Med surg quiz 2
Lower GI acidosis
Leads to acidosis (ASSidosis)
Septic arthritis
When an infection causes bone swelling.
Leading cause of falls with the elderly
Rugs and pets
Peritonitis
ROCK HARD ABDOMEN medical emergency
NSAIDS
Chronic use can cause loss of stomach lining - ulcers
Upper GI problems
Leads to alkalosis
Osteoarthritis
"wear/tear" progressive deterioration of weight-bearing joints. UNILATERAL pain/sweilling in joints. influenced by body weight. Treatment: NSAIDS, Narcotics
displaced fracture
A fracture in which bone fragments are separated from one another and not in anatomic alignment.
Medications for Inflammatory Bowel Disease
1. Anti-inflammatory drugs: Corticosteroids and aminosacylates like mesalamine, balsalazide, olsalazine 2. Immunosupressors: azathioprine, mercaptopurine, cyclosporine, methotrexate. 3. Antibiotics: ciprofloxacin (Cipro) and metronidazole (Flagyl).
Functions of the musculoskeletal system
1. Framework/support 2. Movement 3. Mineral Storage 4. Erythropoiesis
Bone healing process
1. Hematoma formation (do not give NSAIDS for bone injury, use Tylenol) 2. Fibrocatilage callous 3. Bone callous (ossification) 4. Bone remodeling
The nurse is reviewing medications with a patient having gastric ulcer. The nurse should intervene when the following is observed. 1. Taking Maalox PRN for heartburn 2. Taking Ranitidine with meals 3. Taking Antacids and Sucralfate together 4. Taking Omeprazole even after symptoms subsided
3. Sulcrafate- it slows the absorption of other meds
bowel obstruction
A blockage in the GI - associated with N/V - usually an NG tube is given.
nondisplaced fracture
A simple crack in the bone that has not caused the bone to move from its normal anatomic position; also called a hairline fracture.
Ulcerative colitis
Affects outermost layer of the GI - leads to GI bleeding.
Chrohn's disease
Affects submucosal layer of GI (Bottom layer) so there is less GI bleeding.
Rheumatoid Arthritis
AUTOIMMUNE inflammatory disease that causes weak CT/joints. EQUAL pain/swelling in joints Treatment: NSAIDS, DMARDS, glucocorticoids/steroids
Reflux esophagitis
Acute inflammation of the esophagus
A pt is experiencing bleeding related to PUD. Which nursing intervention is the highest priority? A. Starting large-bore IV B. Administer IV pain med C. Prepare equipment for intubation D. Monitor the client's anxiety level
Answer: A A large-bore IV should be placed as requested, so that blood products can be administered. IV pain med is not a recommended treatment for GI bleeding. Intubation is not a recommended treatment for bleeding r/t PUD. The mental status of the client should be monitored; however, it's not necessary to monitor the pt's anxiety level.
A male pt with a long history of ulcerative colitis experienced massive bleeding and had emergency surgery for creation of an ileostomy. He is very concerned that sex with his wife will be impossible because of his new ileostomy pouch. How does the nurse respond? A. A change in position may be what is needed for you to have sex w/ your wife B. Have you considered going to see a marriage counselor with your wife? C. What has your wife said about your pouch? D. You must get clearance from your provider before you can have sex
Answer: A A simple change in positioning during sex may alleviate the pt's apprehension and facilitate sexual relations with his wife. Suggesting marriage counseling may address the pt's concerns, but it focuses on the wrong issue; the pt has not stated that he has relationship problems. Asking the pt what his wife has said about the pouch may address the client's concerns, but it similarly focuses on the wrong issue. Telling the pt that he needs to get clearance from his provider is an evasive response that doesn't address the pt's primary concern.
A pt diagnosed with ulcerative colitis is going to be discharged on loperamide (Imodium) for symptomatic management of diarrhea. What does the nurse teach about this med? A. Know the symptoms of toxic megacolon B. If diarrhea increases, contact your provider C. Avoid pregnancy D. Your dose of sulfasalazine (Azulfidine) will need to be decreased
Answer: A Antidiarrheal drugs can lead to colonic dilation and toxic megacolon (massive dilation of colon w/ risk of developing gangrene and peritonitis). Toxic megacolon is characterized by an enlarged colon with fever, leukocytosis, and tachycardia. Loperamide will decrease diarrhea not increase it. Constipation is sometimes a problem. No contraindication for pregnancy is noted. Sulfasalazine therapy typically continues on a long-term basis
The nurse teaches a pt w/ PUD about the prescribed drug regimen. Which statement by the pt indicates a need for further teaching? A. Nizatidine (Axid) needs to be taken 3x a day to be effective. B. I will take Ranitidine (Zantac) at bedtime as it should decrease acid production at night. C. Sucralfate (Carafate) should be taken 1 hr before meals and 2 hrs after meals. D. Omeprazole (Prilosec) should not be crushed. It should be swallowed whole.
