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Mary's Tests - Spring 2016 > Patho Exam #2 February 2016 > Flashcards

Patho Exam #2 February 2016 Flashcards

1
Q

Pharyngoesophaeal (upper sphincter)

A

what prevents air from entering the esophagus

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2
Q

Gastoesophageal (lower sphincter)

A

what prevents gastric acid from forming.

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3
Q

Achalasia

A

failure of the lower esophageal sphincter to relax due to the absence of a vagal nerve. Can lead to cancer, esophageal erosion and difficulty passing food

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4
Q

Esophageal diverticulum

A

out pouching that causes food to get trapped and inflammation to occur. May cause belching

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5
Q

Esophageal lacerations is also called

A

Mallory Weiss Syndrome

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6
Q

Mallory Weiss Syndrom (esophageal lacerations)

A

can occur with vomiting blood and cause GI bleeding. Seen in alcoholism. May go away over time.

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7
Q

Most common disorder of the esophagus is..

A

GERD

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8
Q

GERD is…

A 
Persistent reflux (backflow) of acidic contents in stomach that can cause erosion and mucosal damage
Regurgitation of gastric contents into esophagus.

Exposure of the esophageal mucosa to gastric acid and pepsin

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9
Q

Characteristics of GERD

A

Can lead to erosion and mucosal damage, scarring, strictures, cancer

Acid reflux - Often occurs after big evening meal & at night. May have belching or burning sensation.

Heartburn (main symptom) - Recumbent position, bending over. Also caused by increased abdominal pressure

Common during pregnancy, >40 years, overweight

Felt as pain or burning in retrosternal area & may radiate to throat, shoulder, back. People may be worried about heart attack since these symptoms are very similar.

Effortless regurgitation of acidic fluid into mouth, especially post-meal and at night.

May cause resp. sxs: wheezing, cough, hoarseness

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10
Q

What is the cause of GERD.

A

Weak lower esophageal sphincter (LES) and increased intra-abdominal pressure, reflux of stomach contents into esophagus & mucosal injury

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11
Q

Foods that cause GERD

A

Fatty foods, spicy foods, alcohol, caffeine, large meals, recumbent position after eating, meds that decrease the CNS

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12
Q

Medications to treat GERD

A

PPI and H2 blockers

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13
Q

What penetrates the gastric mucosal barrier?

A

Alcohol and aspirin

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14
Q

What is the mucosal barrier?

A

It prevents acid from penetrating and is covered in a hydrophobic lipid bilayer.

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15
Q

Prostaglandins do what?

A

increase blood flow, mucous and ion secretion

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16
Q

What interferes with prostaglandins

A

NSAIDS and aspirin

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17
Q

What is inflammation of the gastric mucosa

A

Gastritis

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18
Q

What is acute gastritis

A

This can be caused by a local irritant such as alcohol or bacterial virus (bacteria) This causes upset stomach and is transient (resolves on its own)

S/S: heartburn, vomiting, GI bleeding, stomach upset

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19
Q

What is an example of chronic gastritis

A

H Pylori

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20
Q

Chronic gastritis occurs when there is

A

changes in the epithelial lining and inflammatory changes

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21
Q

H. Pylori is gram positive or negative?

A

NEGATIVE

treat with what meds?? amoxicillin, clarithromycin, metronidazole, tetracycline. May also add peptobismol or kaopectate to disrupt the cells walls and prevent microorganisms from adhering to gastric epitherlium

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22
Q

H. Pylori causes..

A

disruption in the gastric mucosa, inflammatory responses, gastric atrophy, PUD, increases cancer risk,

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23
Q

What meds can be used to treat H Pylori

A

PPI and H2RA.

