nu216final gi

Clinical manifestations of P.U.D: epigastric abdominal pain, pain between meals 

Crohn's & Colitis: Know the differences between the two (both are inflammatory bowel diseases)

Crohns: affects any part of the GI tract from mouth to anus. Transmural (affects the entire GI wall), affects GI tract with skip lesions, cobblestones present during examination, anal fistula & anal fissure formation. Malabsorption & malnutrition are signs of the disease, signs and symptoms (diarrhea, abdominal pain, hyperactive bowel sounds), remission & exacerbation period, toxic megacolon can be present with crohn's (extreme dilation of diseased colon) 

Colitis: only affects the large intestine, not transmural, affects only upper layers of intestinal wall, begins in the rectum and move upward, no fistula or anal fissure, can cause colon cancer, peak age is 15-25 and 55-65, pseudopolyps is present on examination (continuous areas of inflammation). Signs and symptoms: diarrhea, abdominal pain, fever, leukocytosis. Arthritis may be present!

Cholecystitis: assessment findings - inflammation of the gallbladder. acute or chronic, gallstones (that are cholesterol rich) are the most common cause. The small gallstones pass from the gallbladder & cystic duct into the common bile duct causing obstruction. (signs and symptoms: right shoulder pain, RUQ abdominal pain, anorexia, feeling of fullness, fever, leukocytosis, abdominal distention)  pain may be spasmodic or colicky (sudden & comes in waves) the classic physical examination is Murphy’s sign (tenderness & quick inspiration with palpation of RUQ) *”female, flatulent, fat, forty, fertile, family history, fasting, feeling full.” 

^* DO NOT give any morphine or codeine for cholecystitis. ONLY dilaudid