Answer: A Nizatidine= most effective if administered 1x day Ranitidine= one dose at bedtime should decrease acid production throughout the night Sucralfate= should be taken 1 hr before meals and 2 hrs after meals Omeprazole= it is a delayed-release capsule so it should be swallowed whole and not crushed
A pt diagnosed with mild GERD asks the nurse about nonpharmacologic treatments to prevent symptoms. What does the nurse tell the pt? A. Avoid caffeine-containing foods and beverages. B. Eat 3 meals each day and avoid snacking between meals. C. Peppermint lozenges help to reduce stomach upset. D. Sleep on your left side with a pillow between your knees.
Answer: A Teach pt to limit or eliminate foods that decrease LES (lower esophageal sphincter) pressure and that irritate inflamed tissue, causing heartburn (e.g. peppermint, chocolate, alcohol, fatty foods, fried food, caffeine, and carbonated beverages). Large meals increase volume and pressure in the stomach and delay gastric emptying. Remind pt to eat 4-6 small meals each day rather than 3 large ones. Peppermint decreases LES pressure and increases the risk of symptoms. Clients should be taught to elevate the head 6-12 in at night to prevent reflux.
A nurse is teaching a pt with Crohn's about managing the disease w/ adalimumab (Humira). Which instruction does the nurse emphasize? A. Avoid anyone who is sick and avoid large crowds B. Do not take the med if you're allergic to foods containing fatty acids C. Expect difficulty w/ wound healing while taking adalimumab D. Monitor BP and report any significant decrease in BP
Answer: A The pt should avoid large crowds and sick people to prevent developing an infection. The pt client should not take the medication if the pt is allergic to certain proteins. While immune suppression may occur to some degree, the pt shouldn't experience difficulty with wound healing. The pt also shouldn't experience a decrease in BP.
The nurse is teaching a pt about sulfasalazine (Azulfidine) (treats ulcerative colitis and RA). What side effects should the nurse tell the pt to report to the provider? A. Anorexia B. Depression C. Drowsiness D. Frequent urination E. Headache F. Vomiting
Answer: A, E, F Depression, drowsiness, and frequent urination are not side effects.
A pt is presenting with vague symptoms that indicate an acute inflammatory bowel disorder. Which symptom is most indicative of Crohn's? A. Abd. pain relieved by bending knees B. Chronic diarrhea, abd. pain, and fever C. Epigastric cramping D. Hypotension w/ vomiting *Abd= abdominal
Answer: B Abd. pain relieved by bending of knees is indicative of peritonitis or pancreatitis. Epigastric cramping is a symptom more indicative of appendicitis. Hypotension w/ vomiting is not characteristic of Crohn's.
A patient with GERD has undergone a laparoscopic Nissen fundoplication (LNF). What will the nurse include in postoperative home care instructions? A. "Consume carbonated beverages if you experience stomach upset." B. "Remain on a soft diet for about a week and avoid raw fruits and vegetables." C. "You may resume running and weight lifting if you wish." D. "You may stop taking your anti-reflux medications after 1 week."
Answer: B After LNF, clients should be taught to remain on a soft diet for 1 week. Carbonated beverages should be avoided. Clients may walk, but should avoid heavy lifting. Anti-reflux medications should be taken for 1 month after the procedure.
A pt with PUD asks the nurse whether licorice and slippery elm might be useful in managing PUD. What is the nurse's best response? A. They prob won't be useful. You should only use prescription meds in your treatment plan B. These herbs could be helpful. However, you should talk w/ your provider before adding them to your med regimen C. These are known to be effective in managing PUD, but make sure you research them thoroughly before using them D. Herbs are not useful for managing PUD. However, you can use any type of OTC because they have been shown to be safe.
Answer: B Although licorice and slippery elm may be helpful in managing PUD, the pt should consult the healthcare provider before making a change in the tx regimen. Alternative therapies may or may not be helpful in managing PUD. The pt shouldn't use OTC meds without first discussing it with the provider.
