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exam 3 - GI - week 5 content Flashcards

1
Q

Upper GI distress

what 2 drugs Increase protective factors

A

o Antacids
o Sucralfate

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2
Q

upper GI or Lower GI=
- Esophagus
- Stomach
- Beginning of small intestines
- Small intestines
- Colon (large intestines)
- Rectum/anus

A

Upper GI
- Esophagus
- Stomach
- Beginning of small intestines

Lower GI
- Small intestines
- Colon (large intestines)
- Rectum/anus

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3
Q

s/s of what UGI issue
- Pyrosis – heartburn
- Dyspepsia – indigestion
- Regurgitation
- Chest pain
- Dysphagia
- Pulmonary symptoms

A

GERD
Gastro esophageal reflux disease

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4
Q

s/s
- abdominal distension
- fullness
- flatulence
- bloating
- intermittent abdominal pain exacerbated by stress and relieved by BM
- bowel urgency
- intolerance to certain food – sorbitol, lactose, gluten
- non-bloody stool that may contain mucus

A

Irritable bowel syndrome

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5
Q

what develops when the GI tract is exposed to acid and H pylori (when the aggressive factors outweigh the defensive factors)?

A

ulcers
Peptic ulcer disease PUD

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6
Q

s/s differences in duodenal ulcer vs gastric/peptic ulcer
- ________ ulcer timing = 2-4 hours after eating
- __________ulcer timing = 1-2 hours after eating

A

duodenal ulcer timing
= 2-4 hours after eating

gastric/peptic ulcer timing = 1-2 hours after eating

and that makes sense bc food passes through the stomach (gastric) area before it passes through the small intestine (duodenum)

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7
Q

Complications from GERD
- Ulceration
- Scarring
- Strictures
- Barrett esophagus

A

ALL

Barrett esophagus – development of abnormal metaplastic tissue, increased risk of development into cancer

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8
Q

Characterized by
- Chronic inflammation of the intestines
- Exacerbation and remissions

IBD or IBS?

A

Inflammatory bowel disease
A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

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9
Q

Development or presence of diverticula – small pouches in lining of colon that bulge outward through weak spots
- Location – descending colon

A

Diverticulosis

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10
Q
  • appendicitis
  • peritonitis
  • Irritable bowel disorder
  • Inflammatory bowel disorder
  • Crohns ulcerative colitis
  • Diverticulosis/Diverticulitis

lower GI or upper GI issues?

A

lower GI

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11
Q

A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

Chronic condition
Characterized by alterations in bowel pattern due to changes in intestinal motility
- chronic and frequent constipation
OR
- chronic and frequent diarrhea

Inflammatory bowel disease or Irritable bowel syndrome?

A

Irritable bowel syndrome
Chronic condition
Characterized by alterations in bowel pattern due to changes in intestinal motility
- chronic and frequent constipation = IBSC
- chronic and frequent diarrhea = IBSD

Inflammatory bowel disease
A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

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12
Q

Complications
- Perforation
- Peritonitis
- Obstruction

A

Diverticulitis

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13
Q

Patho/cause of ________
- Idiopathic
- Age related
- Injury/damage may weaken the diaphragm muscle
- Constantly too much pressure on the muscles around the stomach
o Severe coughing
o Vomiting
o Constipation and straining to have a BM

A

hiatal hernia

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14
Q

s/s of ______
- asymptomatic
- n/v
- anorexia
- weight loss
- bleeding
- burning pain – in middle abdomen or back , worse when stomach is empty
- cramping
- gas like pain

A

PUD

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15
Q

complications of acute or chronic gastritis?
- PUD
- Bleeding ulcers
- Anemia
- Gastric cancers

A

chronic gastritis
- lasts weeks to years

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16
Q

s/s
- Abdominal pain
- Bloody diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- crypts of lieberkuhn affected

s/s
- LRQ pain
- LRQ mass – palpable
- Cramps
- Watery diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- Malabsorption of nutrients
- Mouth ulcers
- s/e fistula

Crohn’s or UC?

