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chapter 37 - disorders of gastrointestinal intestinal function Flashcards

1
Q

anorexia, nausea, and vomiting are __

A

common manifestations of the digestive system

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2
Q

__ (vomiting/talking/singing) is a sign of digestive orders or systemic infections, kidney failure, or emotional response

A

vomiting

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3
Q

match the vomit type with its correct description:
1. partial digestion of blood by the stomach (hematemesis)
2. contents from lower intestine; seen in pts with intestinal bowel obstruction
3. bile from duodenum
4. visible blood; something in the esophagus
5. after a meal; problem w/gastric emptying (pyloric obstruction)

a. frank blood
b. deep brown
c. yellow
d. brown coffee grounds
e. frequent vomiting

A
  1. d
  2. b
  3. c
  4. a
  5. e
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4
Q

what kinds of blood can you see in stool?

A

frank blood, melena, and occult blood

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5
Q

frank blood in stool

A

red; not digested and results from lesions in the rectum or anal canal

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6
Q

melena in stool

A

dark stool; bleeding in higher intestinal tract; blood is digested

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7
Q

occult blood in stool

A

not visible (blood); can be detected though

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8
Q

general s/s of dysphagia include:

A
  • pain in swallowing
  • inability to swallow large pieces of solids
  • difficulty swallowing liquids
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9
Q

achalasia
congenital atresia
stenosis
diverticulum
tumor

are all types of __ (vomitus/stool/dysphagia)

A

dysphagia

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10
Q

achalasia is __ (failure of lower esophageal sphincter to relax due to loss of nerve innervation/compression or blockage/ undigested food becomes trapped in a blind pouch)

A

failure of the lower esophageal sphincter to relax due to a loss of nerve innervation

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11
Q

congenital atresia is __ (failure of lower esophageal sphincter to relax due to loss of nerve innervation/upper and lower esophagus were not developed properly therefore needing surgical correction/ undigested food becomes trapped in a blind pouch

A

upper and lower esophagus are not developed properly therefore needing surgical correction

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12
Q

stenosis is the __ (narrowing of the esophagus which can be developmental of acquired defects/compression or blockage/ undigested food)

A

narrowing of the esophagus (developmental or acquired defects)

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13
Q

a pt complains that food is stuck in a blind pouch, has accumulated, fermented, broke down, and has caused them to have extreme bad breath. they have __ (diverticulum/stenosis/achalasia)

A

diverticulum

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14
Q

a __ (stenosis/tumor/congenital atresia) is a compression or blockage of the esophagus

A

tumor

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15
Q

when the stomach protrudes through the esophageal hiatus (region of the diaphragm that the esophagus goes through), this is called a __ (axial/paraesophageal/hiatal) hernia

A

hiatal hernia

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16
Q

a __ (axial/paraesophageal) hernia goes around the whole surface (esophageal hiatus)

A

axial

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17
Q

a __ (axial/paraesophageal) hernia goes around one side of the esophageal hiatus

A

paraesophageal

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18
Q

reflux is __ (backward flow of stomach acid into the esophagus/weak lower esophageal sphincter)

A

backward flow of stomach acid into the esophagus

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19
Q

gerd is __ (backward flow of stomach acid into esophagus/chronic/weaker lower esophageal sphincter and food (chyme) can easily move back into esophagus)

A

chronic; weaker lower esophageal sphincter; food can easily move back into esophagus

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20
Q

a pt feels some burning in her esophagus for about 30-60 mins after eating. when she bends over or lays down, it gets worse. she also has hoarseness in her voice. this disorder can cause intestinal metaplasia. what is it?

A

gerd (gastroesophageal reflux disorder)

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21
Q

barrett’s esophagus is caused by __

A

gerd

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22
Q

why is barrett’s esophagus a concern for pts’ health?

A

it can lead to adenocarcinoma, and if it continues, can lead to esophagus cancer due to the constant movement of acid into the esophagus

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23
Q

how would you treat gerd?

