Chapter 37

Question 1

what is the job of the bowel?

Answer 1

to digest food (involves a corrosive solution and potentially pathogenic bacteria). to absorb the food into the blood while keeping the corrosive substances and the bacteria inside the gut. to keep the solution moving down the bowel at the right rate for digestion and absorption.

Question 2

difficulty swallowing is also called

Answer 2

dysphagia

Question 3

dysphagia has to do with weakness of ________ and problems with _______.

Answer 3

weakness of muscles that propel and problems with lower esophegal sphinter

Question 4

GERD occurs when

Answer 4

weak or incompetent sphincter

Question 5

manifestations of GERD

Answer 5

• heartburn/pain in epigastric that may radiate to throat, shoulder or back.
• regurgitation of chyme
• mid -epigastric pain within 1 hour of eating

Question 6

mucosal injury of GERD

Answer 6

edema, inflammation and erosion of mucosal esophagus

Question 7

major causes of irriation and ulcer formation

Answer 7

1. aspirin and NSAIDS

2. infection with H. pylori

Question 8

why do aspirin and NSAIDS cause gastric and ulcer formation?

Answer 8

irritate the gastric mucosa and inhibit prostaglandin synthesis.

Question 9

H. pylori thrives in

Answer 9

an acid enviornment of the stomach

Question 10

H. pylori disrupts

Answer 10

the mucosal barrier that protects the stomach from harmful effects of its digestive enzymes.

Question 11

inflammation and sometimes hemmorhage of the stomach

Answer 11

acute gastritis

Question 12

the common causes of acute gastritis are

Answer 12

• NSAIDS
• alcohol
• bacterial toxins
• cortioscsteriods
• chemo drugs

Question 13

related to inflammtory changes. no gross erioson (spotty erosion r/t inflammation)

Answer 13

chronic gastritis

Question 14

a big cause of chronic gastritis is

Answer 14

h. pylori bacteria

Question 15

toxins and enzymes that promote inflammation and ulceration by interfering with gastric mucosa allowing acid to damage and may cause gastric atrophy and cancers

Answer 15

h. pylori bacteria

Question 16

major cause of ulcers is

Answer 16

h. pylori

Question 17

most common place peptic ulcer disease is found

Answer 17

duodenum

Question 18

peptic ulcer disease is the

Answer 18

damage/erosion to the gastric mucosa

Question 19

what are the contributors to peptic ulcer disease?

Answer 19

• h. pylori
• aspirin/NSAIDS
• family history
• age
• cigarette smoking
• warfarin

Question 20

list the complications of PUD

Answer 20

scar tissue

Question 21

repeated episodes of PUD cause

Answer 21

• hemmorhage, perfortation, pentretation, gastric outlet obstruction, edema and spasms

Question 22

a peptic ulcer that is related to severe illness, neural injury, or systemic trauma

Answer 22

stress ulcer

Question 23

ulcer within hours of a trauma, burns or sepsis

Answer 23

ischemic ulcers

Question 24

ulcers that develop as a result of head/brain injury

Answer 24

cushing ulcers

Question 25

risk factors for developmental of stress ulcers

Answer 25

large surface area burns, trauma, sepsis, acute respiratory distress syndrome, severe liver failure, major surgical procedures, zollinger-ellison syndrome.

Question 26

chronic, relapsing inflammatory bowel disorders of unknown origin

Answer 26

inflammatory bowel diseases

Question 27

inflammatory bowel diseases are caused by

Answer 27

• genetics
• alterations of epithelial barrier functions
• immune reactions to intestinal flora
• abnormal T cell responses

Question 28

two types of inflammatory bowel diseases

Answer 28

crohn’s and ulceritiave colitis

Question 29

idiopathic inflammatory disorder. causes skip lesions anywhere in GI tract. difficult to differeniate from ulceratitive collitis

Answer 29

crohn’s disease

Question 30

chronic nonspecific inflammatory disease that cause ulceration of the colonic mucosa.

Answer 30

ulcerative colitis

Question 31

symptoms of ulcerative colitis

Answer 31

diarrhea, bloody stools and cramping

Question 32

outpouchings of the mucous membranes. lower left quadrant pain. fever and elevated WBC. unknown cause

Answer 32

diverticular disease

Question 33

simple obstruction =

Answer 33

no alteration in blood flow

Question 34

strangulated obstruction =

Answer 34

impaired blood flow… necrosis of tissue

Question 35

impairment of peristalsis. common after abdominal surgrey, vascular insufficenies and electrolyte imbalances

Answer 35

paralytic obstruction

Question 36

what would both types of mechanical and paralytic obstruction look like?

Answer 36

abdominal distention. loss of fluids and electrolytes and accumulation of gases and fluids

Question 37

lactase deficiency means

Answer 37

unable to break down lactose into monosacchrides —> no lactose digestion and no monosacchride absorption

Question 38

fermentation of lactose by bacteria causes

Answer 38

gas and osmotic diarrhea

Question 39

with aging, we see a

Answer 39

decrease in gastric juice secretion, atrophy, loss of hepatic regeneration and may not metabolize drugs well.