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Pathophysiology > Final: Ch 29 Disorders of GI Function > Flashcards

Final: Ch 29 Disorders of GI Function Flashcards

1
Q

dysphagia definition and causes

A

difficulty swallowing

narrowing of esophagus (scarring, cancer)

CNS lesions of swallowing nerves

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2
Q

Dx of dysphagia

A

Dx: endoscopy w/ barium

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3
Q

3 phases of dysphagia

A

1: neuromuscular disorder
2: pharyngeal phage/transport phase
3: esophageal phase/peristalsis

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4
Q

esophageal diverticula

A

weaknesses in the wall retain food

inflammation & ulceration result

requires surgery

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5
Q

esophageal laceraion

A

tear in mucosa

caused by severe vomiting

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6
Q

hiatal hernia

A

stomach protrudes through diaphragm

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7
Q

sliding HH

A

herniation at GE junction

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8
Q

para-esophageal HH

A

separate gastric pouch herniated

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9
Q

GERD

A

gastric contents enter esophagus through weak esophageal sphincter

esophageal mucosa injured

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10
Q

symptoms of GERD (heartburn)

A

heartburn 30-60min after eating (severe)

heartburn worse when bending/lying down

can produce chest pain or trigger asthma

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11
Q

other symptoms of GERD

A

mucosal injury can cause erosion or stricture

barrett’s esophagus (squamous epithelium replaced by columnar)

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12
Q

diagnosis of GERD

A

history

barium swallow

endoscopy

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13
Q

treatment of GERD

A

avoid large meals, fat, caffeine, and alcohol

antacids, proton pump inhibitors

histamine-2 receptor blockers

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14
Q

esophageal cancer

A

squamous cell or adenocarcinoma

squamous cell from alcohol/smoking

adenocarcinoma starts with barrett’s esophagus

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15
Q

treatment for esophageal cancer

A

surgery if early stage

radiation/chemo for late stage

poor prognosis

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16
Q

acute gastritis

A

acute inflammation caused by meds (NSAIDS), alcohol, or bacterial toxins

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17
Q

chronic gastritis

A

chronic inflammation –> atrophy of glandular epithelium

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18
Q

most common cause of chronic gastritis

A

H pylori gastritis

difficult to cure

treat with antibiotics and proton pump inhibitors

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19
Q

autoimmune gastritis

A

Ab vs. parietal cells and IF (intrinsic factor)

accompanies type 1 DM & hashimoto’s thyroiditis

lack of IF –> vit b12 deficiency

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20
Q

peptic ulcer disease can be ______ or _______

A

gastric or duodenal

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21
Q

peptic ulcer disease can penetrate ______ only or enter the ________ muscle

A

mucosa, smooth muscle

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22
Q

risk factors for peptic ulcer disease

A

H pylori

NSAIDS

aspirin

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23
Q

infection in duodenal disease

A

bacteria cause inflammation –> cytokines –> damage mucosa

acid production is increased

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24
Q

NSAIDS in peptic ulcer disease

A

inhibit prostaglandins –> mucosal injury

less gastric irritation if use selective COX-2 inhibitors (celebrex)

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25
Q

clinical presentation of peptic ulcer disease

A

pain when the stomach is empty

hemorrhage b/c of erosion of arteries or veins –> tarry stool or coffee grounds emesis

perforation – peritonitis

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26
Q

Dx of peptic ulcer disease

A

H&P

X-ray w/ contrast

endoscopy

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27
Q

treatment of peptic ulcer disease

A

antacids

proton pump inhibitors

H2 receptor antagonists

surgery for bleeding

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28
Q

Zollinger-Ellison syndrome

A

ulcers from gastrin-secreting tumor

most tumors in the pancreas

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29
Q

stress ulcers

A

seen with burns, sepsis, ARDS

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30
Q

stomach cancer is the __ most common worldwide

A

2nd

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31
Q

what increases risk for stomach cancer

A

eating smoked meat

H pylori infection

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32
Q

most stomach cancer is in which regions

A

pyloric

antrum

irregularly shaped

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33
Q

symptoms of stomach cancer

A

pain

weight loss

N/V

asymptomatic until late stage

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34
Q

Dx/Rx of stomach cancer

A

Dx: x-ray w/ contrast, endoscopy w/ biopsy

Rx: subtotal gastrectomy

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35
Q

irritable bowel syndrome symptoms

A

recurrent abdominal pain

n/v

bloating

farting, altered bowel movements

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36
Q

causes of IBS

A

poor nervous regulation

abnormal contractions due to stress

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37
Q

Dx of IBS

A

based on S&S

continuous or recurrent symptoms for > 12 wks in a year

2/3 of:

relief w/ pooping, onset associated w/ change in frequency, onset w/ change in stool appearance

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38
Q

Rx of IBS

A

reduce stress

avoid fatty foods, alcohol, antispasmotic meds

39
Q

inflammatory bowel disease includes

A

Crohn’s disease

ulcerative colitis

40
Q

common features of inflammatory bowel disease

A

inflammation of large bowel w/ no cause or family pattern

remissions & exacerbations

41
Q

areas of Crohn’s disease

A

distal SI

proximal colon

42
Q

areas of ulcerative colitis

A

descending colon

rectum

43
Q

pathogenesis of inflammatory bowel disease

A

genetics

environment

immune response

microbes

44
Q

Crohn’s disease

A

small/large bowel inflammation

demarcated lesions surrounded by normal mucosa (skip lesions)

submucosa affected

mucosa has cobblestone appearance (fissures surrounded by edema)