A
  • antacids
  • h2 receptor antagonists (histamine is a stimulant of parietal cells in the stomach)
  • proton pump inhibitors
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24
Q

__ (acute/chronic) gastritis has inflamed, red, and edematous gastric mucosa that may be ulcerative/bleeding –> transient and self limiting

A

acute

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25
Q

causes of acute gastritis include:

A

aspirin, nsaids, alcohol, chemotherapy, gastric radiation

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26
Q

these two things decrease the formation of mucin

A

aspirin and nsaids

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27
Q

this cause of acute gastritis is responsible for the increased release of gastric juices

A

alcohol

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28
Q

both __ and __ have activated cells that are decreased in acute gastritis

A

chemotherapy; gastric radiation

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29
Q

chronic inflammatory changes to mucosa and atrophy of the gastric mucosa with loss of secretory glands is considered __ (acute/chronic) gastritis

A

chronic

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30
Q

helicobacter pylori and autoimmune gastritis are the __ of chronic gastritis

A

types

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31
Q

__ is the main cause of chronic gastritis

A

helicobacter pylori

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32
Q

h pylori __ (produces substances - neutralizes stomach pH/auto antibodies against parietal cells and intrinsic factor)

A

produces substances - neutralize stomach pH

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33
Q

how do you treat h pylori?

A

with antibiotics and proton pump inhibitors, histamine (h2) receptor antagonist

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34
Q

autoimmune gastritis is __ (the most common gastritis/defect in acid secretion and vit b12 deficiency)

A

defect in acid secretion and vit b 12 deficiency

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35
Q

why do you see pernicious anemia in chronic gastritis?

A

autoimmune gastritis causes antibodies against intrinsic factor (absorption of vit b 12)

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36
Q

main causes of gastric ulcers are __

A

h pylori
aspirin
nsaids

37
Q

complications of gastric ulcers include:

A

bleeding
perforation
obstruction

38
Q

the treatment for gastric ulcers include:

A

getting rid of h pylori, avoiding nsaids, proton pump inhibitors

39
Q

to test for gastric ulcers, you can look for __ (frank/occult/yellow) blood in stool and hypochromic anemia (iron deficient anemia) as well as an __ and test for __

A

occult; endoscopy; h pylori

40
Q

__ disease affects mouth to anus, distal small intestine and proximal colon

41
Q

crohn’s disease affects the __ the most, but is transmural (all 4 layers affected)

42
Q

arthritis, inflammation of eyes/mouth, kidney stones, fistulas, gall stones, nutritional problems (lack of protein) –> inability to digest and absorb food, pain in lower right abdomen are all s/s of __

A

crohn’s disease

43
Q

crohn’s disease has no known cause because it is an __ disease

A

autoimmune

44
Q

both crohn’s disease and ulcerative colitis predisposes you to __

A

colorectal carcinoma

45
Q

__ can affect the large intestine or colon, descending and sigmoid colon

A

ulcerative colitis

46
Q

this inflammatory bowel disease can be seen in pt whose inflammation is confined to the mucosa and tissues bleed easily

A

ulcerative colitis

47
Q

this ibd also has no known cause because it is autoimmune and predisposes you to colorectal carcinoma

A

ulcerative colitis

48
Q

anti-inflammatory meds
anticholinergic meds (decrease intestinal motility)
nutritional supplements during acute episodes
antimicrobials
surgery: ileostomy or colostomy

are all treatments for __

49
Q

__ (ulcerative/clostridium difficile) colitis occurs when c-diff increases and binds to and damages mucosa layer –> inflammation and hemorrhage

50
Q

a pt can get c diff after antibiotic therapy because __

A

it makes the large intestine susceptible to c diff colonization

51
Q

c diff colitis occurs when __

A

normal flora balance in LI is disrupted

52
Q

c diff is usually acquired in __ (the hospital/at home/outside)

A

the hospital

53
Q

a pt has 1) diarrhea, 2) fever, 3) loss of appetite, 4) abdominal cramping 1-2 weeks after antibiotic therapy. what does the pt have?

A

c diff colitis

54
Q

the pt wants to know the treatment options for c diff colitis. what do you tell them?

A
  • stop antibiotic treatment
  • metronidazole and vancomycin
  • fecal transplant (fecal bacteriotherapy)
55
Q

diverticulitis is most commonly found in the __ (ascending/transverse/sigmoid) colon

56
Q

true or false. most people don’t have symptoms for diverticulitis.

