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Disorders of GI function (pptx 1) Flashcards

1
Q

List 6 organs located in the RUQ of the abdominal cavity

A

1) Liver (majority)
2) Rt kidney
3) Colon
4) Pancreas (small portion)
5) Gallbladder
6) Small intestine

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2
Q

List 6 organs located in the RLQ of the abdominal cavity

A

1) Colon
2) Small intestine
3) Right ureter
4) Right ovary
5) Right fallopian tube
6) Appendix

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3
Q

List 7 organs located in LUQ of the abdominal cavity

A

1) Liver (small portion)
2) Spleen
3) Lt kidney
4) Stomach
5) Colon
6) Pancreas (majority)
7) small intestine

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4
Q

List 5 organs located in LLQ of the abdominal cavity

A

1) Colon
2) Small intestines
3) Left ureter
4) Left ovary
5) Left fallopian tube

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5
Q

List 3 GI disorders located in RUQ of the abdominal cavity

A

1) Hepatitis
2) Duodenal ulcer
3) Acute cholecystitis

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6
Q

List 4 GI disorders located in LUQ of the abdominal cavity

A

1) Gastric ulcer
2) ruptured spleen
3) Aortic aneurysm
4) Pancreatitis

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7
Q

List 11 GI disorders located in RLQ of the abdominal cavity

A

1) Hernia
2) Appendicitis
3) Ovarian cysts
4) Kidney stones
5) Pyelonephritis
6) Ectopic pregnancy
7) Salpingitis (female)
8) Mesenteric adenitis
9) Meckel’s diverticulitis
10) Bowel obstruction/ perforation/ ischemia
11) Inflammatory bowel disease

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8
Q

List 8 GI disorders located in LLQ of the abdominal cavity

A

1) Hernia
2) Diverticulitis
3) Ovarian cysts
4) Kidney stones
5) Pyelonephritis
6) Ectopic pregnancy
7) Bowel obstruction/ perforation/ ischemia
8) Inflammatory bowel disease

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9
Q

List 5 GI disorders located in epigastric region of the abdominal cavity

A

1) Esophagitis
2) Pancreatitis
3) Perforated ulcer
4) Acute cholecystitis
5) MI

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10
Q

Describe parietal abdominal pain

A

Localized
2) Described as knife-like, sharp pain

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11
Q

Describe visceral abdominal pain

A

Distention/ inflammation of body organs
1) Described as colicky, crampy

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12
Q

What is the 3rd type of abdominal pain?

A

Referred pain

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13
Q

How is abdominal pain produced?

A

Biochemical mediators of inflammatory response (Histamine, bradykinin, & serotonin) stimulate organic nerve endings that produce abd pain

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14
Q

List 2 things abdominal organs are sensitive to

A

1) Stretching
2) Distention

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15
Q

LISt 7 disorders of the esophagus

A

1) Dysphagia
2) Achalasia
3) Esophagitis
4) GERD
5) Upper GI bleed
6) Esophageal varices
7) Esophageal cancer

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16
Q

List 6 disorders of the stomach

A

1) Hiatal hernia
2) Pyloric stenosis
3) Peptic ulcer disease
4) Zollinger-Ellison syndrome
5) Bariatric surgery
6) Dumping syndrome

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17
Q

List 6 disorders of the SI

A

1) Hernia
2) Gastroenteritis
3) Celiac disease
4) Short-bowel syndrome
5) Small bowel obstruction
6) Peritonitis

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18
Q

What GI disorder affects ~ 20-40% of US population?

A

GERD

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19
Q

What is GERD?

