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Pathophysiology > Alterations of Digestive Function 1 > Flashcards

Alterations of Digestive Function 1 Flashcards

1
Q

what is anorexia associated with?

A

a) nausea
b) abdominal pain and indigestion
c) diarrhea

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2
Q

what is vomiting a result of?

A

reverse peristalsis in duodenum/stomach

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3
Q

what is vomiting?

A

forceful contraction of abdominal mm.

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4
Q

what is vomiting usually preceded by?

A

by N/V

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5
Q

how is vomiting initiated?

A

a) various drugs
b) trauma or torsion to ovaries, testes, uterus, bladder, kidney, GI or brain
c) activation of medullary centre

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6
Q

what is constipation d/t?

A

a) personal habits
b) various disorders
c) drugs
d) inadequate fluid intake
e) mm. weakness

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7
Q

what may constipation lead to?

A

hard stools and difficult evacuations

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8
Q

what is fecal impaction?

A

retention of hardened stool in rectum or colon causing bowel obstruction

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9
Q

in which populations is fecal impaction more common in?

A

a) elderly
b) immobilized
c) prolonged bed rest

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10
Q

if a patient is experiencing fecal impaction, what is there usually a hx of?

A

watery diarrhea/fecal incontinence

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11
Q

a sigmoidoscope is used for what?

A

treating fecal impaction

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12
Q

what is large volume diarrhea d/t?

A

excessive water and/or secretions in intestines

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13
Q

what is small volume diarrhea d/t?

A

increase intestinal motility

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14
Q

what is parietal abdominal pain?

A

localized and intense

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15
Q

what is visceral abdominal pain?

A

diffuse and vague

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16
Q

what is visceral abdominal pain closely connected to?

A

ANS. will see pallor, sweating, N/V

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17
Q

what is referred abdominal pain?

A

well localized (more than parietal abdominal pain), felt in skin/deeper tissues

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18
Q

what is hematemesis?

A

bloody vomit.

can either be frank or coffee-ground in colour

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19
Q

what is melena?

A

tarry, foul-smelling stool d/t digested blood

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20
Q

what is hematochezia?

A

frank blood from rectum

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21
Q

what is occult blood?

A

trace amounts of blood in stool or gastric secretions (detected in lab)

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22
Q

what does acute severe GI bleeding cause?

A

HR/BP changes

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23
Q

what can happen if there is blood accumulation in the GI tract?

A

vomiting & diarrhea

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24
Q

what is dysphagia d/t?

A

a) lack of salivary glands
b) esophageal obstruction
c) neural or muscular disorders (impaired esophageal motility)

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25
Q

the term used to describe when the lower esophageal sphincter fails to relax is _______.

A

achalasia

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26
Q

what is a hiatal hernia?

A

protrusion of upper part of stomach INTO thoracic cavity through esophageal hiatus

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27
Q

which type of hiatal hernia is common and considered okay in asymptomatic patients?

A

sliding hiatal hernia

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28
Q

which type of hiatal hernia progressively enlarges and may lead to the entire stomach herniating into the thorax?

A

paraesophageal hernia

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29
Q

what can hiatal hernias lead to although often symptomatic?

A

a) GER
b) esophagitis
c) dysphagia
d) regurgitation

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30
Q

what is gastroesophageal reflux?

A

backwards movement of gastric contents into esophagus

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31
Q

what can GER lead to?

A

a) esophagitis
b) cancer
c) asthma attack
d) strictures
e) esophageal spasm
f) decreased esophageal motility

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32
Q

when does GER turn into GERD (gastroesophageal reflux disease)?

A

when regurgitation of chyme into esophagus becomes persistent

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33
Q

what can GERD lead to?

A

a) upper abdominal pain w/in 1 hour of eating

b) heartburn

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34
Q

how can symptoms of GERD worsen?

A

lying down or increased intra-abdominal pressure

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35
Q

what is GERD associated with?

A

a weak gastroesophageal sphincter

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36
Q

what is inflamed in gastritis?

A

gastric mucosa (usually superficial erosions)

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37
Q

what is acute gastritis d/t?

A

mucosal injury d/t drugs, chemicals or bacterial toxins

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38
Q

what erodes in acute gastritis?

