gastro 18/19 Flashcards
what are some manifestations of GI dysfunction?
anorexia nausea vomiting (projectile) Abdominal pain changes is bowel sounds constipation diarrhea GI bleeding (upper and lower) Jaundice
what does black tarry feces indicate?
melena: distinctive, fowl odor
- seen when bleeding is in duodenum, through small bowel and large bowel, profuse amount of bleeding
- some cancers can cause this
what is jaundice?
- caused by increased amount of bilirubin
- yellow discoloration of skin, mucous membranes, sclerae
- will see this when there is liver failure, gallstones, and excessive breakdown is RBS (hemolytic newborn, sickle cell, transfusion reaction)
what is obesity associated with?
the first leading cause of death
what is central obesity?
- the abdomen
- visceral fat that surrounds organs
- abdominal obesity =higher risk of disease and illness compared to ppl who have fat around hips. abdominal is dangerous because it is deeper and sounds organs
risk factors associated with obesity?
- atherosclerosis, cardiovascular disease, diabetic (2) and cancer
- is linked to hypertension and stroke
what are two congenital structure anomalies in children?
prevalence?
-esophageal atresia
-tracheoesophageal fistula
one in ever 3000 births
what is esophageal atresia?
- means there is a dead end, something that should carry through that stops
- condition in which the esophagus end in a blind punch that does connect with the stomach, it just ends
what is tracheoesophageal fistula?
- connects between two structures that should not connect
- abnormal connection between the trachea and the esophagus
- abdominal fetal development around 6 weeks- when spilt is supposed to happen)
risk factors for congenital structure anomalies in children
- sometimes happens without reason
- alcohol, smoking, diabetes, older maternal age, mom exposed to infectious disease, exposure to insecticides
manifestations of esophageal atresia and tracheoesophageal fistula?
-excessive drooling (does get passed down to GI system)
vomiting after meal
choking, coughing (food going into lungs)
-milk return through mouth and nose
abdominal distention
cyanosis
aspiration of stomach contents
complications of esophageal atresia and tracheoesophageal fistula?
- failure to gain weight
- repetitive pneumonia -lung infections
- requires surgical repair after birth
what are the two gastrointestinal obstructions?
-functional obstruction: more usual, loss of function, paralysis of tube, ends up having same result If something was physically blocking tube
-mechanical obstruction: structures, physical things that block something passing through a tube
both = obstructed tube
result of GI obstruction?
- area above obstruction distends, is ischemic, gas and fluid accumulation
- loss of function below, distension above obstruction
- compresses and squeezed blood vessel of lumen of gut and can lead to ischemia and necrosis of gut
what are some examples of functional obstruction?
1) paralytic ileus: paralyzed ileum. occurs after bowel surgery, caused absent bowel sounds
leakage of bail can also cause this
2) Hirschsprung disease: will require surgery
- congenital- born with defective rest and digest NS
- aganglionic: absence of ganglion to bowel, altered NS
- Megacolon (means big colon, due ot lacking PNS, causes distended abdomen).
what are some examples of Mechanical obstruction?
- pyloric stenosis
- Volvulus (twisted bowel)
- Intussusception
- hernias
- impacted feces
- tumors
- most will require surgery
what is Volvulus
(twisted bowel)
what is pyloric stenosis
- narrowing of pyrosis stenosis
- this is the opening into the intestine after the stomach
what is Intussusception
small bowel goes into colon and then folds back
symptoms of bowel obstructions?
- regardless of cause:
- nausea and vomiting
- cramping abdomen (colicky)
- distension
- dehydration
- perforation
- necrosis
- sepsis - dead bowel = HIGH risk of infecc
what does neoplasia of the GI tract include?
cancer at any location:
- esophagus
- stomach
- colon and rectum
- gallbladder
- pancreas
- liver
incidence of colon cancer?
common in developed counties
- second leading cause of death by cancer in men
- is more common in men
- third leading cause of cancer in women
risk factors for colon cancer?
the longer we live, the more mutations we have, the higher the risk -increases with age -heredity diet (high fat low fiber) -smoking obesity high alcohol consumption ulcerative colitis
mortality rate for colon cancer?
5 year survival is around 90% if found early
on average: 70-90%
manifestations of colon cancer?
- pain in most locations
- changes in bowel habits (poos are skinner- passing obstruction)
- blood in poo
- anemia
- rectal discomfort and pain
- regardless of cancer: main manifestations are fatigue
tx of colon cancer?
surgical resection
surgical removal
chemotherapy
cancer of the pancreas incidence?
increases with age
cancer of pancreas mortality rate?
almost 100%
-diagnosis are often too late
risk factors to pancreas cancer?
-smoking, obesity, pancreatitis, diabetes
manifestations of pancreas cancer?
