NON-INFLAMMATORY DISORDERS

Question 1

this is a functional disorder in the GIT

Answer 1

irritable bowel syndrome

Question 2

I in IBS

Answer 2

irritable

Question 3

etiology of IBS

Answer 3

idiopathic

Question 4

based on theories, what problem could be the cause of IBS?

Answer 4

problems in neural or hormonal control in GIT

Question 5

risk factors for IBS

Answer 5

stress & family history

Question 6

if a person with IBS has a presenting symptom of diarrhea, what type of IBS is this?

Answer 6

IBS-d

Question 7

if a person with IBS has a presenting symptom of constipation, what type of IBS is this?

Answer 7

IBS-c

Question 8

if a person with IBS has a presenting symptom of alternating constipation and diarrhea, what type of IBS is this?

Answer 8

IBS-a/m

Question 9

what stool characteristic does a patient have if they have IBS-d?

Answer 9

mucoid

Question 10

why do we advise patients with IBS-d to eat a high protein diet?

Answer 10

to prevent fluid shifting hence lessening diarrhea

protein increases osmotic pressure

Question 11

choice of laxative for IBS-c

Answer 11

lactulose

Question 12

protrusion of an organ through weak muscle

Answer 12

hernia

Question 13

hernia that is common in men

Answer 13

inguinal hernia

Question 14

hernia that is common in women

Answer 14

femoral hernia

Question 15

protrusion of stomach thru hiatus of diaphragm

Answer 15

hiatal hernia

Question 16

main etiology for acquired hiatal hernia

Answer 16

activities that increases intra-abdominal pressure

Question 17

in this type of hiatal hernia, stomach pushes thru the opening in the diaphragm

Answer 17

rolling or paraoesophageal hernia

Question 18

this type of hiatal hernia has part of the stomach and the part of the stomach push upwards into the chest

Answer 18

sliding hiatal hernia

Question 19

prominent s/sx of hiatal hernia

Answer 19

heartburn

Question 20

what is another term for heartburn

Answer 20

pyrosis

Question 21

difficulty of swallowing

Answer 21

dysphagia

Question 22

painful swallowing

Answer 22

odynophagia

Question 23

one complication of hiatal hernia thar causes inflammation of esophagus

Answer 23

esophagitis

Question 24

one complication of hiatal hernia that causes change of one cell type to another (metaplasia)

Answer 24

Barret’s esophagus

Question 25

most definitive test for hiatal hernia

Answer 25

esophagoscopy

Question 26

drugs that dec. LES pressure

Answer 26

diazepam, biphosphonates

Question 27

most effective and cost effective drug for hiatal hernia

Answer 27

PPI

Question 28

when do you give PPIs?

Answer 28

before meal

Question 29

when do you give antacids?

Answer 29

30 mins to 1 hr after meal

Question 30

why do we give antacids after meal

Answer 30

to prevent rebound acidity. antacid right away = alkaline environment = more acid production

Question 31

scarring or fibrosis of the liver

Answer 31

liver cirrhosis

Question 32

also known as alcoholic cirrhosis

Answer 32

Laennec's cirrhosis

Question 33

what component of alcohol is hepatotoxic?

Answer 33

acetaldehyde

Question 34

what do you call it if the liver cirrhosis is idiopathic?

Answer 34

biliary cirrhosis

Question 35

infections that cause post-necrotic cirrhosis

Answer 35

hepa b, hepa c, schistosomiasis

Question 36

dilated vessels in the abdomen due to neovascularization

Answer 36

caput medusae

Question 37

hallmark of liver cirrhosis; red BV appears on skin due to neovascularization

Answer 37

spider angioma

Question 38

what enzymes are released if there is injury in the liver?

Answer 38

AST and ALT

Question 39

why do we put a pillow on RUQ after liver biopsy?

Answer 39

to prevent bleeding

Question 40

metabolic brain disease that is caused by increase ammonia in the blood

Answer 40

hepatic encephalopathy

Question 41

in what form does the liver convert ammonia?

Answer 41

urea

Question 42

position during liver biopsy test

Answer 42

supine with pillow under RUQ

Question 43

position post liver biopsy test

Answer 43

right side lying with pillow under RUQ

Question 44

why do we assess pneumothorax after liver biopsy

Answer 44

because it injects needle that may touch the lungs

Question 45

if liver cirrhosis happened, what s/sx would you see in a patient related to liver's bile production?

Answer 45

weight loss - due to dec. fat storage *bile emulsify fats* jaundice - liver can't take bilirubin from blood pruritus due to jaundice

Question 46

if liver cirrhosis happened, what s/sx would you see in a patient related to liver's glucose metabolism?

Answer 46

fatigue and weakness - liver can't use glucose as source of energy weight loss - glucose can't be stored

Question 47

if liver cirrhosis happened, what s/sx would you see in a patient related to liver's fat metabolism?

Answer 47

fatigue, weakness, weight loss leading to anorexia - dec. use of fats as energy source and dec. storage of fat

Question 48

if liver cirrhosis happened, what s/sx would you see in a patient related to liver's protein metabolism?

Answer 48

bipedal edema - liver produces albumin which exerts oncotic pressure (pull water) hepatic encephalopathy - liver converts ammonia to urea. cirrhosis = no conversion of ammonia to urea

Question 49

earliest s/sx of hepatic encephalophathy

Answer 49

altered LOC

Question 50

if liver cirrhosis happened, what s/sx would you see in a patient related to liver's production of clotting factors?

Answer 50

risk for bleeding that may result to hypovolemic shock

Question 51

if liver cirrhosis happened, what s/sx would you see in a patient related to liver's drug metabolism?

Answer 51

inc. drug toxicity

Question 52

if liver cirrhosis happened, what s/sx would you see in a patient related to liver's storage of vitamin BADEKI?

Answer 52

no storage of said vitamins

Question 53

sign of liver cirrhosis that results from the scarring of the liver

Answer 53

hepatomegaly

Question 54

this may occur due to the cirrhosis of the liver which causes blood flow to slow down and put pressure on the portal vein

Answer 54

portal hypertension

Question 55

enlarged veins in the esophagus due to portal hypertension

Answer 55

esophageal varices

Question 56

distended veins in rectum due to portal HTN

Answer 56

hemorrhoids

Question 57

this happens when fluid leaks out due to inc. portal vein pressure

Answer 57

ascites

Question 58

creating new vessels due to inc. pressure

Answer 58

neovascularization

Question 59

complication of liver cirrhosis in kidneys

Answer 59

hepatorenal syndrome

Question 60

position of patient with bipedal edema and ascites

Answer 60

reverse trendelenburg *helps with breathing*

Question 61

this is inserted to prevent rupture of the esophageal varices

Answer 61

triple lumen tube/sengstaken blakemore tube

Question 62

this is called aspiration of fluid from peritoneal cavity

Answer 62

paracentesis

Question 63

nursing consideration when patient has sengstaken blakemore tube

Answer 63

monitor breathing as tube may compress the traachea; always have pair of scissors

Question 64

why do we avoid bleeding in patients with late stage liver cirrhosis?

Answer 64

because rbc releases hgb which will be converted to amino acids to ammonia

Question 65

diuretics for ascites in liver cirrhosis

Answer 65

furosemide and spironolactone

Question 66

drugs that will dec. pressure in the portal vein

Answer 66

beta blockers

Question 67

this can be a management for portal HTN where you connect the portal and hepatic vein

Answer 67

porto-hepatic shunt