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GI cards
Gastrointestinal System
Question | Answer |
---|---|
Abnormal condition characterized by the inability of a muscle, particularly the cardiac sphincter of the stomach, to relax | achalasia |
abnormal condition characterized by the absence of hydrochloric acid in the gastric secretions | achlorhydria |
surgical joining of two ducts or blood vessels to allow flow from one to the other | anastomosis |
general ill health and malnutrition marked by weakness and emaciation | cachexia |
oncofetal glycoprotein antigen found in colonic adenocarcinoma and other cancers; also found in nonmalignant conditions | carcinoembryonic antigen (CEA) |
partial or complete separation of the wound edges | dehiscence |
difficulty in swallowing | dysphagia |
state in which the patient’s viscera protrude through a disrupted wound | evisceration |
an increase in the seriousness of a disease or disorder | exacerbation |
vomiting blood | hematemesis |
infolding of one segment of the intestine into the lumen of another segment | intussusception |
a white patch in the mouth or on the tongue | leukoplakia |
space within an artery, vein, intestine, or tube | lumen |
abnormal, black tarry stool containing digested blood | melena |
blood that is hidden or obscured from view | occult |
sign or symptom specific to a disease or condition | pathognomonic |
a decrease in the severity of a disease or any of its symptoms | remission |
excessive fat in the feces | steatorrhea |
combining form meaning a mouth or opening | stoma |
ineffective and painful straining with defecation | tenesmus |
twisting of the bowel on itself, causing intestinal obstruction | volvulus |
contrast medium used for upper GI study | barium |
test used to detect any abnormal structural conditions of the upper GI tract | upper GI series |
how quickly must the gallon of Golytely be taken if used for upper GI series? | 2 hours |
what color does barium turn stool? | white, or light in color |
why is it important for a patient to increase fluid intake after UGI series? | to expel all the barium and prevent constipation |
in this test stomach contents are aspirated to determine the amount of acid produced by the parietal cells in the stomach | tube gastric analysis |
how is a sample for tube gastric analysis collected? | via NG tube |
diagnostic test using an endoscope to directly examine the esophagus, stomach, and duodenum | EGD |
some issues that can be detected or address by EGD | tumors, varices, mucosal inflammations, hiatal hernias, polyps, ulcers, H. pylori, strictures, obstructions |
how long must a patient remain NPO following an EGD? | until gag reflex returns |
what are the signs and symptoms of espophageal, gastric, or duodenal perforation? | abdominal pain and tenderness, guarding, bleeding from mouth, melena, hypovolemic shock |
a more thorough version of the upper GI which can detect anatomical abnormalities such as hiatal hernia, left atrial dilation, aortic aneurysm, paraesophageal tumors | barium swallow |
this can be used in place of barium in cases where GI bleed is present or suspected | gastrografin |
this test is used to reproduce the symptoms of esophageal reflux and can be used to differential esophageal pain from angina pectoris | berstein test (esophageal function study) |
how is a positive berstein test determined? | the patient experiences a recurrence of pain when HCl is instilled into the esophagus |
what should be suspected if occult blood is detected in the stool? | benign or malignant GI tumor |
this study allows visualization of the lower GI tract and the collection biopsy specimens of tumors, polyps, or ulcerations of the anus, rectum, and sigmoid colon | sigmoidoscopy |
test used to detect structural abnormalities (polypes, tumors, diverticula, and positional abnormalities) of the lower GI using barium as a contrast medium | barium enema |
what is a possible complication of failure to expel all barium quickly from the GI tract | impaction |
use of a fiberoptic scope to examine the entire colon | colonoscopy |
this diagnostic test is used to test for the presence of bacteria, ova, and parasites | stool culture |
what solutions can be used in an enema for the purpose of collecting a stool specimen for culture | normal saline or tap water |
stool cultures should be taken before the administration of this contrast medium | barium |
accumulation of fluid and albumin in the peritoneal cavity | ascites |
a hand flapping tremor in which the patient stretches out an arm and hyperextends the wrist with the finger separated, relaxed, and extended | asterixis |
a complex of longitudinal, tortuous veins at the lower end of the esophagus | esophageal varices |