A

surface epithelium in diffuse or localized patterns

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39
Q

list the manifestations of acute gastritis (3)

A
  1. vague abdominal discomfort
  2. epigastric tenderness
  3. bleeding (ocasional hematemesis)
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40
Q

in acute gastritis, inflammation is usually ____ and heals ______ w/in a few days.

A

in acute gastritis, inflammation is usually transient and heals spontaneously w/in a few days.

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41
Q

what is chronic gastritis?

A

a) thinning and degeneration of stomach lining
b) absence of visible erosions
c) presence of chronic inflammatory changes leading to atrophy of glandular epithelium

42
Q

which population does chronic gastritis usually affect?

A

the elderly

43
Q

list 3 signs of chronic gastritis

A
  1. anorexia
  2. nausea
  3. pain
44
Q

list causes of chronic gastritis (3)

A
  1. H. Pylori (most common)
  2. autoimmune
  3. chemicals (NSAIDs or secretions/bile)
45
Q

why does auto-digestion occur in peptic ulcer disease?

A

breaks/ulcerations (from pepsin and acid) exposes submucosal tissue to gastric secretions

46
Q

what type of ulcerations erode the mucosa but do not penetrate it?

A

superficial ulcerations/erosions

47
Q

what are true ulcers?

A

ulcers that extend through muscularis and damages blood vessesls

48
Q

why would an ulcer lead to the complication of bleeding?

A

because the ulcer has penetrated to the submucosa or deeper

49
Q

what can happen if slow bleeding occurs in PUD?

A

iron deficiency anemia

50
Q

why would an ulcer lead to the complication of perforation?

A

because the ulcer has extended through the entire stomach wall

51
Q

what else can happen if an ulcer perforates?

A

peritonitis

gastric juices enters the peritoneal cavity

52
Q

where do gastric ulcers usually occur?

A

antrum

53
Q

what age range do gastric ulcers usually occur?

A

55-65 years

54
Q

list the major causes of gastric ulcers (4)

A
  1. H. Pylori
  2. NSAIDs (decrease PGs)
  3. hyper/hyposecretion of acid/bicarbonate
  4. stress/chemicals
55
Q

describe the manifestation of gastric ulcers and how can one relieve this?

A

chronic intermittent pain (burning, gnawing, cramping) that occurs SHORTLY after meals
can be relieved by antacids

56
Q

how do gastric ulcers heal?

A

fibrosis w/in 6-8 weeks

57
Q

gastric ulcerations is an _______ condition

A

gastric ulcerations is an episodic condition

58
Q

do duodenal ulcers have more anorexia, vomiting, and weight loss than gastric ulcers?

A

no. gastric ulcers have more anorexia, vomiting, and weight loss.

59
Q

how is irritable bowel syndrome (IBS) characterized?

A

by persistent and recurrent intestinal manifestations in the absence of structural abnormalities

60
Q

list the manifestations of IBS (7)

A
  1. abdominal pain
  2. diarrhea/constipatino
  3. urgency
  4. bloating
  5. nausea
  6. anorexia
  7. anxiety
61
Q

what is the IBS hallmark?

A

abdominal pain that is relieved by defecation

62
Q

list the treatments for IBS (3)

A
  1. anti-diarrheals
  2. increase fibre
  3. probiotics
63
Q

name the 2 diseases classified under inflammatory bowel diseases

A
  1. ulcerative colitis

2. chron’s disease

64
Q

what is ulcerative colitis?

A

chronic inflammation of colon mucosa

65
Q

where do you typically see ulcerative colitis?

A

rectum and sigmoid colon

66
Q

describe ulcerative erosions

A

they are small erosions that form in the mucosal layer. they can merge to form ulcers that bleed and become necrotic.

67
Q

what are pseudopolyps?

A

ulcerated tissue separated by islands of raise, inflamed mucosa

68
Q

what likes between pseudopolyps?

A

the only remaining muscularis

69
Q

in ulcerative colitis, what happens to the lumen?

A

edema and thickening of muscularis narrows it

70
Q

what will a patient w/ ulcerative colitis experience?

