
What intensity of exercise is most appropriate for a person with sickle cell disease?
low to moderate level exercise
## Footnote
High intensity exercise leads to dehydration and may increase the risk of sickle cell crisis
71
What is hemophilia?
bleeding disorders inherited as a sex-linked recessive disorder
72
Who is commonly diagnosed with hemophilia?
affects males
| females are carriers
73
What is the most common clotting factor deficiency?
Clotting factor VIII deficiency (hemophilia A)
74
What is another name for hemophilia B?
Christmas disease/clotting factor ix deficiency
75
What determines the level of severity and rate of spontaneous bleeding in a person with hemophilia?
percentage of clotting factor in the blood
76
Where is hemiarthrosis most common?
synovial joints
| bleeding in the joint
77
What is observed at a joint with hemiarthrosis?
- swelling
- pain
- decreased ROM
- warmth
## Footnote
long-term results:
- chronic synovitis and arthropathy leading to bone and cartilage destruction
78
What are possible complications of hemophilia?
- scoliosis
- equinus gait
- lack of knee EXT torque
- decreased aerobic capacity
- ADL deficiency
- LLD
- muscle weakness
- contractures (FLX and PF)
79
What are clinical s/s of acute bleeding episodes?
- decreased ROM
- stiffness
- pain
- swelling
- tenderness
- heat
- tingling
80
What PT interventions should be used during the acute stage of hemophilia?
1. RICE (rest, ice, compression, elevation)
2. prevent deformities
81
Why is passive stretching rarely used in those with hemophilia?
Increased risk of myositis ossificans
82
What are the early warning signs of cancer?
- unusual bleeding or discharge
- lumps
- sore throat that does not go away
- B/B disturbance
- hoarseness/persistent cough
- ingestion or dysphagia
- change in size of a wart or mole
- unexplained weight loss
83
What do leukemia and myeloma affect?
blood (unrestrained growth of WBCs) and blood-forming organs (bone marrow)
84
How does a metastasis spread in the body?
lymphatic system or bloodstream
85
What factors are considered when staging cancer?
Primary tumor (T)
Regional lymph node involvement (N)
Metastasis (M)
86
What are the stages of cancer?
0: carcinoma in situ
1: localized tumor <2 cm; no lymph node involvement
2: locally advanced tumor that is 2-5 cm with or without lymph node involvement
3: Advanced local tumor that has spread to the lymph nodes
4: metastasized tumor
87
What are the cancer grades?
1 (Low grade): cells resemble normal cells and are gradually growing
2 (intermediate): cells look abnormal and are faster growing (moderate differentiation)
3 (high grade): cells are abnormal with aggressive growth and spreading (poorly differentiated)
4 (high grade): cancer cells are abnormal (undifferentiated)
88
Cancer can be considered cured if what happens?
If the patient does not have a reoccurrence within 5 years after treatment
89
What are local and systemic effects of radiation therapy?
- pain
- fatigue
- radiation sickness
- immunosuppression
- fibrosis
- burns
- delayed wound healing
- edema
- hair loss
- radiation encephalopathy
- rapid motor weakness (occurs years after therapy)
90
What are the local and systemic effects of chemotherapy?
- fatigue
- GI disturbance
- bone marrow suppression
- rash
- neuropathy
- phlebitis
- hair loss
91
What are the local and systemic effects of immunotherapy?
- fatigue
- weight loss
- flu-like symptoms
- N/V
- anorexia
- fluid retention
92
What are the local and systemic effects of hormone therapy?
- GI symptoms
- HTN
- steroid-induced diabetes
- myopathy
- weight gain
- hot flashes and sweating
- altered mental status
- impotence
93
When examining tumors, pain distal to the tumor may suggest what?
metastasis
94
What are the side effects of cancer treatments?
- intense fatigue
- atrophy and weakness
- ROM deficit
- WBC suppression (leukopenia)
- platelet suppression and increased bleeding (thrombocytopenia)
- anemia
95
What treatments are appropriate to perform with patients who have significant bony metastases, osteoporosis, or low platelet count?
- AROM
- ADLs
96
What are contraindications with exercise in patients those who have cancer?
- severe reaction to radiation therapy
- acute infection or fever
- severe N/T/D within 24-36 hours after treatment
- extreme fatigue, muscular weakness, or bone pain
- chest pain, altered HR, elevated BP
- swelling in the ankles
- severe dyspnea, pain with deep breathing, coughing/wheezing
- dizziness
- disorientation
- confusion
- blurred vision
- ataxia
97
Those receiving chemotherapy should NOT exercise for how long?
At least 24 hours after treatment
98
Cancer patients with low platelets of < _______/mm may experience spontaneous bleeding
<10,000
99
Exercise is contraindicated in patients with platelet counts < _____.
