Gastric System Flashcards
Aoife
1
Q
Describe ingestion
A
food is taken in through the mouth
2
Q
Describe the process of mechanical digestion
A
large pieces of food broken into smaller pieces by chewing. also in stomach when food churned and mixed
3
Q
Describe process of chemical digestion
A
the breakdown/hydrolysis of food molecules by water and digestive enzymes
4
Q
Describe movements
A
Peristalsis propels food through digestive tract
5
Q
Describe absorption
A
Food molecules pass through lining of small intestine into blood/lymph capillaries
6
Q
Describe elimination
A
Food molecules that cant be digested/absorbed are eliminated from the body in the form of faeces
7
Q
What are proteins broken into
A
Amino acids
8
Q
What are fats broken into
A
Fatty acids and glycerol
9
Q
What are carbohydrates broken into
A
Glucose
10
Q
Function of Mouth
A
Saliva moistens food and begins to breakdown starch
11
Q
Function of Oesophagus
A
Peristalsis moves food to stomach
12
Q
Function of Stomach
A
Produces acid and enzymes
13
Q
Function of Pancreas
A
Produces enzymes that metabolise food (small intestine)
14
Q
Function of Liver
A
Produces bile that digests fats and vitamins
15
Q
Function of Gallbladder
A
Stores bile
16
Q
Function of Small Intestine
A
Produces digestive juices which mix with bile and pancreatic enzymes to breakdown proteins, carbs and fats. Absorption of water
17
Q
Function of Large Intestine
A
Water absorption, Vitamin K production and where excess waste becomes stool
18
Q
MUMPS
description
A
an acute viral disease
19
Q
MUMPS
characterised by?
A
Swelling of the parotid salivary glands
20
Q
MUMPS
age group most common in?
A
childhood/adolescence
(5-15 years)
21
Q
MUMPS
when is mumps more severe?
A
In adults if onset is delayed
22
Q
MUMPS
what has made mumps less common?
A
MMR vaccine
23
Q
MUMPS
signs & symptoms (5)
A
- painful swelling in side of face, under ears
- headaches
- joint pain
- fever
- dysphagia (difficulty swallowing)
24
Q
MUMPS
diagnosis
A
- visual in GP
- clinical examination of saliva for IgM
25
How is mumps spread?
Spread via **droplets**
26
When are mumps contagious?
Contagious **before and after** symptoms
27
MUMPS
complications
* may affect other tissues **(joints, pancreas, myocardium, kidneys**)
* **meningitis**
* **orchitis infertility** in males
28
MUMPS
treatment
**Symptom relief**
29
How long until mumps infection passes?
**1-2 weeks**
30
MUMPS
prognosis- immunity?
**Immunity usually lifelong**
31
When does GORD develop?
When **backflow of stomach contents** causes troublesome symptoms
32
What is the development of GORD due to?
Dysfunction of the **lower oesophageal sphincter**
33
GORD
symptoms (2)
1. **heartburn**
2. **acid regurgitation**
34
GORD
causes & risk factors (4)
1. obesity
2. preganancy
3. gastroparesis (delayed emptying of stomach contents)
4. diseases of **connective tissue** (RA, scleroderma, lupus)
35
What is GORD exacerbated by? (4)
1. Smoking
2. High fat foods, chocolate, coffee, alcohol
3. eating shortly before bed
4. medications **(aspirin)**
36
GORD
treatments (5)
1. **Antacids**: **neutralise acid** in stomach and oesophagus
2. **H2 Blockers**: **reduces acid** in stomch by **blocking acid secretion** in stomach
3. **Proton Pump Inhibitors**: **reduce stomach acid** by **blocking protein** that makes stomach acid
4. **Surgery**: severe cases
5. **Lifestyle Changes**: stop smoking, change diet, no aspirin etc
37
GORD
complications (4)
1. Oesophageal Ulcer: caused by acid
2. Oesophageal Stricture
3. Barrett's Oesophagus
4. Lung Problems: due to **inadvertent aspiration of stomach contents**
38
# Barrett's Oesophagus
What is Barrett's Oesophagus sometimes a complication of?
