Digestive Flashcards
Malabsorption vs maldigestion
malabsorption:
not getting across and absorbing
maldigestion:
not broken down enough to be absorbed
hematemesis
blood in the emesis (coming from stomach)
hematochezia
bright red stools
melena
black tarry stools
occult bleeding
stools look normal
breakdown products of blood in stool
*positive Guaiac test indicates occult GI bleeding
Gastric fluid
high in H+ and K+
share transport pump:
H+ pumped out into stomach
K+ pumped out stomach
K+ is contantly leaking out back into stomach
gastric fluid losses
loss of H+ and K+
metabolic alkalosis
hypokalemia
GI and potassium
hyperkalemia:
increase in GI motility
hypo:
decrease
GI and calcium
hypercalciemia:
decrease GI motility
hypo:
increase GI motility
osmotic diarrhea
unabsorbable osmoles within the lumen
ex: lactose intolerance
*eat something you can absorb and it has osmoles that draw fluid
secretory diarrhea
inflammatory or infectious processes
ex: viral, bacterial infection
effects of diarrhea on electrolyte balance
small intestine — ph (8.0) alkalosis
K+ and HCO3 normally absorbed
rapid transit times in diarrhea = loss of K+ and HCO3:
*metabolic acidosis
*hypokalemia
ischemia of the bowel
cause
end result
anything that causes decrease blood flow to GI
bowel ischemia leads to inflammation:
*necrosis:
perforation of the bowel (hole) and
peritonitis (hole causes infection)
intestinal obstruction
leads to
vomiting (push back up)
distention (pushes out)
ischemia (occluded vessels)
gas and fluid accumulation
causes of intestinal obstruction
paralytic ileus
congenital defects of the GI
scarring of bowel
tumors
hernias
volvulus
intussusception
intestinal obstruction causes
paralytic ileus
electrolyte imbalance
drugs (narcotics)
bowel ischemia
abdominal infection
post-op abdominal surgery
causes of intestinal obstruction
scarring of bowel
adhesions (outside bowel)
*scar outside tube causes obstruction
strictures (inside bowel)
*scar narrows inside of bowel
causes of intestinal obstruction
hernias
bowel moved where it shouldnt have
cause of intestinal obstruction
volvulus
twisting of bowel
*emergency
cause of intestinal obstruction
intussusception
small bowel telescopes into large bowel
(happens where they meet)
alterations in esophageal function
dysphagia
difficulty with swallowing
mechanical: tumor, born with it
functional: stroke, issue with signal
alteration in esophageal function
esophagitis
esophageal cancer
gastroesophageal reflux
esophagitis:
*reflux of gastric secretions into esophgus
esophageal cancer
gastroesophageal reflux:
*backward movement of gastric contents into the esophagus
alterations in esophageal function
hiatal hernia
protrusion of part of stomach upwards into the thorax
Sliding hiatal hernia: can slide up and down
alterations in gastric function
gastritis
stress ulcers
inflammation of the stomach
stress ulcers: acute ulcers
*stress conditions activate SNS
*shunts blood away from the GI tract
*acid in stomach irritates mucus and causes stress ulcers
alterations in gastric function
peptic ulcer disease
chronic ulcers:
duodenal ulcers (pain after eating)
gastric ulcers (pain before eating)
alterations in gastric function
cancer of the stomach (nothing)
pyloric obstruction
pyloric obstruction:
*between stomach and intestines
classic sign: projectile vomiting
alterations in intestinal function
acute inflammatory disorders
gastroenteritis: inflammation of stomach and intest
appendicitis
diverticular disease:
*diverticulitis: acute infl.
*diverticulosis: chronic
peritonitis
peritonitis
inflammation/hole within peritoneal cavity
caused by bowel perforation
life-threatining infection
alteratuons in intestinal function
chronic inflammatory diorders
ulcerative clotitis:
ulceration in colon
crohns disease:
small and large intestines
*spots with inflammation and spots that are normal
**called skip lesions
alteration in intestinal function
colorectal cancer
preceds with a premaligant polyp
altered function of gall bladder
cholecystitis
cholelithiasis
cancer of the gallbladder
cholecystitis: inflammation of GB
cholelithiasis: gall stones
*high fat diet
*rapid weight loss
altered function of exocrine pancreas
secrete stuff out (digestive function)
cystic fibrosis:
*AR ch 7
*defective chloride channel
*thickened mucus/secretions
*happens in pancreatic ducts (cant function right)
altered function of the exocrine pancreas
pancreatitis
Acute v chronic
Blood markers
cancer of the pancreas
pancreatitis:
acute vs chronic
(alcohol consumption)
*acute pancreatitis = pseudocyst
increase lipase and amylase = pancreatitis blood marker
primary function of the liver
produces proteins: albumin and clot factors
breaks down proteins
synthesis of bile
produce proteins for immunoglobulin synthesis
breakdown drugs (biotransformation of chemicals)
metabolism of steroid hormones (androgens, estrogens)
structure and function of liver
lobes—lobules—hepatocytes
perfusion:
*bring blood to liver
-hepatic artery
-portal vein
*taking blood from the liver to the IVC
-hepatic vein
components of the liver lobule
hepatocytes
venous sinusoids:
drain into central veins out hepatic vein to IVC
Bile cannaliculi:
drain into bile duct
Kupffer cells:
immune phagocytic cells
Jaundic
deposits of bilirubin
*hyperbilirubinemia
bilirubine is a breakdown product of hemoglobin
2 forms of bilirubin:
unconjugated bilirubin
conjugated bilirubin
unconjugated vs conjugated bilirubin
unconjuated bilirubin:
*lipid soluble
*requires protein transport to travel thru plasma
conjugated bilirubin:
*joined with glucuronic acid in the hepatocytes of the liver turing it into a water soluble
lab studies for hyperbilirubinemia
total bilirubin:
*unconjugated bilirubin
*conjugated bilirubin
total protein and albumin
other molecules competing for transport proteins
causes of hyperbilirubinemia and jaundice
prehepatic:
hemolytic jaundic (excessive RBC destruction)
intrahepatic:
obstruction within the liver
extrahepatic obstructive jaundice:
obstruction in the bile ducts outside of liver
hepatic dysfunction
impaired protein metabolism
decrease protein production
related lab:
total protein
albumin
ammonia
coagulation profile:
*prothrombin time (INR)
*partial prothromboplastin time
*fibrinogen
*fibrin split and d dimer
other manifestations of liver dysfunction
altered carb and fat metabolism and storage
accumulation of toxins, hormones
impaired immune defenses
liver related enzyme released into the blood:
ALT, AST, LDH, alkaline phosphatase
portal hypertension
what it is
complications
increased BP in portal venous system
complications:
*splenomegaly (spleen holds more fluid)
*varices (varicose veins)
-esophageal varices (massive blood loss)
-rectal varices (hemorrhoids)
*acites
ascities
third space
portal HTN with liver disease, ascited resukts from combination of:
↑ capillary hydrostatic pressure
↓capillary colloid osmotic pressure
viral hepatitis
hep A:
*spread by fecal-oral transmission (daycares)
Hep B and C:
*spread by blood and body secretions
(can track by serology)
Hep D and E:
*less common
disorders of the liver:
cirrhosis of the liver
fibrotic scarring of the liver
primary cause of HTN
disorders of the liver
alcohol-induced liver disease
alcoholic steatosis:
fatty liver
alcoholic hepatisis:
inflammation of the liver
alcoholic cirrhosis:
permanent fibrotic scarring of the liver
disorder of the liver
cancer of the liver
primary cancer: inflammation and necrosis
common site for metastasis too:
gets cancer from other organs