excess formation of gases in the stomach or intestine | flatulence |
a type of brain damage caused by liver disease and consequent ammonia intoxication | hepatic encephalopathy |
inflammation of the liver caused by viruses, bacteria, and noninfectious causes of liver inflammation | hepatitis |
yellow discoloration of the skin, mucous membranes, and sclera of the eyes, caused by greater than normal amounts of bilirubin in the serum | jaundice |
an obstruction or closing off | occlusion |
a procedure in which fluid is withdrawn from the abdominal cavity | paracentesis |
tissue of an organ as distinguished from supporting or connective tissue | parenchyma |
small, dilated blood vessels with a bright red center point and spiderlike branches | spider telangiectases |
stools that contain fat | steatorrhea |
this system includes the liver, gall bladder, cystic, hepatic, and common bile ducts and the pancreatic duct | biliary system |
bile travels through the hepatic duct to the _________ for storage | gall bladder |
this organ is responsible for fat metabolism, production of clotting factors, cholesterol and albumin manufacture, blood filtration, conversion of ammonia to urea | liver |
this organ is a sac located on the right inferior surface of the liver | gallbladder |
the storage organ for bile | gallbladder |
the three enzymes present in pancreatic juice | protease, lipase, amylase |
pancreatic juice aids in the digestion of what three substances? | proteins, fats, and carbs |
what is the purpose of the sodium barcarbonate in the pancreatic juice? | to neutralize stomach acids |
Elevated levels of this cause jaundice, which is the most common sign of a liver disorder | bilirubin |
normal levels of total bilirubin | 0.1 to 1.0 mg per dl |
normal values of aspartate aminotransferase(AST) | 0 to 35 iu per L |
liver enzyme that becomes elevated in MI, hepatitis, cirrhosis, hepatic necrosis, hepatic tumor, acute pancreatitis, acute renal disease and acute hemolytic anemia | aspartate aminotransferase (AST) |
normal values of alanine aminotransferase(ALT) | 4 to 36 IU per L |
liver enzyme that becomes elevated in hepatitis, cirrhosis, hepatic necrosis, hepatic tumors, and hepatotoxic drugs | alanine aminotransferase(ALT) |
normal values of lactic dehydrogenase | 100 to 190 IU per L |
liver enzyme that becomes elevated in MI, pulmonary infarction, hepatic disease, pancreatitis, hemolytic anemia and skeletal muscle disease | lactic dehydrogenase(LDH) |
normal values of alkaline phosphatase | 30 to 120 IU per ml |
liver enzyme that becomes elevated in obstructive disorders of the biliary tract, hepatic tumors, cirrhosis, hyperparathyroidism, metastatic tumor in bones, and healing fractures | alkaline phosphatase |
normal values of Gamma glutamyltransferase(Gamma GT) | male or female over 45:8 to 38 U per L; female under 45:5 to 27 U per L |
liver enzyme that becomes elevated in liver cell dysfunction, hepatitis, cirrhosis, hepatotoxic drugs, MI, and congestive heart diseases | Gamma glutamyltransferase (Gamma GT) |
normal value for prothrombin time | 11.0 to 12.6 seconds |
an elevation in this lab value indicates an increased clotting time that can be caused by liver disease (inability to synthesize clotting factors) or vitamin K deficiency | PT |
this lab value can assess the functional status of the liver by measuring the products that are synthesized there, specifically albumin | serum protein test |
low values in this laboratory study can be the result of nephritic syndrome, ascites, or inadequate protein in diet as well as liver dysfunction | serum proteins |
in liver dysfunction, blood levels of this chemical can rise leading to hepatic encephalopathy | ammonia |
normal values for serum ammonia | 10 to 80 ug per dl |
serum ammonia measurements may be affected by these prescription drugs | antibiotics |
a diet high in this substance stimulates emptying of the gallbladder | fat |
in this diagnostic study, radiographic dye is injected intravenously, concentrated by the liver, and secreted into the bile duct | intravenous cholangiography |
this diagnostic study allows radiographic visualization of the hepatic and common bile ducts if the cystic duct is patent | intravenous angiography |
in this diagnostic study, the common bile duct is directly injected with dye | operative cholangiography |
this diagnostic test is used to identify retained stones in a postoperative cholecystectomy patient | t tube cholangiography |
diagnostic study used to detect structural changes in the liver; uses gamma ray radiation | radioisotope liver scanning |
in this diagnostic procedure a needle is inserted directly into the liver to remove tissue | needle liver biopsy |
