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Pathophysiology > Exam 4: GI dysfunction > Flashcards

Exam 4: GI dysfunction Flashcards

1
Q

What substances are present in cirrhosis that suggest the onset of fibrosis?

            a. Mallory bodies
	b. Fatty infiltration in liver cells
	c. Varices
	d. Acetylaldehydes
A

A

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2
Q

Which one of the following organisms may be a causative agent for peptic ulcer disease in many individuals?

	a. E. coli
	b. H. pylori
	c. Staph aureus
	d. H. influenza
A

B

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3
Q

The manifestations of a bowel obstruction are primarily related to which of the following?

a. Decreased absorption of nutrients
b. Accumulation of fluid and gas distal to the obstruction
c. Accumulation of fluid and gas proximal to the obstruction
d. Edema impairing biliary secretion

A

C

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4
Q

Which of the following are signs of Crohn’s disease? Select all that may apply.

a. __ ___ Steatorrhea
b. __ ___ Increased risk for cancer
c. __ ___ Only mucosal layer affected
d. _ ____ Skip lesions present
e. _ ____ Frequent, non-bloody stools common

A

A,D,E

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5
Q

Which one of the following is a characteristic of a gastric ulcer? Select all that may apply.

	a. \_\_\_\_\_ Affects males more than females b. \_\_\_\_\_ Onset is usually between 50 and 70 years of age c. \_\_\_\_\_ Gastritis is also a common occurrence d. \_\_\_\_\_ An affected person has a positive family history for PUD e. \_\_\_\_\_ An increased risk for cancer f. \_\_\_\_\_  Pain relief with food
A

B,C,E

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6
Q

Which of the following people are in need for immunization against Hepatitis B? Select all that apply.

a. _____ People who have unprotected sex with more than one partner
b. _____ Men who have sex with men
c. _¬____ Police officers
d. _____ Health care workers

A

ALL

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7
Q

A characteristic manifestation of malabsorption syndrome is the inability to reabsorb fats from the intestines. What is this sign called?

	a. Ecchymosis
	b. Melena
	c. Borborygmi
	d. Steatorrhea
A

D

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8
Q

What is the condition called when the pyloric valve is bypassed and food is emptied directly into the jejunum without mixing first in the duodenum?

a. Malabsorption syndrome
b. Intestinal obstruction
c. Dumping syndrome
d. Intestinal fistula formation

A

C

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9
Q

Which of the following is the leading cause of acute liver failure in the United States?

a. Alcohol consumption
b. Acetaminophen toxicity
c. Hepatitis B
d. Hepatotoxic antibiotics

A

B

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10
Q

Increased ammonia levels leading to hepatic encephalopathy is called which of the following terms?

a. Ascites
b. Melena
c. Azotemia
d. Varices

A

C

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11
Q

The type of gastritis that predisposes a person to pernicious anemia and stomach cancer is Acute / Chronic gastritis and the transient type that affects persons using alcohol or certain drugs is Acute / Chronic gastritis.

A

Chronic, Acute

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12
Q

The bacteria associated with gastritis and peptic ulcer disease is ___________________.

A

H.Pylori

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13
Q

TRUE – FALSE Duodenal ulcers are more common than gastric ulcers

A

T

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14
Q

A person presents to your clinic complaining of heartburn and gnawing-type pain that is worse after eating a meal. Based on this information you suspect that this person is suffering from a Gastric / Duodenal ulcer.

A

Gastric

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15
Q

A lower GI disease that may affect the large or small bowel is Crohn’s Disease / Ulcerative Colitis and is characterized by continuous inflammation / skip lesions of the intestine.

A

Crohn’s Disease……skip lesions

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16
Q

Frequent bloody, loose stools is a manifestation of Ulcerative colitis / Crohn’s disease and steatorrhea and malabsorption are common signs of Ulcerative colitis / Crohn’s disease.

A

colitis, crohn’s

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17
Q

Sudden abdominal pain, emesis containing bits of fecal matter, frequent watery stools are signs/symptoms of Dumping syndrome / peritonitis / malabsorption syndrome / intestinal obstruction.

A

intestinal obstruction

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18
Q

TRUE – FALSE A life-threatening complication of PUD is peritonitis

A

True

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19
Q

TRUE – FALSE A common complication of Crohn’s disease is toxic megacolon

A

False

20
Q

The type of cirrhosis of the liver that could be caused by viral hepatitis is Portal / Biliary / Postnecrotic cirrhosis.

A

Postnecrotic

21
Q

The stage of alcoholic cirrhosis that shows the presence of Mallory bodies is Alcoholic steatosis / hepatitis / cirrhosis.

A

hepatitis

22
Q

Circle the two types of viral hepatitis transmitted via the oral – fecal route.

	Hepatitis:	A    B    C    D    E    F    G
A

A,E

23
Q

what are the primary manifestations of any GI disorder?

A

pain, bleeding, anorexia, dysphagia, altered elimination, jaundice.

24
Q

What is gastritis?

A

inflammatory disorder of the gastric mucosa. acute and chronic.

25
Q

differentiate between acute and chronic gastritis?

A

acute-caused by local irritants or bacterial toxins

chronic- progressive disease causing thinning and degeneration of stomach wall

26
Q

what are the three types of chronic gastritis?

A

Helicobacter pylori: most common cause is developing countries
Chronic autoimmune:

27
Q

what is PUD? what are the risk factors for PUD?