GORD/GERD
39
# Barrett's Oesophagus
Risk factors (7)
overlap with GORD:
1. obesity
2. pregnancy
3. gastroparesis
4. diseases of connective tissue
different:
5. **family history**
6. being **male**
7. being **Caucasian**
40
# Barrett's Oesophagus
What is the tissue change in the lining of the oesophagus?
**Squamous cells** to **columnar cells**
41
# Barrett's Oesophagus
Metaplasia definition
The conversion of **one cell type to another**
42
# Barrett's Oesophagus
Dysplasia defintion
The transformation of a cell into **an abnormal version of itself**
43
# Barrett's Oesophagus
What does dysplasia increase the risk of?
**Adenocarcinoma** (type of cancer that starts in mucous producing/glandular cells)
44
# Barrett's Oesophagus
What do 3-13% of patients develop?
**Oesophageal cancer**
45
# Barrett's Oesophagus
Symptoms? (4)
1. **heartburn**
2. **regurgitation of stomach contents**
3. **dysphagia**
4. chest pain (less common)
46
# Barrett's Oesophagus
Treatment (2)
1. daily **Proton Pump Inhibitors**
2. **therapy to destroy dysplasia**
47
# Barrett's Oesophagus
Diagnosis (2)
1. **OGD**: OesophoGealDuodenoscopy
2. **Biopsy**
48
# Achalasia
Description?
People with achalasia have **dysfunction of the oesophageal muscles** and their **lower oesophageal sphincter fails to open**
49
# Achalasia
Symptoms (5)
1. **Progressive dysphagia**
2. **Regurgitation**
3. **Heartburn**
4. **Chest pain**
5. **Weight loss** (due to difficulty consuming foods)
50
# Achalasia
Causes (5)
1. **Nerve damage**
2. **Viral infection**
3. **Toxin exposure**
4. **Autoimmune disease**
5. **Genetic**
51
# Achalasia
Diagnosis (4)
1. **Manometry**: tube inserted into oesophagus to measure pressure applied along oesophagus
2. Barium swallow and **x-ray**
3. **Endoscopy** eg: OGD
4. **Biopsy**
52
# Achalasia
Treatment (4)
No cure, only supportive treatments:
1. Medicines: **relaxants (eg: nitrates)** for oesophageal muscles, **short lived** symptom relief
2. **Stretching muscle** through dilation with a balloon, multiple treatments needed for **long lived** symptom relief
3. **Surgery**: **Heller's Myotomy**: muscle fibres of lower oesophageal sphincter cut, **disadvantage: acid reflux**
4. **Botox injection** into muscle
53
# Stomach Disorder Terminology
Gastritis
**Inflammation** of the stomach
54
# Stomach Disorder Terminology
Anorexia
Chronic **loss of appetite**
55
# Stomach Disorder Terminology
Nausea
Unpleasant feeling that **may lead to vomiting**
56
# Stomach Disorder Terminology
Emesis
**Vomiting**
57
# Gastritis
Gastritis is the general term to describe what?
**inflammation** of the **lining of the stomch**
58
# Gastritis
Causes (4)
1. Infection
2. Use of pain relievers **aspirin, ibuprofen**
3. Alcohol abuse: irrates and **erodes** stomach lining
4. **Autoimmune** gastritis: seen in Hashimoto's Disease, T1DM
59
# Gastritis
The onset can be both??
Acute or chronic
eg. acute: food poisoning
60
# Gastritis
Symptoms (4)
1. **Indigestion**
2. **Nausea**
3. **Emisis**: vomiting
4. Feeling of **fullness** in upper abdomen after eating
61
# Gastroparesis
What is gastroporesis?
Delayed gastric emptying
62
# Gastroparesis
Most common cause?
Diabetes
63
# Gastroparesis
What does the delayed gastric emptying do to the flow of food?
**Slows/stops** flow of food to **small intestine** through **pyloric sphincter**
64
# Gastroparesis
Symptoms (4) (same as gastritis)
1. Indigestion
2. Nausea
3. Emesis
4. Feeling of fullness in upper abdomen after eating
65
# Gastric Ulcers
What are gastric ulcers?
