INFLAMMATORY DISORDERS Flashcards
(134 cards)
1
Q
inflammation of mucosal lining of stomach
A
gastritis
2
Q
inflammation and erosion of mucosal lining of the stomach, esophagus, and duodenum
A
peptic ulcer disease
3
Q
what bacteria may cause PUD?`
A
helicobacter pylori
4
Q
what drug can inc. production of HCl acid?
A
steroids
5
Q
what drugs can decrease prostaglandin synthesis in the stomach?
A
aspirin and NSAIDS
6
Q
protective barrier of stomach
A
prostaglandin and mucus
7
Q
stress ulcer that occurs in burn patients
A
curling’s ulcer
8
Q
stress ulcer that occurs in stroke patients
A
cushing’s ulcer
9
Q
a tumor that may cause increase production of HCl acid leading to PUD or gastritis
A
gastrinoma/zollinger-ellison syndrome
10
Q
what chemicals can cause chronic gastritis if you’re exposed to it?
A
nickel and lead
11
Q
which condition does gastritis have in common in regards to their clinical manifestation related to pain?
A
gastric ulcer
12
Q
pain occurs after meals
A
gastritis/gastric ulcer
13
Q
pain occurs 2 hours after meals
A
duodenal ulcer
14
Q
this condition is relieved by vomiting
A
gastritis/gastric ulcer
15
Q
this condition is relieved by eating
A
duodenal ulcer
16
Q
what manifestation related to weight do you see in patients with duodenal ulcer?
A
weight gain
17
Q
what manifestation related to weight do you see in patients with gastritis and gastric ulcer?
A
weight loss
18
Q
why does the pain of gastritis and gastric ulcer happens after meals?
A
because food increases release of HCl acid in the stomach
19
Q
why does the pain of duodenal ulcer happens 2 hrs after meals?
A
because pyloric sphincter opens 2 hrs after meals due to gastric emptying time = acid goes into duodenum
20
Q
patients with this type of ulcer has pain at night due to continuous gastric emptying time
A
duodenal ulcer
21
Q
most common complication of gastritis and PUD
A
bleeding
22
Q
this is a complication of PUD when ulcer completely erodes the mucosa of the stomach
A
perforation
23
Q
this can happen due to perforation caused by PUD
A
peritonitis
24
Q
s/sx of peritonitis
A
rigid, board-like abdomen, (-) bowel sound
25
most definitive dx test for gastritis/PUD
endoscopy
26
this can be a diagnostic test for PUD where you will test for blood in the stool
guaiac test/FOBT
27
a drug that can help to coat the ulcer called cytoprotective drugs
sucralfate
28
when should you administer sucralfate?
before meals
29
removal of vagus nerve supply of stomach
vagotomy
30
a procedure where pylorus is being widened
pyloroplasty
31
complication of pyloroplasty
rapid gastric emptying time
32
a procedure where the stomach and small intestine is being bypassed
gastroenterectomy
33
this procedure directly connects the remaining of the stomach into duodenum
billroth I or gastroduodenostomy
34
this procedure have the distal stomach removed, but instead of reconnecting to the duodenum, it is attached to the jejunum (second part of the small intestine)
billroth II or gastrojejunostomy
35
why is pernicious anemia a complication of stomach surgery?
because stomach produces intrinsic factor that absorbs vit. B12 in the small intestine
36
another complication of stomach cancer wherein food moves too quickly from the stomach into the small intestine, causing a shift in fluid and triggering various symptoms
dumping syndrome
37
why is consuming moderate fat advisable to prevent dumping syndrome?
because fat slows down gastric motility
38
anti-spasmodic drug that dec. motility
buscopan
39
this condition make the intestines to have a cobblestone appearance
Crohn's disease
40
another term for crohn's disease
regional enteritis
41
which part of the intestines does ulcerative colitis affect?
large intestine
42
which part of the intestines does crohn's disease affect?
small intestines
43
a non-inflammatory disease that is a risk factor for developing ulcerative colitis
IBS
44
common risk factor of IBD
autoimmune
45
where does the inflammation starts at crohn's disease?
terminal ileum
46
where does the inflammation starts at ulcerative colitis?
rectum
47
stool characteristic and frequency in crohn's
5 to 6 soft stools per day, rarely bloody
48
stool characteristic and frequency in ulcerative colitis
10 to 20 bloody stools/day
49
where is the pain located in crohn's disease?
RLQ
50
where is the pain located in ulcerative colitis?
LLQ
51
persistent feeling that you need to have a bowel movement, even though your bowels are empty
tenesmus
52
what can you see in the imaging tests in ulcerative colitis?
ulcers in the intestine
53
drug used to relieve the pain in IBD
salicylates
54
this is used in IBD to reduce inflammation
steroids
55
surgery for crohn's disease where ileum is removed
ileal resection
56
surgery for ulcerative colitis when colon is resected
colostomy
57
where is the appendix located?
ileocecal junction; between ileum and cecum
58
etiology of appendicitis
fecalith
59
inflammation of the vermiform appendix
appendicitis
60
how does fecalith causes appendicits?
fecalith compromises blood flow to the appendix which may cause ischemia and injury leading to inflammation of the appendix
61
where is the most common site of pain of appendicitis?
RLQ and epigastric
62
what do you call an abdominal assessment where deep palpation causes pain in RLQ and sudden withdrawal of the palpation causes more pain in the RLQ?
+ blumberg's sign/rebound tenderness
63
what is an abdominal assessment where pain in the RLQ is caused by deep palpation in the LLQ?
+ rovsing's sign
64
what is an abdominal assessment where you place the patient in a supine position and flexing the right hip and knee and rotating it will cause pain in the RLQ?
+ obturator sign
65
what is an abdominal assessment where you place the patient in a supine position and flexing the right hip with knee extended will cause pain in the RLQ?
