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Pathophysiology > 36 GI Disorders > Flashcards

36 GI Disorders Flashcards

1
Q

common manifestations of GI tract disorders

A
  • pain
  • vomiting
  • intestinal gas
  • bowel pattern alterations (const/diarrh)
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2
Q

pathophysio mechanism of bowel pattern alterations

A

1 osmotic
2 secretory
3 exudative (muc, bld, prtein)
4 diarrhea r/t motility disturbances

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3
Q

dysphagia

A

difficulty swallowing

3 types

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4
Q

Type I Dysphagia

A

problem w delivery of food/fluid into esophagus

-cough, aspirate, worse w liquids than solids

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5
Q

Type II Dysphagia

A

problem w transport of bolus down esophagus

-sensation food is “stuck” behind sternum, first w solid, may progress to fluid

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6
Q

Type III Dysphagia

A

problems in bolus entry to stomach

-tight/pain in substernal area during swallowing

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7
Q

GastroEsophageal Reflux Disease [GERD]

A

blackflow of gastruc contents into esophagus thru LES

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8
Q

GastroEsophageal Reflux Disease [GERD]

causes

A

any conditin that alters closure strength of LES or incr ab pressure

1 fatty food
2 caffein
3 lrg amt of alcohol
4 cig smoking
5 pregnancy
6 anatomic features like hiatal hernia
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9
Q

GastroEsophageal Reflux Disease [GERD]

s/s

A

1 hrt burn
2 regurgutation
3 chest pain
4 dysphalgia

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10
Q

GastroEsophageal Reflux Disease [GERD]

treatment

A

histamine H2-blocking for occasional GERD

proton pump inhibitors [PPI] for chronic GERD

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11
Q

GastroEsophageal Reflux Disease [GERD]

complications

A
  • Barrett esophagus
  • ulceration/fibrotic scarring
  • esophageal strictures
  • pilmonary symptoms
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12
Q

Barrett esophagus

A

columnar tissue replaces norm squamous epithelium of distal esophagus
-carries risk for esophageal cancer

complication of GERD

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13
Q

Gastritis

A

inflammation of stomach lining

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14
Q

Acute Gastritis

A

precipitated by ingestion of irritating substances

—alcohol + aspirin, NSAIDs, viral, bacterial, autoimmune

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15
Q

Chronic Gastritis

A

peptic ulcer>gastriic adenocarcinoma

-decr intrinsic factor>decr HCl acid

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16
Q

most common cause of chronic gastritis

A

Helicobacter Pylori

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17
Q

diseases of inflammation of stomach + intestines

A

1 acute gastritis
2 chronic gastritis
3 peptic ulcer disease

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18
Q

Peptic Ulcer Disease

A

disorder of upper GI tract caused by action of ACID + PEPSIN

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19
Q

Peptic Ulcer Disease

cause

A
  • no relation w diet
  • NSAID, stress/GLUCOCORTICOIDS, smoking, generics
  • H.pylori
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20
Q

H. pylori

A

promotes gastric + duodenal ulcer formation

  • thrives in acidic conditions
  • clearance of H pylori promotes ulcer healing
  • common cause of chronic gastritis + peptic ulcer disease
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21
Q

pain of ____ typically occurs on an empty stomach but may present soon after a meal

A

GASTRIC ULCERS

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22
Q

pain of ____ classically occurs 2-3 hrs after a meal and is relieved by further food ingestion

A

DUODENAL ULCER

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23
Q

Peptic Ulcer Disease

diagnosis

A

gastric ulcers should be visualized w ENDOSCOPY + BIOPSY to rule out malignancy

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24
Q

Peptic Ulcer Disease

treatment

A
  • reduce gastric acidity
  • H.pylori antibiotics
  • H2 antagonist
  • PPI
  • sucralfate
  • smoking cessation
  • avoidance of ASA + NSAID
  • stress reduction
  • avoid irritating foods (caffeine,alcohol)
25
Q

inflammatory bowel diseases

A

1 Ulcerative Colitis

2 Crohn Diseased

26
Q

Ulcerative Colitis

A

chronic inflammatory disease of MUCOSA of rectum + colon (lower end)

-assoc w incr cancer risk

27
Q

Ulcerative Colitis

s/s

A

bloody diarrhea + lower abdominal pain

28
Q

Ulcerative Colitis

treatment

A
  • corticosteroid
  • broad spect antibiotic
  • salicylate analog
  • immunomodulating agents (azarthioprine + mercaptopurine)
  • IV followed by oral cyclosporine for refractory
  • Infliximab (remicade)
29
Q

Crohn Disease

A

affects all layers of intestinal wall of the proximal portion of the colon or terminal ileum

