Chapter 36 Gastrointestinal Disorders
Fecal leukocyte screening would be indicated in a pt with suspected
Enterocolitis - manifested by (diarrhea often bloody), abdominal pain, fever, leukocytosis
A disorder of the esophageal smooth muscle function where dysphagia is a symptom is
Esophageal stricture Achalasia Esophageal tumors
A silent abdomen 3 hrs after bowel surgery most likely indicates
Functional bowel obstruction or ileus - refers to the loss of propulsive ability by the bowel and may occur after abdominal surgery or in association with hypokalemia, peritonitis, severe trauma, spinal fractures, ureteral distention and the administration of meds such as narcotics
Epigastric pain that is relieved by food is suggestive of
Gastric ulcer
The earliest manifestation of appendicitis is
Generalized periumbilical pain accompanied by nausea and occasionally diarrhea The pain is often described as migrating or localizing to the lower right abdomen (McBurney's point) due to distention of the serosa from inflammatory edema at which time fever usually manifests
Celiac sprue is malabsorptive disorder associated with
Inflammatory reaction to gluten containing foods Immune disorder Villus atrophy
Osmotic diarrhea
Is due to increased amounts of poorly absorbed solutes in the intestine
Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high
Mortality
An early indicator of colon cancer is
A change in bowel patterns Later in the progression of tumor growth, a sensation of rectal fullness and a dull ache may be felt in the rectum and sacral region
A pt who should be routinely evaluated for peptic ulcer disease is one who is
Being treated with a high dose oral glucocorticoids
What finding should prompt further diagnostic testing in a child presenting with diarrhea
Blood and mucus in the stools (ulcerative colitis and Crohn disease have their onset in childhood or young adulthood)
What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea
Bloody diarrhea
Secretory diarrhea is
Usually due to toxins that stimulate intestinal fluid secretion and impair absorption
The most common cause of mechanical bowel obstruction is
adhesions ( previous abdominal surgery and congenital abnormalities of the bowel)
Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of
appendicitis
Proton pump inhibitors may be used in the management of peptic ulcer disease to
decrease hydrochloric acid (HCL) secretion
Which symptom suggests the presence of a hiatal hernia
heartburn Predisposed to GERD - symptoms (heartburn, chest pain, and dysphagia
Barrett esophagus is a
preneoplastic lesion Is a complication of chronic GERD and represents columnar tissue replacing the normal squamous epithelium of the distal esophagus- carries a significant risk for esophageal cancer
What clinical finding would suggest an esophageal cause of a client's report of dyphagia
Chest pain during meals
A pt with chronic gastritis would likely be tested for
Helicobacter pylori
An urgent surgical consult is indicated for the patient with acute abdominal pain and
Absent bowel sounds
Ulcerative colitis (inflammation and ulceration of the colon and rectal mucosa) is commonly associated with
bloody diarrhea
Premature infants are at greater risk for developing
Necrotizing enterocolitis - is a disorder occurring most often in premature infants ( less than 34 weeks' gestation) and infants with low birth weight less than 5lbs Characterized by diffuse or patchy intestinal necrosis accompanied by sepsis
What is a pathophysiologic mechanism involved in the development of diarrhea
Osmotic diarrhea Secretory diarrhea Exudative diarrhea Motility disturbances
Crohn disease is associated with
Perianal fissures Fistulae Rectal pain
Esophageal varices represent a complication of
Portal hypertension The result of cirrhosis due to alcoholism or viral hepatitis
Exudative diarrhea (mucus, blood, protein)
Results from inflammatory processes
A patient receiving chemotherapy may be at greater risk for development of
Stomatitis - ulcerative inflammation of the oral mucosa that may extend to the buccal mucosa, lips, and palate