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