how should a patient be positioned following needle liver biopsy? | on right side for 2 hours, then flat for 12 to 14 hours |
fiberoptic scope inserted through the GI tract into the duodenum used to diagnose pancreatic dysfunction, evaluate obstructive jaundice, remove common bile duct stones and place biliary and pancreatic duct stents | endoscopic retrograde cholangiopancreatography (ERCP) |
laboratory values of this increase 12 hours after onset of pancreatic disease, but return to normal within 48 to 72 hours | amylase |
normal amylase values | 25 to 125 U per L |
laboratory values of this are elevated in acute pancreatitis | lipase |
normal lipase values | 0 to 110 U per L |
this procedure is used to establish a diagnosis of pseudocyst, pancreatitis, and pancreatic abcess | ultrasound |
a noninvasive but accurate imaging study used to diagnose pancreatic inflammation, tumor, cyst formation, ascites, aneurysm, and cirrhosis of the liver | CT scan |
incurable sores of the mouth and lips ranging in size from 0.5 to 3cm | cold sores, canker sores, aphtous ulcers |
medical treatment for cold sores, canker sores, and aphthous ulcers | antiinflammatory agents, topical agents, debriding agents |
anti | inflammatory agent commonly used in cold sores, canker sores, and aphthous ulcers |
when and how often should amlexanox (aphthasol) be applied? | as soon after noticing symptoms as possible; 4x per day following oral hygiene |
dental decay caused by dental plaque, poor nutrition, acids, and heredity | dental caries |
patient teaching for dental caries should include | proper nutrition and proper oral hygiene techniques |
infection of the oral cavity by the fungus Candida; more frequent in leukemia, diabetes, antibiotics use, and steroids | candidiasis (thrush) |
treatment for candidiasis | nystatin, amphotericin B, hydrogen peroxide rinse (50%) or saline rinse, ketoconazole |
side effects of amphotericin B (fungizone) | headache, hypotension, NVD, nephrotoxicity, hypokalemia |
nystatin oral suspensions or lozenges should be continued for how long following resolution of symptoms? | 48 hours or until cultures are negative |
what common GI medications should not be administered within two hours of ketoconazole? | H2 antagonists or antacids |
topical analgesic overdose is toxic to which two target organs? | brain and heart |
GERD is caused by what? | backflow of stomach content |
what are the two most frequent complaints leading to a diagnosis of GERD? | retrosternal pain after meals and regurgitation |
GERD and this condition have very similar symptoms | angina pectoris |
what lifestyle changes can reduce symptoms of GERD? | stop smoking, no strenuous exercise, sleep with head elevated, eat smaller meals, quit drinking, don’t eat close to bedtime, limit caffeine |
what causes achalasia? | spasm of the cardiac sphincter |
what are some signs and symptoms of achalasia? | difficulty swallowing, regurgitation, chest pain, nocturnal cough, weight loss |
treatment of achalasia focuses on what two outcomes? | dilation of cardiac sphincter and reduction of esophageal pressure |
inflammation of the lining of the stomach | gastritis |
common causes of gastritis | alcohol, smoking caffeine, bacteria, viruses, aspirin, nsaids, stress, chemotherapy, radiation therapy, food allergies |
signs and symptoms of acute gastritis | epigastric pain, nausea, vomiting, headache, anorexia |
diagnostic tests appropriate for gastritis | occult blood, CBC, gastroscopy |
treatment for gastritis | antiemetics, antacids, H2 antagonists, antibiotics, fluid and electrolyte replacement |
ulceration of the mucous membranes of the deeper structures of the GI tract | peptic ulcer disease |
the two most common sites of peptic ulcers | stomach(gastric), duodenum |
the two most common causes of peptic ulcers | chronic hyperacidity or mucous reduction |
this bacteria is found in over 70% of those with gastric ulcers and 95% of those with duodenal ulcers | H. pylori |
this class of medications can cause gastric injury and lead to the development of peptic ulcers | NSAIDS |
complications of peptic ulcer disease | hemorrhage and perforation, gastric outlet obstruction |
diagnostic tests appropriate for peptic ulcer disease | CBC, Upper GI series, esophagogastroduodenoscopy, biopsy, H. pylori |
medications used to manage peptic ulcer disease | antacids, H2 antagonists, antibiotics, mucosal healing agents, proton pump inhibitors, Prostaglandin E analogue |
removal of the entire antrum (lower stomach) to eliminate the main stimuli for acid production | antrectomy |
part of the stomach is removed and the remaining portion of the stomach is connected to the duodenum | gastroduodenostomy |
