Comprehensive Clinical System Disorders Vocabulary Flashcards

500 vocabulary flashcards covering gastrointestinal, urinary, respiratory, endocrine, neurological, musculoskeletal, and cardiovascular system disorders based on lecture notes.

Peptic Ulcer Disease (PUD)

Ulceration of GI mucosa and underlying tissues caused by gastric secretions that have a low pH (acidic).

Most common location of Peptic Ulcer Disease

Duodenum ($98 - 99\%$) or the stomach (ratio of $4:1$).

Chronic peptic ulcer definition

Gastritis.

Commonest cause of Peptic Ulcer Disease

H. pylori infection.

Zollinger Ellison syndrome

Tumor secreting gastrin which increases HCl secretion, causing peptic ulcer disease.

Medication causes of PUD

NSAIDs, aspirin, steroids, and Indomethacin.

Blood type associated with PUD

Blood type O.

Duodenal Ulcer incidence

$4$ times more common than Gastric Ulcer.

Duodenal Ulcer common age group

$20 - 50\,\text{yr}$.

Duodenal Ulcer primary location

First part ($2\,\text{cm}$) of the duodenum.

Duodenal Ulcer pain pattern

Food-relief pattern (reduced by food or antacids).

Duodenal Ulcer pain timing

Burning epigastric pain that occurs $2 - 4\,\text{hours}$ after eating; night pain is common.

Duodenal Ulcer stool manifestation

Melena is more common.

Duodenal Ulcer palpation finding

Deep tenderness in right hypochondrium.

Gastric Ulcer common age group

$> 60\,\text{yr}$.

Gastric Ulcer primary etiology

Disruption of the mucosal barrier.

Gastric Ulcer primary location

Lesser curvature and pyloric antrum.

Gastric Ulcer pain pattern

Food-pain pattern (no night pain).

Gastric Ulcer pain timing

Burning epigastric pain that occurs $1 - 2\,\text{hours}$ after eating.

Gastric Ulcer common clinical features

Vomiting, hematemesis, significant loss of weight, and deep tenderness in the epigastric region.

Pyrosis

Heartburn.

Bismuth administration in PUD

$2\,\text{tab}$ $1\,\text{hour}$ AC (stools will be stained black).

Sucralfate dosing rule

$2\,\text{mg}$ BD; do not use antacids half an hour before or after the dose as it reduces effectiveness.

Triple therapy duration for H. pylori

$6\,\text{weeks}$ (one drug from each specified column).

Triple therapy Column A drug options

Clarithromycin $500\,\text{mg}$ BD, Amoxicillin $500\,\text{mg}$ BD, or Tetracycline.

Triple therapy Column B drug options

Metronidazole $400\,\text{mg}$ TDS or Tinidazole.

Triple therapy Column C drug options

Omeprazole $20\,\text{mg}$ BD, Pantoprazole $40\,\text{mg}$ BD, or Lansoprazole.

Quadruple treatment duration for H. pylori

$14\,\text{days}$.

Quadruple treatment regimen for H. pylori

PPI standard dose (or ranitidine $150\,\text{mg}$ PO BD) + Bismuth $525\,\text{mg}$ PO QID + Metronidazole $500\,\text{mg}$ PO QID + Tetracycline $500\,\text{mg}$ PO QID.

Preferred positioning for PUD nursing management

Semi-Fowler's position.

Billroth I

Gastroduodenostomy; removal of the lower part of the stomach and attachment to the duodenum.

Billroth II

Gastrojejunostomy; removal of the antrum and distal portion of the stomach with anastomosis of the remaining section to the jejunum.

Antrectomy

Removal of the antrum portion of the stomach.

Gastrectomy

Removal of $60\% - 80\%$ of the stomach.

Complications of PUD

Pyloric or duodenal obstruction, hemorrhage, ulcer perforation, and iron deficiency.