A

UC s/s
- Abdominal pain
- Bloody diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- crypts of lieberkuhn affected

Crohn’s
s/s
- LRQ pain
- LRQ mass – palpable
- Cramps
- Watery diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- Malabsorption of nutrients
- Mouth ulcers
- s/e fistula

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17
Q

acute ___________
temporary inflammation of the stomach lining only (intestines are not affected)
- lasts 2-10 days

chronic ___________
progressive disorder with chronic inflammation in the stomach
- lasts weeks to years

acute _____________
inflammation of stomach and small intestine
- lasts 1-3, or 10 days

A

acute gastritis
temporary inflammation of the stomach lining only (intestines are not affected)
- lasts 2-10 days

chronic gastritis
progressive disorder with chronic inflammation in the stomach
- lasts weeks to years

acute gastroenteritis
inflammation of stomach and small intestine
- lasts 1-3, or 10 days

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18
Q

Risk factors for what UGI issue?
- Age
- Smoking
- Obese

A

hiatal hernia

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19
Q

Ulcerative disorder of the upper GI tract

A

Peptic ulcer disease PUD

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20
Q

Treatment for GERD
SATA
- Avoid triggers
- Prevent complications
- Some meds
- surgery

A
  • Avoid triggers
  • Prevent complications
  • Some meds
    X- surgery
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21
Q

Difficulty swallowing
- Begins with solids and progresses to liquids

A

Dysphagia

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22
Q

Etiology of _______
- H pylori
- Injury causing substances – daily use of NSAIDS, ASA, alcohol
- Excess secretion of acid
o Stress – increased gastric acid is secreted with body’s stress response
- Smoking
- Family hx

A

PUD

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23
Q

_________________
o H pylori
o NSAIDS
o Acid
o Pepsin
o Smoking
______________
o Mucus
o Bicarbonate
o Blood flow
o Prostaglandins

which factors cause ulcers and which factors protect against ulcers?

A
  • Aggressive factors
    o H pylori
    o NSAIDS
    o Acid
    o Pepsin
    o Smoking
  • Defensive factors
    o Mucus
    o Bicarbonate
    o Blood flow
    o Prostaglandins
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24
Q

s/s
- LLQ pain
- Fever
- Increase WBC
- Constipation or diarrhea
- Acute – passage of large quantity of frank blood

A

Diverticulitis

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25
Q
  • Elastic reservoir for food, mixing, and initial digestion of proteins
  • Lined with epithelium/gastric glands, which secrete HCl, IF – intrinsic factor, and gastrin
A

Stomach

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26
Q
  • Perforated ulcer
  • Pancreatitis
  • Ruptured gallbladder, spleen, bladder, appendix

cause ________

A

Peritonitis

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27
Q
  • Esophageal disorders like
    o GERD
    o Hiatal hernia
  • Inflammatory disorders of the stomach like
    o Gastritis
    o Acute gastroenteritis
    o PUD

upper or lower GI problems?

A

Upper GI problems

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28
Q

Membrane wall = plicae circulares
Fingers on membrane wall = intestinal villi
Fingers on the fingers = microvilli
These all give larger surface area for digestion

small or large intestine?

A

small

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29
Q

Backflow of gastric acid from the stomach into esophagus
- Occurs via the lower or upper esophagus sphincter?
- Highly acidic material

A

GERD
Gastro esophageal reflux disease
“heart burn”

Backflow of gastric acid from the stomach into esophagus
- Occurs via the LES
- Highly acidic material

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30
Q

PUD Classification
_____________
o Most common
o Age any, early adulthood
_____________
o Age 50-70 peak
o b/c increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses

Gastric/peptic ulcer or Duodenal ulcer ?

A

Classification
- Duodenal ulcer
o Most common
o Age any, early adulthood
- Gastric/peptic ulcer
o Age 50-70 peak
o b/c increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses

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31
Q

s/s of acute gastroenteritis
- watery diarrhea – bloody if bacterial
- abdominal pain
- n/v
- fever
- malaise

complications =

A

FVD

32
Q

__________ intestine
Includes appendix, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum
- No villi and no digestive enzymes
- Cells absorb water and electrolytes
- Goblet cells produce mucus
- Endocrine cells produce hormones

A

Large

33
Q
  • Fatty foods
  • Spicy foods
  • Tomato based foods
  • Citrus foods
  • Caffeine
  • Alcohol
  • Smoking
  • Sleep position
  • Obesity
  • Pregnancy
  • Pharmacologic agents

cause what upper GI issue?