A pt has a long-term history of Crohn's and has recently developed acute gastritis. The pt asks whether Crohn's was a direct cause of the gastritis. What is the nurse's best response? A. Crohn's disease is known to be a direct cause of the development of chronic gastritis B. We know that there can be an association between Crohn's disease and chronic gastritits, but Crohn's doesn't directly cause gastritis to develop C. What did your doctor tell you about how your gastritis developed? D. A familial tendency to inherit Crohn's disease and gastritis has been reported. Have any of your family members been tested for Crohn's disease?
Answer: B Crohn's may be an underlying disease process when chronic gastritis develops, but not when acute gastritis occurs. It is not known to be a direct cause of the disease. Although Crohn's tends to run in families, gastritis is a symptom of other disease processes and is not a disease process in and of itself. Asking the pt what the doctor has said is an evasive response and doesn't help answer the pt's question.
Which statement correctly differentiates Crohn's from ulcerative colitis? A. Pts with Crohn's experience around 20 loose, bloody stools daily B. Pts with ulcerative colitis may experience hemorrhage C. The peak incidence of ulcerative colitis is between ages 15-40 D. There are very few complications associated with Crohn's
Answer: B Crohn's: 5-6 stools per day, fistulas are a common complication Ulcerative colitis: hemorrhage is common, peak incidence is between ages 15-25 and 55-65
The nurse teaches a pt about dietary choices to prevent dumping syndrome after gastric bypass surgery. Which statement by the pt indicates a need for further teaching? A. I will need to avoid sweetened fruit juice drinks B. I can eat ice cream in moderation C. I cannot drink alcohol at all D. It's okay to have a serving of sugar-free pudding
Answer: B Milk products like ice cream must be eliminated from the diet. The client with dumping syndrome can no longer consume sweetened drinks. Alcohol must also be eliminated from the diet. The client can eat sugar-free pudding, custard, and gelatin with caution.
The admission assessment for a pt w/ acute gastric bleeding indicates BP 82/40 mm Hg, HR 124 beats/min, and RR 26 breaths/min. Which admission request does the nurse implement first? A. Type and crossmatch for 4 units of pRBC B. Infuse LR solution at 200mL/hr C. Give pantoprazole (Protonix) 40 mg IV now and then daily D. Insert NG tube and connect to low intermittent suction
Answer: B The pt's most immediate concern is the hypotension associated w/ volume loss. The most rapidly available volume expanders are crystalloids to treat hypovolemia. A type and crossmatch, admin of pantoprazole, and insertion of NG tube all need to be done, but the nurse's immediate concern is correcting the pt's hypovolemia.
A pt in the outpatient clinic tells the nurse about experiencing heartburn and nighttime coughing episodes. Which action does the nurse take first? A. Teach the pt about antacid effects and side effects. B. Ask the pt about meds and dietary intake. C. Suggest that the pt sleep with the head elevated 6 in. D. Tell the pt to avoid drinking alcohol late in the evening.
Answer: B Rationale: The initial action should be further assessment of the pt's risk factors for GERD. Before suggesting interventions or beginning client teaching, the nurse must obtain more info about the pt's symptoms. The nurse needs additional data before telling the pt to avoid drinking alcohol late in the evening.
Nurse is teaching PT about diet to help manage exacerbations of diverticulitis. What does the nurse advise? A. Maintain an exclusively low-fiber diet to prevent pain on defecation. B. Consume a low-fiber diet while your diverticulitis is active. When inflammation resolves, consume a high-fiber diet. C. Maintain a high-fiber diet to prevent the development of hemorrhoids that frequently accompany this condition. D. Consume a high-fiber diet while diverticulitis is active. When inflammation resolves, consume a low-fiber diet.
Answer: B The most effective way to manage diverticulitis is w/ low-fiber diet while inflammation is present, followed by a high-fiber diet once the inflammation has subsided. An exclusively low-fiber diet and exclusively high-fiber diet will NOT effectively manage diverticulitis. A high-fiber diet while diverticulitis is active will only worsen the symptoms and disease.
The nurse is assessing a pt with GERD. Which findings does the nurse expect to observe? A. Blood-tinged sputum B. Dyspepsia C. Excessive salivation D. Flatulence E. Regurgitation
Answer: B, D, E Dyspepsia is one of the main symptoms of GERD. Flatulence is common after eating, as well as regurgitation of food and fluids. Blood-tinged sputum and excessive salivation are not symptoms of GERD.
