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ALU 201 > Chapter 1 > Flashcards

Chapter 1 Flashcards

1
Q

define digestion

A

the breakdown and absorption of nutrients, electrolytes and water

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2
Q

Name two methods of digestion

A

mechanical and chemical

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3
Q

where does the initial site of digestion occur?

A

the mouth

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4
Q

How does food move through the digestive system.

A
  1. gravity,

2. peristalsis

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5
Q

What is another name for the gastroesophageal junction (GE junction)

A

Z-line, d/t zig zag appearance

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6
Q

What is the major function of the stomach

A

mechanical grinding of the food bolus, and to enhance the chemnical process of digestion.

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7
Q

What are the 2 enzymes found in the stomach that digest food and the one protein produced that aids in the absorption of vit B12

A

Hydrochloric acid (HCL)
pepsin
—————————————
Intrinsic factor

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8
Q

What is the name of the muscular chanel between the stomach and the duodenum

A

pylorus

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9
Q

Name the common opening that empties the digestive enzymes produced by the pancreas and bile from the liver.m into the duodenum

A

ampulla or papilla of vater

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10
Q

what food component is broken down in the duodenum?

A

proteins, carbohydrates and fats. This is done by the bile/enzyme mixture along with locally-produced pH neutralizing bicarbonate.

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11
Q

Name the 3 parts of the small intestine

A

duodenum, jejunum, illium

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12
Q

what do you call the projections of mucosa that absorb nutrients?

A

villi.

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13
Q

What is the name of the valve that seperates the sillium and the cecum?

A

ileocecal valve

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14
Q

What are the major funcitons of the large intestine?

A
  1. to reabsorb water and electrolytes secreted by the small intestine
  2. control elimination of the digestive water materia
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15
Q

The large bowel contains bacteria for what purpose?

A

to aid in the production of Vit K.

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16
Q

Oral cancer is usually found in what form?

A

Squamous cell carcinoma.

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17
Q

Name some systemic diseases that have associated oral lesions

A
  1. apthous ulcers- associated with crohns and systemic lupis

2. thrush associated with AIDS or inhaling steroids

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18
Q

Esophageal disorders can occur as a results of what?

A
  1. primary esophageal motor abN
  2. CNS diseases
  3. strictures
  4. masses.
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19
Q

What is dysphagia?

A

difficulty swallowing

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20
Q

what is pain associated with dysphagia

A

odynophagia, described as retrosternal and occurs while swallowing.

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21
Q

what is esophageal manometry

A

pressure monitoring of the esophagus

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22
Q

How would you determine/diagnose an esophageal disease?

A
  1. dx through esophageal manometry and barium x-ray studies
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23
Q

What is a typical tx for dysphagia

A
  1. promotility medication metoclopramide
  2. antisoasmodic agents
  3. nitroglycerin.
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24
Q

how would you dilate the esophagus?

A

use of fiberoptic intrusments (endoscopes)

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25
Q

What is Achalasia, how is it tx’ed?

A

failure of the lower esophageal sphincter to relax- tx’ed with endoscopic ballon dilation/surgery

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26
Q

When does GERD occur?

A

idiopathically

associated with hiatal hernia

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27
Q

What is the medical term for heartburn?

A

pyrosis

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28
Q

Chronic inflammation of the esophagus can lead to what?

A

normal > suqamous mucosa > glandular gastric mucosa – metaplasia—-> intestinal cells. Also called barrett’s esophagus.

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29
Q

How is Barrett’s esophagus diagnosis confirmed?

A

visual: pink mucus appearance of what should be white

biopsy

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30
Q

How can Barrett’s Esophagus be tx’ed?

A 
endoscopic therapy (radifrequency ablation + photodynamic therapy) 
- surveillance is required.
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31
Q

How is GERD tx’ed?

A
  1. diet
  2. timing of indigestion (prior to reclining)
  3. raising the head of the bed
  4. weight loss
  5. medication
  6. surgery
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32
Q

What is the name of the surgery they use to tx GERD

A

they wrap the lower esophagus around the stomach- Nissan fundoplication- performed by laparoscope.

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33
Q

Esophageal cancer is usually found in which two forms?

A

Squamous cell carcinoma

adenocacinoma- associated with B.E

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34
Q

What is a hiatal hernia and how is it detected?

A

> when the stomach pushes up through the diaphragm into the chest.
X-rays or endoscopies

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35
Q

Name two types of hiatal hernias

A
  1. Sliding or axial hiatal hernia

2. paraesophageal hernia.

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36
Q

What is a common cause of gastric and duodenal inflammation and ulceration?