A

A backward movement of gastric contents into esophagus

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20
Q

Contrast a normal functioning lower esophageal sphincter to one seen in someone with GERD

A

Normal → maintains a zone of high pressure to prevent chyme reflux

GERD → lower esophageal sphincter relaxes spontaneously 1-2 hrs after eating, which allows regurgitate into esophagus

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21
Q

Diagnosis of GERD Hint: 2

A

1) Endoscopy
2) Manometry

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22
Q

List 2 results of esophageal mucosal damage associated with GERD

A

1) Erosive esophagitis
2) Barrett’s esophagus

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23
Q

What is Barrett’s esophagus Hint: 3

A

1) Repeated injury causes metaplasia
2) Change to columnar epithelium
3) Precancerous (esophageal adenocarcinoma)

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24
Q

Cause of GERD

A

Certain conditions, substances, foods, & meds that weaken or hinder closure of lower esophageal sphincter

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25
List 10 examples that cause GERD
1) Alcohol 2) Acidic foods 3) Fatty foods 4) Chocolate 5) Coffee 6) Nicotine 7) Obesity 8) Pregnancy 9) Hiatal hernia 10) Anticholinergics; Beta agonists; CCBs; Nitrates; Progesterone
26
List 9 clinical manifestations of GERD
1) **Dysphagia** 2) **Heartburn** 3) **Regurgitation** 4) Bitter taste 5) Upper abd pain within hr of eating 6) ↑ w lying or ↑ intra-abd pressures 7) Can have Sx w no acid 8) Cough, ↑ asthma Sx 9) May seem like angina
27
GERD increases risk of _____
Aspiration
28
List 7 life style & dietary changes that can Tx GERD
1) ↓ dietary fats 2) Eat small meals 3) Stop smoking 4) Avoid lying down for 3 hrs after eating 5) Avoid alcohol 6) Weight loss 7) Elevate HOB
29
List 4 pharmacologic Tx options for GERD
1) Antacids 2) Histamine (H2) blockers 3) Proton pump inhibitors (PPI) 4) Prokinetic agents
30
What is celiac disease?
An autoimmune disorder triggered by gluten
31
List 8 clinical manifestations of celiac disease
1) Abdominal pain 2) Bloating 3) Diarrhea 4) Weight loss 5) Steatorrhea 6) Weakness 7) Flatus 8) Fatigue
32
List 5 labs to look at to help Dx celiac disease
1) H/H 2) CMP 3) Genetic testing 4) IgA 5) Ab testing
33
List 3 Tx options for celiac disease
1) Remove gluten from diet 2) Vitamin replacement 3) Corticosteroids
34
What GI disorders affects 50-75% of the world's population?
Helicobacter pylori (H. pylori)
35
What ethnicities is H. pylori increased in?
Hispanics & African Americans
36
How is H. pylori transmitted?
Person to person → thru saliva, feces, vomiting
37
List 3 disorders H. pylori causes
1) Peptic ulcers 2) Gastritis 3) Gastric (stomach) cancer
38
True or false: Most people Dx with H. pylori are symptomatic?
FALSE → most are asymptomatic
39
What kind of bacteria is H. pylori?
Gram-negative rods that colonize in mucus-secreting epithelial cells of stomach
40
Describe bacteria of H. pylori gastritis
Small, curved or spiral shaped gram-negative rods
41
What does H. pylori gastritis secrete?
Urease (enzyme) → converts urea to ammonia
42
How does ammonia function for bacteria to survive?
Ammonia neutralizes acidity of the stomach for bacteria to survive
43
Where is H. pylori gastritis located?
Burrows into mucus layer
44
List 3 things that production of enzymes & toxins in H. pylori gastritis causes
1) Impacts protection of mucosa to acidic environment 2) Intense inflammatory response 3) Create immune response (T & B cells)
45
List 7 Sx of H. pylori
1) Many are asymptomatic 2) Dull burning pain in abd 3) ↑ pain w empty stomach 4) N/V 5) Dyspepsia 6) Bloating 7) Weight loss
46
List 4 ways to Dx H. pylori
1) Urea breath test 2) Serologic tests 3) Stool Ag test 4) Endoscopic biopsy
47
List 4 Tx options for H. pylori
