3rd Midterm Study Guide: Gastrointestinal

Question 1

What is chemical esophagitis?

Answer 1

Irritants to squamous mucosa

Question 2

What is infectious esophagitis?

Answer 2

usually immunosuppressed (often Herpes, Candida, or Cytomegalovirus)

(Herpes = small ulcers)

Question 3

What are the characteristics of Cytomegalovirus?

Answer 3

• affects the entire GI tract
• Well circumscribed, superficial ulcers
• may be associated with irritable bowel disease
• most likely in glandular epithelium, endothelial cells

*elderly or immunocompromised

Question 4

What is Reflux Esophagitis?

Answer 4

Relaxation of gastroesophageal sphincter combined with reflux of gastric acid

Question 5

What are the symptoms of Reflux esophagitis?

Answer 5

Burning, excessive salivation, choking

Question 6

What are the aggravating factors of Reflux esophagitis?

Answer 6

obesity
pregnancy
alcohol and tobacco use
caffeine
nicotine

Question 7

What are treatments for Reflux esophagitis?

Answer 7

Antacids
H2 blockers
Proton Pump Inhibitors

*lose weight, stop smoking/drinking

Question 8

What are complications of untreated Reflux esophagitis?

Answer 8

Ulceration
Constrictures
Barrett Esophagus

Question 9

What is reactive (erosive) gastropathy induced by?

Answer 9

alcohol
NSAIDS
iron
stress
bile reflux

Question 10

What is acute injury (gastritis)?

Answer 10

asymptomatic with possible significant blood loss

Question 11

What is characteristic of acute peptic ulceration?

Answer 11

Nausea, Vomitting, NSAIDS, Stress

Question 12

What is characteristic of chronic gastritis?

Answer 12

• H. Pylori gastritis
• autoimmune gastritis
• peptic ulcer disease

Question 13

What is characteristic of H. pylori gastritis?

Answer 13

duodenal and pyloric ulcers; may lead to cancer

Question 14

What is characteristic of Peptic Ulcer disease?

Answer 14

• Caused by H. pylori or NSAIDS
• increased acid
• punched out ulcers- perforation and hemorrhage
• Can lead to gastric ulcer, dysplasia, and adenocarcinoma

*can treat H. pylori w/ antibiotics

Question 15

What is characteristic of gastric polyps?

Answer 15

• They are hyperplastic
• In response to gastric injury (around ulcers)
• May contain some dysplasia

Question 16

What is characteristic of gastric adenocarcinoma

Answer 16

• intestinal type form glands

- diffuse type have signet cell morphology

Question 17

What is characteristic of an Intestinal Obstruction?

Answer 17

Usually mechanical (80%) - hernia or postsurgical adhesions

Neoplasm and infarction (20%)

Hirschsprung disease

Question 18

What is characteristic of Hirschsprung disease?

Answer 18

• congenital defect/lack ganglia cells
  
  • can’t pass meconium
• missing ganglion cells to stimulate smooth muscles

Question 19

What are the 4 selected diarrheal diseases?

Answer 19

• Cilac Sprue
• Irritable Bowel Syndrome
• Infectious self-limiting colitis
• Pseudomembranous colitis

Question 20

What is characteristic of Celiac Sprue?

Answer 20

• Immune Mediated
• Triggered by gluten, metabolite causes tissue damage
• Blunts Villi
• Oral effects:
  - Enamel Defects
  - Delayed eruptions
  - Recurrent Aphthous Ulcers

Question 21

What is characteristic of Irritable Bowel Syndrome?

Answer 21

• Relapsing pain, bloating, constipation/diarrhea
• Diet, abnormal motility and stress are factors
• No Gross Microscopic Abnormalities

Question 22

What is characteristic of Infectious Self-limiting Colitis?

Answer 22

Caused by microorganisms such as salmonella, E.coli

Question 23

What is characteristic of Pseudomembranous Colitis?

Answer 23

• Usually caused by C. Dificil (hard to kill)
• Spread person to person
• Often follows antibiotic therapy
• MOST Common nosocomial infection in older adults
• Toxin causes pseudomembranous formation, fluid secretions and ulceration.
• 50% of neonates are carriers

Question 24

What are the 2 Inflammatory Bowel Diseases?

Answer 24

• Crohn’s Disease

- Ulcerative Colitis

Question 25

What is characteristic of Crohn’s Disease?

Answer 25

• Similar to Ulcerative Colitis
• It has skipped areas that are non-lesioned and has intermediate strictures.
• Granulomas
• Fistulas and perianal disease
• Also affects upper GI, but mostly lower GI
• Can lead to cancer
• Transmural lesions

Question 26

What is characteristic of ulcerative colitis?

Answer 26

• More continuous, especially in the colon and no strictures.
• More Superficial

Question 27

What is characteristic of a colon polyp?

Answer 27

• Hyperplastic polyps = no malignancy

- Adenoma = may become malignant

Question 28

What is characteristic of Invasive Colonic Adenocarcinoma?

Answer 28

• 15% cancer death in U.S.
• Dietary Factor
  
  • Low vegetable Soluble Fiber
  • High fat/carbohydrate diet
• Depth of invasion and lymph node involvement are prognostic