a process where the jejunum is anastomosed to the stomach to provide a second outlet for gastric contents and the vagus nerve is severed | gastrojejunostomy and vagotomy |
removal of the entire stomach and the esophagus is joined to the jejunum | total gastrectomy |
a procedure in which an incision in the pylorus is opened and then closed to permit the stomach to relax | pyloroplasty |
treatment of H. pylori usually includes | H2 receptor antagonist or Proton Pump Inhibitor with two antiinfectives for 1 |
antiinfectives used for the treatment of H. pylori | amoxicillin, clarithromycin, metronidazole, doxycycline |
which antiinfective used in the treatment of H. pylori is contraindicated during pregnancy | tetracycline (doxycycline) |
which antiinfective used for the treatment of H. pylori is contraindicated in those with a history of seizures or neurological problems? | metronidazole (flagyl) |
which antiinfective used for the treatment of H. pylori can cause ventricular dysrhythmias and blood disorders? | clarighromycin (biaxin) |
which antiinfective used in the treatment of H. pylori can cause albuminuria and neurotoxicity? | metronidazole (flagyl) |
which antiinfective used in the treatment of H. pylori can cause discoloration and softening of the teeth and bones | tetracycline(doxycycline) |
what food groups and medications should be avoided when administering tetracycline? | milk and dairy products, calcium, antacids, magnesium, sodium bicarb, and other iron supplements |
Antacids usually contain one of these three ingredients | aluminum, magnesium, calcium |
some commonly used Histamine H2 antaonists | cimetidine, famotidine (pepsid), nizatidine, ranitidine(zantac) |
IV dosage of H2 antagonists should be administered slowly to prevent what possible side effect? | bradycardia |
some commonly used Proton pump inhibitors | esomeprazole(nexium), lansoprazole(prevacid), omeprazole(prolosec), rabeprazole(aciiphex) |
what time of day should proton pump inhibitors be administered? | morning |
these two classes of GI medications reduce the secretion of gastric acid | H2 antagonists and proton pump inhibitors |
degenerative disorder of the liver from generalized cellular damage | cirrhosis |
what are some common health problems related to cirrhosis? | impaired digestion and metabolism, reduction in protein synthesis, impaired coagulability, fluid-electrolyte imbalances, ascites |
what would you expect laboratory values of liver enzymes to be in a patient with cirrhosis | elevated |
what would you expect lab values of serum albumin to be in a patient with cirrhosis? | decreased |
what would you expect lab values of serum ammonia to be in a patient with cirrhosis? | elevated |
what would you expect lab values of glucose to be in a patient with cirrhosis? | decreased |
what would you expect the prothromin time to be in a patient with cirrhosis | prolonged |
removal or aspiration of fluid from the peritoneum? | paracentesis |
yellowish discoloration of tissues caused by abnormally high level of bilirubin in blood? | jaundice |
other than yellow discoloration in the eyes and skin, what are some other symptoms of elevated bilirubin | clay colored stool, deep orange urine color |
what substances would you expect to be restricted in a patient with cirrhosis? | fluid, sodium, alcohol, fat, protein |
one way valve moving fluid from peritoneal cavity to superior vena cava | peritoneal jugular shunt (laveen) |
possible complications of a peritoneal jugular shunt | hemodilution, pulmonary edema, CHF, wound infection, peritonitis, septicemia, shunt occlusion |
signs and symptoms of hepatic encephalopathy | inappropriate behavior, disorientation, flapping tremors, twitching extremeties, stupor, coma |
what dietary treatment can help reduce blood ammonia levels? | protein restriction |
inflammation of the liver resulting from several types of viral agents, exposure to toxic substances or lengthy alcohol abuse | hepatitis |
signs and symptoms of hepatitis | RUQ pain, NVD, pruritis, jaundice, dark urine, clay colored stools, hepatomegaly |
the treatment for hepatitis is… | no treatment, palliative care and transmission prevention only |
Hepatitis B vaccine should not be given to patients with anaphylactic reaction to this substance | yeast |
formation of stones in the gallbladder | cholelithiasis |
risk factors for cholelithiasis | overweight, women, pregnant or multiple pregnancies, birth control, diabetes |
common causes of cholecystitis | obstruction, gallstone, tumor |
obstruction of the any of the biliary ducts causes… | spasms |
obstruction of the bile duct leads to bile stasis which causes… | infection and necrosis |
a hormone secreted by the small intestine each time the person eats fatty food which stimulates the release of bile | cholecystokinin |