1) Abx 2) Bismuth (Antibacterial effect) 3) PPI (raise the pH) 4) H2 blockers
48
Where do peptic ulcers occur in GI tract?
Upper portion of GI tract
49
What is peptic ulcer disease?
Inflammatory erosion in stomach (gastric ulcer) or duodenal lining (duodenal ulcer)
50
Pathophysiology of peptic ulcer disease **Hint: 3**
1) Hypersecretion of HCL 2) Ineffective mucous production 3) Poor cellular repair
51
List 2 things to note about peptic ulcer disease
1) Periods of exacerbations & remissions 2) Commonly seen in middle aged individuals
52
List 4 causes of peptic ulcer disease
1) **H. pylori infection** 2) **Use of ASA or NSAIDs** 3) Stress 4) Alcohol
53
Patho of H. pylori PUD: H. pylori **Hint: 3**
1) Secretes enzyme urease 2) Breaks down urea 3) Ammonium toxic to epithelial cells & neutralizes acid
54
Patho of H. pylori PUD: Erosion of mucosal lining **Hint: 3**
1) HCL diffuses into stomach wall & BV 2) Creates inflammatory response 3) Release of histamine & prostaglandins
55
Patho of H. pylori PUD: Histamine **Hint: 2**
1) Causes vasodilation & stimulates pepsin & gastrin release 2) Acid secretion stimulated which attacks unprotected lining
56
Patho of H. pylori PUD: HCL **Hint: 2**
1) Released by parietal cell 2) Irritates & destroys lining & continues to trigger inflammation
57
Patho of H. pylori PUD: Scarring & fibrosis of lining **Hint: 2**
1) Fibrosis inhibits healthy cell reproduction 2) Decreased mucus & bicarb production to protect lining
58
Patho of H. pylori PUD: Development of... **Hint: 2**
1) Erosion 2) Ulcer → extends into muscularis layer
59
Gastric ulcer (PUD) **Hint: 5**
1) Occurs in stomach 2) Epigastric pain 1-2 hrs after eating 3) Causes hematemesis or melena 4) Heartburn, chest discomfort & early satiety common 5) Can cause gastric carcinoma
60
Duodenal ulcer (PUD) **Hint: 5**
1) Occurs in duodenum 2) Epigastric pain 2-3 hrs after eating 3) Can cause melena or hematochezia 4) Heartburn, chest discomfort less common 5) Pain may awaken pt during night
61
Where in the stomach do gastric ulcers tend to develop?
Antral region of the stomach, adjacent to the acid-secreting mucosa of the body
62
Common age to see gastric ulcers
Ages 55-65 male & female
63
Patho of gastric ulcers **Hint: 3**
1) Primary defect is ↑ mucosal permeability to H+ ions 2) Frequent H. pylori 3) Gastric secretion is normal or less than normal
64
What is the most common type of PUD?
Duodenal ulcer
65
List 5 causes of duodenal ulcers
1) H. pylori 2) Smoking 3) NSAIDs 4) Stress 5) Genetic predisposition
66
List 4 things that occur with presence of duodenal ulcers
1) ↑ gastrin levels that stay high after eating, continue to stim secretion of acid 2) Impaired duodenal bicarb secretion 3) Failure of feedback where acid in antrum inhibits gastrin release 4) Rapid gastric emptying overwhelms buffering
67
List 6 clinical manifestations of duodenal ulcers
1) Chronic intermittent pain in epigastric area 2) Pain ↑ ~ 30 min to 2 hrs after eating 3) Night time pain btwn 11p-2a 4) Spasm & acid 5) Relieves w food, antacids 6) Tx H. pylori, help acids, relieve pain
68
List 7 clinical manifestations of gastric ulcer
1) Pain tends to ↑ w eating 2) Belching 3) Early satiety 4) Anorexia 5) N/V 6) Weight loss 7) Tends to be chronic
69
List 2 things both duodenal & gastric ulcers can cause
1) Melena 2) Hematemesis
70
List 3 things both duodenal & gastric ulcers can lead to
1) Hemorrhage 2) Perforation 3) Gastric outlet obstruction
71
List 4 goals of Tx PUD
1) Promote healing 2) Relieve pain 3) Decrease acid levels 4) Prevent recurrence
72
List 4 Tx options for PUD
1) Lifestyle changes 2) Abx 3) PPI 4) H2 inhibitors
73
List 3 lifestyle changes for treating PUD
1) Avoid caffeine, alcohol, tobacco 2) Avoid spicy, high fat foods 3) Avoid ASA or NSAIDs

Pharm Final Exam (34 decks)

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