Adult GI

Question 1

How long is the adult GI tract?

Answer 1

~30 feet

Question 2

What are the layers of the GI tract?

Answer 2

mucosa, submucosa, muscle, and serosa

Question 3

What are the 4 functions of the GI system?

Answer 3

Ingestion, Digestion, Absorption, and Elimination

Question 4

Where does digestion occur?

Answer 4

stomach, small intestine

Question 5

Where does absorption occur?

Answer 5

stomach, small intestines (primary)

Question 6

Where does elimination occur?

Answer 6

colon, anus

Question 7

What are different types of endoscopies?

Answer 7

EGD, Colonoscopy, ERCP, Video capsule

Question 8

What types of radiology diagnostic tests are done for GI issues?

Answer 8

CT, MRI, Nuclear medicine, ultrasound

Question 9

What system stimulates the GI system?

Answer 9

parasympathetic

Question 10

What are lab values that are related to GI function?

Answer 10

amylase, lipase, gastrin, AST, ALT, Alk Phos, Bilirubin, Albumin, Total protein

Question 11

What are 3 reasons that malnutrition may occur?

Answer 11

Starvation, chronic-disease related, acute disease/injury related

Question 12

What are s/s of malabsorption?

Answer 12

weight-loss, weakness, fatigue, anorexia, hypocalciemia, bone fx, muscle weakness/tenderness, ecchymosis, anemia (pernicious from lack of B12), steatorrhea, hypoalbuminemia, reduced muscle mass (including cardiac!)

Question 13

What things should be assessed when looking into a GI assessment?

Answer 13

Anthropometric Measurements
Physical Examination
Health History
Dietary History
Laboratory Studies
Functional Status

Question 14

What are some types of enteral nutrition?

Answer 14

G-tube, J-tube
NG, ND, NJ

Question 15

What are three things that obesity may contribute to?

Answer 15

DM2, CAD, and cancers

Question 16

Which systems does obesity effect?

Answer 16

all of them

Question 17

Who is affected by obesity?

Answer 17

all cultures, ethinicities, races, genders, ages, socioeconomic classes (the worst among the poor)

Question 18

What is the most common clinical manifestation of a GI disease?

Answer 18

nausea/vomiting

Question 19

What are some pharmacological txs for nausea/vomiting?

Answer 19

Anticholinergics, Antihistamines, Cannabinoids, 5-HT3 Agonists, Phenothiazines

Question 20

What is the most common upper GI problem?

Answer 20

GERD

Question 21

Where does enteral nutrition go?

Answer 21

Into the stomach

Question 22

What are factors that affect the esophageal sphincter?

Answer 22

ETOH, chocolate, medications, fatty food, nicotine, peppermint, tea/coffee

Question 23

What is required when parenteral nutrition is used?

Answer 23

bowel rest

Question 24

How is GERD diagnosed?

Answer 24

H&P exam, EGD, Barium Swallow, mobility studies

Question 25

How is GERD managed?

Answer 25

Identify & eliminate cause, stop eating 2 hours before bedtime, avoid acidic foods and drinks, lifestyle management, Meds (PPIs, H2 receptor blockers, antacids, prokinetic therapy), Endoscopic therapy, surgical therapy

Question 26

How many hours before bed should you stop eating if you have GERD?

Answer 26

2

Question 27

How often should blood glucose be taken when parenteral nutrition is being used?

Answer 27

4-6 hours

Question 28

What kind of medications can be used to treat GERD?

Answer 28

PPIs, H2 receptor blockers, antacids, prokinetic therapy

Question 29

When does TPN need to changed? And the tubing?

Answer 29

every 24 hours

Question 30

What is a hiatal hernia?

Answer 30

Herniation of part of the stomach above the diaphragm

Question 31

What is the most common upper GI problem found on X-ray?

Answer 31

hiatal hernia

Question 32

What is a sliding hiatal hernia?

Answer 32

top of stomach slides through when patient is supine and slides back down when patient is upright

Question 33

What is a paraesophageal or rolling hernia?

