Nausea, Vomiting, and Oral Cancer Quiz
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Questions and Answers

Which symptom is NOT commonly associated with nausea and vomiting?

  • Dehydration
  • Anorexia
  • Asthma (correct)
  • Fluid imbalances

Which medication is classified as an antihistamine for symptom relief in nausea and vomiting?

  • Chlorpromazine
  • Hydroxyzine (correct)
  • Ondansetron
  • Scopolamine

Which of the following is a major predisposing factor for oral cancer?

  • High cholesterol
  • Tobacco use (correct)
  • Sedentary lifestyle
  • Hypertension

What diagnostic method utilizes a blue dye to identify cancer cells?

<p>Toluidine blue test (A)</p> Signup and view all the answers

Which type of oral cancer is correctly defined as beginning in the mouth and progressing to the oropharynx?

<p>Oral cavity cancer (D)</p> Signup and view all the answers

Which treatment involves the removal of deep cervical lymph nodes in oral cancer patients?

<p>Radical neck dissection (B)</p> Signup and view all the answers

Which of the following is NOT a clinical manifestation of oral cancer?

<p>Severe headache (C)</p> Signup and view all the answers

What treatment option would primarily focus on symptom relief in a patient unable to keep food down?

<p>Antiemetic drugs (A)</p> Signup and view all the answers

What is a significant consequence of increased intraabdominal pressure?

<p>It may cause tissue damage due to ischemia. (B)</p> Signup and view all the answers

Which of the following is NOT a clinical manifestation associated with esophageal disorders?

<p>Severe abdominal cramping (C)</p> Signup and view all the answers

What surgical intervention involves folding the top part of the stomach and sewing it to the lower esophageal sphincter?

<p>Fundoplication (A)</p> Signup and view all the answers

In the context of esophageal strictures, which symptom is commonly associated?

<p>Weight loss (C)</p> Signup and view all the answers

What characterizes chronic peptic ulcer disease?

<p>Formation of fibrous tissue (C)</p> Signup and view all the answers

Which symptom is most likely indicative of a person suffering from esophageal diverticula?

<p>Food trapped in pouches (A)</p> Signup and view all the answers

What is the primary treatment option for esophageal strictures?

<p>Dilation with bougies or balloons (A)</p> Signup and view all the answers

Which of the following risk factors is associated with peptic ulcer disease?

<p>Increased secretion of HCL and pepsin (B)</p> Signup and view all the answers

What primary factor contributes to the chronic mucosal damage in Gastroesophageal Reflux Disease (GERD)?

<p>Incompetent lower esophageal sphincter (C)</p> Signup and view all the answers

Which of the following is NOT a common symptom of GERD?

<p>Frequent urination (A)</p> Signup and view all the answers

What is a significant complication of untreated GERD that involves the replacement of esophageal cells?

<p>Barrett’s Esophagus (C)</p> Signup and view all the answers

In managing GERD, which dietary change is recommended?

<p>Maintain a low-fat diet (D)</p> Signup and view all the answers

Which medication class is known to decrease hydrochloric acid secretion and may lead to vitamin B12 deficiency with prolonged use?

<p>PPIs (A)</p> Signup and view all the answers

What is a hallmark diagnostic study for diagnosing upper GI issues like GERD?

<p>Upper GI endoscopy (D)</p> Signup and view all the answers

What is the most common clinical manifestation of GERD?

<p>Heartburn (pyrosis) (C)</p> Signup and view all the answers

Which of the following interventions would NOT be appropriate for a patient with GERD?

<p>Eating a heavy meal 1 hour before bedtime (B)</p> Signup and view all the answers

What is the emergency situation related to a rolling hiatal hernia?

<p>Surgical intervention is required immediately (C)</p> Signup and view all the answers

What respiratory complication may occur due to untreated GERD?

<p>Chronic bronchitis (D)</p> Signup and view all the answers

Which surgical procedure involves the removal of the distal â…” of the stomach and anastomosis to the jejunum?

<p>Gastrojejunostomy-Billroth II (C)</p> Signup and view all the answers

What is a common symptom associated with dumping syndrome?

<p>Defecation urge (B)</p> Signup and view all the answers

Which complication can occur postoperatively after gastric surgery, leading to low blood glucose levels after eating?

<p>Postprandial hypoglycemia (D)</p> Signup and view all the answers

What is the primary purpose of performing a vagotomy during gastric surgery?

<p>To reduce gastric acid secretion (C)</p> Signup and view all the answers

Which symptom is NOT typically associated with dumping syndrome?

