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Exam II Patho II
Vitamin K1 (Phytonadione)
Mechanism
Synthesizes Clotting Factors II, VII, IX, X
Indications
Hypoprothrombinemia
Newborn Prophylaxis
Bleeding from Warfarin Overdose
Side Effects
Shock
Kernicterus
Cardiac Arrest
Considerations
Bile Salts required for Intestinal Absorption
Increased Risks with IV Administration
2 mins
Ondansetron
Indications
Postoperative Vomiting
Chemotherapy-induced Nausea and Vomiting
Mechanism
5-HT3 Serotonergic Antagonist
Centrally-acting Antiemetic
Side Effects
Headache
Constipation
QT Prolongation
1 min
Cimetidine and Famotidine (H2 Receptor Blockers)
-tidine Suffix
Mechanism
H2 Receptor Blocker
Indications
Suppress Gastric Acid Secretion
Side Effects (All)
Pneumonia
Side Effects - Cimetidine
Anti-androgen Effects
CNS Changes
2 mins
Stomach Digestion
Characteristics
Chief Cells Secrete Pepsinogen
Pepsinogen Turned to Pepsin By H+
Protein Breakdown Begins
Mucous Cells Secrete Mucus and Bicarbonate
G Cells Secrete Gastrin
Gastrin Stimulates Parietal Cell HCl Release
Parietal Cells Secrete Intrinsic Factor
2 mins
Small Intestine Digestion
Brush border enzymes
Pancreatic Enzymes are secreted via a Duct
Pancreas secretes bicarbonate
Brush Border activates Pancreatic Trypsin
Trypsin activates Chymotrypsin
Trypsin and Chymotrypsin digest Proteins
Gallbladder Releases Bile
Pancreatic Lipase breaks down Lipids
Goblet cells secrete mucus
Pancreatic Amylase breaks down Carbohydrates
Pancreatic Nucleases breakdown DNA/RNA
Digestion occurs in the Duodenum
2 mins
Large Intestine
Characteristics
Colon
Electrolyte Reabsorption
Water Reabsorption
Microflora Produce Vitamins
Rectum Stores Feces
1 min
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
2 mins
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
NSAIDs
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
1 min
Helicobacter pylori Associations
Gastritis
Peptic Ulcer Disease
Stomach Cancer
50 secs
Helicobacter Pylori
Characteristics
Gram-Negative
Bacilli
Curved
Polar Flagellum
Catalase-Positive
Oxidase-Positive
Disease
Gastric and Duodenal Ulcers
Ammonia
Neutral Environment
Gastric Adenocarcinoma
MALT lymphoma
Diagnosis
Serology IgG antibody
Stool Antigen
Urease Positive Breath Test
Biopsy
Treatment
2 ABX and PPI
2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
1 min
Omeprazole (Prilosec)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Proton Pump Inhibitor (PPI)
Inhibit H+/K+/ATPase
Side Effects
Hip Fracture
Pneumonia
2 mins
Barrett's Esophagus
Histological findings
Metaplasia in Lower Esophagus
Columnar Epithelium
Associated Pathologies
Gastroesophageal Reflux Disease (GERD)
Esophagitis
Esophageal Ulcers
Increased Risk of Esophageal Adenocarcinoma
1 min
Ulcerative Colitis Assessment
Assessment
Cramping Abdominal Pain
Tenesmus
Bloody Diarrhea
Up to 10-20 / Day
Fever
Complications
Hemorrhage
1 min
Irritable Bowel Syndrome (IBS) Interventions
Interventions
Identify Triggers
Increase Fiber Intake
Probiotics
Anticholinergics
Tricyclic Antidepressants (TCAs)
Loperamide
Linaclotide
Medications for Women
Tegaserod (Zelnorm)
Lubiprostone (Amitiza)
Alosetron (Lotronex)
2 mins
Diverticulosis and Diverticulitis Assessment
Diverticulosis
Outpouching
Diverticulitis
Inflamed Diverticula
Assessment
Abdominal Pain
Abdominal Distention
Flatulence
Fever
Rectal Bleeding
Alternating Constipation and Diarrhea
Considerations
Peritonitis
2 mins
Diverticulosis and Diverticulitis Interventions
Interventions
High Fiber Diet
Reduce Intra-abdominal Pressure
Stool Softeners
Exercise
Anticholinergics
Considerations
Antibiotics
Bowel Resection
2 mins
Intestinal Obstruction
Partial/Early Obstruction
Severe Abdominal Pain
Vomiting
High Pitched Bowel Sounds
Abdominal Distention
Increased Peristalsis
Total/Neurogenic Obstruction
Absent Bowel Sounds
Paralytic Ileus
1 min
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