Disorders of GI Function Flashcards
Define anorexia; dysphagia; odynophagia; achalasia; gastritis; melena; hematemesis; hematochezia and peritonitis
anorexia: loss of appetite
dysphagia: difficulty in swallowing
odynophagia: painful swallowing
achalasia: failure of the esophageal sphincter to relax
gastritis: inflammation of the gastric mucosa
melena: passage of black, tarry stools. occur as a result of gastrointestinal bleeding. bleeding originates from the upper gastrointestinal (HI) tract; includes mouth, stomach and first part of small intestine.
hematochezia: passage of fresh blood per anus, usually in or with stools
peritonitis: swelling of peritoneum
Explain common esophageal disorders - diverticulum, hiatal hernia and Mallory-Weiss tear
diverticulum: a herniation of the esophageal wall caused by a weakness of the muscularis layer
hiatal hernia: a protrusion or herniation of the stomach thr the esophageal hiatus of the diaphragm. two anatomic patterns - axial (or sliding) and nonaxial (or paraesophageal)
Mallory-Weiss tear: longitudinal tears in the esophagus at the esophagogastric junction that often extend distally
Understand gastroesophageal reflux (GERD); its characteristic symptoms and complications; Barrett’s esophagus
symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus or into the oral cavity (including the larynx) or the lung
GERD is broadly classified into 2 groups on the basis of endoscopy findings: having esophageal mucosal damage (erosive esophagitis and Barrett esophagus) and no mucosal damage (endoscopy-negative reflux disease or nonerosive reflux disease)
heartburn & regurgitation are characteristic symptoms of GERD
Barrett esophagus: an abnormal change (metaplasia) in the cells of the lower portion of the esophagus characterized by a reparative process in which the squamous mucosa that normally lines the esophagus gradually is replaced by abnormal columnar epithelium resembling that in the stomach or intestines. associated w/ increased risk of development of esophageal adenocarcinoma.
Explain the role of H. pylori in gastritis and peptic ulcer disease
thrives in an acid environment of the stomach. disrupts the mucosal barrier that protects the stomach from harmful effects of its digestive enzymes
Know the complications of peptic ulcer disease
hemorrhage - caused 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 pylorus or adjacent areas
perforation - occurs when an ulcer erodes through all layers of stomach or duodenum wall
Understance c. difficile and E. coli H0157:H7 intestinal infection
c. difficile colitis is associated w/ antibiotic therapy.
E. coli H0157:H7: infection may cause no symptoms or cause a variety of manifestations; acute, non bloody diarrhea; hemorrhagic colitis; hemolytic uremic syndrome (HUS). HUS characterized by hemolytic anemia, thrombocytopenia, and renal failure. use of antibiotics or antimotility/antidiarrheal agents in the early stages of diarrhea have shown to increase the risk of HUS.
Know characteristics of irritable bowel syndrome
persistent or recurrent symptoms of abdominal pain; altered bowel function; varying complaints of flatulence, bloatedness; nausea and anorexia; constipation or diarrhea; anxiety or depression
Know etiology and manifestations of celiac disease
an immune-mediated disorder triggered by ingestion of gluten-containing grains (including wheat, barley, and rye).
disease results from an inappropriate T-cell mediated immune response against ingested gluten protein in genetically predisposed people
manifests as failure to thrive, diarrhea, abdominal distention and occasionally severe malnutrition. in adults GI symptoms may manifest as diarrhea, constipation, or other symptoms of malabsorption such as bloating, flatus, or belching.
Differentiate between diverticulosis and diverticulitis
colonic diverticula have a thin wall composed of a flattened or atrophic mucosa, compressed submucosa, and attenuated, or most often, totally absent muscularis propria
diverticulitis: pain in LLQ, nausea and vomiting, tenderness in LLQ, slight fever, elevated WBC count
Know similarities and difference between Crohn’s and ulcerative colitis
both diseases produce inflammation of the bowel, lack confriming evidence of a proven causative agent, have a pattern of familial occurence, and can be accompanied by systemic manifestations
crohn disease most commonly affects the distal small intestine and proximal colon but can affect any area of the GI tract from the esophagus to the anus, whereas ulcerative colitis is confined to the colon and rectum
cancer of colon - long term complication of ulcerative colitis
Explain various types of intestinal obstructions
intussusception: invagination or shortening of the bowel caused by movement of one segment of the bowel into another
volvulus of the sigmoid colon: twist is counterclockwise in most cases. note the edematous section of the bowel
hernia (inguinal): sac of the hernia is a continuation of the peritoneum of the abdomen. hernial contents are intestine, omentum, or other abdominal contents that pass through the hernial opening into the hernial sac.