< 20,000
| Use caution with counts between 20,000-50,000
100
(true/false) thermal agents are contraindicated for those with cancer.
true
101
(true/false) hydrotherapy is appropriate for a patient with cancer
false
102
Do not use (cold/heat) therapy in those who have delayed wound healing
cold therapy
103
# diagnosis
Individual has a long-term pattern of manipulating, exploiting, or violating the rights of others
| often criminal
antisocial personality disorder
104
# diagnosis
individual has varying moods, impulsive actions, and problems with relationships; may experience intense episodes of anger, depression, and anxiety that can last hours to days
borderline personality disorder
105
# diagnosis
individual has an inflated sense of their own importance, troubled relationships, a deep need for excessive admiration, and a lack of empathy for others
narcissistic personality disorders
106
# diagnosis
Individual has feelings of extreme social inhibition and sensitivity to negative criticism and rejection
avoidant personality disorder
107
(true/false) onset of PTSD symptoms can be delayed
true
108
# definition
A type of schizophrenic disorder characterized by mutism or stupor; unresponsiveness; catatonic posturing (unable to move or talk for periods of time; fixed position)
catatonia
109
# diagnosis
Patient experiences neurological symptoms without evidence of specific neurological disease or other medical condition
- significant loss of function and emotional distress
functional neurologic symptom disorder
| conversion disorder/functional neurologic syndrome
110
What are the stages of death and dying?
1. denial
2. anger
3. bargaining
4. depression
5. acceptance and preparation for death
111
What are the stages of grief?
1. shock/disbelief
2. increased awareness and anguish
3. mourning
4. resolution of loss
5. idealization of lost person or function
112
What does the upper GI tract consist of?
1. mouth
2. esophagus
3. stomach
| ingestion and intial digestion of food
113
What does the middle GI tract consist of?
small intestine (duodenum, jejunum, and ileum)
| digestion and absorption of nutrients
114
What does the lower GI tract consist of?
Large intestine (cecum, colon, rectum)
| absorption of water and electrolytes, storage, and elimination of waste
115
What are the major GI hormones?
1. cholecystokinin
2. gastrin
3. secretin
116
What is achalasia?
lower esophageal sphincter fails to relax leading to food being trapped in the esophagus
117
What does nausea stimulate?
Medullary vomiting center
118
What is obstipation?
intractable constipation with resulting fecal impaction or inability to pass gas and retention of hard, dry stools in the rectum and colon.
| can cause partial or complete bowel obstruction
119
Where can constipation pain refer to?
- abdomen
- anterior hip, groin, or thigh
120
Visceral pain from the esophagus can refer to the ______.
midback
121
Midthoracic spine pain (nerve root pain) can appear as _______ pain.
esophageal pain
122
What organs can have visceral pain referral to the shoulder?
1. liver
2. diaphragm
3. pericardium
123
What organs can have visceral pain referral to the midback and scapular regions?
1. gallbladder
2. stomach
3. pancreas
4. small intestine
124
What organs can have visceral pain referral to the pelvis, low back, and/or sacrum?
1. colon
2. appendix
3. pelvic viscera
125
What is hepatitis?
Inflammation of the liver
| can be caused by bacteria or a virus
126
How is hepatitis A transmitted?
fecal-oral route
127
(true/false) all forms of hepatitis can be acute or chronic.
False-
Hepatitis A is only acute
128
How is hepatitis B transmitted?
1. blood
2. body fluids
3. body tissues
| through blood transfusion, oral or sexual contact, contaminated needles
129
How is hepatitis C transmitted?
1. blood
2. body fluids
3. body tissues
| Through blood transfusion, oral or sexual contact, contaminated needles
130
How is hepatitis D transmitted?
Dependent upon having hepatitis B
- prognosis is poor and those often have liver failure
131
What are the s/s of the preicteric phase of hepatitis?
| Initial stage
- fever
- anorexia
- N/V
- diarrhea
- fatigue
- malaise
- HA
- abdominal tenderness
- myalgia
- arthralgia
132
What are the s/s of the jaundice (icteric) phase of hepatitis in addition to the s/s of the preicteric phase?
- fever
- jaundice
- enlarged liver with tenderness
- amber-colored or dark urine
133
What can chronic hepatitis B and hepatitis C lead to?
chronic liver infection
| necrosis, cirrhosis, liver failure
134
# [](http://)
What is the leading cause of liver cancer and common reason for liver transplants?
viral hepatitis
135
# diagnosis
Irreversible chronic injury of the hepatic parenchyma as a result of chronic hepatitis
cirrhosis
136
# diagnosis
- jaundice
- peripheral edema
- dupuytren's contracture
- palmar erythema
- angiomas
- hepatomegaly
- splenomegaly
- ascites
cirrhosis
137
What is a late complication of cirrhosis?