Complications of PUD Surgery

Dumping Syndrome, hemorrhage, pneumonia, and pernicious anemia.

Dumping Syndrome (DS)

Rapid gastric emptying; rapid passage of food (especially carbohydrates/sugar) from the stomach to the jejunum/duodenum.

Most common condition following Bariatric surgery

Dumping Syndrome.

Early Dumping Syndrome timing

GI and vasomotor symptoms occur $10 - 30\,\text{minutes}$ after a meal.

Early Dumping Syndrome GI symptoms

Abdominal pain, bloating, borborygmi, diarrhea, nausea, and vomiting.

Early Dumping Syndrome Vasomotor symptoms

Diaphoresis, flushing, headache, hypotension, palpitations, syncope, and tachycardia.

Late Dumping Syndrome timing

Adrenergic and neuroglycopenic symptoms occur $2 - 3\,\text{hours}$ after eating.

Late Dumping Syndrome Adrenergic symptoms

Palpitations, perspiration, and tremors.

Late Dumping Syndrome Neuroglycopenic symptoms

Difficulty concentrating, fatigue, hunger, and syncope.

Liver Cirrhosis

Irreversible fibrosis and degeneration of the liver where normal functioning parenchyma is replaced with scar tissue and regenerative nodules.

Alcoholic cirrhosis

Cirrhosis related to alcohol abuse; alcoholism is the main cause of liver cirrhosis.

Post necrotic macro-nodular cirrhosis

Most common type of cirrhosis, related to hepatitis B and hepatitis C.

Biliary cirrhosis

Cirrhosis related to biliary stasis in the hepatic duct; may be an autoimmune response.

Cardiac cirrhosis

Cirrhosis related to long-term right-sided heart failure (associated with peripheral edema).

Fetor hepaticus

Musty, sweetish odor of the breath seen in liver cirrhosis.

Cause of Esophageal Varices in cirrhosis

Portal hypertension.

Delirium in liver failure cause

Increased blood ammonia level.

Best diagnostic method for Liver Cirrhosis

Liver biopsy.

Serum enzyme changes in liver cirrhosis

Increased AST, ALT, ALP, and GGT due to release from damaged hepatic cells into the bloodstream.

Albumin levels in liver cirrhosis

Decreased serum albumin due to dilution from fluid retention (ascites).

Prothrombin Time in liver cirrhosis

Prolonged Prothrombin Time due to failure of the liver to produce sufficient clotting factors.

Medications to decrease blood ammonia in cirrhosis

Neomycin and Lactulose.

Abdominal paracentesis

Also known as abdominal tapping; procedure to remove excess abdominal fluid.

Cirrhosis dietary protein and sodium guidelines

Protein restricted to $80 - 100\,\text{g/day}$ and sodium restricted to $500 - 1000\,\text{mg/day}$.

Hepatic Encephalopathy (Hepatic Coma)

Gradual or sudden onset of altered level of consciousness as a result of liver failure.

Hepatic Encephalopathy dietary restrictions

Protein reduced to $15 - 30\,\text{g}$, high calorie diet ($1500 - 2000\,\text{kcal}$), and minimized fluid intake.

Vasopressin mechanism in esophageal varices

Decreases portal pressure in portal hypertension.

Sengstaken-Blakemore Tube

Balloon tamponade device used to control bleeding from esophageal varices by applying direct pressure.

Octreotide mechanism in esophageal varices

Constricts splanchnic arterioles, decreasing blood inflow to the portal system and significantly reducing intra-variceal pressure.

Appendicitis

Compromised circulation and inflammation of the vermiform appendix; more common in males ($> 30\,\text{yrs}$).

Fecalith (appendicolith)

Calcified mass formed by hardened fecal matter causing obstruction in the appendix.

Parasite associated with appendicitis

Enterobius vermicularis (worm).

McBurney's point pain location

Right lower quadrant pain characteristic of appendicitis.

