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Pathophysio week 8 > chapter 45: disorders of gastrointestinal function > Flashcards

chapter 45: disorders of gastrointestinal function Flashcards

1
Q

signs and symptoms common to gastrointenstinal disorders

A
  • anorexia
  • nausea
  • vomiting
  • gastrointestinal bleeding
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2
Q

Anorexia, nausea, retching, and vomitting

A
  • anorexia, nausea, and vomiting are physiologic responses that are common to many GI disorders
  • Retching consts of the rhythmic spasmodic movements of the diaphragm, chest wall, and abdominal muscles
  • signal for disease and removes noxious agents
  • contributes to impaired intake or loss of fluids and nutrients
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3
Q

vomiting and neural structures

A
  • vomiting involves two functionally distinct medullary centers- the vomiting center and the chemoreceptor trigger zone
  • vomiting center: located in the medulla near the sensor nuclei of the vagus nerve
  • Chemoreceptor trigger zone: located in small area on the floor od the brains fourth ventricle, where it is exposed to both blood and cerebospinal fluid. reacts to the emetic effects of blood-borne drugs and toxins
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4
Q

swallowing

A
  • mechanisms:
    • depends on the coordinated action of the tongue and pharynx
    • theses structures are innervated by cranial nerves V,IX, X
  • alterations:
    • dysphagia: difficulty swallowing
    • Odynophagia: painful swallowing
    • achalasia: failure of the esophageal sphincter to relax
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5
Q

Gastroesophageal Reflux a.k.a GERD

A
  • heart burn: 30-60 minutes adter meal, typically an evening onset, pain in the epigastric area (can radiate),
  • how to overcome GERD?
    • avoid large meals, smoking, alcohol, bending for long periods or with pillows, recumbent position several hours after a meal
    • eat meals sitting up, sleep with head of bed elevated, losing weigh if overweight
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6
Q

Complaints accompanying esophageal

A

the food stops before it reaches the stomach,

gurgling, belching, coughing, foul-smelling breath

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7
Q

esophageal cancer

A

-squamous cell carcinoma
+alcohol and tobacco use
-Adenocarcinoma
+which has a close association with Barret’s esophagus (reflux leads to metaplasia of epithelial cells which can lead to cancer in lower esophagus)
-Symptoms
+dysphagia, weight loss, anorexia,fatigue,painful swallowing, not easily diagnosed

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8
Q

factors contributing to the protection of gastric mucosa

A
  • gastric mucosal barrier exists in the stomach
    + there should be an impermeable epithelial cell surface covering protecting the stomach
    +there are mechanisms for the selective transport of hydrogen (hydrocholric cid) and bicarbonates ions
    + there are 2 characteristic types of gastric mucus
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9
Q

Types of mucus protecting the gastric mucosa

A

-water-insoluble mucus: +forms, a thin stable gel that adheres to the gastric mucosal surface. +Provides protection.
+forms an unstirred layer that traps bicarbonate, forming an alkaline interface between the luminal contents of the stomach and its mucosal surface

-water-soluble mucus
+washed from the mucosal surface
+mixes with the luminal contents
+ its viscid nature makes it a lubricant that prevents mechanical damage to the mucosal surface

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10
Q

major cause of gastric irritation and ulcer formation

A
  • Asipirin or nonsteroidal anti-inflammatory drugs (NSAIDS): irritates the gastric mucosa and inhibit prostaglandin synthesis
  • infection with H.pylori: thrives in an acid environment of the stomach & disrupts the mucosal barrier that prtects the stomach from harmful effects of its digestive enzymes
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11
Q

Types of gastritis

A
  • acute gastritis

- chronic gastritis

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12
Q

acute gastritis

A
  • a transient inflammatino of the gastric mucosa

- most commonly associated with local irritants such as bacterial endotoxins, alcohol, and aspirin

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13
Q

chronic gastritis

A
  • characterized by the absence of grossly visible erosions and the presence of chronic inflammatory changes
  • leads eventually to atrophy of the glandular epithelium of the stomach
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14
Q

major types of chronic gastritis

A
  • helicobacter pylori gastritis
  • autoimmune gastritis
  • multifocal atropic gastritis
  • chemical gastropathy
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15
Q

Helicobacter pylori

A
  • colonize the mucus-secreting epithelial cells of the stomach
  • produce enzymes and toxins that have the capacity to interfere with the local protection of the gastric mucosa
  • produce intense inflammation
  • elicit an immune response
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16
Q

methods establishing presence of H. Pylori infection

A
  • C urea breath test using a radioactive carbon isotope
  • stool antigen test
  • endoscopic biopsy for urease testing
  • blood tests to obtain serologic titers of H. Pylori antibodies
17
Q

peptic ulcers

A

ulcerative disorders that occur in areas of the upper GI tract that are exposed to acid-pepsin secretions
-spontaneous remissions and exacerbations are common
-causes
+H. pylori, aspirin, age, warfarin, smoking

18
Q

complications of peptic ulcer

H.O.P

A

-Hemorrhage
+cause by bleeding from granulation tissue or from erosion of an ulcer into an artery or vein

