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- Crohn's Disease •Inflammation and ulcerations occurring ANYWHERE in GI tract from mouth to anus - Patchy, "skip" lesions - Ulcerations may be full thickness •High risk of peritonitis and fistulae's
- Ulcerative Colitis •Inflammation of Colon/Large Intestine ONLY
- Continuous ulcerations beginning in rectum and moving upward
- Ulcerations only involve the mucosa and submucosa (superficial)
- Higher risk for colon cancer 3. Cirrhosis Patho- physioly
- Hepatocytes get replaced with fibrotic and scarred tis- sue. Permanent and irreversible.
- Liver Disease s/s Confusion/disorientation •Edema/Peripheral edema (low albumin)
- Ascites (portal HTN) •Jaundice - yellowing of skin & eyes
- Pruritis (itching) •Anemia (low HgB) •Bruising or bleeding easily (low platelets) •Bilirubinuria (dark colored urine)
- Clay colored stools 5. Esophageal Varices
- Pathophysiolo gy
- Abnormal, enlarged veins in the esophagus. Usually due to a complication from cirrhosis.
- gastritis Pathophysiology: Inflammation of the stomach lining. Causes/ Risk factors: Medications -> NSAIDS, aspiring, steroids ETOH consumption, smoking. NG Tubes Recurrent H.Pylori infection
- GERD Pathophysiology: Reflux of acid from stomach into esoph- agus via the lower esophageal sphincter. Signs/Symptoms: Epigastric pain often worse at night (heartburn) Chronic cough Sour/bitter taste in the morning
- Pancreatitis Pathophysiology: Auto-digestion of pancreas due to acti- vation of digestion enzymes within the pancreas. Cause: Men- alcoholism Woman- biliary disease Labs: Elevated amylase, Elevated lipase, hypocalcemia, elevated WBC
lated hernia Signs/symptoms: Central colicky intermittent pain, cramping. Frequent and severe vomiting Severe fluid imbalance and metabolic alkalosis (vomit- ing) Some passage of stool initially then obstipation Mils abdominal distention Complications: Bowel perforation Electrolyte imbalance
- Large Bowel Large bowel obstructions Colon cancer or volvulus Sings/ symptoms: Crampy, lower abdominal pain Absolute constipation Minimal or no vomiting Massive abdominal distention Complications: Bowel perforation Electrolyte imbalance
- Viral Hepatitis Hepatitis A: Transmission route: fecal/ Oral
- Diverticulitis Inflammation and infection of outpouchings within the colon, usually due to blockage s/s fever, nausea, leukocytosis (increased WBC) LLQ pain
- Paralytic ileus Patho: Lack of peristalsis causing lack of forward motion of stool in intestines Usually after abdominal surgery or a serious illness (sep- sis, burns)
- Peptic Ulcers Gastric Ulcers: Ulceration of the stomach/gastric lining. Pain WITH eating Duodenal Ulcers: Ulceration of the duodenum/ small in- testine Pain RELIEVED by eating.
20. Bacterial Testing
Activated by: LOW blood volume (i.e, blood loss, fluid volume deficit) Low blood pressure (i.e, Hypotension) Net effect: I n c r e a s e d p l a s m a v o l u m e I n c r e ased blood pressure Increase vascular tone Increased cardiac output Pre-renal: Decreased renal blood flow- hemorrhage, de- hydration Intra-renal: Damage to renal architecture-drugs, disease.
Post-renal: Obstruction of urinary outflow system- BPH
24. Acute Kidney In- jury Phases **of Recovery
- Chronic** Kidney **Disease
- Nephrotic** Syn- drome Oliguric (<400ml of urine in 24 hours) Urinalysis: casts, RBC, WBC's, hyperkalemia/hyponatremia, elevated BUN and Creatinine. Fatigue and malaise Diuretic (excessive urine>2-4L per day) Gradual increase in urine output Hypovolemia, dehydration, hypotension. BUN/Creatinine levels still high Recovery (urine returns to normal 1-2 L per day) GFR improves BUN/creatinine return to normal Renal damage leads to reduced glomerular filtration re- sulting in excess fluid and waste accumulation within the body. Serum changed in CKD: Increases: sodium, potassium, chloride, hydrogen ions, magnesium, phosphate, BUN, Creatinine, PTH Decrease: calcium, erythropoietin, vitamin D, RBCs. Damage to the glomerulus (not inflammatory).
EDEMA (periorbital, extremities) Hyperlipidemia-> hepatic compensation -> creation of more proteins, but also more FATS (** Hyperlipidemia) Proteinuria >3.5 g in 24 hours= foamy urine
27. Acute Glomerulonephri- tis (Nephritic **syndrome)
- Urinary Inconti-** nence Glomerulonephritis -> INFLAMMATION of the glomeruli Cause: antigen-antibody complex causing inflammation of glomerulus and basement membrane -> leaky base- ment membrane (to ALL things) S/S: cola-colored urine, HTN Stress Incontinence: sphincter/ valve malfunction. Risk factors: Multiple pregnancies, female>male, age 40's Urge incontinence (OAB): detrusor muscle overactivity. Risk factors: sudden, frequent urges more common in females>males. Overflow incontinence: chronic bladder distension due to retention/obstruction.
Risk factors: BPH, incomplete emptying, Male>females. Neurogenic bladder: due to SCI, no sensation of fullness. Risk factor: Brain unable to sense fullness of bladder.
Infection of the female reproductive orans including uterus, fallopian tubes, ovaries and cervix. Complications: Permanent damage, infertility. Twisting of the cord that supplies blood to the testicles (acute/emergent). Often occurs several hrs. after vigorous activity, minor injury or while sleeping. S/S: sudden onset of unilateral scrotal pain, scrotum swelling, abdominal pain, N/V, higher than normal testicle, frequent urination, fever.
- Cryptorchidism (undescended testes) Testes remain in the abdomen or inguinal canal. Higher prevalence in premature born males. Complication-risk for infertility and testicular cancer. 35. BPH (benign pro- static hyperpla- sia) Hyperplasia of prostatic tissue that will cause compres- sion of urethra and urinary obstructions S/S- obstructed urine flow, difficulty urinating, drippling, increased frequency/urgency, nocturia, decreased flow strength. Risk factors: infection, post renal kidney injury.
- Types of cancer Carcinomas - epithelial cell cancers (i.e., oral, skin, lung, colon, breast, prostate, uterus, etc.) • Sarcomas- connective tissue (i.e., osteosarcoma of bone
- present with bone pain/fracture) • Lymphomas- lymphatic tissue (i.e., Hodgkin's/Non-Hodgkin's lymphoma) • Present with en- larged lymph nodes, fever, night sweats
