Final Exam- Gastrointestinal/ Digestive Disorders Flashcards
Definition of melena/ what does it indicate
black/tarry stool
bleed that originated in upper GI
What does vomiting blood indicate
upper GI bleed (esophagus, stomach, duodenum)
What is direct bilirubin
already chemically changed in the liver
ready to leave body
From the blood where do nutrients travel to
liver (for processing)
What are the factors that influence the rate of gastric emptying
volume
osmotic pressure
chemical composition of contents
blood glucose level
What does direct bilirubin elevation indicate
liver failure
blockage of the common bile duct.
What does bright red blood in vomit mean
active bleed (gastritis, ulcer, esophageal varices)
Term for the presence of non-inflamed diverticula
diverticulosis
What are signs for a small intestines obstruction
rapid onset
frequent vomiting
some feces
The splanchnic system supplies blood to what organs
Liver
stomach
spleen
pancreas
small intestines
colon
What is the cause of cholecystitis
obstruction from a gallstone
billiard sludge
What is the mechanism of cirrhosis
chronic inflammation –> destruction of liver cells –> scar tissue/nodules
What happens to the electrolytes in the GI tract
most reabsorbed into bloodstream
some excreted by kidneys
rest to large intestines for reabsorption/excretion
What stop peristaltic activity
sympathetic nervous system
secretin is secreted
What is a diagnostic test for hepatic encephalopathy
serum ammonia level
What nutrients does the small intestines breakdown/ into what
carbs –> monosaccharides/ disaccharides
protein –> amino acids
fats –> fatty acids/ monoglycerides
What causes Hepatitis B
mom-baby
dirty needles
sex
Manifestations of esophagitis
dysphagia
painful swallowing
What causes Hepatitis E
fecal oral route (contaminated water)
blood (rare)
What is the cause of hepatitis A
contaminated food/water (fecal oral route)
Term for inflammation of the gall bladder
cholecystitis
What is the effect of peritonitis
inflammation allows blood vessels to leak
fluid enters abdominal space
possible hemodynamic instability = shock
What cell types make up the liver/purpose
hepatocytes- functional cell of liver
lipocytes- store lipids
Kipper cells- phagocytes
How does hypo/hypertonic solutions affect gastric emptying
osmoreceptors are activate to delay gastric emptying
need to neutralize acids to be more isotonic
Lower esophageal sphincter purpose
prevents regurgitation from the stomach
Type of ulcer from severe illness, trauma, or neuro injury
stress ulcer
What are causes of acute pancreatitis
endoscopic retrograde cholangiopancreatography (cause inflammation)
chronic alcohol gallstones
What is indirect bilirubin
produced from broken down red blood cells
What are manifestations of portal hypertension
abdominal distension
increased abdominal girth
weight gain
What makes up gastric secretions/ purpose of each
mucus- protects against stomach acid
intrinsic factor- helps intestines absorb B12
gastroferrin- helps iron absorb in small intestine
What do the autodigestion enzymes during acute pancreatitis cause
edema
necrosis
hemorrhage
vascular permeability
Manifestations of peritonitis
hard/distended abdomen
rebound tenderness
Cullen’s sign
Grey Turner’s sign
What is the mechanism process of hepatic encephalopathy
elevated ammonia –> neurotoxic effects
What happens to the water in the GI tract
almost all reabsorbed in bloodstream
rest go to large intestines
Causes of a bowel obstruction
intussusception = lumen narrows/telescopes
volvulus = lumen twists
Is Hepatitis A acute, chronic, or both
acute
mild infection
What are late manifestations of cirrhosis
abnormal liver function test
jaundice
scleral icterus
peripheral edema
thrombocytopenia
adenocarcinoma of the stomach
gastric cancer
Where do peptic ulcers typically occur
stomach
What hormones/neurotransmitters stimulate acid secretion
acetylcholine
gastrin
histamine
What does “coffee ground” colored blood in vomit mean
past bleed that has stopped
due to iron oxidizing
Definition of hematochezia/ what does it indicate
blood in stool
lower GI bleed (colon, rectum, anus)
What enzymes are secreted by the pancreas
amylase
lipase
What is the cause of secondary peritonitis
chemicals/enzymes
trauma
What are risk factors for diverticular disease
low fiber intake
inactivity
obesity
What does elevated amylase and lipase indicate
pancreatitis
What is a diagnostic test for peritonitis
diagnostic paracentesis (to check for bacteria)
What are manifestations of cholelithiasis
biliary colic (pain)
dark/amber urine
What is the primary cause of primary peritonitis
bacteria (urinary/bloodborne)
What is contained in bile/ purpose of each
salts- emulsify fats
cholesterol
bilirubin- give pigment
electrolytes
water
Where does ulcerative colitis most likely occur
rectum
sigmoid colon
What is Cullen’s Sign
classic sign of peritonitis
ecchymosis (discoloration) around umbilicus
What are risk factors for acute pancreatitis
alcoholism
trauma
post-op
infection
How does motilin help peristalsis
presence of acid/fat in duodenum
increase in GI motility