Hepatic encephalopathy
138
What is asterixis?
myoclonus of the hand with the wrist in EXT
| "liver flap"
139
What is asterixis a sign of?
liver cirrhosis
| Why? liver is unable to convert ammonia to urea
140
____ can be used to increase bowel movement and excrete ammonia in the stool
lactulose
141
What is cholelithiasis?
gallstones
142
What is the treatment for gallstones?
often asymptomatic- no treatment needed
143
What can happen if a gallstone blocks the common bile duct?
biliary colic
| obstruction of biliary tract
144
Where does pain refer to when a gallstone is present?
RUQ and right scapula
| can worsen after a fatty meal
145
what is cholecystitis?
partial or complete obstruction of the common bile duct resulting in inflammation of the gallbladder
146
Where does pain from cholecystitis refer to?
Severe pain in the RUQ and radiating to the right scapula
147
Describe the Murphy's sign.
Palpate near right subcostal margin while the patient takes a deep breath
(+) pain elicited
148
A positive murphy's sign is indicative of what?
cholecystitis
149
What pain pattern is formed with acute pancreatitis?
Bandlike pain that can radiate to the back
150
What position can aggravate pain caused by acute appendicitis?
supine
151
# Diagnosis
- bandlike pain radiating to the back
- pain aggravated in supine position
- hypotension
- tachycardia
- N/V
acute pancreatitis
152
What interventions are used to treat acute pancreatitis?
- IV fluid
- pain medication
- NPO order
- surgery
153
What pain pattern is caused by chronic pancreatitis?
epigastic and LUQ pain
154
What are the s/s of chronic pancreatitis?
- anorexia
- N/V
- constipation
- flatulence
- greasy stools (steatorrhea)
155
When do symptoms of pancreatic cancer arise? What are they?
Once the cancer is more advanced
- abdominal pain radiating to the back
- unexplained weight loss
- jaundice
- dark urine
- light-colored stool
- fatigue
156
What causes GERD?
Failure of the lower esophageal sphincter to regulate flow of food from the esophagus into the stomach with an increased gastric pressure
| diaphragm and esophageal muscles also contrinute to anti-reflux function
157
Over time, a pH <___ damages the esophagus and causes reflux esophagitis
< 4
158
Heartburn caused by GERD commonly occurs when?
1. 30-60 minutes after eating
2. at night when laying down (nocturnal reflux)
159
What can esophageal pain present as?
head, neck, or chest pain
160
What is esophageal pain commonly mistaken as?
heart attack
161
What is Barret's esophagus?
damage to lower portion of esophagus
162
What should you avoid during activity when a patient has barret's esophagus/GERD?
1. supine/declined position
2. jogging
3. jumping
4. any exercise that exacerbates symptoms
163
What medications are used for treatment of GERD?
1. acid-suppressing proton pump inhibitor (PPI) (prilosec)
2. H2 blockers (famotidine/pepcid)
3. cimetidine (tagamet)
4. antacids
164
A rolling hiatal hernia is a protrusion of the stomach through the ______ .
diaphragm
165
# definition
displacement of both the stomach and gastroesophageal junction into the thorax
sliding hiatal hernia
166
Those who have a hiatal hernia can have symptoms of ____.
GERD
167
What are s/s of esophageal cancer?
- dysphagia
- unexplained weight loss
- chest pain
- worsening indigestion
- coughing/hoarseness
168
What is gastritis?
inflammation of the stomach mucosa
169
What causes acute gastritis?
- severe burns
- aspirin/NSAIDS
- corticosteroids
- food allergies
- viral/bacterial infections
170
What are the s/s of acute gastritis?
- N/V
- anorexia
- pain
171
What needs to be monitored in patients who are long-term users of NSAIDS?
- stomach pain
- bleeding
- n/v
172
What medications are used for treatment of gastritis?
Symptom-based
- acid-suppressing PPIs
- H2 blockers
- antacids
173
What is peptic ulcer disease?
Ulcerative lesions that occur in the upper GI tract in areas exposed to acid-peptin secretions
| Can affect 1 or more layers of the duodenum or stomach
174
# diagnosis s/s
- epigastric pain described as gnawing, burning, or cramping
- pain aggravated by change in position and absence of food within the stomach
- relieved with use of antacids or food
peptic ulcer disease
175
Where is pain caused by peptic ulcer disease found?
presents as radiating back pain that can radiate to the right shoulder
| peptic ulcers are found on the posterior wall of the stomach
176
# definition
A complex of disorders characterized by problems with intestinal absorption of nutrients
malabsorption syndrome
177
# s/s
- anorexia
- weight loss
- abdominal bloating
- pain/cramps
- indigestion
- steatorrhea (fatty feces)
- chronic/excessive diarrhea
malabsorption syndrome
178
Malabsorption syndromes can cause iron-deficiency anemia with easy bruising and bleeding due to lack of _______.
vitamin K
179
Malabsorption syndromes can cause muscle weakness and fatigue due to lack of what?