if the gallbladder ruptures or becomes grossly infected, _________ can result | peritonitis |
a gallstone that has become lodged in and obstructs the common bile duct | choledocholithiasis |
chronic cholecystitis is treated with | low fat diet |
the drug of choice for pain control in cholelithiasis | demerol |
this treatment for cholelithiasis involves the use of shockwaves to break up stone | extracorporeal shock wave lithotripsy |
this treatment for a gallstone lodged in the common bile duct involves the insertion of an endoscope through the mouth and into the duodenum to capture the stone | endoscopic sphincterotomy |
the preferred method of gallbladder removal | endoscopic cholecystectomy |
indications for an open cholecystectomy | extreme inflammation, infection, or large gallstones |
a biliary drainage tube left in place after cholecystectomy to keep the duct open and drain bile until the inflammation of the common bile duct has resolved | t tube |
t tube should drain less than this much in an 8 hour period | 50ml |
possible complications of cholecystectomy | jaundice, hemorrhage, peritonitis |
indication that bile is being deposited normally into the GI tract following cholecystectomy | normal stool and urine color |
inflammation of the pancreas | pancreatitis |
common causes of pancreatitis | trauma, disease, inflammatory bowel disease, heredity, alcohol, drugs, refeeding after prolonged fasting or anorexia |
possible complications of pancreatitis | necrosis, hyperglycemia, hypercalcemia, hemorrhage, peritonitis, abcess, renal failure, sepsis, pleural effusion, blood coagulopathies |
signs and symptoms of pancreatitis | mid upper abdominal pain, NVD, flatulence, frothy, foul smelling stool, jaundice |
cullens sign, turners sign, chvosteks sign, and trousseaus sign are all signs of | pancreatitis |
elevated serum and urine amylase, lipase, and AST-ALT levels, bilirubin levels, WBC’s, glucose with decreased calcium, potassium, and magnesium would be indicative of | pancreatitis |
the most common cause of chronic pancreatitis | alcoholism |
when the pancreatic duct is not obstructed what is the treatment for pancreatitis | diet restriction, then gradual advancement, pain control, enzyme replacement, pancreatectomy or transplant |
most common entry point of intestinal infections into the body | the mouth via contaminated food or water |
long term use of antibiotic can lead to the death of normal flora and overgrowth of opportunistic bacteria such as… | C. difficile |
most common sign of intestinal infection | diarrhea |
primary test for intestinal infection | stool culture |
treatment for diarrhea | fluid and electrolyte replacement |
IBS is often related to.. | psychological problems |
most common symptom of IBS | abdominal pain associated with change in bowl habits |
IBS is diagnosed by… | ruling out other GI disorders |
In IBS, anticholinergic drugs are used… | to relieve abdominal cramps |
In IBS, dietary fiber, milk of magnesia, and mineral oil are used to treat | constipation |
in IBS, antianxiety drugs are used to treat | distress, panic, and depression |
how many grams per day of dietary fiber should a person with IBS consume? | 20 |
inflammation of the colon and rectum characterized by alternating periods of exacerbation and remission | ulcerative colitis |
the hallmark symptom of ulcerative colitis | diarrhea containing pus and blood |
10 to 20 liquid stools per day, containing blood, mucus, and pus would be indicative of which inflammatory bowel disease? | ulcerative colitis |
hallmark sign of this inflammatory bowel disease is a cobblestone appearance in parts of the GI tract | crohns disease |
severe cases of crohns disease are treated with | corticosteroids |
patients on long term corticosteroid therapy should be monitored for | infection |
anticholinergics are contraindicated in patients with | glaucoma, hemorrhage, tachycardia, myasthenia gravis |
in this procedure the entire colon and rectum are removed and the stoma is located in the right lower quadrant | ileostomy |
this procedure is done to allow the intestine to repair itself following inflammatory disease, injury, or intestinal surgery | temporary colostomy |
colostomy placed when there is a debilitating intestinal disease or cancer requiring removal of the colon and rectum | permanent |
in this “ostomy” material discharged is liquid to semiliquid and contains digestive enzymes | ileostomy |
in this “ostomy” fecal material discharges is liquid to semi liquid requiring frequent emptying to keep the patient dry and to control odor | ascending colostomy |
in this “ostomy” fecal material is semi formed, can be irrigated daily to reduce number of bowel movements | transverse colostomy |
