NSG 555 Quiz 2 Module 3 GI/GU – Questions
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CBC, LFTs, PT (usually normal but can become longer in severe hepatitis, if
high this is poor prognosis
Choose an answer
1 Cranial nerve function 2 diagnostics for hepatitis
Gold standard treatment of Measures how liver is excreting
3 4
CHRONIC anal fissure things
Don't know?
Terms in this set (197)
Reflects brainstem function
Cranial nerve function Pupil response, eye movement, cough/gag/corneal
reflexes
, external: usually asymptomatic unless a small
thrombus , then acutely painful and itchy and edema
External vs internal
hemorrhoids s/s
internal: painless bright red blood with BMs and
occ. a reducible prolapse.
increased pressure-->vascular engorgement--
Hemorrhoids definition
>trauma to vessels-->pain and prolaps of tissue
1. painless bleeding, bulge but no prolapse
2. prolapse during defacation, reduce
spontaniously, bleeding/itching
4 degrees of internal
3. prolapse with defacation+manual reduction
hemorrhoids
needed. pain
4th degree: permanently prolapsed and not
reducible.
diagnostics of clinical one. further testing not needed but if pt over
hemorrhoids 50 or concern re cancer should get colonoscopy.
high fiber diet, increased fluid. fiber 20-30 g/day
sitz baths
stool softeners (not laxatives, can make it worse
because of variable consistency)
management of
topical analgescis reduce inflammation.
hemorrhoids
vasoconstrictive preps cnan help too
can do rubber band ligation if still symptomatic
after dietary/lifestyle change
4th degree can be at risk for strangulation and can
become gangrenous and need surgery. use rubber
complications of band ligation.
hemorrhoids
s/s perianal sepsis: urinary retention and fever after
rubber band ligation
painful linear cracks common in kids and middle age
adults.
if present <6 weeks it's acut if >6 weeks it's chronic
anal fissure
caused by trauma from constipationor diarrhea
which causes a chemical burn or anal stenosis
, anal fissure that is NOT suspect STI, TB, HIV, infection, UC, crohns, malignant
posterior midline neoplasm, etc REFER THESE PTS
tearing with passing stool, pain, small amounts of
s/s and PE of anal fissure
blood on TP.
anal cancer, perianal abscess, thrombosed
hemorrhoid
differential dx anal fissure
RED FLAG s/s: anal carcinoma hx, persistent
anorectal pain/bleeding, bloody diarrhea, wt loss
usually resolve without tx.
Inc fiber, stool softeners, sitz baths, supps or foam
management of anal antiinflammatory agents
fissures lidocaine gel before BMs
topical nitrates or oral CCBs (diltiazem) helps
healing of fissures
Gold standard treatment lateral internal sphincerotomy: reduces internal
of CHRONIC anal fissure sphincter tone allowing fissure to heal
RED FLAG IF wieght loss or refractory s/s to rule on
cancer
Itching. very common. caused by hundreds of
things.
Pruritis ani
dx: ITCH: infection, topical irritan, cutaneous/cancer,
hypersensitivite. rule out STI, may need biopsy if no
relief, assess if food alergy or detergent allergy, pin
worms, yest, etc.
hygien. increase fiber if there are loos stools. Use a
hair dryer on cool setting to dry anus. avoid
perfumes.
management of pruritis 1% hydrocortisone cream (d/c after 2 weeks to avoid
ani skin atrophy)
antihistamine with antipruritic (Atarax/hydroxyzine)
Witch hazel
relief in 4-6 weeks
With Accurate Answers
Save
Practice questions for this set
Learn 1 /7 Study with Learn
CBC, LFTs, PT (usually normal but can become longer in severe hepatitis, if
high this is poor prognosis
Choose an answer
1 Cranial nerve function 2 diagnostics for hepatitis
Gold standard treatment of Measures how liver is excreting
3 4
CHRONIC anal fissure things
Don't know?
Terms in this set (197)
Reflects brainstem function
Cranial nerve function Pupil response, eye movement, cough/gag/corneal
reflexes
, external: usually asymptomatic unless a small
thrombus , then acutely painful and itchy and edema
External vs internal
hemorrhoids s/s
internal: painless bright red blood with BMs and
occ. a reducible prolapse.
increased pressure-->vascular engorgement--
Hemorrhoids definition
>trauma to vessels-->pain and prolaps of tissue
1. painless bleeding, bulge but no prolapse
2. prolapse during defacation, reduce
spontaniously, bleeding/itching
4 degrees of internal
3. prolapse with defacation+manual reduction
hemorrhoids
needed. pain
4th degree: permanently prolapsed and not
reducible.
diagnostics of clinical one. further testing not needed but if pt over
hemorrhoids 50 or concern re cancer should get colonoscopy.
high fiber diet, increased fluid. fiber 20-30 g/day
sitz baths
stool softeners (not laxatives, can make it worse
because of variable consistency)
management of
topical analgescis reduce inflammation.
hemorrhoids
vasoconstrictive preps cnan help too
can do rubber band ligation if still symptomatic
after dietary/lifestyle change
4th degree can be at risk for strangulation and can
become gangrenous and need surgery. use rubber
complications of band ligation.
hemorrhoids
s/s perianal sepsis: urinary retention and fever after
rubber band ligation
painful linear cracks common in kids and middle age
adults.
if present <6 weeks it's acut if >6 weeks it's chronic
anal fissure
caused by trauma from constipationor diarrhea
which causes a chemical burn or anal stenosis
, anal fissure that is NOT suspect STI, TB, HIV, infection, UC, crohns, malignant
posterior midline neoplasm, etc REFER THESE PTS
tearing with passing stool, pain, small amounts of
s/s and PE of anal fissure
blood on TP.
anal cancer, perianal abscess, thrombosed
hemorrhoid
differential dx anal fissure
RED FLAG s/s: anal carcinoma hx, persistent
anorectal pain/bleeding, bloody diarrhea, wt loss
usually resolve without tx.
Inc fiber, stool softeners, sitz baths, supps or foam
management of anal antiinflammatory agents
fissures lidocaine gel before BMs
topical nitrates or oral CCBs (diltiazem) helps
healing of fissures
Gold standard treatment lateral internal sphincerotomy: reduces internal
of CHRONIC anal fissure sphincter tone allowing fissure to heal
RED FLAG IF wieght loss or refractory s/s to rule on
cancer
Itching. very common. caused by hundreds of
things.
Pruritis ani
dx: ITCH: infection, topical irritan, cutaneous/cancer,
hypersensitivite. rule out STI, may need biopsy if no
relief, assess if food alergy or detergent allergy, pin
worms, yest, etc.
hygien. increase fiber if there are loos stools. Use a
hair dryer on cool setting to dry anus. avoid
perfumes.
management of pruritis 1% hydrocortisone cream (d/c after 2 weeks to avoid
ani skin atrophy)
antihistamine with antipruritic (Atarax/hydroxyzine)
Witch hazel
relief in 4-6 weeks
