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22 Cards in this Set
- Front
- Back
fecal smelling emesis indicates:
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intestinal obstruction below level of pylorus
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bile in emesis indicates:
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possible intestinal obstruction; possible bile reflux gastritis
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partially digested food in emesis indicates:
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gastric outlet syndrome;
delay in gastric emptying |
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coffee-ground emesis indicates:
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gastric bleed (HCL acid mixed with blood - dark, curdled)
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bright red emesis indicates:
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esophageal varices (liver cirrhosis); mallory-weiss tears; gastric or duodenal ulcer; neoplasm
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Clinical manifestations of Upper GI bleeding include:
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hematemesis (coffee-ground or bright red blood); melena (black tarry stools); occult blood (need lab test)
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Drugs that cause upper GI bleeding:
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NSAIDS; Salicylates; Corticosteroids
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what drugs are contraindicated in upper GI bleeding?
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anticholinergics
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Anti-emetic drugs include:
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anticholinergics (scopalamine); antihistamines (promethazine); phenothiazines (thorazine, compazine); buytophenones (droperidol); metocolpramide (Reglan)
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contraindications of Reglan
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hyperactive bowel sounds and loose stools - this drug increases gastric emptying
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what is pyrosis?
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"heartburn". Burning sensation from zyphoid to throat and jaw.
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what is dyspepsia?
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Pain or discomfort centered in upper abdomen, midline, between zyphoid and umbillicus.
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clinical manifestations of GERD
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dyspepsia, pyrosis, hypersalivation; noncardiac chest pain; respiratory symptoms (wheezing, coughing, dyspnea, hoarseness, sore throat, lump in throat, choking); food regurgitation; gastrci symptoms (early satiety, postmeal bloating, n/v);
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Complications of GERD
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Esophagitis; Barrett's esophagus (precancerous lesions); Respiratory (bronchospasm, larygospasm, cricopharyngeal spasm); dental erosion
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What drug is used in Diagnosis of GERD?
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High-dose proton pump inhibitor treatment will reduce symptoms
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dehydration due to vomiting: what is initial fluid of choice for rehydration by mouth?
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water! 5 - 15 mL q 15 - 20 minutes
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what is best way to check for fluid status?
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daily weight (normal fluctualtion is 1 lb per day)
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Predisposing factors involved in development of GERD
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incompetent LES; hiatal hernia; impaired esophageal motility (delayed espohageal clearance); delayed gastric emptying.
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biological irritants in the production of GERD
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HCL acid; gastric enzyme Pepsin; intestinal enzyme Trypsin; bile salts: all corrosive to esophageal lining
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diet and lifestyle factors that contribute to GERD
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tobacco products; caffeine, chocolate, peppermint, drugs (anticholinergics) lower LES pressure; obesity;
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What are hiatal hernias?
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Hiatal hernias occur when the stomach squeezes through the hiatus in the diaphragm meant for the esophagus.
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Name the 2 types of hiatal hernias and describe differences.
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Sliding Hiatal hernia: the stomach and LES comes up thru the hiatus.
Paraesophageal hernia: the stomach bulges thru the hiatus next to the esophagus |