chap 13 - GI tract Flashcards

Question

epigastric and umbilical hernia

Answer 1

found in infants

Answer 2

inflammation of the esophagus, main job is to get the bolus of food into the stomach can present with: - dysphagia - pain - bleeding - regurgitation of food into the trachea - choking and coughing

Answer 3

gastroesophageal reflux disease and laryngopharyngeal reflex

Answer 4

obesity, diet, bulimia, age (the spincter is less tight as you age), alcohol (loosens the sphincter), pregnancy (baby pushes on everything), laying down right after eating

Answer 5

acidity can break down and harm the esophagus

Answer 6

barrett's esophagus - metaplasia -- dysplasia => esophageal cancer

Answer 7

GERD = reflux more than two times a week heartburn is more acute

Answer 8

avoid foods that increase acidic reflux medications that reduce acid production - proton pump inhibitors = less hydrochloric acid, the pH goes up a little bit, less irritation to the esophagus avoid lying down after eating

Answer 9

Acute injury to gastric mucosa caused by agents that compromise the protective mucous barrier lying over the epithelial cells Inflammation of the stomach Causes lesions in the protective mucus that lines the stomach May be associated with bleeding symptoms: - nausea - vomiting - epigastric pain

Answer 10

acute and chronic

Answer 11

- non steroidal anti inflammatories - alcohol

Answer 12

autoimmune - Parietal cells - make the hydrochloric acid - Helicobacter Pylori - bacteria that infects the stomach and can lead to chronic gastritis

Answer 13

Most prevalent infectious agent worldwide Infections More Frequent With Age - we produce less hydrochloric acid Adapts to low pH of stomach - the pH level kills bacteria and helps to breakdown food Testing Antibodies detected in blood Breath test Stomach biopsy - endoscopy Risk Factor for: Ulcer - peptic ulcer just means an increase in the acid that causes irritation Stomach cancer

Answer 14

A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum Leading cause? H. Pylori

Answer 15

- Nausea - Vomiting - Gnawing or burning upper-abdominal pain - Weight loss with decreased caloric intake

Answer 16

- Internal bleeding - Anemia (what kind?) iron-deficiency anemia - Penetration into the pancreas: acute pancreatitis - Perforation leading to infection, peritonitis

Answer 17

antibiotics revolves around: - Decreasing acid secretion - Eliminating cofactors that led to development of ulcers - test for h. Pylori, if not there then what else could have caused it? NSAIDS taken on an empty stomach? - Recurrences are common - Some patients require surgical intervention

Answer 18

Failure to digest and/or absorb food Caused by disease processes that impair enzyme activity and absorption of nutrients across the gastrointestinal epithelium

Answer 19

Lactase deficiency Inflammatory bowel disease Pancreatic insufficiency Pancreatic Enzymes Bile salt deficiency Celiac Disease

Answer 20

malabsorption - Deficiency of lactase - enzyme that breaks down lactose - Needs to be broken down into galactose and glucose and then those can be absorbed into the GI tract - Brush boarder enzyme - right on the microvilli of the intestine - Lactose stays and then moves into the large intestine → the bacteria will metabolize the lactose and ferment it which draws water into the large intestine which leads to diarrhea - Symptoms: bloating, diarrhea, GI tract upset - Treatment? Cut out dairy products (not the best option), oral enzyme supplements, or you can buy milk products meant for those who are lactose intolerant

Answer 21

malabsorption - Autoimmune disease - Allergy to gluten – Gluten? Protein that plants use (found in wheat, barley, and rye) - Affect villus of small intestine Symptoms - Abdominal pain, bloating, gas - Fat in stool - not absorbing the fat so it stays in the lumen - Weight loss - Malnutrition - Constipation - Treatment? Cut out gluten

Answer 22

inflammatory Causes - Pathogens - Virus Rotavirus = children Norovirus = adults Bacteria= less common, more severe E. coli Salmonella Campylobacter Can happen from food contamination, not washing your hands after handling meat, etc. Symptoms Diarrhea Vomiting What someone might call the stomach flu Leads to diarrhea = increase in volume of stool or frequency of defecation (3x/day) 2nd leading cause of death in children under 5

Answer 23

inflammatory Causes - Pathogens - Virus - Rotavirus = children - Norovirus = adults - Bacteria= less common, more severe - E. coli - Salmonella - Campylobacter - Can happen from food contamination, not washing your hands after handling meat, etc. Symptoms - Diarrhea - Vomiting - What someone might call the stomach flu - Leads to diarrhea = increase in volume of stool or frequency of defecation (3x/day) - 2nd leading cause of death in children under 5

