Exam 3 Gastrointestinal And Digestive Disorders Flashcards
What separates the gastric contents from the esophagus?
Lower esophageal sphincter (LES)
What is difficulty swallowing and risk for aspiration called?
Dysphagia
What is the lack of esophageal motility and relaxation of the LES?
Achalasia
What structure of the small intestine that receives pancreatic juice and bile from the liver and gallbladder?
Duodenum
What part of the intestines absorbs amino acids, glucose, lipids, iron, calcium, vitamin B12 and the fat solvable vitamins A,D,E, and K?
Jejunum and ileum
What part of the intestines is the site of enterohepatic bile reabsorption?
Ileum
What is the final area of water, vitamin and electrolyte absorption?
Large intestine
What assists in metabolism through carb fermentation and vitamin production?
Intestinal Flora
What is disease of gastric reflux into the esophagus accompanied by the failure of the anatomical (sphincter) and physiological mechanisms (ANS function) and mucosal protection to protect the esophagus?
Gastroesophageal reflux disease (GERD)
What occurs when the lower esophageal sphincter becomes enlarged allowing the a portion of the stomach to protrude into the mediastinum?
Hiatal hernia
What stage of chronic reflux esophagitis is characterized by epithelial hyperplasia and keratosis with scarce submucosal lymphatic infiltrate?
Stage 1
What stage of chronic reflux esophagitis is characterized by epithelial hyperplasia and keratosis with scarce submucosal lymphatic infiltrate with the addition of superficial erosion and neutrophilic infiltration?
Stage 2
What stage of chronic reflux esophagitis is characterized by epithelial hyperplasia and keratosis with scarce submucosal lymphatic infiltrate with the addition of superficial erosion and neutrophilic infiltration with epithelial ulceration and more pronounced epithelial regeneration?
Stage 3
Complications of what include fibrous scarring and stenosis, mucosal metaplasia and cancer?
Chronic reflux esophagitis
What is necrosis of the esophagus epithelium and subsequent erosion and ulceration?
Esophagitis
What is precancerous changes of the esophagus epithelium due to chronic injury?
Barrett esophagus
What is injury and Barrett metaplasia initiating the progression to cancers?
Esophageal adenocarcinoma
Pt. Presents with an erosion or ulcer of the stomach that is caused by low dose aspirin, NSAIDS, and H. pylori infection. The patient is also constantly stresses, has a poor diet, consumes caffeine, tobacco and alcohol. What is likely their diagnosis?
Peptic ulcer disease
Pt presents with pain in the abdomen that occurs between meals about 2-3 hours after eating. He describes pain to be intense , burning and gnawing that is relieved by food. Lab work shows positive for H. Pylori. What is likely the patients diagnosis?
Peptic ulcer disease
What disorder is characterized by abdominal pain, altered bowel habits, GI bleeding, And weight loss ?
Irritable bowel syndrome
This disease affects anywhere in the GI tract from mouth to anus, has healthy tissue interrupted by areas of diseased tissue, affects the whole thickness of the intestinal wall and does not characteristically predispose to cancer.
Crohn’s disease
This disorder only affect the large intestine from rectum upwards, affects upper layers of intestinal wall, has pseudopolyps and predisposes to colon cancer.
Ulcerative colitis
What disease presents with diarrhea, abdominal pain, GI bleeding, and weight loss with fever and malaise? It may present with extra intestinal inflammatory autoimmune or hypersensitivity disorders such as arthritis or cutaneous inflammation.
IBD (inflammatory bowel disease)
This disease presents with fistula and strictures from inflammation and scar tissue healing that may obstruct the bowel. Watery diarrhea is often seen.
Crohn’s disease
It’s disease presents gradually with exacerbation followed by improvements in the disease. It’s hallmark characteristic s bloody diarrhea with or without mucus.
Ulcerative colitis
This complication includes acute colon distention causing obstruction and impaired absorption which can cause sepsis, perforation, or peritonitis. Pt. May have autoantibodies that cross react with other organs of the body causing arthritis, skin lesions, and anemia.
Toxic megacolon
What is the inflammation of the veriform appendix the results in necrosis and perforation with generalized peritonitis?
Appendicitis
This is caused by obstruction due to feces, infection, or lymph hyperplasia.
Appendicitis
What is inflammation of the serous membrane lining the abdominopelvic cavity?
Peritonitis
This is an inflammation of the peritoneum that is caused by bacterial invasion or chemical irritation that is a complication of perforation of the intraabdominal organs.
Acute peritonitis
This is a group of stomach disorders involving the superficial inflammation of the stomach mucosa that may be infectious H. Pylori and other pathogens, inflammatory of autoimmune
Gastritis
This is caused by several neoplasms and cancers that can develop from genetic risk factors, environmental insults, or chronic inflammation. These can include esophageal, gastric, or colorectal cancers.
GI-Associated cancers
This is the outpouching of the wall of the small intestine or colon due to structural changes in the bowel wall
Diverticulosis
This is the inflammation of the outpouching in diverticulosis which cause a obstruction, abscess, bleeding, and perforation.
Diverticulitis
This is an immune-mediated disorder due to the intestinal hypersensitivity reaction to gluten which has a primary cause of malabsorptive syndrome that causes nutritional deficiencies of nutrients, folate, iron, and vitamins.
Celiac disease
These are superficial varicose veins in the perinatal region that can become irritated, inflamed, or infected causing pain and rectal bleeding.
Hemorrhoids
These are protrusions of intestines through the weakened abdominopelvic wall that can cause strangulation and infarction.