<p>Prolonged fatigue (C)</p> Signup and view all the answers

What is the most prevalent demographic for gastric ulcers?

<p>Females over 50 years (C)</p> Signup and view all the answers

What symptom differentiates gastric from duodenal ulcers regarding pain timing after meals?

<p>Pain occurs at 1-2 hours after eating (A)</p> Signup and view all the answers

Which of the following is a risk factor specifically associated with duodenal ulcers?

<p>COPD (B)</p> Signup and view all the answers

What is the primary goal of interprofessional management for peptic ulcer disease?

<p>Enhance mucosal defenses and decrease stomach acid (C)</p> Signup and view all the answers

Which medication is most effective as a first-line treatment for peptic ulcer disease?

<p>Proton pump inhibitors (B)</p> Signup and view all the answers

What complication is most commonly associated with duodenal ulcers?

<p>Hemorrhage (A)</p> Signup and view all the answers

Which of the following statements regarding the management of peptic ulcer disease is false?

<p>NSAIDs are recommended for pain relief. (B)</p> Signup and view all the answers

What is the primary diagnostic tool used for direct visualization of peptic ulcers?

<p>Endoscopy (A)</p> Signup and view all the answers

What condition is most likely to occur if an uncontrolled high carbohydrate bolus enters the small intestine?

<p>Hypoglycemia (C)</p> Signup and view all the answers

Which of the following treatments is effective in managing bile reflux gastritis?

<p>Cholestyramine (A)</p> Signup and view all the answers

What is a key nursing management intervention for preventing infection after gastric surgery?

<p>Administer antibiotics prophylactically (A)</p> Signup and view all the answers

What symptom may indicate an anastomosis leak post-surgery?

<p>Tachycardia (C)</p> Signup and view all the answers

What dietary strategy is recommended for someone with chronic gastritis?

<p>Consume six small, frequent meals (B)</p> Signup and view all the answers

Which condition can arise from acute gastritis due to damage of the gastric mucosa?

<p>Gastric hemorrhage (D)</p> Signup and view all the answers

What is a critical factor in the management of chronic gastritis?

<p>Elimination of H. Pylori (A)</p> Signup and view all the answers

What should be avoided during meals to promote effective nutrition management post-surgery?

<p>Fluids (C)</p> Signup and view all the answers

Flashcards

Nausea

Feeling of discomfort in the upper stomach area.

Vomiting

Forceful ejection of food and fluids from the stomach.

Oral Cancer Types

Can start in the mouth (oral cavity) or throat (oropharynx).

Oral Cancer Risk Factors

Tobacco, alcohol, sun exposure, HPV, and STDs can increase risk.

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Oral Cancer Symptoms

Chronic sore throat, voice changes, ulcers, trouble swallowing (dysphagia), or changes in speech.

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Oral Cancer Diagnosis

Typically involves biopsy, oral cytology, Toluidine blue test, or imaging (CT, MRI, PET).

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Oral Cancer Treatment

Surgery (including minimally invasive robotic surgery, partial mandibulectomy, etc.) is often employed.

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Nausea/Vomiting Treatment

Includes anticholinergics, antihistamines, serotonin antagonists, phenothiazines to relieve sickness.

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GERD (Gastroesophageal Reflux Disease)

Chronic damage to the esophagus caused by stomach acid flowing back up.

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Lower Esophageal Sphincter (LES) incompetence

The valve between the esophagus and stomach doesn't close properly, allowing acid to reflux.

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Heartburn (pyrosis)

Burning sensation in the chest, often radiating to the throat or jaw.

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Hiatal Hernia

Part of the stomach bulges through the diaphragm, creating an opening.

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Sliding Hiatal Hernia

Part of the stomach slides up into the chest through the diaphragm.

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Rolling Hiatal Hernia

More serious type, fundus rolls up and creates a pocket; may cause emergencies.

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Upper GI Endoscopy

Medical procedure to examine the upper digestive tract using a camera.

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PPIs (Proton Pump Inhibitors)

Drugs that decrease acid production in the stomach.

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Esophagitis

Inflammation of the esophagus, often due to GERD.

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Barrett's Esophagus

Cell changes in the esophagus caused by GERD. Increases cancer risk.

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Esophageal Diverticula

Sac-like outpouchings of the esophagus, occurring in different areas.

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Esophageal Strictures

Narrowing of the esophagus often due to GERD.

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Symptoms of Hiatal Hernia

Heartburn, dyspepsia, regurgitation, chest pain.