A

GERD
Gastro esophageal reflux disease

anything that alters closure/strength of LES or increases abdominal pressure

34
Q

complications of _______

Fluids Shifting
1. Third spacing: fluids leave blood vessel and accumulate in the abdomen or pleural cavity.
2. This can lead to hypovolemia and Hypovolemic shock: If fluid loss is significant
3. Sepsis: infection

Decreased Peristalsis
1. Paralytic ileus: intestines stop moving
2. Intestinal obstruction: intestines become completely blocked

associated with which lower GI issue

A

Peritonitis

35
Q

obstruction that causes Appendix inflammation

A

Appendicitis

36
Q

complications of PUD

H –
O –
P –

A

complications of PUD

H – hemorrhage – if blood vessels are damaged
O – obstruction – scar tissues
P – perforation and peritonitis

37
Q

Crypts of lieberkuhn – secrete fluid
Goblet cells and brunner glands – make mucus for protection against acid

small or large intestine?

A

small

38
Q
  1. _________ esophageal sphincter – prevents food and fluids from aspirating into lungs (top of esophagus)
  2. _______ esophageal sphincter or “cardiac sphincter” – separates the esophagus from the stomach, prevents acidic content of the stomach from entering back into the esophagus (bottom of esophagus)
A

– upper
– lower (LES)

39
Q

_____________ is a chronic inflammatory bowel disease (IBD) that can affect any part of the digestive tract, from the mouth to the anus.

________ is a chronic inflammatory bowel disease (IBD) that causes inflammation of the mucosa of the rectum and colon

A

Crohn’s disease

ulcerative colitis

40
Q
A
41
Q

which layer of the stomach
contains:
- G-cells – produce gastrin which facilitates production of HCl
- Parietal cells – produce HCl to help break down food, and produce IF to protect mucosa
- Chief cells – secrete pepsin
- epithelial cells – secrete bicarbonate-rich solution to protect mucosa
- blood vessels

A

Mucosa layer - Inner layer

42
Q

Cause
- Autoimmune activated by an infection

causes IBS or IBD?

A

Inflammatory bowel disease
A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

43
Q

s/s of ________
- Asymptomatic
- Belching
- Dysphagia
- Chest or epigastric pain

A

hiatal hernia

44
Q

Complications of what lower GI issue
- Gangrene
- Abscess formation
- Peritonitis

A

Appendicitis

45
Q

Inflammation of one or more of the pouches (diverticula)
- May resolve spontaneously

A

Diverticulitis

46
Q

s/s
- Sudden and severe
- Abdominal pain
- Tenderness
- Rigid board like abdomen
- n/v
- fever
- elevated WBC
- increased HR – r/t pain and fluid shifts
- decreased BP – r/t pain and fluid shifts

A

Peritonitis

47
Q

Patho for crohn’s disease
1. Lymph structures in the GI tract are _______
2. Tissue becomes engaged and ________
3. Skip lesions - Deep linear fissures and ulcers develop in a patchy pattern in the bowel wall, _________ appearance

A

Patho
1. Lymph structures in the GI tract are blocked
2. Tissue becomes engaged and inflamed
3. Skip lesions - Deep linear fissures and ulcers develop in a patchy pattern in the bowel wall, cobblestone appearance

48
Q

A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

A

Inflammatory bowel disease

49
Q

Patho of PUD
1. ______ is damaged
2. _________ secreted
3. ___crease in acid and pepsin secretion = causes further tissue damage
4. Vaso____tion = causes edema
5. Destroyed blood vessels = bleeding ulcers

A

Patho
1. Mucosa (lining of the stomach) is damaged
2. Histamine secreted
3. Increase in acid and pepsin secretion = causes further tissue damage
4. Vasodilation = causes edema
5. Destroyed blood vessels = bleeding ulcers

50
Q

s/s
- Asymptomatic
- Accidentally discovered or with presentation of acute diverticulitis

A

Diverticulosis

51
Q

is it Common for GERD and hiatal hernia to coexist ?

Treatment for HH
1. Teaching
o meals =
o don’t _____ after eating
o _____- tight clothes and abdominal supports
o ________ if obese
o _______ meds for GERD symptoms
2. surgery if other treatment doesn’t work

A

Treatment
1.Teaching
o Small frequent meals
o don’t lie down after eating
o avoid tight clothes and abdominal supports
o weight control if obese
o antacids for GERD symptoms
2. surgery if other treatment doesn’t work

52
Q

s/s
- RLQ pain
- Rebound pain – severe pain after release of palpating hand over RLQ
- Sudden pain relief = rupture (peritonitis)

A

Appendicitis

53
Q

o CVA-stroke
o Achalasia – LES cant open properly
o Common in intubated people

resulting in dysphagia

cause is….
Mechanical obstruction (structure issue) or Neuromuscular dysfunction (brain issue)?