The nurse finds a pt vomiting coffee-ground emesis. The nurse assess the pt and finds that has a BP of 100/74 mmHg, is acutely confused, and has a weak and thready pulse. Which is the nurse's first priority? A. Administer H2 antagonist B. Initiate enteral nutrition C. Administer IV fluids D. Administer anti-anxiety meds
Answer: C Admin IV fluids is necessary to treat the hypovolemia caused by acute GI bleeding. Admin of H2 antagonist will not treat the basic problem, which is the upper GI bleeding. Enteral nutrition will not be part of the tx plan for acute GI bleeding. Admin of an anti-anxiety med will not treat the basic problem causing the client's change in mental status, which is hypovolemia.
Pt w/ ulcerative colitis is prescribed sulfasalazine (Azulfidine) and corticosteroid therapy. As the pt's ulcerative colitis improves, what change does the nurse expect in the pt's med regimen? A. Corticosteroid therapy will be stopped B. Sulfasalazine will be stopped C. Corticosteroid therapy will be tapered D. Sulfasalazine will be tapered
Answer: C After clinical improvement is established, corticosteroids are tapered over a 2-3 month period. Stopping corticosteroid therapy abruptly is UNSAFE. Steroids must be gradually decreased. Usually the amount that the pt has been taking dictates how quickly/slowly they can be stopped. Sulfasalazine therapy will be taken long-term. Sulfasalazine therapy may be increased or decreased, depending on pt symptoms, but will likely never be stopped. These decisions are made over a long period of therapy.
The nurse and dietitian are planning sample diet menus for a pt experiencing dumping syndrome. Which sample meal is best? A. Chicken salad on whole wheat bread B. Onions and liver C. Rice and chicken D. Cobb salad w/ buttermilk ranch dressing
Answer: C Chicken and rice is the only selection suitable because it contains high protein without the addition of milk or wheat products. The pt w/ dumping syndrome should not be allowed to have mayonnaise, onions, or buttermilk ranch dressing; the dressing is made from milk products. The pt can have whole wheat bread only in very limited amounts.
Pt is diagnosed with ulcerative colitis. The nurse teaches the pt about what diet and lifestyle choices? A. Drinking carbonated drinks will help with the abd. distress B. It's okay to smoke cigarettes just be sure to limit yourself to 1/2 pack per day C. Foods containing lactose should be decreased or eliminated from your diet D. Raw veggies and foods high in fiber may help diminish symptoms
Answer: C Food containing lactose are often poorly tolerated and should be reduced or eliminated. Carbonated drinks are GI stimulants that can cause discomfort and should be used rarely or completely eliminated. Cigarette smoking is a stimulant that can cause GI distress. Nurses should NEVER advise clients that any amount of cigarette smoking is okay (lol). Raw veggies and foods high in fiber can cause GI symptoms in clients with UC.
The nurse is reviewing the medication history for a PT with GERD who has been prescribed esomeprazole (Nexium) once daily. The pt reports that the drug doesn't completely control the symptoms. The nurse discusses which intervention with the provider? A. Add a second proton pump inhibitor medication B. Increase esomeprazole dose C. Change to a twice-daily dosing regimen D. Switch to omeprazole (Prilosec)
Answer: C The proton pump inhibitors are usually effective when given once daily. They can be given twice daily if symptoms are not well controlled. Adding a second medication, increasing the dose, or switching to another proton pump inhibitor is not recommended.
The nurse teaches the pt how to prevent recurrent chronic gastritis symptoms before discharge. Which statement by the pt demonstrates a correct understanding of the nurse's teaching? A. It's okay to continue to drink coffee in the morning B. I will need to take vitamin B12 shots for the rest of my life C. I should avoid alcohol and tobacco D. I should eat small meals about 6x a day
Answer: C The pt w/ chronic gastritis should avoid alcohol and tobacco and eliminate caffeine from the diet. The pt will need to take vitamin B12 shots only if the pt has pernicious anemia. The pt should not eat six small meals daily because this may actually stimulate gastric acid secretion.
