Gastrointestinal and Elimination Alterations

Vocabulary practice flashcards covering pathophysiology, assessment findings, diagnostic procedures, and interventions for GI and elimination disorders, including cholecystitis, pancreatitis, hepatitis, cirrhosis, abdominal trauma, and GI hemorrhage.

Cholecystitis

Inflammation of the gallbladder that presents as acute (calculous or acalculous) or chronic, characterized by intense epigastric or right upper quadrant (RUQ) abdominal discomfort often radiating to the right shoulder.

Calculous Cholecystitis

Inflammation of the gallbladder caused by the obstruction of bile flow by gallstones; it represents the most common form of acute cholecystitis.

Acalculous Cholecystitis

Acute inflammation of the gallbladder occurring without the presence or obstruction of gallstones.

Blumberg's Sign

Rebound tenderness characterized by sharp abdominal pain experienced when compressed fingers are abruptly withdrawn during abdominal palpation, noted in the right quadrant in cholecystitis.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

An invasive diagnostic and interventional endoscopic procedure used to directly visualize the liver, gallbladder, bile ducts, and pancreas, requiring a procedural time out, informed consent, and vital signs monitoring during and every $15\text{ to }30\,\text{minutes}$ post-procedure.

Steatorrhea

Excessive excretion of fat in the feces resulting from impaired digestion and biliary duct blockage, typically observed in chronic cholecystitis.

Acute Pancreatitis

Acute inflammation of the pancreas that causes exocrine and endocrine dysfunction, driven by premature activation of proteolytic enzymes (trypsin, lipase, elastase) resulting in autodigestion; most frequently caused by gallstone migration and alcoholism.

Grey Turner Sign

Gray-blue ecchymosis and discoloration localized to the flank regions, indicating retroperitoneal pancreatic hemorrhage or intra-abdominal trauma.

Cullen Sign

Bluish-purple discoloration around the periumbilical region denoting retroperitoneal bleeding, seen in severe necrotizing pancreatitis or blunt/penetrating abdominal trauma.

Hepatitis A

A viral infection of the liver transmitted via the fecal-oral route or person-to-person contact through contaminated food or water handled by infected individuals, typically causing flu-like symptoms.

Hepatitis B

A bloodborne and body-fluid-transmitted hepatitis virus spread through unprotected sexual intercourse, needle sticks, blood transfusions, and hemodialysis; chronic carriers are at elevated risk for liver cirrhosis and hepatocellular carcinoma.

Hepatitis C

A viral liver infection transmitted via blood through sharing needles or receiving blood transfusions, carrying a high risk for chronic carrier status and progressive liver cirrhosis.

Hepatitis D

A defective bloodborne RNA virus associated with high-risk behavior that requires the co-presence of the Hepatitis B virus ($\text{HBV}$) to replicate.

Hepatitis E

A waterborne viral hepatitis transmitted via the fecal route, primarily causing epidemics in India, Asia, Africa, the Middle East, Mexico, and Central and South America.

Post-Liver Biopsy Positioning

The practice of placing the patient in a right lateral decubitus position following a percutaneous liver biopsy to utilize body weight to compress the puncture site and prevent hemorrhage.

Acute Liver Failure

A sudden, life-threatening loss of liver function characterized by massive hepatocyte necrosis, coagulopathy, and hepatic encephalopathy developing over $1\text{ to }3\,\text{weeks}$ (frequently within less than $2\,\text{weeks}$) in a patient without prior liver disease.

Asterixis

A non-rhythmic flapping tremor of outstretched hands caused by neurotoxicity related to elevated serum ammonia levels in hepatic encephalopathy.

Lactulose

A non-absorbable disaccharide laxative administered to trap ammonia as ammonium ions in the colon and eliminate nitrogenous waste through increased diarrhea.

Cirrhosis

A chronic, progressive, and irreversible condition characterized by extensive fibrotic scarring of hepatic tissue, resulting in portal hypertension and end-stage liver failure; most commonly caused by alcoholic liver disease and chronic Hepatitis C.

Steatohepatitis

A form of fatty liver disease marked by lipid accumulation in hepatocytes accompanied by inflammatory cell death and necrosis that can progress to cirrhosis.

Spontaneous Bacterial Peritonitis (SBP)

An acute bacterial infection of ascitic fluid occurring without an obvious intra-abdominal source, causing severe abdominal wall rigidity and tenderness.

Ballance's Sign

A dull percussion sound detected over the left upper quadrant of the abdomen during physical examination, indicating a subcapsular hematoma or ruptured spleen.

Kehr's Sign

Referred pain to the left shoulder resulting from diaphragmatic irritation caused by blood, indicating a lacerated or ruptured spleen.

Diagnostic Peritoneal Lavage

A diagnostic procedure in abdominal trauma where saline is introduced into and drained from the peritoneal cavity; aspiration of frank blood signifies internal hemorrhage requiring immediate laparotomy.

Abdominal Compartment Syndrome

An emergent condition marked by sustained intra-abdominal hypertension exceeding $12\,\text{mmHg}$ (normal is $5\text{ to }7\,\text{mmHg}$) that compromises visceral organ perfusion and demands prompt surgical decompression.

Stress-Related Erosive Syndrome (SRES)

Acute erosive gastritis occurring in critically ill patients, characterized by multiple superficial mucosal lesions caused by physiological stress and elevated gastric acid secretion.

Hematochezia

The passage of bright red bloody stool per rectum, signifying either an active lower gastrointestinal hemorrhage or massive upper GI bleeding with rapid transit time.

Melena

Black, tarry, foul-smelling feces containing digested blood, typically indicating an upper gastrointestinal bleeding source.

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

An invasive fluoroscopically guided vascular procedure that places a metal stent between the portal vein and hepatic vein to reduce portal hypertension and relieve bleeding from esophageal and gastric varices.

Octreotide (Sandostatin)

A synthetic somatostatin analog medication given intravenously to manage acute variceal bleeding by reducing portal venous and splanchnic pressures.

Sucralfate (Carafate) Administration

A mucosal protective agent administered as an aqueous slurry (dissolved in water, never crushed) to coat mucosal lesions, requiring tube feedings to be held before and after delivery to prevent tube blockage and impaired absorption.