What inhibits bacteria growth in the stomach
acid
kills ingested pathogens/stops growth
Manifestations of diverticulitis
lower ab cramping
bloating
lower GI bleed
What causes Hepatis C
dirty needles (blood)
When is bile released and where
What is the destination
after eating from liver –> common bile duct
gallbladder for stage
Manifestations of acute pancreatitis
epigastric pain –> back
leukocytosis
hemodynamic instability/inflammation
Inflammation of gastric mucosa
gastritis
What are risk factors for developing peptic ulcer disease
H-pylori bacteria
NSAIDS
Manifestations of an intestinal obstruction
Abdominal pain
nausea/vomiting
distention
constipation
high pitched bowel sounds above obstruction
no bowl sounds below obstruction
Is Hepatitis C acute, chronic, or both
mostly chronic
mild-severe symptoms
What are characteristics of Crohn’s disease
one side of intestinal wall affected/ not other
ulcers lead to fissures
inflammation goes into lymphatic ties
fistulae formation between intestines –> bladder/rectum
strictures = obstructions
Term for end stage liver disease
cirrhosis
Term for stones in the gallbladder
cholelithiasis
Is Hepatitis E acute, chronic, or both
acute (will resolve)
chronic inflammatory disease that causes ulcers in colonic mucosa
ulcerative colitis
What gastric contents slow down gastric emptying
solids
fats
hyper/hypotonic solutions
Increased hemolysis causes _______________
jaundice
What is a complication of chronic inflammation from esophagitis
scarring/strictures
Mallory-Weis tear
What are causes for a stress ulcer
burn (Curling’s ulcer –> histamine)
head trauma/surgery (Cushing’s ulcer –> acetylcholine)
What is absorbed from the intestinal mucosa–> blood
nutrients
water
vitamins
electrolytes
An inflammatory disorder from mouth to anus
Crohn’s Disease
What 2 hormones and nerve induce peristalsis
gastrin
motilin
Vagus n
What are manifestations of hepatic encephalopathy
asterixis (flapping hands)
change in LOC/confusion
What stop bacterial growth in duodenum
bile acid secretion
intestinal motility
antibody production
What controls the release of saliva
autonomic nervous system (sympathetic/parasympathetic)
Term for inflammation of esophagus
esophagitis
Is Hepatitis D acute, chronic, or both
chronic
can combine with Hep B (chronic)
severe illness
What is the main cause of esophagitis
GERD
What is the mechanism of ulcerative colitis
small erosions develop into ulcers
abscess formation/necrosis
edema narrows colon= passage hardens
Manifestations of cholecystitis
jaundice
RUQ pain –> shoulder
localized or general inflammation of the peritoneal lining
peritonitis
Upper esophageal sphincter purpose
stop air from entering esophagus when breathing
What hormones/neurotransmitters inhibit acid secretion
somatostatin
prostaglandin
What are manifestations of hepatic failure
enlarged liver
jaundice
scleral icterus
Condition where an abnormal path is made between the esophagus and trachea
esophageal fistula
How does volume affect gastric emptying
the more food there is –> increases stomach pressure
leads to increased peristalsis=gastric emptying
What are complication related to portal hypertension
ascites (fluid backup)
splenomegaly
What does elevated indirect bilirubin indicated
excessive hemolysis
What are signs for a large intestines obstructions
gradual onset
rarely vomit
constipation
What are causes of cirrhosis
alcohol
HEP C
hepatosteatosis (fatty liver)
Condition of erosion in GI mucosa from HCl and pepsin acids
peptic ulcer disease
What are complications of hepatic failure
decreased fibrinogen –> bleeding and bruising
portal HTN –> esophageal varices= bleeding
What causes Hepatitis D
contaminated needles (blood)
What is the mechanism for diverticular disease
more water absorbed from stool–> hardens
increased pressure
diverticular formation in weak areas
Inflammation of 1+ diverticular r/t bacteria or hypoxic injury
diverticulitis
How does blood glucose level affect gastric emptying
low blood glucose stimulates vagus n. to increase peristalsis BUT doesn’t increase emptying
Manifestations of peptic ulcer disease
epigastric pain
heartburn
Fat digestion stimulates __________
CCK
Difference between mechanical and non-mechanical intestinal obstruction
specific adhesion, tumor, or hernia
vs
neuromuscular tissue (paralytic ileus)
What is the cause of portal hypertension
cirrhosis
Manifestations of ulcerative colitis
frequent diarrhea
bowel urgency
bloody stool
Is Hepatitis B acute, chronic, or both
Mostly acute
Infants develop chronic infections
How does gastrin help peristalsis
presence of protein
gastrin secretes
stimulates release of HCl and pepsinogen
stimulates gastric mucosa
What does saliva consist of/ purpose of each component
Amylase- breaks down carbs
IgA- protects mucosal surfaces against microorganisms
Bicarbonate- maintain normal pH in mouth
When/How does the gallbladder release bile
30 min after eating
gallbladder contracts
sphincter of Oddi relaxes
enters duodenum
What is the mechanism process for gastritis
mucusal barrier broken
HCl and pepsin go into mucosa
breakdown gastric mucosal barrier
