Exam 4 Flashcards
What is the basic pathophysiology of ileus?
Obstruction of the intestines
Small intestine is more common due to a narrower lumen
What are the manifestations of small intestine obstructions?
Colicky pains, nausea, vomiting
What are the manifestations of large intestine obstruction?
Hypogastric pain, abdominal distention
What are the manifestations of obstruction at the pylorus?
Early, profuse vomiting of clear gastric fluid
What are the manifestations of obstruction in the lower small intestine?
Pronounced distention, vomiting may occur later with fecal material
What is gastritis?
Inflammation of the gastric mucosa
What are the manifestations of acute gastritis?
Abdominal discomfort, bleeding, epigastric tenderness
What is PUD?
A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum
What are the manifestations of duodenal ulcers?
Epigastric pain, pain-food-relief pattern
What are the manifestations of gastric ulcers?
Pain-food-relief, pain immediately after eating, more chronic, anorexia, vomiting, weight loss
What is dumping syndrome?
Rapid emptying of chyme from a surgically created residual stomach into the small intestine
What is maldigestion?
Failure of the chemical process of digestion
What is malabsorption?
Failure of the intestinal mucosa to absorb digested nutrients
What are the manifestations of vitamin deficiencies?
A: night blindness, D: decreased calcium absorption, K: prolonged prothrombin time, E: testicular atrophy
What is ulcerative colitis?
Causes ulceration of the colonic mucosa, lesions are continuous, limited to mucosa, not transmural
What is Crohn’s disease?
Idiopathic inflammatory disorder affecting anywhere from mouth to anus, inflammation in skipped lesions affecting entire intestinal wall
What is diverticular disease?
Herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon
Diverticula
herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon
Example sentence: Diverticula can lead to diverticulitis if inflamed.
Diverticulosis
a symptomatic diverticular disease
Diverticulitis
inflammatory stage of diverticular
Example sentence: Diverticulitis can cause abscess formation.
Appendicitis
Inflammation of the vermiform appendix
Example sentence: Appendicitis can present with RLQ pain.
IBS
Functional GI disorder characterized by recurrent abd pain associated with altered bowel habits that present as diarrhea or constipation or both
Portal hypertension
High blood pressure in the portal venous system is caused by resistance to portal blood flow. High pressure in the portal veins causes collateral vessels to open between the portal veins and systemic veins.
Example sentence: Portal hypertension can lead to varices.
Ascites
Accumulation of fluid in the peritoneal cavity
Example sentence: Ascites can be caused by cirrhosis.
Hepatic encephalopathy
Accumulation of toxins related to liver failure, causing a disruption of neurotransmission
Example sentence: Hepatic encephalopathy can lead to confusion.
Jaundice
Yellow pigmentation of the skin caused by hyperbilirubinemia
Example sentence: Jaundice can be caused by gallstones.
Hepatitis
types and stages, basics of each type
Example sentence: Hepatitis B is transmitted through contact with infected blood.
Cirrhosis
Irreversible inflammatory fibrotic disease that disrupts liver function and even liver structure. Decreased hepatic function from fibrosis, biliary channels become obstructed and cause portal hypertension, and then blood is shunted away from the liver and hypoxic necrosis develops.
Example sentence: Cirrhosis can be caused by alcohol abuse.
Cholelithiasis
gallstone formation
Example sentence: Cholelithiasis can present with RUQ pain.
Cholelithiasis
Gallstone formation
Cholesterol stone: forms in bile that is supersaturated with cholesterol
Pigmented stone:
- Black: formed in sterile environment and are composed of calcium bilirubinate polymer from hyperbilirubinemia
- Brown: associated with bacterial infection of the bile ducts with formation of stone that is composed to calcium soaps, unconjugated bilirubin, cholesterol, fatty acids, and mucin. Manifestations: RUQ pain, intolerance to fatty foods, + Murphy sign, biliary colic, jaundice, fever, common complication is pancreatitis.
Cholecystitis
Inflammation of the gallbladder
Manifestations: fever, leukocytosis, Murphy’s sign, increased pain with fatty meal, abd muscle guarding.
Pancreatitis
Inflammation of the pancreas
Patho: injury or damage to pancreatic cells and ducts, causing a leakage of pancreatic enzymes into the pancreatic tissue. These enzymes cause autodigestion of pancreatic tissue and leak into the bloodstream to cause injury to blood vessels
Acute: resolves spontaneously, epigastric pain, N/V, fever, leukocytosis, elevated amylase and lipase
Chronic: repeated exacerbations of acute can lead to chronic changes usually from alcoholism; destroys acinar cells and the islets or Langerhans, risk factor for pancreatic cancer. Manifestations: continuous or intermittent pain, associated with increased intra-ductal pressure, increased tissue pressure, ischemia, neuritis, changes in central pain perception, weight loss, steatorrhea.
Splenomegaly
Enlargement of the spleen
- Portal hypertension contributes to congestive splenomegaly by increasing intrasplenic blood pressure
- Decreased platelet count is the most common manifestation.
Cancers of GI tract basics
Esophageal cancer: alcohol and tobacco use concurrently, GERD –> Barrett’s esophagus can predispose
Gastric: associated with H pylori, symptoms develop only after tumor has penetrated the wall of the stomach
Colon cancer:
- Tumors of right ascending colon: large and bulky
- Tumors of left descending, sigmoid develop as small button-like masses and stool is pencil shaped. Manifestations: pain, bloody stools, and change in bowel habits
Pancreatic: risk is heavy cigarette smoking, high mortality rate, s/s may not be evident until the tumor has spread to surrounding tissues.
