Medications
PPI: MOA, when to take, examples
ex: (-zole)
decrease secretion of gastric acid
take once daily or with meal
What are classic signs of duodenal ulcers?
melena (dark stools)
pain several hours after eating
food helps the pain
what is the main difference between IBS & IBD?
length of time: ask the patient how long he/she has had symptoms
IBD is chronic
peritoneal lavage: results
if you see brown discharge, this is a medical emergency
What does shift to the left mean?
sign of infection
what is sulfasalazine?
drug used for IBD remission
safety note: may cause yellowish/orange skin & urine, makes skin very sensitive to sunlight, may cause infertility in men
what is coffee-ground emesis?
bleeding in the GI tract; mixing w/ HCl
complications of ulcerative colitis
toxic megacolon, strictures, fistulas, peritonitis, perforation
how often should patients get colonoscopies & FOBT
colonoscopy: every 5 years
FOBT: annually to catch intermittent bleeding from tumors
major symptom of type 1 diabetes
what is pepsid useful for?
stress ulcers (trauma, surgery, etc)
what diagnostic test do we use for hiatal hernias?
barium swallow; use cathartics after to avoid impaction
patients with Chron's disease may be at risk for (think back to exam 1)
megaloblastic anemia
what does this mean?
what do you document if you see a pinkish/red stoma?
normal findings
what is the first thing we check pot-op if a patient has emergent delirium?
oxygen levels
what is infliximab (Remicade)?
biologic drug for Chron's given IV
may reactivate hepatitis & TB
risk for lymphoma, UTI, upper respiratory infection
what is a vagotomy used for?
to inhibit the stomach from making stomach acid
how do we definitively define Chron's/ulcerative colitis?
colonoscopy w/ biopsy
what is CEA and why is it important?
carcinoembryonic antigen: use this lab value after tumor removal to see if it rises/falls
is the cancer coming back?
people with pancreas issues are at risk for?
infection!
why do we put a Chron's patient on NPO status?
to rest the gut
how do we diagnose ulcers?
EGD w/ sedation
how do you give perianal care?
wash, use water, skin barrier creams
what is METS as related to CRC?
metastasis: spreads to liver, brain, bones, lymph nodes
what is the rule of 15?
is patient is hypoglycemic, give 15 g of simple carb and reassess in 15 min, if still low give another 15g of simple car, if still low call the dr