Answer 24

- Appendix: hangs of the beginning of the large intestine, kind of part of the immune system, collection of white blood cells - More common in teenagers and young adults - Inflammation of the appendix - Medical Emergency - If it bursts all the bacteria of the large intestine is released into the abdominal cavity and can lead to sepsis - Possible causes - Infection,Obstruction Typical Presentation - Right Lower Quadrant Pain - Nausea - Vomiting - Fever Most serious complication is peritonitis - inflammation of the peritoneum (the membrane that lines the abdominal cavity)

Answer 25

crohn's disease and ulcerative colitis

Answer 26

- Episodic bloody diarrhea - Crampy abdominal pain - Inappropriate immune response - the immune system is causing the inflammation but it is not considered to be autoimmune - Family History - Peak Age 15-30 - Involvement of extraintestinal tissues - tissues that are outside of the small and large intestine

Answer 27

Anti-inflammatories Decrease activity of immune system Resection - last resort

Answer 28

Patchy - patches of inflammation not a whole segment Mouth to Anus Transmural = across the GI tract -- the mucosa, submucosa, etc. Risk Factors Caucasian Female Smokers

Answer 29

Limited to? Mucosa only - the inflammation does not go across the whole wall of the intestine Colitis = inflammation of the colon, only in the colon

Answer 30

- Small Pouches That Push out in weak spots in colon wall - outpouching - Found almost exclusively in sigmoid colon - Diverticulosis usually asymptomatic - If It Becomes Inflamed, diverticulitis - inflammation of diverticulosis - occurs mostly in the sigmoid colon Complications - Pain - Bleeding Abscess - Perforation

Answer 31

Inflammation of the peritoneum - membrane that lines the abdominal cavity Types Infectious usually due to bacteria from bowel due to perforation Sterile due to chemical irritation as when enzymes spill on peritoneum Could be from an ulcer that drips enzymes or chemicals from other organs onto the peritoneum Once healed, may produce adhesions - scar tissue on the intestine, adhesions don't allow the small intestines to slide against each other as much, lack of movement during digestion can become dangerous

Answer 32

usually due to bacteria from bowel due to perforation

Answer 33

due to chemical irritation as when enzymes spill on peritoneum Could be from an ulcer that drips enzymes or chemicals from other organs onto the peritoneum

Answer 34

GI tract cancers include cancers of the: Esophagus Stomach Small intestine Colon Anus Colon cancer accounts for the majority of GI tract cancers Typically aren't found till stage four

Answer 35

Arise From Epithelial - the epithelium that lines the esophagus Risk Factors: Tobacco use Alcohol use GERD Poor Prognosis Tends to invade & metastasize early - and you don't catch it in time, there isn't a screening test for esophageal cancer May present with dysphagia but this would be caught later

Answer 36

Worldwide as deadly as lung cancer (#1 in U.S) Epithelial tissue lining the stomach Risk factors H. pylori & chronic gastritis Diet high in smoked, pickled, or salt-preserved food Gastric cancer is highly prevalent in Japan because their diets are high in these food Diet low in fresh fruit & vegetables Usually asymptomatic until advanced

Answer 37

Tumors of small bowel are uncommon Most are premalignant Takes years to become fully malignant Most colon cancers are adenocarcinomas Make and release mucus One of the most curable cancers if detected early

Answer 38

Begins With Polyps On The Lining Of The colon Polyps are pre-malignant treatment Includes Radiation,chemotherapy, or surgery Survival Rates Vary Depending On Age, treatment response, stage of cancer diagnosis Risk Factors Age Family History History of Polyps High intake red meat IBD Manifestations Bleeding Blood in stool Altered bowel habits Diarrhea; constipation; or narrow, pencil-shaped stools Iron-deficiency anemia Diagnosis requires histologic confirmation

Answer 39

Occult blood test Not very sensitive but used over long periods of time has proven to be beneficial Colonoscopy Can reduce death rate by about 60% Recommended for those over 50 Cologuard test Detects genetic abnormalities in colonic epithelial cells shed in the stool

Answer 40

Failure of absorption process can be tolerated for a number of days Severe vomiting or diarrhea may prove fatal Most susceptible? Serious morbidity results from complications of disease process rather than from alterations of digestion and absorption Example, blood loss Surgical resection of large parts of the gut can be fairly well tolerated Requires change in food consumption Tube feedings can provide calories and nutrients Defecation can be mechanically circumvented with ileostomy or colostomy