57
Q

diverticulitis is __ in the pouches (diverticulum)

58
Q

diarrhea and cramping abdominal pain are symptoms of __

A

diverticulitis

59
Q

inflammation of the appendix is called __

A

appendicitis

60
Q

appendicitis is caused by: __, __, __, or __

A

fecalith; gall stones; twisting; spasms

61
Q

__ can lead to ischemia and necrosis –> gangrene

A

appendicitis

62
Q

a pt has 1) increased water in stool, 2) noninflammatory and inflammatory, and 3) osmotic and secretory. this is called __

63
Q

__ (acute/chronic) diarrhea is caused by infectious agent, self limiting (2 weeks)

64
Q

__ (inflammatory/noninflammatory) diarrhea is caused by a toxin that leads to large water volume, non-bloody, diarrhea

A

non-inflammatory

65
Q

a pt has a small volume of bloody diarrhea and a fever. do they inflammatory or non-inflammatory diarrhea?

A

inflammatory

66
Q

true or false. bacteria invade the intestinal wall and cause damage in inflammatory diarrhea

67
Q

the symptoms of chronic diarrhea can last __ (1-2 weeks/2-3 weeks/3-4 weeks) in children/adults and __ (2 weeks/3 weeks/4 weeks) in infants

A

2-3 weeks; 4 weeks

68
Q

this diarrhea is caused by hyperosmotic chyme: lactose intolerant and secretory diarrhea: increased intestinal secretions or w/excessive bile salts (present in SI)

69
Q

the __ is when chyme from the stomach is dumped into the SI too quickly bc of pyloric sphincter damage

A

dumping syndrome

70
Q

hyperosmolar chyme __ fluid out of vascular component

71
Q

hypovolemia results due to __ (fluid shift from blood to SI to dilute hypertonic chyme/digest and absorb food)

A

fluid shift form blood to SI to dilute hypertonic chyme

72
Q

hypovolemia can be detected by:

A
  • decreased bp
  • feeling faint, weak, or dizzy
  • tachycardia
  • pallor, diaphoresis
73
Q

distended intestine results from __

A

fluid shift

74
Q

s/s of distended intestine are

A
  • pain
  • cramps
  • nausea
  • vomiting
75
Q

__ (hypoglycemia/hyperglycemia) is followed by __ (hypoglycemia/hyperglycemia)

A

hyperglycemia; hypoglycemia

76
Q

why does hyperglycemia result from the dumping syndrome?

A

chyme is rapidly dumped into the SI, digested , and absorbed

77
Q

why does hypoglycemia result from hyperglycemia in the dumping syndrome?

A

insulin is released; glucose goes into cells; 2-3 hrs following a meal; no food or chyme to supply additional glucose

78
Q

intestinal obstruction can be __ or __

A

mechanical; paralytic

79
Q

a pt has a hernia, post operative adhesions, tumor, and had intestinal twisting. what obstruction is this?

A

mechanical intestinal obstruction

80
Q

a pt has both neurological and muscular impairment. what kind of obstruction is this?

81
Q

high pitched peristalsis is heard in which obstruction?

A

mechanical

82
Q

s/s of mechanical obstruction include:

A
  • intestinal hernias
  • tumors
  • ibd
  • twisting (volvulus)
  • telescoping of intestine (intussusception)
83
Q

__ has inaudible bowel sounds

A

paralytic obstruction

84
Q

s/s of paralytic obstruction include:

A
  • malfunction of nerves and muscle
  • electrolyte imbalance
  • gastroenteritis
  • appendicitis
  • pancreatitis
  • surgical complications
  • certain drugs and medication
85
Q

inflammation of the peritoneal membrane sis

A

peritonitis

86
Q

__ peritonitis includes a ruptured gall bladder/spleen

87
Q

__ peritonitis is caused by perforation in intestines

88
Q

a 1) board-like abdomen (abdominal wall muscles tighten), 2) reflex paralysis or paralytic ileus (pain and sympathetic nervous stimulation cause bowel to freeze), and 3) shallow breathing (diaphragm & accessory muscle breathing decrease) are __ of peritonitis

pathophysiology (11 decks)

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