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Peptic Ulcer Disease (PUD)

Erosion in the GI tract caused by acid secretions.

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PUD Risk Factors

One important risk factor is H. Pylori.

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Hiatal Hernia Complications

GERD, esophagitis, ulcers, stenosis, strangulation, aspiration can occur.

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Treatment for Esophageal Strictures

Dilation with bougies or balloons, or surgical excision.

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Board-like Abdomen

A rigid, hard abdomen with no bowel sounds, indicating a serious medical condition like peritonitis.

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Billroth I

Surgical procedure where the distal â…” of the stomach is removed and the remaining stomach is connected to the duodenum.

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Billroth II

Surgical procedure where the distal â…” of the stomach is removed and the remaining stomach is connected to the jejunum.

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Dumping Syndrome

A complication after gastric surgery where food moves too quickly into the small intestine, causing symptoms like weakness, sweating, and diarrhea.

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Postprandial Hypoglycemia

Low blood sugar after eating, a potential complication of gastric surgery.

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H. pylori Transmission

H. pylori is primarily spread through fecal-oral contact, meaning it's transferred through contaminated food or water.

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H. pylori Risk Factors

Besides fecal-oral transmission, other risk factors for H. pylori infection include NSAID use, smoking, and excessive alcohol or caffeine consumption.

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Gastric Ulcer Signs

Gastric ulcers often cause burning or gas pain, especially 1-2 hours after eating. Food often worsens the pain. In some cases, the first symptom is a perforation, leading to peritonitis.

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Duodenal Ulcer Signs

Duodenal ulcers cause burning pain across the mid-epigastric region and often feel worse 2-5 hours after eating. Pain usually gets better with antacids.

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Diagnostic Tests for Ulcers

Diagnosis usually involves endoscopy for direct visualization, barium contrast imaging, blood tests (CBC, liver enzymes, amylase), and stool samples for blood.

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Peptic Ulcer Management Goal

Management focuses on reducing stomach acid (PPIs) and strengthening the stomach lining.

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Peptic Ulcer Medications

PPIs are the mainstay for ulcers, often combined with antibiotics for H. pylori infection. Sucralfate protects the stomach lining.

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Complications of Ulcers

The most common complication is duodenal hemorrhage. Perforation is also possible, causing severe abdominal pain.

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What is a common cause of bile reflux gastritis?

Bile reflux gastritis is caused by the backflow of bile from the small intestine into the stomach, leading to irritation and inflammation of the stomach lining.

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What is a key symptom of an anastomosis leak after gastric surgery?

An anastomosis leak is a serious complication following gastric surgery, where the connection between the stomach and the small intestine leaks, leading to inflammation, sepsis, and potentially death. A common symptom is tachycardia (rapid heart rate).

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Why are small, frequent meals recommended after gastric surgery?

Small, frequent meals are recommended to prevent the stomach from becoming overly full and putting pressure on the surgical site, reducing the risk of leaks and complications.

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What is a major risk factor for acute gastritis?

Acute gastritis is an inflammation of the stomach lining, and a major risk factor is the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen and Naproxen.

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What is a key nursing intervention for acute gastritis?

A key nursing intervention for acute gastritis is eliminating the cause of the irritation. This may include discontinuing NSAIDs, avoiding spicy foods, or treating H. pylori infection.

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What is the primary treatment for chronic gastritis?

Chronic gastritis is characterized by long-term inflammation of the stomach lining. The primary treatment is antibiotics, particularly to target H. pylori infection.

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What is a common symptom of acute gastritis?

Acute gastritis, or sudden inflammation of the stomach lining, often causes nausea and vomiting.

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What is pernicious anemia and how is it related to chronic gastritis?

Pernicious anemia is a deficiency in vitamin B12 caused by the body's inability to absorb it properly. Chronic gastritis can damage the stomach lining which prevents it from producing intrinsic factor, a substance necessary for vitamin B12 absorption.

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Study Notes

Nausea and Vomiting

  • Nausea: Discomfort in the upper stomach area.
  • Vomiting: Forceful expulsion of stomach contents.
  • Manifestations: Loss of appetite, weight loss, fluid and electrolyte imbalance, decreased blood volume, and circulatory failure.
  • Treatment Considerations: Identifying the cause and providing symptom relief using anticholinergic (scopolamine patches), antihistamines (hydroxyzine), serotonin antagonists (ondansetron), and phenothiazines (chlorpromazine, promethazine).