in this “ostomy” fecal material is semi | formed to formed |
in this “ostomy” fecal material is formed | sigmoid colostomy |
a pink or red stoma is | healthy |
a dusky blue stoma indicates | ischemia |
a brown black stoma indicates | necrosis |
the four types of hernias | inguinal, femoral, umbilical, and ventral (incisional) |
most common type of hernia | inguinal |
inguinal hernias are more frequent in which gender? | male |
this type of hernia occurs more often in women and easily becomes strangulated | femoral |
this type of hernia occurs when the rectus muscle is weak and is most common in children | umbilical |
this type of hernia is due to weakness in the abdominal wall at the site of a previous incision | ventral(incisional) |
if the protruding structures of a hernia can be replaced into the abdominal cavity via manipulation, it is referred to as | reducible |
a hernia that cannot be manually manipulated and replaced into the abdominal cavity | irreducible |
a hernia where blood supply and intestinal flow are occluded | strangulated |
edema of the hernia and constriction of the muscular opening causing it to be irreducible | incarcerated |
two methods for hernia repair | approximating adjacent muscles or use of synthetic mesh |
in this type of hernia the stomach prolapses through the diaphragmatic esophageal hiatus | hiatal hernia |
following hernia repair, the patient should be encouraged to breathe deeply but discouraged from | coughing |
most intestinal obstructions occur here | ileum |
90% of obstruction are due to these two pathologies | adhesions and incarcerated hernias |
the most common form of non mechanical bowel obstruction | paralytic ileus |
inflammation of the vermiform appendix located at the tip of the cecum | appendicitis |
hallmark sign of appendicitis | rebound tenderness |
treatment of choice for acute appendicitis | appendectomy |
the presence of pouchlike herniations through the muscular layer of the colon | diverticulosis |
the inflammation or infection of one or more diverticula | diverticulitis |
signs and symptoms of diverticulitis | pain in left lower quadrant, fever |
test of choice for diverticulitis | ct scan with oral contrast |
diverticulitis or osis caused by muscular atrophy is treated by | low residue diet, stool softeners, and bedrest |
diverticulitis or osis caused by increased intracolonic pressure and muscle thickening is treated by | high fiber diet of bran, fruits, and vegetables |
inflammation of the abdominal peritoneum | peritonitis |
how is peritonitis related to diverticular disease | rupture of diverticula can cause leakage into the peritoneum |
hallmark symptom of peritonitis | severe abdominal pain |
this finding on xray is indicative of peritonitis | trapped air under the diaphragm |
treatment for peritonitis | surgical removal of irritant, antibiotics, NG intubation |
patient with peritonitis should be placed in this position | semifowler’s |
laxatives are used to | prevent constipation or to prepare the bowel for radiologic or endoscopic procedures |
types of laxatives | bulk forming, osmotic cathartics, saline laxatives, stimulants, stool softeners |
laxatives should generally be administered at this time of day | bedtime |
during laxative therapy patient should intake more or less fluid than normal? | more |
varicosities of the lower recrum and anus resulting in congestion of the anal and rectal veins | hemorrhoids |
an abnormal opening on the cutaneous surface near the anus | fistula |
a linear ulceration or laceration of the skin of the anus | anal fissure |
opening of the fistula tract, incising the fistula with a partial anus division | fistulotomy |
removal of the fistula tract | fistulectomy |
small reddish appearing lumps at the edge of the anus | hemorrhoids |
procedural treatment of hemorrhoids | ligation, sclerotherapy, cryotherapy, infrared photocoagulation |
conservative treatment for hemorrhoids | stool softeners, topical creams, analgesic ointments, sitz baths |
surgical treatment for hemorrhoids | laser excision, hemorrhoidectomy |
usually occur as a result of trauma caused by hard stool the overstretches the anal lining and is aggravated by defecation | fissures |
these can form a local crypt abcess and are common in crohn’s disease | fistulas |
act on the chemoreceptor trigger zone to inhibit nausea and vomiting | phenothiazines |
act as antiemetics by diminishing motion sickness | dimenhydrate, scopolamine, meclizine |
decreases nausea and vomiting by its effects on gastric emptying | metoclopramide |
block the effects of serotonin at the 5HT3 receptor sites to reduce nausea and vomiting | dlasetron, granisetron, ondansetron |