30
Q

Crohn Disease

s/s

A
  • interminent fevers
  • diarrhea (may be blood but not as severe as ulcerative colitis)
  • chronic RLQ pain
  • RLQ mass/tenderness
31
Q

Enterocolitis Disorders

A

1 Antibiotic-Associated Colitis
2 Appendicitis
3 Diverticular Disease

32
Q

Antibiotic-Associated Colitis aka Pseudomembranous Enterocolitis

A

acute inflammation + necrosis of lrg intestines

33
Q

Antibiotic-Associated Colitis aka Pseudomembranous Enterocolitis

cause

A

Clostridium difficile

34
Q

Antibiotic-Associated Colitis aka Pseudomembranous Enterocolitis

s/s

A 
diarrhea (often bloody)
abdominal pain
fever
leukocytosis
sepsis
colonic perforation
35
Q

Antibiotic-Associated Colitis aka Pseudomembranous Enterocolitis

diagnosis

A

HISTORY IS CRITICAL

36
Q

Antibiotic-Associated Colitis aka Pseudomembranous Enterocolitis

treatment

A
  • stop current antibiotic
  • treat ischemia
  • treat contributing conditions
  • oral antibiotics: metronidazole or vancomycin
  • recurrence common
  • rare: fecal transplant
37
Q

Appendicitis

A

inflammation of the vermiform appendix

-obstruction by a fecalith

38
Q

Appendicitis

s/s

A
  • RLQ pain “McBurney’s Point”
  • rebound tenderness
  • n/v
  • fever
  • diarrhea
39
Q

Appendicitis

treatment

A
  • immediate surgical removal

- antibiotics w fluid/electrolyte replacement

40
Q

Motility Disorders

A

1 Irritable Bowel Syndrome
2 Volvolus
3 Intussusception

41
Q

Irritable Bowel Syndrome

A

alternating diarrhea + constipation

  • accompanied by abdominal cramping pain
  • no ID pathologic process in GI tract
42
Q

Irritable Bowel Syndrome aka

A

Spastic Colitis

Irritable Colon Syndrome

43
Q

Irritable Bowel Syndrome

s/s

A
  • diarrhea/constipation
  • —or alternating pattern of both
  • abdomincal pain
  • mucus in stool
  • nasusea
44
Q

Volvulus

A

twisting of bowel on itself causing intestinal obstruction + blood vessel compression (ISCHEMIA)

45
Q

Motility Disorders

A

1 Intussusception

2 Celiac Disease

46
Q

Intussusception

A

telescoping/invagination of a portion of bowel into adjacent bowel causing intestinal obstruction

  • most often in infants
  • more often in males more than females
47
Q

Celiac Disease

A

-malabsorption disorder

familial intolerance of gluten-containing foods leading to inflammation and atrophy of the intestinal villi

48
Q

Celiac Disease

treatment

A
  • gluten-free diet
  • supplemental Fe, folate, B12
  • fat soluble vitamins (A,D,E,K)
  • oral corticosteroids or other immunomodulating agents for refractory
49
Q

Neoplasms of GI Tract

A 
1 Esophageal Cancer
2 Gastric Carcinoma
3 Small Intestinal Neoplasms
4 Colonic polyps
5 Colon Cancer
50
Q

Neoplasms of GI Tract

A 
1 Esophageal Cancer
2 Gastric Carcinoma
3 Small Intestinal Neoplasms
4 Colonic polyps
5 Colon Cancer
51
Q

Esophageal Cancer

A

accounts for 1-2% of all cancer

  • men 3x more than women
  • poor prognosis
  • V high degree of metastasis
52
Q

Esophageal Cancer

risk factors

A
  • genetic
  • diet high in NITROSAMINE content
  • chronic severe reflux “BARRETT ESOPHAGUS”
  • environmental
  • smoking
  • alcohol
53
Q

Gastric Carcinoma

A
  • prevalence in Japan

- Men less than 30yrs

54
Q

Gastric Carcinoma

risk factors

A

H. pylowri

epstein barr virus

55
Q

Small Intestinal Neoplasms

A
  • benign or malignant
  • account for <5% GI tumors
  • 50 yrs or older
56
Q

Colonic Polyps

A
  • any protrusion into the GI lumen

- major precursor lesion in dvlpt of colon cancer

57
Q

Colon Cancer

A

-second only to lung cancer as a cause of cancer deaths

58
Q

Colon Cancer

risk factors

A
  • 40+ years old
  • high-fat, low-fiber diet
  • polyps
  • chronic irritation or inflammation
  • hereditary

Pathophysiology (32 decks)

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