A

NSAIDS use.
alcohol
cigarettes (inhibits healing)
gastric cancer

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37
Q

What is the main complication of inflammation and ulceration of the stomach and duodenum, and how is it detected??

A

bleeding and perforation.

endoscopies or xray

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38
Q

How do you treat gastritis, duodenitis, and ulcer disease?

A

medications used to reduce acid content of the stomach.

- antacids, H2blockers, proton pump inhibitors.

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39
Q

What is H. Pylori, how is it detected and how is it treated?

A

Bacterium
biopsy or serum antibody testing, stool testing, breath test
antibiotics

40
Q

What does H pylori cause?

A

atrophy of stomach lining
^ risk of adenocarcinoma
MALT lymphoma ( tumor)

41
Q

what is pancreatitis, and how is it dx?

A

inflammation of the pancreas

serum amuylase and lipase levels, or imaging studies

42
Q

What causes pancreatitis?

A 
alcohol
blockage by gallstomes
Rx
infection
autoimmune disease
hypertriglyceridemia 
idiopathy
43
Q

What is pseudocyst?

A

cyst like mass in the pancrease

44
Q

chronic pancreatitis can lead to what?

A

diabetes and inadequate digestive enzyme productions.

tx’ed with insulin /digestive enzyme pills

45
Q

What is the most common tumor of the pancreas?

A

pancreatic adenocarcinoma

high mortality rate

46
Q

What are the 3 most common endocrine tumors and sxs?

A
  1. gastrinomas (Zollinger-Ellison synfrome)- ulcers
  2. insulinomas- hypoglycemia
  3. VIPomas- watery diarrhea
47
Q

How can you determine the nature of a pancreatic cystic lesion? (ie is is malignant?)

A

ERCP
CT
MRI
biopsy

48
Q

Blockage of the bile flow into the duodenum by tumors, stones or strictures interfere with the absorption of what?

A

fats and fat-soluble vits

49
Q

What is a common example of a mild form of insufficient intestinal enzyme production?

A

lactase deficiency, causing inability to digest the milk sugar, lactose

50
Q

What can cause the Blunting of the villous surface of the small intestine?

A

infection (viral or bacterial gastroenteritis) or an immune or allergen-mediated destruction, such as celiac sprue.

51
Q

What are some physiological symptoms of malabsorption?

A 
bloating
diarrgea
weight loss
abdo pain
anemia
low serum albumin
osteoporosis
Vit Dif. sxs
52
Q

What are some tx options for celiac sprue?

A

often gluten free diet, but also may need steroids.

53
Q

What is another name for crohns, and what part of the colon does it affect?

A
  1. granulomatous or regional enteritis

2. distal 3rd of the small intestine- ileum and colon.

54
Q

What part of the colon is affected by U.C?

A

large intestine

55
Q

What is difference between crohns and uc besides size

A
  1. crohns is non-continuous pattern- skip lesions

2. UC always involves recum and is continuous until some part of the lare intestine

56
Q

Crohns affects which layers of the bowel?

A

All, and can be complicated by strictures, fistulas and absecess

57
Q

UC affects which layers of the bowel?

A

mucosa.

58
Q

Which disorder Crohns or UC reveals micoscopic granulomas

A

crohns

59
Q

UC that is limited to 15 cm up and 25 cm up is called what?

A

Ulcerative proctitis

ulcerative proctosigmoiditis

60
Q

How often should people with 10 yrs of crohns or UC be getting c-scopes

A

1-2 yrs, and getting random biopsies

61
Q

How do you tx crohns?

A

Put them in remission

  1. abx
  2. steroids
  3. immunosuppressive agents
  4. sulfasalazines
62
Q

How do you tx UC

A

1/ abx
2. sulfasalazines or derivatives
3. steroids
Sulfasalazine if often used to maintain remission and prevent relapse

63
Q

What are DMARS?

A

biologic-disease modifying agents. New drug used to avoid prolonged used of steroids/
they gave an increase risk of infection and lymphoma.
they are IV or injected

64
Q

What is an ileostomy?

A

procedure that connects the terminal ileum to an opening in the skin in the right Lower quadrant of the abdo with an external bag to collect the fluid.

65
Q

What is ileoanal anastomosis?

A

procedure that attaches the ileum to the anus with the creation of an internal pouch.

66
Q

What is pouchitis?

A

complication of ileo-surgery which is inflammation of the about- and can be refractory to tx

67
Q

Crohns disease mortality is associated with what?

A

bleeding,
malabsorption
complications of the Rx used
late cancer risk (increases with depth of disease and yrs had)
obstructive + infectious and surgical complications

68
Q

What are the mortality risks associated with UC?