The nurse reviews a medication history for a pt diagnosed w/ PUD who has a history of using ibuprofen (Advil) frequently for chronic back pain. The nurse anticipates that the provider will request which med for the pt? A. Bismuth subsalicylate (Pepto-Bismol) B. Magnesium hydroxide (Maalox) C. Metronidazole (Flagyl) D. Misoprostol (Cytotec)
Answer: D Bismuth= antidiarrheal drug, contains salicylates that can cause bleeding and should be avoided with PUD pts Magnesium hydroxide= anatacid, doesn't specifically help to prevent NSAID-induced ulcers Metronidazole= antimicrobial agent, used to treat H. pylori infection Misoprostol= prostaglandin analogue, helps protect against ulcers induced by NSAIDS (more on pg. 1134 in ignatavicius book)
The nurse is working with the dietitian to plan a menu for a pt who has persistent difficulty swallowing. What is a suitable selection for breakfast? A. Scrambled eggs and toast B. Oatmeal and orange juice C. Pureed fruit and English muffin D. Cream of wheat and applesauce
Answer: D Cream of wheat and applesauce are of semi-solid consistency and are appropriate for this client. The pt who is having difficulty swallowing should be given semi-solid foods and thickened liquids. Toast is not appropriate, and o.j. should be thickened before given to pt. An English muffin is not appropriate because it's not a semi-solid food.
A pt demonstrates the manifestations of diverticulitis w/ suspected complication of peritonitis. The priority nursing intervention is? A. Assess for changes in vital signs B. Medicate pt for pain C. Monitor for changes in pt's mental status D. Prepare pt for emergency surgery
Answer: D Highest priority is to prepare pt for emergency surgery so the source of the infection can be removed. It is expected that the client will experience changes in vital signs from the infectious process and accompanying pain. Monitoring vitals, medicating the client for pain, and determining whether the client is experiencing changes in mentation are important but are not the highest priority. The pt has an immediate need to go to surgery.
A pt with ulcerative colitis has started sulfasalazine (Azulfidine). What should the nurse tell the pt about the drug? A. The drug stops diarrhea and bloody stools B. The drug minimizes your GI discomfort C. The drug will relieve your cramping D. The drug will reduce your intestinal inflammation
Answer: D Sulfasalazine (Azulfidine) is one of the primary tx for ulcerative colitis. Although it is hoped that reduction of inflammation will cause the diarrhea and bloody stools to stop, this is not the way that the drug works. Antidiarrheal drugs "stop" diarrhea. Sulfasalazine's action as an anti-inflammatory will diminish the pt's pain as the inflammation subsides, but this is not the purpose of the drug. It is NOT an analgesic.
Medications for GERD
Antacids (Tums, Rolaids) PPIs (lansoprazole, omeprazole) H2 receptor blockers (cimetidine, famotidine, nizatidine, and ranitidine)
Black poop (Melena)
Associated with upper GI bleed except when iron supplements are given.
rheumatoid arthritis
Autoimmune markers are usually checked: ANA(anti nuclear antibodies), ESR(erythropoetin sedimentation rate), CRP(C reactive protein), RF (Rheumatoid factor) Usually starts with a viral infection
Pernicious anemia can be caused by a lack of ____, which is a deficiency resulting from ________
B12, Chronic Gastritis
Vancomycin
Cannot exceed 72 hours in the same line, need to change the line - consider central line UNLESS THERE IS AN INFECTION IN THE BLOOD
C.diff
Clostridium difficile Cause by antibiotic use Consider concurrent probiotics when giving antibiotics
Divertilulosis/Diverticulitis
Constipation is the leading cause of this disease. Can lead to peritonitis from perforation and infection
2 types of inflammatory bowel disease
Crohn's disease and ulcerative colitis
What are the two types of inflammatory bowel diseases?
Crohns and Ulcerative Colitis
DEXA scan
procedure that measures bone mineral density (BMD) to examine for osteoporosis ONLY confirmatory scan for osteoperosis.
Osteomylitis risk factors
Diabetes, injury, lingering infection, advancing age, immunocompromised patients.
Growth hormone
produced by the pituitary gland, stimulates cell growth but can also stimulate abnormal cell growth - can lead to cancer.
Vitamin D
Facilitates the absorption of calcium is deposited under the skin by the kidneys and is activated by exposure to the sun
Gallbladder stones
Female Forty Fat Fregnant Fair If pt is taking calcium, make sure they drink a lot of water to avoid this Most common complication - pancreatitis
Fosamax
For osteoporosis treatment. Take in the morning upon arising (Empty stomach) Drink 6-8oz of water SIT for at least 30 mins (maintain upright position) because this medication can erode the esophagus.
What is GERD?
Gastric content backs up into the esophagus. patients may experience sore throat, heartburn, hematemesis, ulcers.
Acute complications of peptic ulcer
Gi bleed
H Pylori
Helicobacter pylori - chronic inflammation of stomach can cause gastric cancer After treatment of H pylori its possible to get it again
Bones
Highly vascular - a bone injury can cause bleeding Pain is the worst pain - cancer of the bone can cause a lot of pain
Occult blood testing
INVISIBLE blood in stool only done if no blood is seen
Best time to take calcium?