Oral Cancer

  • Types: Oral cavity (starts in the mouth), oropharyngeal (behind the mouth) cancers.
  • Head and Neck Squamous Cell Carcinoma (SCC): Majority of oral cancers.
  • Predisposing Factors: Tobacco, alcohol, sun exposure, HPV, and STDs.
  • Clinical Manifestations: Chronic sore throat, voice changes, ulcers, dysphasia, slurred speech, toothache, and leukoplakia (precancerous lesion caused by smoking).

Gastroesophageal Reflux Disease (GERD)

  • Pathology: Stomach acid refluxing into the esophagus, causing damage.
  • Primary Factor: Incompetent Lower Esophageal Sphincter (LES).
  • Clinical Manifestations: Heartburn, dyspepsia (pain/discomfort in the upper abdomen).

Regurgitation

  • Symptoms: Sour, bitter, or hot liquid in the mouth and throat.
  • Complications: Respiratory disturbances such as wheezing, coughing, dyspnea, night-time disturbances or hoarseness, sore throat, lump, or choking, increased saliva, esophagitis (ulcers, scar tissue, strictures, dysphagia); Barrett's Esophagus (increased risk for cancer); respiratory problems such as cough, bronchospasm, laryngospasm, aspiration into respiratory systems, chronic bronchitis, pneumonia; dental erosion of posterior teeth.

Hiatal Hernia

  • Types of Hiatal Hernias: Sliding (part of the stomach slides into the chest), Rolling/Paraesophageal (part of the stomach rolls up causing a pocket). Rolling/Paraesophageal hernias are considered a MEDICAL EMERGENCY.
  • Sliding Hernia: Part of the stomach slides through the diaphragm.
  • Rolling Hernia: The fundus (top part of the stomach) rolls up and creates a fixed pocket. This can cause decreased circulation and tissue damage due to ischemia (lack of blood flow).

Esophageal Diverticula

  • Conditions: Sac-like outpouchings of esophageal layers, occurring above the upper esophageal sphincter, near the esophageal midpoint, and above the lower esophageal sphincter.
  • Zenker's (pharyngoesophageal), Traction (midesophageal), and Epiphrenic types.

Esophageal Strictures

  • Description: Narrowing of the esophagus due to GERD.
  • Manifestations: Dysphagia, regurgitation, and weight loss.
  • Treatment: Dilation with bougies/balloons, surgical excision.

Peptic Ulcer Disease (PUD)

  • Subtypes: Acute (superficial erosion/minimal inflammation), Chronic (erosion of the muscular wall/formation of fibrous tissue), located in either the gastric or duodenal areas.
  • Risk Factors: H. pylori, NSAIDS, smoking, excessive alcohol use, and caffeine.
  • Gastric Symptoms: Burning/gassy pain, 1-2 hours after a meal (duodenal pain is different); food worsens; perforation.

Gastric Surgery Complications

  • Dumping Syndrome: Rapid transit of food contents, causing decreased plasma volume and distension.
  • Symptoms: Weakness, sweating, palpitations, dizziness, cramping, increased bowel sounds, urgent defecation urges.
  • Treatment: Resting after eating for at least 30 minutes to slow digestion.
  • Postprandial Hypoglycemia: Low blood sugar after eating.
  • Bile Reflux Gastritis: Bile reflux damages stomach mucosa.

Gastritis

  • Description: Inflammation of the gastric mucosa.
  • Pathophysiology: Breakdown of the gastric mucosal barrier, allowing hydrochloric acid and pepsin to diffuse back into the mucosa, resulting in edema and possible hemorrhage.
  • Causes: Drug related (NSAIDS), spicy foods, and H. pylori.
  • Clinical Manifestations: Anorexia, nausea, vomiting, epigastric tenderness, and hemorrhage.

Upper GI Bleeding

  • Hematemesis: Vomiting blood.
  • Bright red (arterial blood loss) or coffee ground (digested blood)
  • Melena: Black, tarry stools originating from digested blood.
  • Occult: Blood in gastric secretions, vomitus, or stool (detected by guaiac test)

Other conditions discussed include:

  • Cirrhosis, Pancreatitis, Zollinger-Ellison syndrome, Pyloroplasty, Billroth I & II, Gastroduodenostomy, Gastrojejunostomy, Total Gastrectomy, Vagotomy

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Test your knowledge on the causes, symptoms, and treatments of nausea and vomiting, along with awareness of oral cancer types and risk factors. This quiz covers essential clinical manifestations and considerations for managing these conditions effectively.

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