Med Surg Session 10: GI

GI session 10

 

Gastritis – usually acute but can by chronic.

  • Often from an irritant such as increased Ibuprofen (or other NSAIDs) intake
  • Irritation of the stomach
  • May cough up blood
  • Gastroenteritis – inflammation of stomach an bowel.

 

PUD – Peptic Ulcer Disease –

  • gastric – superficial, more common in women, 50 and 60 y.o., pain after meals,
  • duodenal – Deep, more common in men, 35-45 yo, pain just below xiphoid process, H. pylori in 90%+
  • PPI’s tend to be better for recovery
  • H2 blockers tend to be better for prophylaxis of PUD
  • Surgeries are less common now because of the medications controlling it well
    • Billroth 1 stomach to Duodenum
    • Billroth 2: stomach to the Jejunum
  • Avoid SMOKING, NSAIDs, chocolate, and fatty foods

 

IBD -Inflammatory bowel disease

  • can be Crohn’s Dx (CD) or Ulcerative Colitis (UC)
  • CD – cobblestone (skip) lesions, can be throughout the whole bowel large or small, full thickness of bowel affected,
  • UC – continuous lesions, Partial thickness, Rectal bleeding, colonic dilation, colorectal cancer,
  • colonoscopy for visualization of the lesions
  • Drugs: to decrease inflammation: 5-Aminosalicylates, corticosteroids, immunosuppressants, antidiarrheals.
  • treatment: colectomy or Proctocolectomy (colostomy or ileostomy)
  • We are looking for dehydration, imbalance in electrolytes, Pain

 

Viral Hepatitis

  • inflammation of the liver
  • caused by drugs, chem, autoimmune, virus,
    • viral – a,b,c,d,e
  • s/s: tired, anorexia, nausea, abd pain, jaundice, hepatomegaly, occasional vomiting
  • Diagnosis with labs (do not need to know the specific bili and liver levels right now)
  • Types
    • A food born, and poor hygiene
    • B sexually transmitted
    • C iv drug and contaminated blood transfusion

 

Obstructions

  • proximal obstruction
    • accumulation of fluid and gas, this can lead to sepsis
  • Small BO
    • vomiting, dehydration, high pitched bowel sounds above obstruction, alkalosis, ABD distension.
  • Large BO
    • vomiting, high pitched bowel sounds above obstruction, ABD distension.
  • care: NPO, NG tube on suction, I/O, abd girth, IVF, and electrolytes.

 

Gallbladder Alterations

  • gallstones
  • Risk factors 5 Fs: female forty fat fertile, fare (white)
  • ERCP – tube down the esophagus to the common bile educt, to break up and pull out stones
  • The stones can block the duct of both the bile and the pancreatic enzymes causing pancreatitis.

 

Diverticulitis – inflammation of the diverticula, causing a perforation into the peritoneum.

diverticulosis – out pouching of the colon.

  • caused by constipation most of the time.

 

Appendicitis

  • wory about perforation

 

Peritonitis

  • extreme guarding and pain
  • surgery asap to clean out the cavity

 

Anti emetic meds

  • reglan
  • zofran
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