Answer 33

The fundus and greater curvature roll up through and form a pocket

Question 34

What type of hernia is a medical emergency?

Answer 34

acute paraesophageal

Question 35

What are the manifestations of a hiatal hernia?

Answer 35

similar to GERD

Question 36

Should a patient with GERD be lying down after a meal?

Answer 36

no

Question 37

How are hiatal hernias diagnosed?

Answer 37

barium swallow, EGD

Question 38

What is gastritis?

Answer 38

inflammation of gastric mucosa

Question 39

What kind of drugs are -prazoles?

Answer 39

PPIs

Question 40

What kind of drugs are -tadines?

Answer 40

h2 receptor blockers

Question 41

How is gastritis diagnosed?

Answer 41

H&P, drug and ETOH use, occ CBC and EGD

Question 42

What can cause hiatal hernias?

Answer 42

anything that is making the abdominal cavity larger

Question 43

When will someone with a gastric ulcer experience pain after eating?

Answer 43

1-2 hours after eating

Question 44

When will someone with duodenal peptic ulcers experience pain after eating?

Answer 44

2-5 hours after meals

Question 45

What kind of ulcers are common in women?

Answer 45

gastric peptic ulcers

Question 46

What causes 80% of gastric peptic ulcers?

Answer 46

h. pylori

Question 47

Are gastric peptic ulcers or duodenal peptic ulcers more common?

Answer 47

duodenal ulcers

Question 48

What is the second most common reason for a gastric peptic ulcer?

Answer 48

antacid use

Question 49

What is the management for gastric peptic ulcers?

Answer 49

Stop NSAIDS, ABX for H. pylori, ETOH & smoking cessation, eliminate coffee, Meds (H2 or PPI)

Question 50

Where can pain occur with duodenal ulcers that is not seen with gastric peptic ulcers?

Answer 50

back

Question 51

What is done to treat a hemorrhage/upper GI bleed?

Answer 51

EGD to cauterize bleed, meds/IVF to support pt, frequent vitals, blood products?

Question 52

What are the s/s of perforation?

Answer 52

sudden, severe upper abdominal pain, not relieved by rest or food, no bowel tones, septic shock

Question 53

Which chronic PUD complication is most lethal?

Answer 53

perforation

Question 54

If a patient presents with pain/discomfort in the upper abdomen that worsens as the day goes on, constipation, n/v, belching, anorexia, and dehydration, what may this patient have?

Answer 54

gastric outlet obstruction

Question 55

Why does a patient need to be NPO if there is a gastric outlet obstruction?

Answer 55

the bowels need to rest

Question 56

What is diarrhea defined as?

Answer 56

3 or more loose/liquid stools per day

Question 57

How can diarrhea be treated?

Answer 57

fluid/electrolyte support, nutrition support, antidiarrheal meds, fecal transplant for severe C-Diff

Question 58

what can constipation be a symptom of?

Answer 58

diverticulitis or bowel obstruction

Question 59

Why does constipation occur?

Answer 59

Too much water absorption

Question 60

How is constipation treated?

Answer 60

increase dietary fiber & water, limit low fiber foods, limit processed foods, increase exercise & activity, beware of laxatives (dependent)

Question 61

What are two types of IBD?

Answer 61

Crohn's and Ulcerative Colitis

Question 62

When does IBD typically occur?

Answer 62

at ages 15-30

Question 63

What organ does ulcerative colitis involve?

Answer 63

colon only

Question 64

Which organs does Crohn's disease involve?

Answer 64

colon or small intestine

Question 65

Who is at a higher risk for IBD?

Answer 65

white and ashkenazi jews, urban populations

Question 66

What kind of bowel movements does someone with Crohn's disease have?

Answer 66

Diarrhea without blood

Question 67

When does Crohn's and Ulcerative colitis typically have its onset?

Answer 67

teens-mid 30s and >60

Question 68

Where is Crohn's disease commonly found?

Answer 68

in distal ileum and colon

Question 69

What layer is ulcerative colitis involved in?

Answer 69

mucosal layer