USUALLY 2 ANTIBIOTICS

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24
Q

What is PUD

A

it is attributed to an imbalance in the cell destructive and cell protective effects. It causes exposure to pepsin and gastrin. Scar tissue replaces damaged muscle

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25
Q

What is PUD often associated with

A

Stress, trauma, h pylori, caffeine, alcohol, warfarin use, blood group O, older adult >60, NSAID or ADA drugs

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26
Q

duodenal ulcers are more common than

A

gastric ulcers

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27
Q

duodenal ulcers occur with

A

h. pylori and NSAID ingestion- can occur at any age and is usually chronic in nature. Theses ulcers heal more slowly

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28
Q

Duodenal ulcer S/S

A

dull, gnawing pain, hematemesis, melena Empty stomach feeling 2-3 hours after eating. May be relieved by food or antacids

pain is usually…epigastric

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29
Q

What tests would you run to diagnose a Duodenal ulcers.

A

Gastroscopy/duodenoscopy and biopsy for H pylori, barium xrays, Labs (hgb & hct)

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30
Q

Gastric ulcers differ from duodenal ulcers in that it

A

is common most after eating

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31
Q

Peptic ulcers are found in what regions

A

stomach, esophagus and duodenum

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32
Q

Name two stress ulcers

A

Cushings: caused from increased intracranial pressure. There is an increase of gastric acids related to stimulation of vagus nerve and is seen in head injuried

Curling Ulcer: caused from major trauma like sepsis, spinal cord injuries, surgery. Patients often have NG tube that turns bright red. There is an increase in bile salts entering stomach

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33
Q

Cell destructive efforts for UGI disorders to prevent recurrence of lesions..

A

take patients off of NSAIDS, advise against smoking, take patient off of steroids

34
Q

What is the first line drug mainly used in most situations for ulcers

A

PPIs

35
Q

Antacids contain compounds incorporating:

A

Aluminum, Magnesium and Calcium

They neutralize the acids in the stomach and act locally

36
Q

Medication examples of antacids..

A

Aluminum hydroxide/ magnesium hydroxide–Maalox

Alum. Hydroxide, magnesium hydroxide, simethicone–Mylanta

37
Q

Simethicone (Mylicon)

A

antiflatulent- reduces gas, distention, and abd. discofort

38
Q

Nursing implications of antacids:

A

it binds with other drugs and prevents absorption.

Give 1 to 2 hours before or after other meds and at night

39
Q

H2RA drug

A

blocks basal secretion of gastric acid and secretion stimulated by histamine, acetylcholine and gastrin; decreased amount, acidity and pepsin content of gastric juices

40
Q

Histamine causes strong stimulation of..

A

gastric acid secretions

41
Q

H2 recepts when stimulated increase

A

production of HCl acid from parietal cells

42
Q

H2 blockers are used from prevention or treatment for

A

PUD, GERD, Esophagitis, GI bleed

43
Q

Drugs that are H2 blockers are

A

Famotide (Pepcid), ranitidine (Zantac), cimetidine (Tagamet) and nizatidine (Axid)

44
Q

Adverse Effects of H2 blockers:

A

hypotension, rash, diarrhea, headache, constipation

45
Q

H2 blockers can cause patients to develop

A

pneumonia due to the decreased gastric acid production which increases normal flora in the stomach

46
Q

PPI drugs prevent

A

pumping of gastric acid into the stomach. They inhibit daytime and nocturnal HCL acid secretions

47
Q

Adverse effectos of PPI

A

minimal

48
Q

PPI drugs include:

A 
omeprazole (prilosec)
pantoprazole (protonix)
iansoprazole (Prevacid)
esomeprazole (nexium)
rabeprazole (aciphex)
49
Q

Sucralfate

A

works locally in the stomach and binds to normal and ulcerated mucosa to form a protective barrier

50
Q

Sucralfate prevents and treats what type of ulcer

A

duodenal

51
Q

Does sucralfate inhibit acid secretion?

A

NO!!!! it acts locally!

52
Q

Sucralfate should be given..