45
Q

symptoms of Crohn’s disease

A

pain, diarrhea, weight loss, electrolyte imbalances

fistula, abscess, obstruction

46
Q

Dx of Crohn’s disease

A

sigmoidoscopy w/ biopsy

CT

H&P

47
Q

Rx of Crohn’s disease

A

anti-inflammatory meds

immunosuppressant meds

surgical resection

48
Q

ulcerative colitis

A

inflammation of colon only - begins in rectum and spreads proximally

mostly impacts mucosa - pinpoint hemorrhages

49
Q

symptoms of ulcerative colitits

A

relapsing attacks of severe diarrhea - bloody stool/mucus

incontinence

anorexia

weakness

50
Q

Dx of ulcerative colitis

A

sigmoidoscopy

H&P

51
Q

Rx of ulcerative colitis

A

avoid caffeine, lactose, spicy foods

anti-inflammatory meds

colectomy

52
Q

complications of ulcerative colitis

A

colon cancer

53
Q

infectious enetocolitis

A

viral, bacterial, protozoal

spread person to person in food

54
Q

viral infectious enterocolitis

A

rotavirus

protection from nursing

diarrhea causes dehydration in infants

use supportive management

vaccinate

55
Q

bacterial infectious enterocolitis

A

clostridium, E. coli, salmonella, C. difficile

some invasive, some non-invasive

2ndary to Antibiotic therapy

severe and life-threatening dehydration

56
Q

diverticular disease

A

colon mucosa herniates through submucosa in multiple places

lack of fiber and inactivity

57
Q

longitudinal muscle of colon is not continuous… (diverticular disease)

A

3 bands called teniae coli

places where blood vessels penetrate circular muscle are weak spots for herniations

58
Q

symptoms of diverticular disease

A

pain, diarrhea, constipation, bloating, farting

59
Q

complications of diverticular disease

A

perforation

bleeding

obstruction

fistula

60
Q

Dx of diverticular disease

A

H&P

CT

barium enema

61
Q

Rx of diverticular disease

A

stop solid food during acute attack

increase bulk in diet

62
Q

appendicitis

A

inflamed appendix – possibly gangrenous

abrupt onset of localized pain, signs of infection, rebound tenderness

63
Q

Dx/Rx of appendicitis

A

H&P, ultrasound, CT

removal

64
Q

complications of appendicitis

A

peritonitis

abscess

systemic sepsis

65
Q

acute diarrhea

A

less than 2 wks duration

inflammatory or non-inflammatory

66
Q

non-inflammatory acute diarrhea

A

large volume of watery stool b/c bacterial toxins

E. coli, S. aureus, vibro cholerae

67
Q

inflammatory acute diarrhea

A

small volume of bloody stool & fever b/c bacterial infection

salmonella

68
Q

chronic diarrhea

A

more than 4 wks duration

osmotic - lactose intolerance/excess magnesium salts

secretory - bile salts not reabsorbed in SI

inflammatory - inflammatory bowel disease

treat w/ oral rehydration

69
Q

causes of constipation

A

neurologic (MS parkinson’s)

endocrine (hypothyroidism)

drugs (narcotics, anticholinergics, Ca channel blockers, diuretics)

70
Q

treatment of constipation

A

treat cause

hydrate

exercise

dont use laxatives/enemas

71
Q

fecal impaction

A

hard stool in rectum that interferes with pooping

multiple causes that progress from constipation

digital or sigmoidoscopy dis-impaction

72
Q

intussusception

A

telescoping of bowel

usually terminal ileum enters colon

common in kids > adults

73
Q

volvulus

A

bowel twists on axis

usually cecum or sigmoid colon

74
Q

inguinal hernia

A

SI enters defect

may strangulate

75
Q

paralytic ileus

A

neurological disease or post surgical

76
Q

mass

A

bowel cancer

77
Q

symptoms of intestinal obstruction

A

abdominal distention

fluid loss

n/v

severe pain

78
Q

complications of intestinal obstruction

A

perforation

peritonitis

sepsis

79
Q

treatment of intestinal obstruction

A

NG suction w/ IV fluids

surgery

80
Q

peritonitis

A

inflammation of the peritoneum

due to bacteria or chemicals

gut perforation

81
Q

peritonits causes

A

massive fluid loss –> hypovolemic shock

82
Q

treatment of peitonitis

A

NPO

NG suction

fluid resuscitation

fix perforation

83
Q

malabsorption syndrome

A

poor fat absorption –> fat in stool

pancreatic or hepatic insufficiency

mucosal lesions

lymphatic obstruction

84
Q

celiac disease

A

autoimmune disorder triggered by gluten

inflammation damages villi –> less absorption surface

85
Q

celiac is more common in people with

A

type 1 DM

other autoimmune disorders

increases risk for cancer

86
Q

symptoms of celiac

A

infancy w/ diarrhea and FTT

malnutrition

87
Q

diagnosis/treatment of celiac

A

Dx: biopsy, measure Ab

Rx: don’t eat gluten

88
Q

adenomatous polyps

A

benign growths from intestinal mucosal epithelium

crypt cells proliferate –> abnormal –> adenoma

1/2 in rectum or sigmoid

89
Q

tubular adenoma

A

some dysplasia only –> unlikely to progress to cancer

90
Q

villous adenoma

A

broader more diffuse lesion

more likely to progress to cancer

91
Q

colorectal cancer

A

3rd most common cancer, 2nd leading cause of death

familial risk and high risk for those with inflammatory bowel disease

high fat diet and bacterial infection increases risk

92
Q

familial adenomatous polyposis increases risk for what

A

colorectal cancer

93
Q

what protects vs. colorectal cancer

A

aspirin

94
Q

Dx/Rx of colorectal cancer

A

Dx: screening - DRE, fecal occult blood test, colonoscopy

Rx: surgical removal

Pathophysiology (24 decks)

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