**Open sores** that develop on lining of stomach
66
# Gastric Ulcers
Symptoms (4)
1. Indigestion
2. Heartburn
3. Nausea
4. Asymptomatic - open sore = blood in stool
67
# Gastric Ulcers
Causes (2)
1. **Helicobacter pylori**
2. **NSAID** use: aspirin, ibuprofen
68
# Gastric Ulcers
Risk factors for H. pylori infections (5)
1. low socio economic background
2. geography: **high rates in developing world**
3. hygiene
4. non filtered water
5. high **meat/fish** content diet
6. smoking
69
# Gastric Ulcers
Risk factors for development of H.pylori ulcers (5)
1. Diet: too much sugar/fat/acidic foods/spicy foods
2. Alcohol
3. Smoking
4. Family history
5. Age
70
# Gastric Ulcers
Diagnosis- to visually detect
OGD
71
# Gastric Ulcers
Diagnosis- Micro Methods (5)
1. Antigen tests: **presence/absence of antigens specific to bacterium** in stool sample
2. Urea breath test: breathe into 2 tubes, H.pylori breaks up substance (**urea C13**) if present
3. Culture/ sensitivity: **biopsy** placed in special culture medium & grown in special conditions
4. PCR: stool sample, **detection of genes specific to bacterium, ability to detect resistance to antibiotics**
5. Serology: detection of **IgM antibodies** specific to bacterium
72
# Gastric Ulcers
Diagnosis- Histo Method
Staining of biopsy
73
# Gastric Ulcers
Treatment (2)
1. Antibiotics -> **Clarithromycin and Amoxicillan**
2. PPIs
74
# Gastric Ulcers
Why is antibiotic resistance a concern in the diagnosis??
**Treatment failures** after receiving **Clarithromycin,** **limited choices** then, have to do **susceptibility testing = biopsy**
75
# Gastric Ulcers
Complications (5)
1. **Bleeding**: most common
2. **Perforation**: hole forms through stomach
3. **Penetration**: ulcer/perforation continues to adjacent organs/ tissues
4. **Obstruction**: cycles of inflammation= scarring = **pyloric stenosis**
5. **Cancer**: most commonly **adenocarcinoma**
76
# Coeliac Disease
Description
A digestive problem where the **SI can't absorb nutrients due to it becoming inflamed**
77
# Coeliac Disease
Symptoms (8)
1. Diarrhoea
2. Abdominal pain & cramps
3. Bloating
4. Indigestion & Constipation
Systemic symptoms:
5. Tiredness -> malnutrition
6. Weight loss
7. Rash
8. Nerve damage
78
# Coeliac Disease
Causes (2)
1. **Autoimmune**: immune system **mistakes substances found in gluten as threat & attacks them**
2. **Damage to intestines**: affects ability to absorb nutrients from food
79
# Coeliac Disease
What is the genetic component of the autoimmunity demostrated by??
The dependence of certain **halotypes**
80
# Coeliac Disease
What are halotypes?
A set of **DNA variations** that tend to be inherited together
81
# Coeliac Disease
What do the halotypes affect?
**Genes of white blood cells** that distinguish between **self and non self cells**
82
# Coeliac Disease
Diagnosis- Histo
**Biopsy** examined using different stains for**presence/absence of villi destruction** commonly seen in Coeliacs Disease
83
# Coeliac Disease
Diagnosis- Biochem/Immunology
Blood serum analysed for **antibodies specific to Coeliac Disease
eg. anti-TGA**
84
# Coeliac Disease
What do worldwide rates mirror?
Spread of **wheat consumption**
85
# Coeliac Disease
Complications (6)
1. Malnutrition: insufficient absorption of nutrients
2. Bone weakening: insufficient absorption of **calcium & Vit.D**
3. Infertility & miscarraige
4. Lactose intolerance: damage to SI
5. Cancer: **intestinal lymphoma** and **cancer of SI**
6. Spleen disorders: reduced immunity
86
# Coeliac Disease
Treatment
Exclude foods w/ gluten
87
# Coeliac Disease
What may be the problem if a gluten free diet does not work?
Patient has **Refractory Coeliac Disease**
88
# Coeliac Disease
Treatment of refractory coeliac disease
Medicines to reduce inflammatory response -> **steriods**
89
# Coeliac Disease
Cause of Refractory coeliac disease (5)
1. Inadvertant gluten contaminations
2. Microscopic colitis
3. Bacterial overgrowth of small bowel
4. Lactose intolerance
5. Bowel disorders
