Chapter 42 Flashcards
__________: the telescoping part of the intestine into another section of the intestion, usually causing _______ of the blood supply
intussuception
strangluation
alcoholic liver disease the sequence for the development of alcoholic liver disease is: 1 2 3
steatosis
steatohepatitis
fibrosis
forceful emptying of the stomach and intestinal contents through the mouth
vomiting
clinical manifestations of GI dysfunction
in visceral pain- ______, _____, poorly ______ and ____
diffused
vague
localized
dull
diarrhea
_____ stools per day are considered the upper limits of normal!!!!
three
alcoholic cirrhosis
hepatic __ accumulation happens in alcohlic cirrosis!!!!!!!
fat
cirrhosis alcoholic liver disease \_\_\_\_\_\_\_\_ (alcoholic fatty liver) -\_\_\_\_\_\_ form -is \_\_\_\_\_ if drinking is stopped
_______ hepatitis (________)
- is characterized by _________
- _________ and _____ of the ______ occur
- _______ cirrhosis (____)
- toxic effects of alcohol metabolism on the liver, ________ alterations, ______ stress from lipid ______, and ______ occur
steatosis mildest reversible alcoholic steatophepatitis inflammation degeneration, necrosis hepatocytes alcoholic, fibrosis immunologic oxidative perioxidation malnutrition
if the obstruction is at the _______ or high in the ___ intestine then ____________ initially develops as a result of excessive loss of _________ that normally would be reabsorbed from the ________
pylorus small metabolic alkalosis hydrogen ions gastric juices
osmotic diarrhea
_______ related to _____ deficiency
malabsorption
lactase
primary cause of peptic ulcers
h pylori
___ sided colon cancers
- _____- and _____ shaped stools
- tumors of the left, or _______, colon are ____, ______, _______ masses
- _______ is common but occurs slowly
left narrow, pencil descending small, elevated, button-like obstruction
disorders of motility
small intestine obstruction
most common: _________
fibrous adhesions
viral hepatitis
_______ (_____) phase
-begins approx _ weeks after exposure; ends with appearance of ______
-clinical manifestations: ______, _____, and _____
-is highly transmissable
prodromal (preicteric) phase
2
jaundice
fatigue, vomiting, hyperalgia
vomiting center
medulla oblongata
secratory diarrhea
primary causes of secretory diarrhea are bacterial _____, particularly those released by ______
enterotoxins
cholera
clinical manifestations of duodenal ulcers
- bleeding from duodenal ulcers causes ________ or _______
- the characteristic pain begins __ min to __ hours after eating when the stomach is empty
- duodenal ulcers occur w ______ frequency than other types of peptic ulcers
- pain is relieved by ____
hematemesis, melena
30, 2
greater
food
the pathophys process of alcoholic cirrhosis
-impairs the hepatocytes ability to oxidize ______, synthesize ____ and ____, degrade _____ and clear ______ of ______ and _____
- alcohol is transformed to _________, which promotes liver ______
- ________ function is impaired, decreasing _____ of fatty acids
- _________ inhibits export of _____ from the liver
fatty acids enzymes, proteins hormones portal blood ammonia toxins acetaldehyde fibrosis mitochondrial oxidation acetaldehyde proteins
vomiting
_________ medications: for nausea and vomiting
_________, ________, and _________ are antagonists of _______ which activates the trigger zone of vomiting
antiemetic metoclopramide domperidone haloperidol dopamine
disorders of motility
intestinal obstruction
any condition that prevents the flow of chyme through the intestinal lumen or failrue of normal intestinal motility in the absence of an obstructing lesion
clinical manifestations:
cardinal symptoms of ____intestine obstruction: _____ pain caused by _______, followed by ________
small
colicky
distention
vomiting
bloody stools with frank bright red or burgundy blood from the _____
hematochezia
rectum
chronic antral gastritis
generally involves only the _______ and is more common than __________
it is caused by __________ or the chronic use of ____, ____ and _____
h. pylori antrum fundal gastritis H. pylori alcohol, tobacco, NSAIDs
the most immediate result of a small intestinal obstruction is _________
it beings almost immediately, as gases and fluids accumulate _______ to the obstruction
within __ hours, up to __ L of fluid and ______ enters the ____ in the form of _____, _____, ____, ______ and ________
_____ vomiting or ________ of fluids in the intestinal lumen prevents their reabsorption and produces severe ____ and ______ disturbances
distention proximal 24 8 electrolytes lumen saliva gastric juice bile pancreatic juice intestinal secretions copious sequestration fluid electrolyte
true facts regarding the sources of increased ammonia that contribute to hepatic encephalopathy
- _____ of intestinal ____ digestion are sources of increased ammonia