A

Neuromuscular dysfunction (brain issue)

54
Q

Risk factors for _______ induced PUD

  • older Age
  • Higher doses of NSAIDS – inhibit prostaglandin, lose protective mucus coating
  • Hx of PUD
  • Use of corticosteroids long term and anticoagulants
  • Serious systemic disorders – autoimmune
  • H pylori infection
A

NSAID

55
Q

2 types of hernia - - Paraesophageal hernia
and Sliding hernia

________
o Usually small
o Doesn’t need treatment
o Less severe
__________
o Part of the stomach pushes through the diaphragm and stays there
o More severe

A

2 types
- Sliding hernia
o Usually small
o Doesn’t need treatment
o Less severe
- Paraesophageal hernia
o Part of the stomach pushes through the diaphragm and stays there
o More severe

There are types 3 and 4 and they are a mixture and worse

56
Q

psychosocial stress and IBS
T/F
- emotional stress doesn’t cause IBS
- emotional stress doesn’t make IBS worse
- IBS doesn’t cause emotional stress

T/F
Causes of IBS
- Idiopathic
- Triggered by stress
- Triggered by food
- Triggered by hormone changes
- Triggered by GI infections
- Triggered by menses
- autoimmune activated by an infection

A
  • emotional stress doesn’t cause IBS
    X - emotional stress can make IBS worse
    X - IBS can cause emotional stress
  • Idiopathic
  • Triggered by stress
  • Triggered by food
  • Triggered by hormone changes
  • Triggered by GI infections
  • Triggered by menses
    X- autoimmune activated by an infection = IBD
57
Q

___________ __________
- Normally closed at rest
- Prevent the movement of food backwards

A

Esophageal sphincters

58
Q

Complications of ______
- Malnutrition and anemia
- Scar tissue and obstructions
- Fistulas – inappropriate connections
- Cancer

Complications of ________
- Hemorrhage
- Perforation
- Cancer
- Malnutrition
- Anemia
- Strictures
- Colon, rectal and/or Anal Fissures
- Colon, rectal and/or Anal abscesses
- Toxic megacolon – rapid dilation of the large intestine that can be life threatening
- Colorectal carcinoma
- Liver disease – from inflammation and scarring of the bile ducts
- F&E and pH imbalances

Crohn’s or UC?

A

crohn’s Complications
- Malnutrition and anemia
- Scar tissue and obstructions
- Fistulas – inappropriate connections
- Cancer

UC Complications
- Hemorrhage
- Perforation
- Cancer
- Malnutrition
- Anemia
- Strictures
- Colon, rectal and/or Anal Fissures
- Colon, rectal and/or Anal abscesses
- Toxic megacolon – rapid dilation of the large intestine that can be life threatening
- Colorectal carcinoma
- Liver disease – from inflammation and scarring of the bile ducts
- F&E and pH imbalances

59
Q

etiology of _______:
- irritating substances – like alcohol
- drugs – like NSAIDS
- infectious agents – like H pylori

2 main etiology of ______:
- Autoimmune – attacks parietal cells (produce HCl to help break down food, and produce IF to protect mucosa)
- H pylori infection

etiology of ________:
- viral – noro and rota
- bacterial – E.coli, salmonella, campylobacter
- parasitic infection

acute gastroenteritis, acute gastritis, or chronic gastritis?

