ABGs still exist?
What type of Acid-Base imbalance is produced by vomiting?
Metabolic Alkalosis
What kind of diarrhea does Dumping Syndrome cause?
Water is being pulled into the gut - Causes hypotension
- Twisted bowel
Volvulus or Intussusception?
Volvulus
Intussusception is where the bowel telescopes into itself.
What is a concerning complication of GERD? and WHY is it concerning:)
Barrett Esophagus!
Tissue lining the esophagus is replaced by tissue similar to the lining of the small intestine.
Increases risk of developing esophageal cancer
In which phase of hepatitis is the disease highly transmissible?
Prodromal Phase
What Acid-Base imbalance is caused by diarrhea?
Metabolic Acidosis
What are common S/S of a hiatal hernia?
GERD-like symptoms: dysphagia, heartburn, vomiting
- Oliguria
- Tea-colored Urine (Hematuria and Proteinuria)
- Can be autoimmune
Glomerulonephritis or Nephrotic Syndrome?
Glomerulonephritis!
Remember: there are NO RBCs in the urine with Nephrotic Syndrome
Grey-Turner Syndrome vs. Cullen Sign. Describe and connect them to a disease process.
Acute Pancreatitis (Hemorrhagic)
Grey-Turner: Ecchymosis/discoloration of flank area
Cullen: Periumbilical ecchymosis
Which type of Hepatitis will kill you?
D! Can progress to liver failure- necrosis of liver tissue, & death.
Think: D = Death
Discuss the difference between the maintenance/oliguria phase and the recovery/polyuric phase of acute renal failure.
oliguric: weeks-months, urine output is low, BUN and Creatinine increased, fluid retention
polyuric: glomerular function returns, diuresis is common, loss of sodium, potassium, and water -> watch for F&E imbalances.
- prone to dehydration here since they're losing so much fluid
A patient comes into the ER with suprapubic pain, back pain, and reported urinary urgency and frequency, with pain during urination. Urine cultures come back negative.
Which diagnosis does this patient have?
Interstitial Cystitis.
UTI not caused by bacteria. Could be result of viral, fungal, or chlamydial infection.
Cultures are negative, but they still have all the S/S of a UTI.
- Caused by head injury
Curling or Cushing Ulcer?
Cushing!
Curling ulcers are caused by burns. Think: "Curling iron, Cushing Head"
When dead bowel perforates, it causes...
Peritonitis!
Dead bowel is fragile, it will perforate and cause peritonitis.
S/S of peritonitis = Rigid, board-like abdomen, fever, chills, tachycardia.
Tell me the symptoms you will see during the Icteric phase of Hepatitis
Jaundice, dark urine, & pale (clay-colored) stools
What is your end Acid-Base imbalance in renal failure?
Metabolic Acidosis
Let's talk Liver complications. List complications of Liver Dysfunction.
Cirrhosis: Scarring of the liver
Portal HTN: Abnormally high BP in the portal venous system caused by resistance to portal blood flow
Esophageal Varices: Distened, frail, tortuous vessels, will rupture very easily.
Hepatic encephalopathy: Loss of brain function when a damaged liver fails to remove toxins from the blood. Ammonia builds, causing severe confusion.
- Continuous lesions, recurring cramping pain, frequent diarrhea with blood and mucus.
Crohn's or UC?
UC!
While UC is specific to the Sigmoid colon, Crohn's can involve the entire GI tract. "Skip lesions"
Difference between renal insufficiency, renal failure, and ESRD/F in terms of GFR.
Insufficiency: GFR = 25-30 or 25% of normal functioning
Failure: Less than 25% function
ESRD: Less than 10%
What are the time frames for the phases of Hepatitis?
Prodromal: exposure-up to 2 weeks
Icteric: 1-2 weeks after prodromal; lasts 2-6 weeks
Recovery: 6-8 weeks after exposure; lasts 2-12 weeks
Stages of Chronic Renal Failure: Symptoms, labs.
Reduced Renal Reserve: high/normal BUN and Creatinine, absence of symptoms
Renal Insufficiency: Headaches, nocturia, polyuria, weakness and fatigue, GFR 25% of normal, inc. BUN & Creat, mild anemia because the kidneys are damaged and cannot produce eryrthopoeitin anymore.
End Stage: Yellow discoloration, pruritic, uremic frost (kidneys cannot filter out the urea, so it comes out in your sweat on the skin as crystals), GFR <10%, anemia, hypertension, GI bleeding, many more.
List causes of Prerenal, Intrarenal, and Postrenal ACUTE renal failure?
Pre: hypotension, shock, impaired blood flow, hemorrhage, inadequate cardiac output (Anything that impairs perfusion of the kidneys)
Intra: trauma to kidney, burns, glomerulonephritis, DIC, drugs
Post: BPH, bladder outlet obstruction, urethral obstruction from stones, edema, tumors, or clots.
- Pain 2-3 hours after eating
- Most common type of peptic ulcer
Duodenal or Gastric ulcer?
Duodenal!
With Gastric, there is pain with eating that is relieved 2-3 hours afterwards.
Increased BUN and Creatinine.
Present in ESRD
What types of Hepatitis have vaccines and what types are curable?
Curable: A, C, and E
Vaccines: A & B