A

peptic ulcer disease: break in mucosal lining of the lower esophagus, stomach, or upper small intestine. duodenal ulcers more commons than gastric ulcers.

risk factors: smoking, alcohol use, aspirin use, emotional stress

28
Q

How does the assessment of pain assist in determining gastric vs duodenal ulcers?

A
  • Duodenal – upper abdomen, intermittent, pain-antacid or food relief, nocturnal pain
  • Gastric- upper abdomen, intermittent, pain-antacid relief, food pain pattern
29
Q

Define ulcerative colitis and Crohn’s disease. Compare the two conditions: incidence, etiology, pathophysiology and manifestations.

A

• Ulcerative colitis – inflammatory disease of the colon
o Incidence
 Common between 20 and 25 but can affect any age group
 Females and males affected equally
 May be associated with family history
 Has increased risk for cancer
o Etiology – unknown; may have autoimmune component
o Pathophysiology
 Continuous inflammatory process in rectum and left colon
 Ulcers and denuded areas cause bleeding and bloody diarrhea
 Characteristic lesion
o Manifestations
 Mild to severe abdominal pain
 Bloody stools and diarrhea common
 Rare abdominal mass, malabsorption, and steatorrhea (fat secretion in feces)
• Crohn’s Disease – inflammatory disease of large or small intestine
o Incidence
 10 to 30 most common but affects any age group
 Males and females equally
 Family history more common
 Cancer risk not increased
o Etiology – unknown; may have genetic component
o Pathophysiology
 Progressive granulomatous inflammatory response frequent in ileocecal area
 All bowel layers affected
 Skip lesions present
o Manifestations
 Mild to severe abdominal pain
 Frequent stools and diarrhea common
 Abdominal masses common
 Malabsorption common
 Steatorrhea common
 Fever possible

30
Q

What are mechanical vs nonmechanical intestinal obstructions?

A
  • Mechanical – anything that encroaches on the lumen of the bowel
  • Non-mechanical – paralytic ileus (non-contractibility of intestine)
31
Q

Define: volvulus

A

obstruction due to knotting or twisting of gastrointestinal tract

32
Q

Define:• Intussusception

A

condition in which part of intestine slides into adjacent part of intestine

33
Q

• Peritonitis –

A

inflammation of membrane lining abdominal wall and covering abdominal organs

34
Q

inability of intestine to contract normally

A

• Paralytic ileus –

35
Q

Why is peritonitis and/or paralytic ileus a dangerous complication in a client?

A
  • Prevents elimination of waste leading to Fluid imbalances

* Pt. develops s/sx. Common to heart failure

36
Q

Define intrahepatic disorders. Types?

A
  • Disrupt flow of bile through liver, causing cholestasis and biliary cirrhosis
  • Primary Biliary Cholangitis (PBS): autoimmune destruction of small intrahepatic bile ducts and cholestasis
  • Secondary Biliary Cholangitis (SBS): prolonged obstruction of extrabiliary tree; most common cause: cholelithiasis
37
Q

Define cirrhosis

A
  • Scarring of the liver

* End stage of chronic liver disease

38
Q

What are the manifestations of liver failure? . . . complications?

A 
•	Weakness, weight loss, anorexia, fatigue
•	N/V, change in bowel habits
•	Pruritus
•	GI bleeding
•	Jaundice
•	Ascites
•	Ecchymosis, Petechiae, spider angioma
•	Palmer erythema
•	Hepatomegaly (liver shrinks)
Complications:
•	Portal hypertension
•	Varices
•	Ascites
•	Encephalopathy
•	Bleeding and DIC
•	Hepatorenal syndrome
39
Q

What are esophageal varices and why are they a serious complication?

A
  • Distended thin-walled and fragile collateral veins in esophagus
  • Rupture of varices due to erosion by gastric acid causes serious hemorrhage
  • Can lead to hypovolemic shock
40
Q

Define hepatic encephalopathy: etiology,

A

• Coma
• Etiology:
o Unknown but associated with increased ammonia level
o Blood shunted around liver due to failure and collateral vessels

41
Q

Describe/define the various types of hepatitis according to:
• Inflammation of liver
Cause/etiology:

A

: toxins, reactions to drugs, infectious agents

42
Q

• Describe/define the various types of hepatitis according to:
Route of infection:

A 
o	Hep. A- fecal-oral route
o	Hep. B- contaminated blood and body fluids
o	Hep C- blood and body fluids
o	Hep D- blood and body fluids
o	Hep E- oral fecal route
o	Hep F and G- unknown
43
Q

• Describe/define the various types of hepatitis according to:
Available vaccine

A

o Hep A – vaccine available
o Hep B- vaccine available
o Hep C- no vaccine
o Hep D- prevention of HBV prevents HDV

44
Q

Describe the clinical manifestations according to each phase of illness.

A 
•	Prodromal (Preicteric)
o	Flu-like symptoms: Anorexia, fatigue, N/V, malaise, headache, hyperalgia, low-grade fever
o	RUQ pain and tenderness
o	Weight loss
•	Icteric Phase
o	Characterized by jaundice
o	Clay colored stools, dark urine
o	Hepatomegaly
o	Splenomegaly
o	Abdominal pain/tenderness
•	Recovery (Posticteric)
o	Decreases in symptoms
45
Q

What is chronic active hepatitis? Autoimmune hepatitis?

A
  • Chronic- persistence of signs and symptoms and liver inflammation after Hep B,C and/or D
  • Autoimmune- severe type of chronic hepatitis of unknown origin with high levels of serum immunoglobulins

Pathophysiology (12 decks)

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