Exam 1: GI Cont. Flashcards
MC stomach infection
H. Pylori
Normal stomach defenses
Bicarbonate
Mucus
Mucus blood flow
Epithelial regeneration
NSAIDs inhibit what secretion
Bicarbonate
Inflammation of gastric mucosa
Gastritis
Significant bleeding caused by acute gastritis
Acute erosive hemorrhagic gastritis
3 typical NSAIDs
Aspirin
Ibuprofen
Naproxen
Symptoms of acute gastritis
Epigastric pain N + V Anorexia Hematemesis Melena
Acute peptic ulceration aka
Stress-related mucosal Disease
Small shallow ulcerations MC in stomach and duodenum, with symptoms of N + V, coffee-ground hematemesis
Stress-relelated mucosal disease
Caused of acute peptic ulceration
- Severe physiologic stress
- High NSAID dose
- Intracranial disease
___ is rare in chronic gastritis
Hematemesis
Potential causes of chronic gastritis
H pylori
Increase age
Chronic gastritis can lead to
Peptic ulcer disease
Gastric adenocarcinoma
70-90% of all cases of chronic gastritis positive for ____
H pylori infection
Risks for developing H pylori gastritis
Poor childhood sanitation/ hygiene
Autoimmune gastritis involves antibodies against
Parietal cells and Intrinsic factor
Autoimmune gastritis MC in what population
> 60 yo
Females
Autoimmune gastritis can cause what form of anemia
Pernicious
2 types of ca H pylori gastritis can cause
Gastric adenocarcinoma
MALT lymphoma
Autoimmune gastritis complicates ___
Erythropoiesis
Solitary “punched out” ulceration with pin point pain indicative of
PUD
PUD MC in what locations
Proximal duodenum
Gastric antrum
PUD contain what tissue
Granulation
Freq of PUD in population
10% males
4% females
Risks for PUD
H pylori
NSAIDs
Smoking
Alcohol
5-10% of everyone with H pylori will develop
PUD
Symptoms of PUD
N/V
Bloating
Cachexia
Epigastric pain (1-3 hrs postprandial)
Shared features of gastric and duodenal ulcers
Eating influences pain
Relieved by alkaline substances
Worse at night
Duodenal ulcers classic presentation
Postprandial relief (dairy)
Gastric ulcer classic presentation
Worse postprandial
Risk for gastric polyps
Chronic gastritis
___ makes up 75% of gastric polyps
Inflammatory and hyperplastic Polyps
___ makes up 15% of gastric polyps
Fundic gland polyp
___ makes up 10% of gastric polyps
Gastric adenomas
Gastric adenomas MC in __
Males (older age)
1/3 of gastric adenomas transition to
Adenocarcinomas
90% stomach cancer
Adenocarcinoma
10% stomach cancer
Lymphomas and carcinoid tumors
Stomach cancer MC ___ age ___, and ___ ethnicity
Males
55
Japanese
Advanced symptoms of stomach cancer
Gastritis Altered bowels Nausea Anorexia Weight loss Hemorrhage Anemia
Hypertrophy/ narrowing of pyloric sphincter
Pyloric stenosis
Freq of pyloric stenosis
1 in 400 births
Risks for pyloric stenosis
History
Caucasian
Males
Turner syndrome
Symptoms of pyloric stenosis
Hyperperistalsis
Projectile vomiting w/o bile
Dehydration
Irritable
Small and large intestine disorders commonly causes ___ and ___
Malabsorption and diarrhea
Intestinal obstructions MC in ____
Small intestine
4 common mechanical obstructions in intestine
Hernia
Adhesion
Intussusception
Volvulus
Hernia
Abdominal wall defect
Allows segment of intestine to protrude
Adhesion
Chronic inflammation due to adherent segments
Intussusception
Proximal segment telescopes into distal segment
Infants
Frank blood
Volvulus
Twisting loop of bowel
Frank blood
MC GI vascular disorder
Hemorrhoids
5% adults
Dilated hemorrhoidal venous plexus risks
> 50 yo
Pregnancy
Constipation
Liver cirrhosis
Internal hemorrhoids
Above anorectal line
External hemorrhoids
Below anorectal line
Recurrence of hemorrhoids is
5-50%
Vascular lesion MC in cecum or ascending colon
Angiodysplasia
20% of lower intestinal bleeds
Angiodysplasia
Ischemic bowel disease can occur due to occlusion of which arteries
Superior mesenteric
Inferior mesenteric
Celiac
Chronic ischemic bowel disease
Mimics IBD
Acute ischemic bowel disease
Severe abdominal pain
N and V
Acute ischemic bowel disease is a risk for ___ and prognosis is ___
Septic or hypovolemic shock
50% mortality
malabsorption conditions in US due to
Celiac
Crohn’s
Pancreatic insufficiency
Chronic diarrhea decreases absorption of which nutrients
Fats Carbs Proteins Vit ADEK Minerals Electrolytes Water
Steatorrhea
Excessive fat in feces
Frothy, greasy, yellow
Dysentery
Bloody diarrhea following infection
Features of malabsorption
Weight loss Muscle wasting Flatulence Anorexia Abnormal distention
Consequences of malabsorption
Iron deficiency anemia Osteopenia Tetany (low calcium) Amenorrhea Infertility Neuropathies (low Vit b12)
Immune mediated reaction to gliadin
Celiac disease
In celiacs, lymphocytes cause _____ primarily in duodenum and jejunum
Villous atrophy
Genes associated with celiacs
HLA DQ2
HLA DQ8
Gluten can be broken down into
Gliadin
Glutenin
Congenital outpouching of SI
Meckel’s diverticulum
Characteristics of Meckel’s
2 in long
2% pop
2X risk males
2% asymptomatic
MC cause of acute abdomen
Acute appendicitis
Freq of acute appendicitis
7% US population
Early symptoms of acute appendicitis
Periumbilical/ epigastric discomfort
Late signs of acute appendicitis
RLQ
Deep, sharp, constant pain
Leukocytosis is characteristic of
Acute appendicitis
Acute appendicitis MC in
Adolescents
Young adults
Males
Common cause of acute appendicitis
Obstruction
MC tumor of appendix
Carcinoid
MC form of gastric Ca
Adenocarcinoma
Sigmoid diverticulitis risks
Age (50% >60 yo)
Low fiber
Tenesmus is ___ and is common in ____
Sensation of inadequate bowel movements
Sigmoid diverticulitis
Celiac freq
1% US and Europe
Age 30-60
Untreated celiacs can increase risk of
Intestinal adenocarcinoma
Diagnosis of celiac
Duodenal biopsy
IgA tissue transglutaminase
IgG deaminated gliadin
Additional tests that can be performed for celiacs
DEXA
Nutritional tests
Celiac disease manifesting on skin
Dermatitis herpetiformis
10% of celiac patients develop ___, which appear as ____
Dermatitis herpetiformis
Itchy Small blisters (arms, elbows, legs, buttocks)
Environmental enteropathy aka
Tropical sprue
Tropical sprue common in
Children 2-3 yo
Tropics
Environmental enteropathy includes cycles of
Mucosal injury
Malnutrition
Inflammation
Hypotheses for tropical sprue
Autoimmune causing villus flattening
+
Infectious component
MC form of lactose intolerance
Acquired
Lactose intolerance is rarely congenital, which is due to ___
Autosomal recessive disorder
Diagnosis for lactose intolerance
Breath hydrogen test