Test #2 Flashcards
(98 cards)
0
Q
In the 1st 2 years post-surgery, by-pass pts will lose on avg what % of their excess weight?
A
62%
1
Q
Nausea, diarrhea, & dizziness assoc. w/ gastric bypass surgery is known as what?
A
Dumping Syndrome
2
Q
In 1st 2 years post surgery, banding pts will lose an avg of what % of excess weight?
A
47%
3
Q
The thin vacuum-powered tube used in liposuction is known as what?
A
Cannula
4
Q
Tightly packed collections of partially digested or undigested material that is unable to exit the stomach
A
Bezoars
5
Q
Bezoars often occur in pts w/ what?
A
Gastroparesis (abnormal gastric emptying)
6
Q
Bezoars sometimes produce what symptoms?
A
Gastric outlet obstruction (fullness, nausea, vomiting, pain, GI bleeding)
7
Q
Where is the M/C site for impaction?
A
Esophagus
8
Q
What are the symptoms of abdominal pain that is parietal in origin?
A
Precise onset
Stabbing or shooting
Constant & severe
9
Q
What are the symptoms of abdominal pain that is visceral in origin?
A
Vague or less precise onset
Cramping or gassy
Intermittent, crescendo/decrescendo pattern
10
Q
Abdominal pain that occurs ever 5-10 mins suggests what? 10-15 mins?
A
Small bowel peristalsis problem; large bowl peristalsis problem
11
Q
Abdominal pain at night could indicate what?
A
Ulcer
12
Q
Abdominal pain in women that occurs monthly could indicate what?
A
Endometrious
13
Q
Describe the location of parietal pain
A
Muscular pain precisely located
14
Q
Describe the location of visceral pain
A
Diffuse, difficult to pinpoint
15
Q
How does a pt get relief from parietal pain?
A
Avoid provoking movement
16
Q
What position do pt’s find relief from visceral pain in?
A
No position change is of any help
17
Q
Abdominal pain may cause symptoms assoc. w/ what other types of diseases?
A
GI disease
Urinary disease
Gynecological disease
18
Q
Acute pain in the abdomen is called what until a precise dx is made?
A
Acute abdomen
19
Q
Chronic pain in the abdomen is typical of what?
A
Cancer
20
Q
What are the two types of visceral organs?
A
Hollow organs
Solid organs
21
Q
What type of pain pattern is assoc. w/ hollow organs?
A
Waxing/waning pattern, in a crescendo-decrescendo type wave pattern
22
Q
What pain pattern is assoc. w/ solid organs?
A
Produce a constant pain
23
Q
Visceral pain is typically described as what?
A
Vague
Poorly localized
Dull
Nauseating
24
Peritonitis (inflammation of the peritoneal cavity) is usually from what?
Perforations; Can also be caused from any abdominal condition that produces marked inflammation
25
What are some of the negative effects of peritonitis?
Causes fluid shifts into peritoneal cavity & bowel leading to severe dehydration & electrolyte disturbances which can lead to respiratory distress, kidney failure & liver failure
26
What conditions should be considered w/ RUQ pain?
Cholecystitis
Biliary Colic (spasms)
Hepatitis
Perforated Duodenal Ulcer
27
What conditions should be considered w/ LUQ pain?
Gastritis (TQ)
Splenic disorders
Peptic Ulcer Disease
Pancreatitis (TQ)
28
What conditions should be considered w/ Epigastric pain?
```
Acute pancreatitis (TQ)
Herpes zoster
Lower lobe pneumonia
Myocardial Ischemia
Radiculitis
Ulcer (TQ)
```
29
What conditions should be considered w/ RLQ pain?
Appendicitis (TQ)
Diverticulitis (TQ)
Ovarian Disorders
Fallopian tube disorders
30
What conditions should be considered w/ LLQ pain?
```
Sigmoid diverticulitis (TQ)
Ovarian Disorders
Fallopian Tube disorders
```
31
This is assoc. w/ ecchymosis (large bruising) of the flanks
Grey Turner's Sign
32
What ds is Grey Turner's sign usually assoc. w/?
Acute pancreatitis
33
This is ecchymosis around the umbilicus
Cullen's Sign
34
What diseases is Cullen's sign assoc. w/?