Hernia
What is the functional unit of the liver that consist of hepatocytes, dual blood supply forming sinusoids and bile ducts.
hepatic lobules.
What does the liver convert bilirubin into?
Bile pigment
This is the yellow-green pigment derived from heme metabolism from senesced RBC’s and is excreted into the GI tract and is converted to urobilinogen for excreted in feces or urine
Bilirubin
Water and sodium bicarbonate, pancreatic analyses, proteases, pancreatic lipase and nucleases are all components of what?
Pancreatic juice
This is a decrease in liver metabolism of estrogen that causes vasodilation.
Spider angiomas
This is excessive bilirubin production usually due to excessive RBC hemolysis.
Prehepatic jaundice
This is hepatocellular of liver injury that prevents bilirubin metabolism
Intrahepatic jaundice
This is bile duct obstruction
Posthepatic jaundice.
What does serum level have to reach for the sclera have to be to present with jaundice? Skin?
3 mg/dL ; 5-6 mg/dL
What is the progressive loss of the liver tissue with fibrotic tissue replacement creating irregular nodules?
Cirrhosis
What is the increased vascular resistance of the liver increasing the pressure within the hepatic portal vein and venous system?
Portal hypertension
What is the abnormal accumulation of fluid in the peritoneal cavity caused by decompensated live cirrhosis, heart failure, or other disease when more that 500 mL of fluid has accumulated causing weight gain and abdominal extension.
Ascites
What is the altered mental status and cognitive function that occurs in the process of cirrhosis and liver failure that presents with symptoms ranging from confusion, stupor, disorientation and coma.
Hepatic encephalopathy
What is the acute or chronic inflammation of the liver caused by autoimmune, viral infection, medications, chemical or toxic substances, or alcohol abuse.
Hepatitis
This is transmitted vie fecal-oral route and typically is caused by ingestion of contaminated food or water, person to person contact due to unsanitary conditions or on surfaces at room temperature.
Hepatitis A
This presents with jaundice and other symptoms accompanied by the appearance of IgM and IgG type antibodies that signal recovery and immunity against reinfection.
Hepatitis A
This is a stable virus spread by blood products, body fluids, or sexual contact that is associated with multiple sexual partners and IV drug use.
Hepatitis B
This is a blood borne pathogen that infects hepatocyte and B lymphocytes.
Hepatitis C
What the other name for a fatty liver?
Steatosis
Gallstones are also known as?
Cholelithiasis
What is inflammation of the gallbladder that can be acute or chronic?
Cholecystitis
What are stones in the common bile duct that can lead to the backup of bile into the gallbladder and liver?
Choledocholithiasis
These are the most common stones formed in the gallbladder due to supersaturation of cholesterol; 80% of all gallstones are caused by this.
Cholesterol stones
What are small hard gallstones composed of calcium bilirubinate and inorganic calcium salts?
Black pigment stones
What are calcium salts of unconjugated bilirubin, with small amounts of cholesterol and protein?
Brown pigment stones.
This presents with abdominal pain, nausea, anorexia, vomiting, RUQ pain and can be triggered by eating fatty meals or consuming alcohol.
Pancreatitis
What is the bluish discoloration around the umbilicus resulting from hemorrhagic pancreatitis?
Cullen sign
What is the reddish-brown discoloration along the flanks resulting from retroperitoneal blood dissecting along the tissue planes?
Grey-turner sign.
This is characterized by elevated serum pancreatic amalyase and serum pancreatic lipase that is treated with electrolytes and nutrients vie IV, pain control and preventing eating by mouth.
Pancreatitis
This can initiate internal hemorrhage, disseminated intravascular coagulation, septicemia, circulatory collapse and shock, multiple organ failure and death.
Severe hemorrhagic pancreatitis
A 68 y/o obese male w/ a hx of alcohol abuse is lethargic, disoriented, and is speaking incoherently. You notice his skin and the sclera of his eyes have a yellow appearance, his abdomen is distended with prominent umbilicus veins and his urine is dark yellow. The physician orders several lab tests. What additional findings would indicate a diagnosis of a liver failure?
Prolonged prothrombin time and low serum albumin
A physician orders an abdominal ultrasound and several blood and serum labs. Which of the following lab findings would support a diagnosis of acute pancreatitis due to alcohol abuse ?
Elevated serum pancreatic lipase and amalyase
1 47 y/o female reports symptoms of fatigue, headache, abdominal pain, easy bruising, mild ascites and hemorrhoids. You assessment notes a yellow hue to her skin and sclera with petechiae and bruises. She reports several previous bouts of abdominal pain and illness that resolved in several days. The pt. Has a hx of past illegal substance abuse including injected narcotics. Which of the following is the most likely diagnosis? What diagnostic test would be utilized to identify the etiology?
Liver failure; Hepatitis C virus RNA assay
An 18 y/o male reports abdominal pain that has increased in severity over the last day. He presents with nausea, vomiting, and fever. You physical exam identifies severe RLQ pain with rebound tenderness and Rovsing’s sign. Which of the following is most likely the diagnosis? What finding would be utilized too validate the diagnosis?
Appendicitis; abdimnopelvic ultrasonography
A 22 y/o male reports with anorexia, nausea and worsening bouts of abdominal pain with diarrhea that has intensified over the last month. Physical exam identifies a low grade fever and pallor. He indicated he has lost 20 lbs over the past month. The physician orders the following lab reports and procedures; complete blood count with differential, complete metabolic pane, C reactive protein and a referral for a colonoscopy. According to the diagnostic studies ordered, you presume that the physician suspects a diagnosis of?
Inflammatory bowel disease