In the morning before activity because activity promotes absorption
Cigarette smoking
Increases hydrochloric acid production - ulcers?
TPN (total parenteral nutrition)
Indicated if npo for more than 5 days - need central line.
Estrogen decline
Leads to osteoperosis if not taking calcium and vitamin D
PTH
Low calcium stimulates parathyroid to increase calcium in the blood by taking it from bones Opposite of calcitonin
Pyrazinamide
Medication for tb but can cause secondary gouty arthritis
GERD (gastroesophageal reflux disease)
Most common upper GI disorder in the US Occurs as a result of backward flow of stomach contents into esophagus.
GI bleed
Needs GI rest = NPO possibly NGT on low suction Assess for hemodynamic stability - vital signs Check labs - H+H trend if pt is STABLE - diagnostics - endoscopy or colonoscopy if pt is UNSTABLE - blood transfusion - type and crossmatch - packed RBCs or bolus plasma expanding 0.9% NS
pelvic fracture
No surgery, just wait for it to heal.
Acromegaly
Overactive pituitary gland at ADULT age causes excessive growth hormone, leading to this.
Gigantism
Overactive pituitary gland at YOUNG age causes excessive growth hormone, leading to this.
Peritonitis
Peritonitis: Life-threatening inflammation and infection of peritoneum "rock hard abs"/rigidity from swelling.
Vitamin K
Produced by GI flora - depletion of flora from antibiotics can lower vitamin K
Calcitonin
Produced by thyroid, lowers calcium levels in blood and gives to bones. Inhibits osteoclats. Opposite of PTH
Osteoarthritis common past medical history
Renal disorders Thyroid or parathyroid problems Diabetes
Woman with extremely low bone density.
SHORT term estrogen therapy - risk for breast cancer and DVT - leads to pulmonary embolism.
Female screening for osteoperosis
Start at 40 y/o Other risk factors - removal of ovaries and long term use of steroids.
Colon cancer
Usually people 65 and older get this, start colonoscopy at age 50 Unexplained anemia and older than 65? Could be colon cancer
Fracture risk factors
Traumatic injury, pathologic bone disease such as orseoperosis, bone cancer, advancing age, females of menopausal age, previous fracture
How to strengthen bones
Working out/ lifting weights Obese people tend to have strong bones but crappy joints
intrinsic factor
a gastric secretion that combines with vitamin B12 so that the vitamin can be absorbed
diverticulosis
abnormal pocket/diverticula in the intestinal wall of the colon, which can get infected
pancytopenia
deficiency of all types of blood cells Can be caused by radiation therapy
Hyperphosphatemia
excessive phosphate in the blood Caused by kidney disease - phosphate is chronically elevated which means calcium is always low which stimulates PTH - breaking down bones in a neverending bone breaking cycle. Causes renal osteodystrophy.
Osteomyelitis
infection of the bone. Usually needs at least 6 weeks antibiotic therapy - needs PICC line Can be seen in xray but confirmed in MRI
gouty arthritis/Gout
inflammation of joints caused by excessive uric acid. Primary (purine metabolism) and secondary (caused by another disease). Can be influenced by diet/metabolic disorder Test: Blood Uric Acid, arthrocentesis Treat: allopurinol, colchicine
Gastritis
inflammation of the lining of the stomach - leads to no intrinsic factor (Needs paranteral administration of B12 - IM injection)
What is Crohn's disease?
inflammatory disease that can occurs anywhere in GI tract, but usually affects terminal ileum and leads to thickening/scaring/abscess/fistulas
What is ulcerative colitis?
it is an IBD that results in poor absorption of nutrients, and usually begins in rectum spreading upward.
pernicious anemia
lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream Chronic gastritis can cause this.
pathologic fracture
occurs when a weakened bone breaks under normal strain Can be caused by disease that weakens bones.
Signs of a fracture
pain, swelling, deformity, abnormality with mobility, and point tenderness
Septic arthritis
painful infection in a joint (bacterial/fungal/viral) Test: Arthrocentesis, blood culture Treat: Antibiotics
Why do NSAIDs cause ulcers?
they inhibit the release of prostaglandins, which would normally encourage mucus and HCO3 secretion and decrease acid production, so when you inhibit prostaglandins, you get increased acid secretion.
What is PUD?
ulcerations/lesions in mucous (gastric/duodenal/esophageal ulcers)