Week 11- GI System 2

Question 1

The presence of outpouchings in the wall of the colon or small intestine

Answer 1

Diverticulosis

Question 2

The mucosa and submucosa herniate through the muscular layers of the ________ to form outpouchings

Answer 2

Colon

Question 3

Inflammation/infection of the diverticula with possible complications such as perforation, abscess formation, obstruction, fistula formation, and bleeding

Answer 3

Diverticulitis

Question 4

Diverticular disease has a higher incidence in…

Answer 4

Western countries

Question 5

Risk factors of diverticular disease

Answer 5

-Constipation
-Physical inactivity
-Eating red meat
-Obesity
-Smoking
-NSAID, chronic steroids, and immunosuppressants use
-Several connective tissue disorders

Question 6

_____% of affected with diverticular disease are asymptomatic

Answer 6

80%

Question 7

Clinical manifestations of diverticular disease can be…

Answer 7

Uncomplicated
Complicated

Question 8

Mild symptoms are nonspecific and there is episodic pain. When diverticula become blocked, bacteria that are trapped inside begin to proliferate, causing infection and inflammation.

Answer 8

Uncomplicated diverticular disease

Question 9

A fistula may develop with the bladder (colovesical fistula).
Pneumaturia (air in the urine), fecaluria (urine in the stool), or recurrent urinary tract infections, in conjunction with fever, abdominal pain, or palpable mass.

Answer 9

Complicated diverticular disease

Question 10

Medical management of diverticular disease

Answer 10

-CT imaging
-Elevated WBCs
-Colonoscopy (4-6 weeks after resolution of the initial attach; avoid in the acute stage)
-Medications (antibiotics and pain control)
-Lifestyle change
-Surgery
-Prognosis is good (low mortality for diverticulitis)

Question 11

True or false: Physical activity and exercise have protective effect and lowers the risk of diverticulitis and diverticular bleeding

Answer 11

True

Question 12

It is important to be careful to avoid activities that increase ____________ to avoid further herniation

Answer 12

Intraabdominal pressure

Question 13

This type of pain is associated with diverticular disease

Answer 13

Back pain
Referred pain in hip or thigh

Question 14

An inflammation that often results in necrosis and perforation with subsequent localized or generalized peritonitis

Answer 14

Appendicitis

Question 15

Appendicitis affects the…

Answer 15

Vermiform appendix

Question 16

Peak incidence of appendicitis is between the ages of _____

Answer 16

15-19

Question 17

True or false: Appendicitis occurs more in females than males

Answer 17

False

(males more than females)

Question 18

True or false: About half of all cases of acute appendicitis have a known cause

Answer 18

False

(no known cause)

Question 19

Appendicitis occurs primarily from obstruction of the…

Answer 19

Lumen
Bacterial infection

Question 20

True or false: One-third of appendicitis cases are caused by obstruction that prevents normal drainage

Answer 20

True

Question 21

How appendix obstruction occurs

Answer 21

Distends the obstructed appendix – > the intraluminal pressure rises and eventually exceeds the venous pressure –> ischemia, necrosis, and perforation

Question 22

Type of pain associated with appendicitis

Answer 22

Abdominal (epigastric, periumbilical, or right lower quadrant) pain accompanied by anorexia, nausea, vomiting, and low-grade fever in adults (high fevers if perforation)

Question 23

True or false: Pain is constant and may shift within 12 hours of symptom onset to the right lower quadrant with point tenderness over the site at McBurney point

Answer 23

True

Question 24

WBC count for appendicitis

Answer 24

WBCs > 20,000/mm3

Question 25

____% of appendicitis cases are atypical because of the position of the tip of the appendix

Answer 25

40-50%

Question 26

Treatment for appendicitis

Answer 26

-Antibiotics -Appendectomy, or surgical removal, is performed ASAP, either by open procedure or laparoscopically (for uncomplicated patients)

Question 27

Client with appendicitis may present with symptoms of...

Answer 27

Right thigh pain Groin (testicular) pain Pelvic pain Referred pain in the hip

Question 28

True or false: If appendicitis is suspected, medical attention is not immediate

Answer 28

False (it is)

Question 29

An ulceration or tear of the lining of the anal canal, usually on the posterior wall

Answer 29

Rectal/anal fissure

Question 30

Occurs as a result of excessive tissue stretching or tearing, such as childbirth or passage of a large, hard bowel movement through the area

Answer 30

Acute fissure

Question 31

Type of pain associated with rectal fissure

Answer 31

Sharp pain, followed by burning, accompanies defecation, bleeding, spasms, mucus, and itching

Question 32

Anal fissures frequently heal within ________ when treated with a combination of bran and bulk laxatives or stool softeners, sitz baths, and emollient suppositories

Answer 32

1-2 months

Question 33

Varicose veins of a pillow-like cluster of veins that lie just beneath the mucous membranes lining the lowest part of the rectum and anus

Answer 33

Hemorrhoids

Question 34

Hemorrhoids are associated especially with anything that increases ___________

Answer 34

Intraabdominal pressure

Question 35

Occur in the lower rectum and usually are noticed first when a small amount of bleeding occurs during passage of stool, especially if straining occurs during a bowel movement

Answer 35

Internal hemorrhoids

Question 36

Located under the skin around the anus bleed (bright red blood) if the hemorrhoid is injured or ulcerated and are very painful because they form in nerve-rich tissue outside the anal canal

Answer 36

External hemorrhoids

Question 37

External hemorrhoids can be treated with...

Answer 37

-A local application of topical medications -Sitz baths -High-fiber diet -Avoidance of constipation and other causes of increased intraabdominal pressure