A

etiology acute gastritis
- irritating substances – like alcohol
- drugs – like NSAIDS
- infectious agents – like H pylori

2 main etiology chronic gastritis
- Autoimmune – attacks parietal cells (produce HCl to help break down food, and produce IF to protect mucosa)
- H pylori infection

etiology acute gastroenteritis
- viral – noro and rota
- bacterial – E.coli, salmonella, campylobacter
- parasitic infection

60
Q

___________
- Tube for food and fluids
- Connects throat to stomach
- Mucus and muscles help move food

A

Esophagus

61
Q

gastroenteritis vs gastritis?

s/s
- asymptomatic
- anorexia
- n/v
- postprandial pain – after eating
- intestinal gas
- hematemesis
- tarry stool
- anemia

s/s
- watery diarrhea – bloody if bacterial
- abdominal pain
- n/v
- fever
- malaise

A

gastritis
s/s
- asymptomatic
- anorexia
- n/v
- postprandial pain – after eating
- intestinal gas
- hematemesis
- tarry stool
- anemia

gastroenteritis
s/s
- watery diarrhea – bloody if bacterial
- abdominal pain
- n/v
- fever
- malaise

62
Q

o Stenosis or stricture
o Diverticula
o Tumor

resulting in dysphagia

cause is….
Mechanical obstruction (structure issue) or Neuromuscular dysfunction (brain issue)?

A
  • Mechanical obstruction – structure issue
63
Q

Cause _______
- Congenital or acquired
- Low fiber diet = chronic constipation

A

Diverticulosis

64
Q

Small intestine
1st
2nd
3rd

jejunum
ileum
duodenum

A

Small intestine
1st duodenum
2nd jejunum
3rd ileum

65
Q

Peritoneum inflammation – serous membrane that lines the abdominal cavity and covers visceral organs

A

Peritonitis

66
Q

Chronic condition
Characterized by alterations in bowel pattern due to changes in intestinal motility
- chronic and frequent constipation
OR
- chronic and frequent diarrhea

A

Irritable bowel syndrome
- chronic and frequent constipation = IBSC
- chronic and frequent diarrhea = IBSD

67
Q

complications of _______
H – hemorrhage – if blood vessels are damaged
O – obstruction – scar tissues
P – perforation and peritonitis

A

complications of PUD

H – hemorrhage – if blood vessels are damaged
O – obstruction – scar tissues
P – perforation and peritonitis

68
Q

G – granulomas
A – all
L – layers
S – skip lesions

Crohn’s disease of ulcerative colitis?

A

Crohn’s disease

69
Q

H pylori causes
________ and ________ and ___________
SATA
- Bacteria or virus?
- Acidic environment
- Persistent inflammation
- Transmission
o person to person via saliva, feces, or vomit
o contaminated food/water

A

chronic gastritis
PUD
stomach cancer

  • Bacteria
  • Acidic environment
  • Persistent inflammation
  • Can cause chronic gastritis, PUD, and stomach cancer
  • Transmission
    o person to person via saliva, feces, or vomit
    o contaminated food/water
70
Q

Defect in the diaphragm that allows part of the stomach to pass into the thorax

A

Hiatal hernia

71
Q

bacteria or virus causes acute gastroenteritis?

bacteria or virus causes chronic gastritis?

A

acute gastroenteritis
- viral – noro and rota
- bacterial – E.coli, salmonella, campylobacter
- parasitic infection

chronic gastritis
Bacteria = H pylori
also autoimmune

72
Q

IBD or IBS
More common in
- Women
- White
- Jewish
- Smokers

A

Inflammatory bowel disease
A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

73
Q

Small intestine sphincter
is called __________ sphincter
where food passes from small intestines to large intestines
- Distention allows passage and prevents reflux back onto ileum

A

Ileocecal sphincter

74
Q

Peptic ulcer disease PUD

  • Esophageal – ulcer in the _________
  • Gastric ulcer – ulcer in the __________
  • Duodenum ulcer – ulcer in the ___________
A

esophagus
stomach
first part of the small intestine

75
Q

Patho of UC
1. Begins in_______and extends in a continuous segment that may involve the entire colon
2. Inflammation = large ulcerations
3. _____ abscesses - Necrosis of the epithelia tissue can cause abscesses
4. Colon and rectum try to repair the damage with new _________ tissue – which is problematic b/c it is fragile and bleeds easy

A

Patho
1. Begins in rectum and extends in a continuous segment that may involves the entire colon
2. Inflammation = large ulcerations
3. Crypt abscesses - Necrosis of the epithelia tissue can cause abscesses
4. Colon and rectum try to repair the damage with new granulation tissue – which is problematic b/c it is fragile and bleeds easy

76
Q

which quadrant
diverticulitis =
appendicitis =
crohns =

A

Left LQ (descending colon)
Right LQ
Right LQ (mouth to anus)

sav NUR 326 (19 decks)

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