-Obstruction:
+ caused by edema,spasm, or contraction of scar tissue and interference with the free passage of gastric contents through the pylorous or adjacent areas

-Perforation
+occurs when an ulcer erodes through all the layers of the stomach or duodenum wall. bleeding and spilling of gastric contents into the perotoneum could be fatal

19
Q

GI tract bleedin

A

-HEMATEMESIS
+ blood in the vomitus
+ may be bright red or have coffee groun appearance

-MELENA
+blood in the stool
+ranges in color from bright red to tarry black
+may be occult (hidden). we can hemoccult test

20
Q

Treatment of Peptic Ulcer

A

-Eradicate the cause and promote a permanent cure for the disease, usual meds:
-Eradicating H. pylori with 2 antibiotics
+Mucosal protective like Carafate
+Antacids to relieving ulcer symptoms like Maalox, Tums
+Use of a Proton pump inhibitors like Prevacid, Protonix
+Maybe a prostaglandin agonist like Cytotec or H2 antagonist like Zantac instead of a PPI
+Discouraging alcohol, NSAIDs, ASA

21
Q

Risk factors for development of stress ulcers

A

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

22
Q

risk factors for dev. gastric cancer

A

-genetic predisposition, carcinogenic factors in the diet, autoimmune gastritis, gastric adenomas or polyps

23
Q

conditions causing altered intestinal function

A

-irritablebowel disease, inflammatory bowel disease, diverticulitis, appendicitis, alteration in bowl motility, malabsorption syndrome, cancer of the colon and rectum

24
Q

infections of the intestine

A 
-VIRAL INFECTION
  \+rotavirus
-BACTERIAL INFECTION
  \+clostridium difficile colitis
  \+escheichia coli O157:H& Infection
- PROTOZOAL INFECTION
  \+E. Histolytica
25
Q

characteristic of irritable bowel disease

A

-persistent or reccurent symptoms of abdominal pain, altered bowl function, varying complaints of flatulence, bloatedness, nausea and anorexia, constipation or diarrhea, anxiety or depression

26
Q

Inflammatory bowel disease

A

-CROHN DISEASE
+Recurrent, granulomatous tpe of inflammatory response that can affect any area of the GI tract from the mouth to the anus
-ULCERATIVE COLITIS
+ A nonspecific inflammatory condition of the colon

27
Q

symptoms of diverticulitis

A

-pain in the lower left quadrant, nausea and vomiting, tenderness in the lower left quadrant, a slight fever, an elevated while blood cell count

28
Q

Appendicitis

A
  • the appendix becomes inflames, swollen, and gangrenous, and it eventually perforates if not treated
  • appendicitis is related to intraluminal obstruction with a fecalith ( hard poop), gallstones, tumores, parasites, or lymphatic tissue
29
Q

Types of diarrhea

A

-Large volume
+osmotic, secretory
-Small-volume
+inflammatory bowel disease, infectious disease, irritable colon

30
Q

manifestation of classic form of celiac disease

A

-presents in infancy
-manifests as
+faulire to thrive, diarrhea, abdominal distention, occasionally, severe malnutrition

31
Q

common cause of constipation

A
  • failure to respond to the urge to defecate
  • inadequate fiber in the diet
  • inadequate fluids
  • weakness of the obdominal muscles
  • inactivity and bed rest
  • preggers
  • hemorrhoids
32
Q

fecal impaction

A
  • painful anorectal disease
  • tumors
  • neurogenic disease
  • use of constipating antacids or bulk laxatives
  • a low-residue diet
  • drug-induces colonic stasis, paralytic ileus
  • prolonged bed rest and debility
33
Q

INTESTINAL OBSTRUCTION

A
  • mechanical obstruction can result from post operatice causes such as external hernia and postoperatice adhesions
  • paralytic, or adynamic, obstructino results from neurogenic or muscular impairment of peristalsis
  • mechanical (twist stool)
  • paralytic
  • abdominal distention, n/v, high pitch bowel sounds, no flatus, loss of fluids and electrolytes, may necessitate NG tube placement and/or surgery
34
Q

perotoneal caivty and perotonitis

A

-permits rapid absorption of bacterial toxins
-favors the dissemination of contaminants
-great inflammatory response (thick, fifrinous protective substance)
-causes?
+perforated peptic ulcer, ruptures appendixm perforated diverticulum, gangrenous bowel, PID, nangrenous gallbladder, abdominal trauma and wounds

35
Q

intestinal malabsorption

A
  • failure to transport to dietary constituents from the lumen of the intestine to the extracellular fluid
  • Causes: Celiac disease
  • symptoms: diarrhea, steatorrhea, flatulence, bloating, abdominal pain, cramos, weakness
36
Q

colorectal cancers and testing

A
  • age, family history, crohn disease, ulcerative colitis, diet
  • stool occult blood test, digital rectal examination, x-ray studies using barium, flexible sigmoidscopy and coloscopy

Pathophysio week 8 (3 decks)

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