A

bleeding
acute dilation (toxic megacolon)
perforation of colon
-increased risk of cancer

69
Q

What are some extra intestinal complications associated with crohns and UC?

A 
ankylosing spondylitits
arthritis 
orotos
pyoderma gangernosum
eruthema nodosum
^ LFTS
70
Q

What is the name of the disease where bile ducts throughout the liver become scarred and narrows causing obstruction of bile flow? its detected by abN Alk phos and GGT.

A

PSC

primary sclerosing cholangitis

71
Q

What is IBS, and what are the sxs

A

disorder of the motor function of the gastrointestinal tract, creating spasm and pain.
diarrhea, abdo pain, constipathion

72
Q

how is IBS dx’ed and what are the tx?

A

usually by exclusion, based on hx and absence of findings on endoscopic or xray test.
fiber products, antispasmodics, antidiarrhheal agents, and anticonstipation agents

73
Q

is mortality affected by IBS?

A

no but there are sig morbidity issues.

74
Q

What do you call a polyp that is broad-based and on that is on a stalk?

A

sessile

pedunculated

75
Q

Name 3 kinds of pre-malignant adenoma polyps

A

tubular adenomas
villous adenoma
tubulovillous adenomas

76
Q

What do you call a benign polyp with no malignancy potential- 3 names

A

hyperplastic
inflammatory
juvenile polyps

77
Q

How do you tx polyps?

A

polypectomy. Preformed during a c-scope

78
Q

What is the average age for colonoscopic screening

A

50 in average risk
40 in increase risk
repeat every 3-5 yrs with premalignant polyps or 10 o/w

79
Q

What is a CT colonography. And name 4 other less sensititve methods of screening

A

a noninvasive , readiographic technique for a colon screening. its not as reliable,
FIT, occult blood, barium enema, flex sigmoidoscopy, and DNA of Stool

80
Q

What are diverticula

A

out pouchings of the colon. (L side usually)

81
Q

When diverticulosis presents with sxs, it does so in which two ways?

A
  1. lower intestinal hemorrhage

2. diverticulitis

82
Q

What is diverticulitis and what are the sxs and tx?

A
  1. when diverticula become inflamed or infected.
  2. abdo pain and fever.
  3. without perforation just rest and abs o/w surgery
83
Q

What would prompt an evaluation for small volume gartrointestinal bleeding?

A
  1. Fe deficient anemia on CBC

2. microscopic quantities of blood detected through Hemoccult cards.

84
Q

What are some causes for slow gastrointestinal bleeding?

A
  1. esophagitis
  2. gastritis
  3. duodenitis
  4. IBD
  5. vascular abN6. gastric and duodenal ulcers
  6. malignant and benign tumors throughout GI tract.
85
Q

What are hemmorhoids

A

dilations of the rectal veins

86
Q

What other sxs would be present with Large volume acute GI blood loss of the upper GI ?

A

usually presents with vomiting of blood (hematemesis) and or melena (black tinny stools)

87
Q

What are the most common sources of large volume upper GI bleeding?

A
  1. esophageal varices
  2. ulcers
  3. severe gastritis
  4. Mallory Weiss tear
88
Q

What other sxs would be present with large volume acute GI blood loss of the lower GI

A

bright red blood per rectum, (hematochezia)- caused by

  1. diverticulosis
  2. AVMS
  3. polyps
  4. cancer
89
Q

What is the impairment of concern in view of its high incidence and high mortalitiy risk in terms of GI bleedin of Older vs younger age groups?

A
  1. older cancer

2. inflammation

90
Q

What are the most common weight loss surgery operations?

A
  1. gastric bypass
  2. sleeve gastrectomy
  3. adjustable gastric band
91
Q

what is gasrtric bypass?

A

dividing the stomach so that a smaller reservoir is created and connecting it to a part of the small intestine so that it empties further down the intestine.
- causes intended malabsorption

92
Q

What is sleeve gastectomy

A

removing the pouch-like portion of the stomach, creating a narrow “sleeve-like” shaped stomach

93
Q

What is lap ban?

A

a silicone ring that is placed around the outside of the upper stomach, connected to an injectable port that is placed under the skin. This allows for ban adjustments

94
Q

how long does it take to lose 60-120lbs following each of the bariatric surgeries? And what is the expected regain weight over time?

A

12-18 mo- gastric bypass and sleeve
24 mo with lap ban

10% regain

95
Q

What are some long term complications related to bariatric surgery?

A 
esophageal reflux
stenosis of anastromosis sites
ulceration and bleeding
Vit and Mineral deficiencies
intestinal obstructions

ALU 201 (16 decks)

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