Pancreatitis
| Hemorrhagic peritonitis
35
These are sounds produced by fluids/gases being forced thru the intestines
Borborygmi
36
Severe pain w/ a silent abdomen suggests what?
Peritonitis
37
Back pain w/ shock suggests what?
Ruptured abdominal aortic aneurysm
38
What symptoms are common in all types of perforations?
Nausea
Vomiting
Anorexia
39
How are perforations diagnosed?
Presence of free air in the abdomen on x-rays
40
What is the suggested cause of an appendicitis?
Results from obstruction of appendix lumen either by lymphoid hyperplasia or a fecalith (a hard stony mass of feces) or a foreign body
41
Acute inflammation of the appendix usually results in what symptoms?
Abdominal pain
Anorexia
Abdominal tenderness
42
What are classic symptoms of an acute appendicitis?
Epigastric or periumbilical pain followed by brief nausea, vomiting, & anorexia. After a few hours, the pain shifts to the RLQ
43
An appendicitis can be detected using a rebound tenderness test over what point?
McBurney's point
44
This is an indication of peritonitis in which pain is felt upon severe release of steadily applied pressure on a suspected area of abdomen
Blumberg's Sign
45
This pain felt in the RLQ w/ palpation of LLQ. Increase pain is indicative of appendicitis
Rovsing's Sign
46
This is increased pain from passive extension of the R hip joint
Psoas Sign
47
This is pain upon passive internal rotation of flexed R thigh
Obturator Sign
48
What is the M/C cause of acute abdominal pain requiring surgery?
Acute appendicitis
49
What s/s is assoc. w/ acute peritonitis?
Absence of peristalsis
50
What's the difference b/w where the pain starts w/ appendicitis vs acute peritonitis?
Pain beings in epigastric region or periumbilical area for an appendicitis vs localized or generalized over the whole abdomen for acute peritonitis
51
What's the difference in the course of symptoms b/w appendicitis vs acute peritonitis?
Appendicitis has a brief course of nausea & vomiting whereas acute peritonitis has nausea & vomiting throughout
52
What type of fever is assoc. w/ appendicitis? Acute peritonitis?
Low grade fever (100-101); High fever (>103)
53
Describe peristalsis activity assoc. w/ an appendicitis? Acute peritonitis?
Slowed or absent; Always absent
54
What are the M/C etiologies of intestinal obstruction?
Adhesions
Hernias
Tumors
55
Which type of intestinal obstructions typically do not require surgery?
Partial obstructions
56
Which type of obstruction does not compromise intestinal blood supply?
Simple (Strangulating does)
57
How rapidly do symptoms assoc. w/ small bowel obstruction usually occur?
Shortly after onset of obstruction
58
Tumors that cause obstruction of the large bowel usually occur where?
Splenic & sigmoid flexures
59
Diverticulitis assoc. w/ obstruction of the large bowl most often occur where?
Sigmoid colon
60
What is the M/C site of volvulus?
Sigmoid colon
61
What type of deformity seen on x-ray is assoc. w/ obstruction of the large bowel?
Bird-beak deformity
62
Obstruction of a blood vessel by a foreign substance or blood clot is known as what?
Embolism
63
Formation or presence of a blood clot in a blood vessel
Thrombosis
64
X-ray via barium enema will show _______ which is diagnostic of ischemic colitis
Thumb-printing
65
How is pancreatitis diagnosed?
Dx is one of exclusion
66
What are etiologies of pancreatitis?
Alcohol abuse
| Gallstone blockage of bile
67
What are the M/C causes of Acute Pancreatitis?
```
Biliary tract ds from gallstones producing ductal P d/t to distention of duct
Chronic heavy alcohol intake
Trauma
Organ abnormalities
Use of prescription drugs
Unknown etiology (~15% of cases)
```
68
What are symptoms of acute pancreatitis?
Severe pain - steady, boring (knife-like) in upper ab areas (epigastric)
Eating aggravates pain
69
What is the M/C cause of fat malabsorption in adults in US?
Chronic Pancreatitis
70
What are s/s of chronic pancreatitis?
Steatorrhea
Diarrhea
Grey-Turner Sign
Cullen's Sign
71
This is the M/C life-shortening genetic ds in Caucasion pop.
