Module 12: Gastrointestinal Disorders
Module Authors
Miguel Medina, PA-C
Assistant Professor, Physician Assistant Education Department
Western University of Health Sciences Pomona, CA
Debbie Santivaņez-Williams, MSc, FNP
Instructor, Master of Science in Nursing/Family Nurse Practitioner Program
Western University of Health Sciences, Pomona, CA
Tina M. Meyer, PA-C
Clinical Consultant and Adjunct Professor
Western University of Health Sciences, Pomona, CA
Review Concepts
Review Concept 1: Abdominal Pain
By the end of this Review Concept you should be able to:
- Describe the epidemiology of abdominal pain
- Differentiate between acute and chronic pain
- List medical and pharmacological causes of abdominal pain
- Describe signs and symptoms that often accompany abdominal pain, and the clinical significance of each
- Describe procedures and protocols in the diagnostic workup of the patient with abdominal pain
- Explain the significance of the location and extent of the pain in determining the underlying cause(s) of abdominal pain
- Describe procedures and protocols in the clinical management of the patient with abdominal pain
Review Concept 2: Dysphagia and Esophageal Disorders
By the end of this Review Concept you should be able to:
- Define dysphagia
- Describe the etiology and pathogenic mechanisms that cause dysphagia
- Differentiate among transfer dysphagia, achalasia, and dysphagia due to mechanical obstruction
- Describe procedures and protocols for the diagnostic workup and clinical management of patients with dysphagia
- Describe the etiology, clinical presentation and treatment of the following esophageal disorders:
- Esophagitis
- Gastroesophageal reflux disease (GERD)
- Hiatal hernia
- Esophageal strictures
- Shotky's Ring
- Esphageal varices
- Mallory-Weiss syndrome
- Esophageal cancer
Review Concept3: Duodenal and Gastric Ulcer Disease
By the end of this Review Concept you should be able to:
- Describe the epidemiology of duodenal and gastric ulcer disease
- List the signs and symptoms of early and advanced duodenal ulcer
- Describe procedures and protocols for the diagnostic workup and clinical management of the patient with duodenal ulcer
- Compare the effectiveness of antacids, H2 receptor agonists, and proton pump inhibitors as treatment for duodenal ulcers
- Outline mechanism of action, dosing requirements, and adverse reactions associated with pharmacological agents used in the treatment of duodenal ulcers
- Explain the relationship between NSAIDS and the development of gastric ulcers
- Describe the clinical presentation of gastric ulcer
- Describe procedures and protocols for the diagnostic workup and clinical management of the patient with gastric ulcer
- Describe interventions for the prevention and management of recurrent ulcers
Review Concept 4: Irritable Bowel Syndrome, Diverticular Disease, and Infectious Diarrhea
By the end of this Review Concept you should be able to:
- Describe the etiology of irritable bowel syndrome (IBS) and diverticular disease
- Describe the incidence/prevalence of irritable bowel syndrome and diverticular disease
- Describe risk factors and the onset of irritable bowel syndrome and diverticular disease
- Describe the pathogenesis/pathophysiology of irritable bowel syndrome and diverticular disease
- Describe the diagnostic workup of irritable bowel syndrome and diverticular disease
- Describe the clinical management of irritable bowel syndrome and diverticular disease
- Describe the clinical management of infectious diarrhea.
Review Concept 5: Constipation
By the end of this Review Concept you should be able to:
- Describe the epidemiology of constipation
- Differentiate the etiology of constipation with gut dilation from that of constipation without gut dilation
- List drugs that can cause constipation
- Describe areas that should be explored while taking a history of the patient with constipation
- Outline procedures and protocols for the diagnostic workup of the patient with constipation
- Describe nonpharmacological measures used to manage the patient with constipation
- Describe the different types of fecal softeners used in the treatment of constipation and the principal agents and mechanisms of action associated with each
- Describe the different types of laxatives used in the treatment of constipation and the principal agents and mechanisms of action associated with each
- Explain the use of enemas in cases of constipation
Review Concept 6: Rectal Disorders
By the end of this Review Concept you should be able to:
- Describe the epidemiology, clinical presentation, diagnostic workup, and management of the following disorders:
- Hemmorhoids
- Anal fissures
- Anorectal abscess
- Pilonidol cyst
- Rectal polyps
- Rectal cancer
- Rectal pruritis
- Rectal proctitis
- Describe the epidemiology and clinical presentation of common GI Helminthic infections.
- Outline procedures and protocols for the diagnostic workup and clinical management of patients with common GI Helminthic infections
Review Concept 7: Cholecystosis
By the end of this Review Concept you should be able to:
- Describe the epidemiology of cholecystitis
- Describe the pathogenesis of gallstones
- List risk factors for cholecystitis
- Outline procedures and common findings in the diagnostic workup of the patient with cholecystitis
- List differential diagnoses for cholecystitis
- Outline procedures and protocols in the clinical management of the patient with cholecystitis
Review Concept 8: Viral Hepatitis
By the end of this Review Concept you should be able to:
- List the various types of hepatitis and the primary etiology for each
- Describe the epidemiology, etiology, and clinical characteristics of:
- Hepatitis A (HAV)
- Hepatitis B (HBV)
- Hepatitis C (HCV)
- Hepatitis D (HDV)
- Hepatitis E (HEV)
- Hepatitis G (HGV)
- List the principal risk factors for viral hepatitis
- Describe the clinical presentation of acute and chronic viral hepatitis
- Outline procedures and common findings in the diagnostic workup of the patient with HCV
- Outline procedures and protocols for the clinical management of patients with acute and chronic HCV
- Describe the pathogenesis, clinical presentation, and treatment of chronic alcholic hepatitis and cirrhosis
- Describe the epidemiology of hepatocellular carcinoma (HCC) associated with chronic hepatitis
Review Concept 9: Appendicitis, Gastritis, Pyloric Stenosis And Gastric Neoplasms
By the end of this Review Concept you should be able to:
- Describe the epidemiology of appendicitis
- Describe the pathogenesis and pathophysiology of appendicitis
- Differentiate the clinical presentations of appendicitis for infants, children, and adults
- Outline procedures and clinical indicators in the diagnostic workup of the patient with appendicitis
- List the differential diagnosis of appendicitis
- Describe the clinical management of appendicitis
- Describe the epidemiology, clinical presentation and management of the following conditions:
- Gastritis
- Pyloric stenosis
- Gastric neoplasms
Review Concept 10: Pancreatitis
By the end of this Review Concept you should be able to:
- Describe the epidemiology of pancreatitis
- List primary and secondary causes of pancreatitis
- Describe the pathogenesis and pathophysiology of pancreatitis secondary to alcohol abuse
- Differentiate acute and chronic presentations of pancreatitis
- Describe the procedures and findings associated with the diagnostic workup of the patient with pancreatitis
- List differential diagnosis for pancreatitis
- Explain how Ranson's Criteria is used to evaluate the severity of pancreatitis
- Describe the diagnostic workup
- Describe the clinical management of patients with pancreatitis
- Describe the epidemiology of pancreatic cancer, treatment options and expected outcomes
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