1. protein
2. folic acid
3. vitamin B
180
Malabsorption syndromes cause bone loss, pain, and increased risk of fractures due to lack of what?
1. vitamin D
2. calcium
3. phosphate
181
Malabsorption syndrome can cause neuropathy due to lack of what?
| includes tetany, parasthesia, and N/T
1. magnesium
2. calcium
3. vitamin B
4. vitamin D
5. potassium
182
What are the types of inflammatory bowel disease (IBD)?
1. crohn's disease
2. ulcerative colitis
183
What are the symptoms of ulcerative colitis and crohn's disease?
| Inflammatory bowel diseases
- abdominal pain
- frequent diarrhea/fecal urgency
- weight loss
- stunted growth in pediatric patients
184
(true/false) Ulcerative colitis and crohn's disease are characterized by remission and exacerbation of bowel inflammation.
true
185
Where is pain from UC and CD found?
Lower back
186
What are the complications of UC and CD?
- intestinal obstruction
- corticosteroid toxicity (low bone density, increased Fx risk)
- nutritional deficiencies
- Chronic IBD can cause anxiety and depression
187
What are the differences between UC and CD?
CD:
- granulomas inflammation that can occur anywhere in the GI tract
- Skip lesions are present (areas of adjacent normal tissue)
UC:
- ulcerative and exudative inflammation of the large intestine and rectum
- Bloody diarrhea, mucus, and pus
- no skip lesions are present
188
What is diverticulosis? What are the symptoms?
pouchlike herniations of the colon (especially the sigmoid colon)
- minimal but can include rectal bleeding
189
What can diverticulosis progress to?
diverticulitis
190
What is diverticulitis? What are the symptoms?
inflammation of one or more diverticula (pouchlike herniations) of the colon's mucosal layer -- fecal matter penetrates the diverticula and causes inflammation and an abscess
- pain and cramping in LLQ
- N/V
- slight fever
- elevated WBCs
191
What is noted as appendicitis progresses?
becomes swollen, gangrenous, and possibly perforated
192
What happens if the appendix is perforated?
Life-threatening and can lead to the development of peritonitis
193
Where is pain located if caused by appendicitis?
- abrupt onset
- localized in the epigastric or periumbilical areas
- intensity progresses over time
194
What 6 signs are used for additional testing for appendicitis?
1. Blumberg's sign (rebound tenderness)
2. McBurney's point (point tenderness)
3. Rozsing's sign
4. psoas sign
5. obturator sign
6. markle's sign
| Immediate medical attention is needed if any are positive
195
Describe blumberg's sign
Rebound tenderness in response to depression of the abdominal at a site distal to the painful area
196
Describe McBurney's point.
Point tenderness 1/3 of the distance from the ASIS and umbilicus
197
Describe Rovsing's sign
Pain in the RLQ with pressure administered to the LLQ
198
Describe the psoas sign.
Pain elicited in the RLQ when the patient is passively put into **right** hip EXT
199
Describe the obturator sign.
RLQ pain with **right** hip ER and FLX (90 degrees) in addition to knee FLX (90 degrees)
200
What is a (+) psoas sign indicative of?
inflammation of peritoneum over the psoas muscle
201
What is a (+) obturator sign indicative of?
inflammation of the obturator nerve sheath
202
What is Markle's sign?
Elicited RLQ pain when a patient drops from toes --> heel with an abrupt landing
203
An elevation of WBC count > _______ are indicative of appendix perforation and surgery is indicated
> 20,000
204
What is peritonitis?
Inflammation of the peritoneum (serous membrane in the abdominal cavity wall)
205
What causes peritonitis?
bacterial invasion and infection of the peritoneum
206
# Diagnosis s/s
- abdominal distention
- severe abdominal pain
- rigidity from reflex guarding
- rebound tenderness
- decreased or absent bowel sounds
- N/V
- tachycardia
- fever
- elevated WBCs
- electrolyte imbalance
- hypotension
peritonitis
207
What can peritonitis lead to?
1. toxemia and shock
2. circulatory failure
3. respiratory distress
208
# diagnosis
Internal and/or external varicosities in the lower rectum or anus caused by congestion of the veins in the hemorrhoidal plexus
hemorrhoids
209
# s/s
local pain, irritation, and rectal itching
## Footnote
pain is increased with defecation, constipation, and prolonged sitting
hemorrhoids
210
(true/false) Pregnancy increases the risk of hemorrhoids
true