Cystic Fibrosis
72
What is the initial sign of cystic fibrosis?
Obstruction of viscous meconium (meconium ileus) that may cause perforation of bowel or rectal prolapse or volvulus
73
What causes black stool?
```
Blood (upper GI)
Licorice
Lead
Iron pills
Blueberries
Pepto-Bismol
```
74
What causes green stool?
Increase in bile
Lots of green leafy veggies
Taking chlorophyll tablets
Normal in breastfed babies
75
What causes red stool?
```
Frank blood (lower GI)
Lots of beets or tomatoes
```
76
What causes grey (pale/chalky white stools)?
Indicative of liver problems
Indicative of pancreas problems
Indicative of gallbladder problems
77
What causes yellow stools?
```
Increase in bilirubin (hyperbilirubinemia-Gilbert's syndrome)
Parasite infection (M/C is giardia)
```
78
How does chronic constipation differ from acute constipation as far as etiology?
Chronic can be either physiological or functional whereas acute is usually just physiological cause
79
What are the different types of laxatives?
```
Wetting agents (soften stool)
Osmotic agents (speed up defecation; used for colonoscopy)
Bulking agents (contain fiber)
```
80
Fever plus bloody diarrhea is what type of diarrhea?
Inflammatory diarrhea
81
Type of chronic diarrhea that occurs when unabsorbable H20-soluble solutes remain in bowel & retain H20. Occurs w/ sugar intolerance.
Osmotic Diarrhea
82
Type of chronic diarrhea that occurs when bowels secrete more electrolytes & water than they absorb. Typically assoc. w/ bacterial toxins
Secretory Diarrhea
83
Type of chronic diarrhea that occurs w/ some infections & diseases that cause mucosal inflammation or ulcerations (Crohn's, Ulcerative Colitis, TB, Lymphomas, Cancer
Inflammatory Diarrhea
84
Type of chronic diarrhea that occurs when chyme is not in contact long enough w/ adequate absorptive surface of GI tract, which causes too much water to remain in stool
Diarrhea d/t decreased absorption time AKA Motility disorders, Acceleration of intestinal transit
85
Type of chronic diarrhea that may be result of either/both osmotic or secretory mechanisms. Hallmark of this condition is wt loss & nutritional def.
Malabsorption-Related Diarrhea
86
This is a functional bowel disorder & is considered a motility disorder that involves the entire GI tract
IBS AKA mucus colitis, colonic spasms, nervous colon, spastic colon
87
What are symptoms assoc. w/ IBS?
```
Tends to begin in the teens & early 20's
Does not awaken pt from sleep
Abdominal pain typically in LLQ or suprapubic
Abdominal cramping
Constipation or diarrhea (or both)
Abdominal bloating
No blood in stool
```
88
IBS is diagnosed using the Rome Criteria which includes disturbed defecation involving at least 2 of what symptoms?
```
Altered stool freq.
Altered stool form
Altered stool passage
Passage of mucus in the stool
Bloating or a feeling of distention
```
89
This is inflammation of the lining of stomach & both intestines
Gastroenteritis
90
What are the M/C causes of gastroenteritis?
Viruses
91
What symptoms are assoc. w/ malabsorption syndrome?
```
Chronic diarrhea (M/C symptom)
Steatorrhea
Abdominal bloating
Gas
Weight loss
```
92
What is the M/C form of CHO intolerance?
Lactase deficiency
93
This is an autoimmune ds in people that have gluten intolerance resulting in mucosal inflammation which leads to malabsorption. GLIADIN fraction of gluten (?)
Celiac Sprue AKA Non-tropical spruce, Gluten enteropathy, Celiac disease
94
Acquired ds of unknown etiology probably related to bacterial, viral, or parasite infections or from rancid fats used in cooking. May be from a chronic infection of the small bowel by strains of coliform bacteria. Chiefly found in the Caribbean, Southern india, & Southeast Asia, it affects both natives & visitors
Tropical Sprue
95
Primary symptoms assoc. w/ Tropical sprue
Acute diarrhea
| Steatorrhea
96
Rare systemic illness caused by the bacterium Tropheryma Whippelii
Whipple's Disease
97
Protein & calorie malnutrition
Marasmus