- digested ___ leaking from ruptured ____ is a source of increased ammonia
- ________ bacteria in the colon are sources of increased ammonia
end products, protein
blood, varices
ammonia-forming
cancer of the ___ and _______ colon clinical manifestations
- ______ colored blood mixed with ______
- ______
- ______
- _______ mass in the _____ ____ quadrant
cecum ascending mahogony stool anemia pain palpable, lower right
______
inflammation of the pancreas
-associated w several clinical disorders _______ and _________
pancreatitis
alcohol intake
cholelithiasis
__________ vomiting - is caused by direct stimulation of the vomiting center by __________ such as _________, ______, or ______ involving the brainstem
projectile neurologic lesions intracranial pressure tumors aneurysms
__________
idiopathic inflammatory disorder, affects any part of the digestive tract, from mouth to anus
alterations in ______ production have been found in individuals w this disorder
ulcerations: _______ having ______ projections
crohn disease
immunoglobulin
granuloma
cobblestone
__________
is an altered level of consciousness as a result of liver failure
the underlying mechanism is believed to involve the build up of ______ in the blood, a substance that is normally removed by the ____
hepatic encephalopathy
ammonia
liver
______
accumulation of fluid in the peritoneal cavity
most common cause: _______
ascites
cirrhosis
ulcerative colitis
inflammation begins at the base of the ___________ in the ___ intestine, primarily the ____ colon, with infiltration and release of inflammatory ______ from _________, _______, _______, _______, ________, and ______
increased risk for _______ is demonstrated
crypts of liberkuhn large left cytokines neutrophils lymphocytes plasma cells macrophages eosinophils mast cells colon cancer
common complications of liver disorders
- _______
- ____________
- _________
ascites
hepatic encephalopathy
jaundice
facts about chronic gastritis
- tends to occur in _________
- results in chronic ________ and _______ _______
- __________ is a common outcome of chronic gastritis
- __________ _______ is often observed w chronic gastritis
older adults
inflammation, mucosal atrophy
mucosal atrophy
epithelial metaplasia
acute pancreatitis
___ or _____ duct obstruction blocks the outflow of pancreatic digestive
-can also result from direct ______ injury from ____ or ____ infection
-acute pancreatitis is usually ___ and _______ resolves
bile, pancreatic cellular drugs viral mild spontaneously
\_\_\_\_\_\_\_\_\_\_\_\_: is a break or ulceration in the protective mucosal lining of the lower \_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_, or \_\_\_\_\_\_!!!!!! -acute versus chronic ulcers -superficial (\_\_\_\_\_) versus deep risk factors - genetic \_\_\_\_\_\_\_\_\_ -\_\_\_\_\_\_\_\_\_ infection -habitual use of \_\_\_\_\_\_ -excessive use of \_\_\_\_\_\_\_, \_\_\_\_\_\_, acute \_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_ and over \_\_ years of age
peptic ulcer disease esophagus, stomach, duodenum erosions predisposition h. pylori NSAIDs alcohol, smoking, acute pancreatitis, COPD, obesity cirrohsis 65
constipation
normal bowel habits range from ___ or __ evacuations per day to ___ per week
two, three
one
all forms of acute hepatitis present with: 1 2, \_\_\_\_\_\_, \_\_\_\_\_\_ and \_\_\_\_\_ 3 4 5 \_\_\_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_\_\_
jaundice fever, weight loss, fatigue dark urine hepatosplenomegaly nausea, vomiting, abdominal pain
cause of abdominal pain
-chemical mediators such as _______, _______, and _______ produce abdominal pain
- ______ and _______ congestion produce abdominal pain by ______
- _______, caused by distention of bowel _______, or _________ vessel ______, produces abdominal pain
histamine, bradykinin, serotonin edema, vascular stretching ischemia obstruction mesenteric, thrombosis
disorders of motility
large bowel obstruction
most common: __________, _______ (twisting), and ______ related to _________
colorectal cancer
volvulus
strictures
diverticulitis
true statements concerning the accumulations of fluid in the peritoneal cavity
- impaired excretion of ________ by the _____ promotes ____ retention
- decreased ________ pressure and increased _______ ______ _____ pressure cause the movement of fluid into the peritoneal cavity
sodium kidneys water oncotic hepatic sinusoidal hydrostatic
acute hepatitis
- hepatitis is an infection or inflammation of the liver
- most cases of acute hepatitis are from viral hep A or B. ________ for unknown reasons, rarely presents with an accute infection and is found as a silent infection on blood test, unfortunately, when pt present with ________
- hep __ exits exclusively in those who have active viral replications of hep B
hep C
cirrohsis
D