+ psoas sign
66
most definitive dx test for appendicitis
CT scan
67
non-pharmaceutical intervention that we can do to alleviate the pain in appendicitis
cold compress over abdomen
68
why do we avoid placing hot compress over abdomen when a patient is suspected of appendicits?
because the appendix may rupture
69
what drug should we avoid to administer to prevent rupture of the appendix?
laxative
70
what procedure is being avoided to prevent rupture of appendix?
enema
71
in what position can we instruct the patient with appendicitis to relieve the pain?
side lying knee chest position
72
inflammation of diverticulum/diverticula
diverticulitis
73
outpouching, sac-like formation in wall of colon
diverticulum
74
presence of several diverticula
diverticulosis
75
common risk factor of diverticulosis
constipation
*may cause increase pressure in the colon causing diverticula to form*
76
why do elderly is most at risk in having diverticulosis?
they have weakened muscle in colon causing distention
77
s/sx of diverticulosis
asymptomatic
78
how are diverticulosis diagnosed?
incidental findings
79
most common etiology of diverticulitis
infection
80
why is infection common cause of diverticulitis?
colon are full of bacteria that may proliferate in the outpouching
81
where is the pain of diverticulitis?
LLQ
82
most definitive test for diverticulitis
CT scan
83
what diet is best for patients with diverticulitis?
high fiber diet
84
when is surgery considered in managing diverticulitis?
when there is already an obstruction and abscess formation
85
inflammation of the gallbladder
cholecystitis
86
other term for gallstones
cholelithiasis
87
most common cause of cholecystitis
gallstones
88
what color is pigment stone?
green
89
what color is cholesterol stone?
yellow
90
risk factors of cholecystitis
4Fs: fat, female, forty y/o and above, fertile
91
where is bile being stored and concentrated?
gallbladder
92
what can be formed due to supersaturation of bile?
stone
93
formed due to supersaturation of cholesterol
cholesterol stone
94
formed due to supersaturation of bile
pigment stone
95
location of pain in cholecystitis
RUQ
96
patient supine -> palpate on RUQ -> stop inspiration due to pain
+ murphy's sign
97
how does gallstone cause inflammation of the gallbladder?
stone causes irritation of the wall which may cause injury every time the gallbladder contracts when a person eats fatty food
98
what do you call a stone in the common bile duct?
choledocholithiasis
99
complications of cholecystitis
ascending cholangitis and septic shock
100
how does ascending cholangitis happens?
bacteria in duodenum ascend in the common bile duct making it infected
101
what s/sx does the charcot's triad have?
fever, RUQ pain, jaundice
102
what s/sx does the reynold's pentad have?
fever, jaundice, RUQ pain, hypotension, altered LOC: confusion
103
you may suspect choledocholithiasis if a patient's stool is:
gray-colored
104
what do you call the gray-colored stool in a patient who has choledocholithiasis?
acholic stool
105
how long will be the drug therapy to remove gallstones?
6 to 12 months
106
what are the drugs that is used in dissolving cholelithiasis?
chenodeoxycholic acid and ursodeoxycholic acid
107
what do you call the procedure where you can pulverize gallstone?
lithothripsy
108
removal of the gallbladder
cholecystectomy
109
in open chole, where is the incision?
subcostal area
110
nursing consideration regarding respiratory function post-open cholecystectomy
splint while breathing
111
how many ml of bile should be draining in the t-tube drain on the first 24 hrs?
500-750 ml
112
this is done to prevent pressure on the sutures after cholecystectomy
t-tube drain
113
if there is no bile in the t-tube drain on the first 24 hrs, what should you do?
assess for jaundice and refer
114
complication that may happen if you do not insert t-tube drain after cholecystectomy
peritonitis
115
inflammation of the pancreas
pancreatitis
116
why does patients with pancreatitis at most risk for FVD?
they are put on NPO to prevent/manage an attack
117
most common cause of pancreatitis
gallstone obstruction in pancreatic duct
*choledocholithiasis may enter the pancreatic duct as these two ducts meet the ampulla of vater to enter the duodenum*
118
risk factors for pancreatitis
alcohol, fatty meal, obesity
119
how does pancreatitis develops?
autodigestion
*if there is an obstruction in the pancreatic duct, enzymes will backflow to the pancreas that can digest the pancreatic tissue causing injury*
120
pain location of pancreatitis
LUQ
*other books - pain radiating to back, left flank, left shoulder area*
121
most definitive dx test for pancreatitis
elevated serum levels of lipases and amylases
*lipase and amylase leak into bloodstream due to pancreatic cell damage*
122
primary management in pancreatitis
NPO
123
pain reliever DOC in acute pancreatitis
meperidine demerol - morphine can cause spasm of sphincter of oddi
morphine - less adverse effect; meperidine is neurotoxic
124
hematoma in umbilical area that happens in pancreatitis when BV bursts
cullen's sign
125
hematoma in flank area that happens in pancreatitis when BV bursts
grey turner's sign
126
TPN can be given to patients with pancreatitis whose on NPO, what are the possible complications?
fluid overload, hypernatremia, hyperglycemia, infection
127
what electrolyte imbalance does pancreatitis cause?
hypocalcemia
128
how would you know that acute pancreatitis is resolving?
serum levels of enzymes are decreasing
129
goals in managing chronic pancreatitis
prevent an attack, manage an attack, manage complications
130
why is DM a complication of chronic pancreatitis?
beta cells are also destroyed
131
management of steatorrhea as complication of chronic pancreatitis
pancrealipase w/ meals
132
fat in stool
steatorrhea
133
pain reliever of choice for chronic pancreatitis
non-narcotics
134
diet for pancreatitis
low fat, high carb, high protein