A

2 hours beofre or after other drugs since it can prevent the drugs actions from occuring

53
Q

Misoprostol (cytotec)

A

Synthetic prostaglandin E- protects gastric mucosa

54
Q

Misoprostol (cytotec) should be taken with what to prevent ulcers

A

NSAIDS to prevent ulcers

55
Q

Do not use misoprostol in these individuals

A

pregnancy women since it may induce abortions

56
Q

Antiemetic drugs act on the a vomiting center in the medulla called

A

CTZ (chemoreceptor trigger zone), cerebral cortex, vestibular apparatus or combination

57
Q

Receptors involved in activation of chemoreceptor trigger zones (CTZ)

A

serotonin, dopamine and muscarinic

58
Q

receptors involved in signals from pharynx and gi tract from vagal pathways

A

serotonin and dopamine

59
Q

receptors involved in vestibular appartatus

A

histamine and muscarinic

60
Q

Phenothiazides block

A

dopamine receptor sites in CTZ

61
Q

Adverse effects of phenothiazides:

A

sedation, cognitive impairment, extrapyramidial reactions (parkinsons with involuntary movements)

62
Q

phenothiazides work on motion sickness

A

false

63
Q

Phenothiazide drugs:

A

Chlorpromazine (thorazine). prochlorperazine (compazine),

**promethazine(phenergan)treats psych disorders

64
Q

I love you

A

Happy Valentines Day!

65
Q

What do stimulant cathartics do?

A

Pull water into bowel

66
Q

What are examples of stimulant cathartics? (4)

A

Bisacodyl (Dulcolax), caster oil, Sennocide (Serocat)

67
Q

What is a side effect of stimulant cathartics?

A

May cause electrolyte imbalance (works quick and strong)

68
Q

What blocks prostaglandin?

A

Corticosterods (Antiemetic)

69
Q

What are examples of Corticosterods (Antiemetic)? (2)

A

methylprednizone (medril) and dexamethazone (decradron)

70
Q

Cholestyramine, Questran Drug

A

lowers cholesterol levels in the blood and improves itching related to liver disease. It binds to bile acids in th intestines and prevents their absorption

AE: constipation, bloating, belching, gallstones, diarrhea

71
Q

Lovastatin

A

“used along with a proper diet to help lower “bad” cholesterol and fats (such as LDL, triglycerides) and raise “good” cholesterol (HDL) in the blood. It belongs to a group of drugs known as “statins.” It works by reducing the amount of cholesterol made by the liver.” WebMD

72
Q

Niacin

A

Vitamin B3- can be used in combo with statins

Can treat high cholesterol and triglyceride levels and slows the narrowing of the arteries.

73
Q

Nicotinic

A

used to prevent or treat niacin deficiency. Niacin deficiency can cause demetia, redness/swelling.

74
Q

Gemfibrozil

A

used with diet to treat high cholesterol and triglyceride levels in people with pancreatitis.

do not take if you have liver disease or gallbladder disease

75
Q

Hctz

A

used for high blood pressure and prevents the body from absorbing too much salt

76
Q

Doxazosin

A

can be used to treat high BP. do not take if there is liver disease or a blockage in the stomach.

77
Q

Captopril

A

used to treat high blood pressure and heart disease. ACE inhibitor.

78
Q

Losartan

A

It can treat high blood pressure. It can reduce the risk of stroke in patients with high blood pressure and an enlarged heart. It can also treat kidney disease in patients with diabetes.

79
Q

amlodipine

A

calcium channel blockers that widens blood vessels and increases blood flow.
used for hypertension, angina, and coronary heart disease

80
Q

Norvasc

A

calcium channel blocker used for hypertension

81
Q

hydralazine

A

Hydralazine apparently lowers blood pressure by exerting a peripheral vasodilating effect through a direct relaxation of vascular smooth muscle.

82
Q

clonidine

A

alpha agonist hypotensive agent- vasodilator

Mary's Tests - Spring 2016 (10 decks)

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