A

frequent diarrhea (large volume) w/ passage of small amounts of blood, purulent mucous and cramping

71
Q

what happens if the entire colon is suffering from ulcerative colitis?

A

a) fever
b) increased pulse rate
c) urgency
d) frequent, bloody diarrhea
e) continuous crampy pain

72
Q

name the treatments used for ulcerative colitis?

A
  1. avoid caffeine, lactose, spicy or gas-forming food
  2. increase fibre intake
  3. anti-inflammatories
  4. immunosuppressive drugs
  5. surgical resection/colostomy (if other therapies fail)
73
Q

does UC increase risk of colon cancer?

A

yes

74
Q

what is chron’s disease and what does it affect?

A

it is recurrent granulomatous inflammation that beings in submucosa w/ hyperemia.
it affects the distal 10-20 cm of ileum, rarely affects colon

75
Q

in chron’s disease, what do you call portions of the bowel that are unaffected?

A

skip lesions

76
Q

name the IBD that has a greater familial predisposition

A

chron’s disease

77
Q

what can happen to the ileum?

A

WBC infiltration -> fibrosis -> rigidity like a lead pipe

78
Q

manifestations of chron’s disease

A
  1. weight loss
  2. lower abdominal pain
  3. malaise
  4. low grade fever
79
Q

what can happen if the ileum is involved in chron’s disease?

A

anemia d/t malabsorption of vitamin B12

80
Q

what is infectious enterocolitis?

A

infection to the small or large intestine that leads to inflammation

81
Q

how does infectious enterocolitis commonly manifest?

A

rapidly w/ low grade fever, vomiting, abdominal pain, and watery diarrhea

82
Q

name the virus that can cause infectious enterocolitis

A

norwalk virus

83
Q

name the bacteria that can cause infectious enterocolitis

A
  1. staph
  2. salmonella
  3. c. diff
  4. e. coli
84
Q

how does c diff proliferate?

A

when broad-sprectrum antibiotics wipe out mucosal bacteria

85
Q

what does e. coli do?

A

produces toxins that lead to local inflammation (diarrhea), damage the kidneys and other structures if systemic

86
Q

what is diverticular disease?

A

multiple herniations of mucosa through muscularis externa

87
Q

where do you see diverticular disease usually?

A

sigmoid colon

88
Q

describe the surface of the colon suffering from diverticular disease

A

hyperemic

89
Q

what can happen to the erosion from the stool in the diverticula?

A

it can become inflamed and hemorrhage

90
Q

in which population is diverticular disease most common?

A

in the elderly and young people w/ low dietary fibre

91
Q

what is inflammation of diverticula usually d/t?

A

infection from an accumulation of fecal matter

92
Q

when not asymptomatic, what symptoms will you see with diverticular disease?

A
  1. cramping
  2. distension
  3. constipation
  4. flatulence
93
Q

how can you relieve diverticular disease?

A

from increasing dietary fibre

94
Q

what will you observe if inflammation occurs in diverticular disease?

A
  1. LLQ pain

2. rectal bleeding

95
Q

how do you treat diverticular disease?

A
  1. antibiotics

2. bowel rest

96
Q

fecalith, tumour and foreign bodies all can cause _____ by?

A

appendicitis by obstructing lumen of appendix resulting in bacterial infection or torsion

97
Q

manifestations of acute appendicitis

A
  1. gastric/periumbilical pain of incresing intensity over 2-12 hrs –> pain will focus in the RLQ once serosa is involved
98
Q

name the complications of appendicitis

A
  1. abcess formation

2. gangrene -> performation -> peritonitis

99
Q

how can an intestinal obstruction occur?

A

by any condition that prevent normal flow of chyme through intestinal lumen

100
Q

types of intestinal obstructions

A
  1. simple (mechanical blockage by lesion or motility issue)
  2. acute or chronic
  3. intrinsic
  4. extrinsic
101
Q

list 4 major causes of intestinal obstruction

A
  1. herniation
  2. adhesion
  3. intussusception
  4. volvulus
102
Q

clinical manifestations of intestinal obstruction

A
  1. intermittent pain with peristalsis
  2. constipation w/ peristaltic noises
  3. sweating
  4. N/V
  5. abdominal distention

Pathophysiology (2 decks)

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