Exam 5: Chapter 29, 30, 31, 32

Question 1

Upper GI bleeding causes

Answer 1

bleeding varices, peptic ulcers, mallory-weiss tear

Question 2

Lower GI bleeding causes

Answer 2

polyps, cancer, inflammatory disease, hemorrhoids

Question 3

Sx of Gi bleeding

Answer 3

melena, decreased Hct and Hgb, tachycardia, hypotension, change in LOC, hematemesis, diarrhea

Question 4

Pathophysiology of GERD

Answer 4

reflux of chyme through LES; decreased LES tone

Question 5

Causes of GERD

Answer 5

increased abdominal pressure, delayed gastric emptying, and certain foods

Question 6

Sx of GERD

Answer 6

heartburn, indigestion, acid regurgitation, dysphagia, cough, chest pain, asthma, abdominal pain with eating

Question 7

Complications of GERD

Answer 7

esophageal cancer (Barretts tumor)

Question 8

Pathophysiology of hiatal hernia

Answer 8

part of the stomach protrudes through diaphram into the thorax

Question 9

Sx of hiatal hernia

Answer 9

GERD, esophagitis, dysphagia, epigastric pain

Question 10

Pathophysiology of acute gastritis

Answer 10

usually superficial erosions due to injury to the mucosal barrier by drugs and chemicals like NSAIDs and aspirin

Question 11

Pathophysiology of chronic gastritis

Answer 11

thinning and degeneration of the stomach wall; more in the elderly population

Question 12

Pathophysiology of chronic fundal gastritis

Answer 12

the worst; leads to gastric atrophy, decreased acid secretion, pernicious anemia

Question 13

Pathophysiology of peptic ulcer disease

Answer 13

a break or ulceration in the mucosal lining in the lower esophageal, stomach, or duodenum; exposed to gastric secretions and autodigestion

Question 14

Causes of gastric ulcers

Answer 14

H. pylori and NSAIDs

Question 15

Risk factors for gastric ulcers

Answer 15

chronic gastritis, decreased PG synthesis, duodenal reflux of bile and pancreatic enzymes

Question 16

Causes of duodenal ulcers

Answer 16

H. pylori and NSAIDs; there is increased acid and pepsin secretion

Question 17

Complications of duodenal gastritis

Answer 17

intestinal obstruction, bleeding, perforation, and death

Question 18

Causes of a stress ulcer

Answer 18

an acute peptic ulcer related to severe illness, trauma, or neural illness

Question 19

Pathophysiology od dumping syndrome

Answer 19

rapid emptying of hypertonic chyme into duodenum 10-20 min after eating

Question 20

Sx of dumping syndrome

Answer 20

cramping pain and diarrhea

Question 21

Pathophysiology of anemia related to post-gastrectomy

Answer 21

iron is malabsorbed and related to decreased acid production or no duodenum

Question 22

Cholelithiasis

Answer 22

gall stones

Question 23

Sx of cholelithiasis

Answer 23

abdominal pain, pain radiating to the right shoulder, jaundice, pruritus, heartburn, food intolerance especially fatty food

Question 24

Cholecystitis

Answer 24

inflammation of gallbladder usually from gall stones stuck in cystic duct

Question 25

Sx of cholecystitis

Answer 25

abdominal pain, fever, increased WBC, and rebound tenderness

Question 26

Pathophysiology of acute pancreatitis

Answer 26

obstruction of outflow of pancreatic enzymes; enzymes are activated and autodigestion occurs

Question 27

Causes of acute pancreatitis

Answer 27

alcoholism and biliary tract obstruction

Question 28

Sx of acute pancreatitis

Answer 28

abdominal pain, vomiting, and abdominal distension

Question 29

Causes of chronic pancreatitis

Answer 29

chronic alcoholism, fibrosis, continued inflammation, calcification, and cysts

Question 30

Complications of chronic pancreatitis

Answer 30

pancreatic cancer

Question 31

Pathophysiology of alcohol detoxification

Answer 31

alcohol turns into acetaldehyde and hydrogen. acetaldehyde damages hepacyte mitochondria, inhibits removal of proteins from liver, and alters metabolism of vitamins and minerals

Question 32

Pathophysiology of portal hypertension

Answer 32

obstructed blood flow through portal system

Question 33

Causes of portal hypertension

Answer 33

thrombosis, inflammation, and fibrous changes in liver

Question 34

Pathophysiology of esophageal varicies

Answer 34

increased portal vein pressure that causes development of collateral vessels; usually occurs in the lower esophagus, stomach, and rectum

Question 35

Pathophysiology of ascites

Answer 35

increased hydrostatic pressure in mesenteric tributaries of the portal vein that leads to water in peritoneal cavity

Question 36

Sx of ascites

Answer 36

abdominal distension, wt gain, SOB, and spider angioma

Question 37

Complication of ascites

Answer 37

bacterial peritonitis

Question 38

3 phases of HAV

Answer 38

prodromal: 2 wks after exposure and causes general sx icteric: 1-2wks later jaundice, dark urine, clay colored stool, and enlarged liver recovery: 6-8 wks after exposure. sx diminish, liver still enlarged and tender. liver normal 2-12 wks after exposure

Question 39

Cirrhosis of the liver

Answer 39

irreversible and inflammatory disease

Question 40

Fatty Liver

Answer 40

mildest form; reversible when drinking is stopped

Question 41

Alcoholic Hepatitis

Answer 41

inflammation, degeneration and necrosis of liver cells; infiltration by leukocytes and lymphocytes

Question 42

Cirrhosis

Answer 42

fibrosis of liver

Question 43

Sx of alcohol cirrhosis

Answer 43

wt loss, anorexia, enlarged liver and spleen, ascites, GI hemorrhage, hepatic encephalopathy, esophageal varicies