Rovsing's sign

Pain elicited in the right lower quadrant when palpation pressure is applied to the left lower quadrant.

Psoas sign

Right lower quadrant pain elicited with extension of the right hip or flexion of the right hip against resistance.

Obturator sign

Right lower quadrant pain on passive internal rotation of the hip when the right knee is flexed.

Bloomberg's sign

Rebound tenderness observed in appendicitis.

Intestinal Obstruction

Interference with peristaltic movement of intestinal contents; obstruction in the forward movement of fecal contents.

Volvulus

Twisting of the intestine; the commonest cause of intestinal obstruction in Nepal.

Intussusception

Telescoping of the bowel into itself.

Mesenteric infarction

Occlusion of arterial blood supply to the bowel leading to necrosis.

Peritonitis

Inflammation of the peritoneal cavity.

Commonest causative organism of peritonitis

E. coli.

Cholelithiasis

Stone formation in the gallbladder.

5F risk factors for Cholelithiasis

Female, fertile, fatty, forty, and fair.

Cholecystitis

Inflammation of the gallbladder, enlarged lymph nodes, or tumor of the gallbladder; main cause is a gallstone blocking the cystic duct.

Murphy sign

Rebound tenderness in abdomen that increases on inspiration; classic sign of cholecystitis.

Steatorrhea

Presence of excess fat in the stool.

Oral dissolution therapy drugs for small gallstones

Chenodiol (Chenodeoxycholic acid; CDCA) or Ursodiol (UDCA) given for $6 - 12\,\text{months}$.

Antispasmodic given in cholecystitis

Baralgan $5\,\text{mL}$ IV.

Expected T-tube bile drainage post-cholecystectomy

$300 - 500\,\text{mL}$ of bile-colored drainage for the first $24\,\text{hours}$, decreasing to $200\,\text{mL}/24\,\text{hours}$ for $3 - 4\,\text{days}$.

Pancreatitis

Inflammation of the pancreas characterized by escape of pancreatic juice into surrounding tissue leading to fat necrosis.

Acute pancreatitis mechanism

Auto-digestion of the pancreas by pancreatic enzymes (Trypsin).

Most common cause of pancreatitis

Gallstones.

Cullen sign

Peri-umbilical bruising seen in severe necrotizing pancreatitis.

Grey Turner's sign

Flank bruising seen in severe necrotizing pancreatitis.

Glasgow Criteria for Acute Pancreatitis (PANCREAS)

PaO2 $< 8\,\text{kPa}$ ($60\,\text{mmHg}$), Age $> 55\,\text{years}$, Neutrophils WBC $> 15 \times 10^9/\text{L}$, Calcium $< 2\,\text{mmol/L}$, Renal Urea $> 16\,\text{mmol/L}$, Enzymes LDH $> 600\,\text{IU/L}$ or AST/ALT $> 200\,\text{IU/L}$, Albumin $< 32\,\text{g/L}$, Sugar glucose $> 10\,\text{mmol/L}$ ($3$ or more denotes severity).

Haemorrhoids

Collection of dilated, tortuous plexuses of veins covered by mucous membrane at the anorectal junction.

Grade I Haemorrhoid

No prolapse; prominent blood vessels that only bleed.

Grade II Haemorrhoid

Prolapse upon bearing down, but reduces spontaneously.

Grade III Haemorrhoid

Prolapse upon bearing down that requires manual reduction.

Grade IV Haemorrhoid

Permanent prolapse that cannot be manually reduced.

Positions of the three prominent hemorrhoidal cushions

Left lateral ($3\,\text{o'clock}$), Right posterior ($7\,\text{o'clock}$), and Right anterior ($11\,\text{o'clock}$).

Sclerotherapy for 2nd degree hemorrhoids

Submucosal injection of $5\%$ phenol in arachis oil or almond oil above the pectinate line.

Reducible Hernia

Protruding organ or structure that can be manipulated back into place.