- non or very little
- symptoms occur late in this cancer which is why mortality is high
what is Gastroesophageal reflux disease? (NOT GERD)
- inflammation of the esophagus
- repeated acid in esophagus
- occasional
- chronic, more severe form of reflux / heartburn is GERD
risk factors for Gastroesophageal reflux disease?
-age (older= weaker esophageal schinter)
-drugs, nicotine, alcohol
hiatal hernia, which is the budging above the diaphragm, acid can easily go up into the esophagus because it loosens schincter
-increased abdominal pressure (obesity, preggo)
what is gastritis?
- inflammatory disorder of the mucosa of the stomach
- acute is more common
- chronic (autoimmune disorder)
manifestations of gastritis?
anorexia, pain
fullness
nausea, vomiting
bleeding
complications of gastritis?
- pernicious anemia (unable to absorb B12 because intrinsic factor which comes from lining of stomach is lessened
- gastric carcinoma= chronic inflammation of stomach is linked to cancer
- peptic ulcer
what is peptic ulcer disease?
a breakdown or ulceration in the protective mucosal lining of the stomach or duodenum
- inflammation to the point where a hole is present in the stomach or duodenum
- there can be single or multiple
- depth varies
risk factors for peptic ulcer disease?
- NSAID’s
- alcohol
- smoking
- age
incidence of peptic ulcer disease?
10% of ppl will have this at some point in their life
complications of peptic ulcer disease?
- bleeding
- possible perforation (hole all the way through)
what is a stress ulcer?
- a type of peptic ulcer that is related to severe illness, neural injury, or systemic trauma
1) ischemia ulcers
2) cushing ulcers: with severe head injury or brain surgery
3) curling ulcers: associated with burn injuries
what are the inflammatory disorders of the bowel?
diverticulitis
inflammatory bowel disease
what is diverticulitis?
- inflammation of teh diverticula in the sigmoid colon
- diverticulae are little pouches that protrude from the colon (make the colon lump, in its natural state)
- prone to getting fecal matter caught up at the entry point of inside them
complications of diverticulitis?
- they can rupture an cause fistula or inflammation
- reduce chance of complications by increasing fiber in diet
what is inflammatory bowel disease?
- chronic, relapsing and remitting patter of inflammatory bowel disorders
- types: crohns disease and ulcerative colitis
incidence of inflammatory bowel disease
one in every 150 ppl
causes of inflammatory bowel disease?
- genetics
- abnormal T cell response
manifestations of UC and crohns?
crampy pain
frequent diarrhea
-pattern of remission and exacerbations
what is crohns disease?
layers of bowel is inflamed - through entire intestinal wall
-occurs in patches
pain is worse in crohns
manifestations of crohns?
diarrhea pattern of relapse crampy pain malabsorption weight loss
complications of Crohns?
- Malabsorption of B12-percious anemia
- Fistula (passing of fecal matter through the skin)
what is ulcerative colitis?
affects the large intestine, not the small
-pattern of inflammation is different
-inflammation is continuous
inflammation with pinpoint areas of bleeding
-doesnt affect all the way through the colon, do fistulas dont occur
only affects MUCOSA
manifestations of ulcerative colitis?
pain
diarrhea (profound, sometimes 20 per day
-patter of relapse
-interruption of lifestyle
-poor absorption of water so loss of function and person will become dehydrates
Tx of both inflammatory bowel disease?
- anti-inflammatory/ anti-immune meds
- surgery
what is cholecystisis
inflammation of the gallbladder
-gallstones obstruct cystic duct
what is gallstone cholelithiasis?
- prevalent in developed countries
- caused by abnormalities in bile composition, bile statis, and inflammation of gallbladder
risk factors for gallstone cholelithiasis?
- female
- forty or older
- overweight
- preggo
- Indian (FN)
manifestations of cholecystisis?
-RUQ pain
-pain that is in a pattern and is intense than eases
-food intolerance (fatty foods)
heartburn
tx of cholecystisis?
-prevention
pain managment
antibiotics
removal of gall bladder
what is pancreatitis?
- acute or chronic inflammation of the pancreas
- obstruction of pancreas ducts
- causes the pancreas enzymes to start digestive the duct behind the obstruction
what is pancreatitis associated with?
- gallstones
- heavy intake of alcohol
- peptic ulcers
- trauma
- drugs
what is chronic pancreatitis associated with ?
- chronic alcohol abuse and smoking
- linked to pancreatic cancer
- causes scarring, strictures, and cysts
what is hepatisis?
- inflammation of the liver
- occurs due to exposure to drugs and chemicals
- can have viral causes
what is viral hepatisis?
systemic viral disease that primarily affects the liver
- vaccines are available
- hepatisis A,B,C,D, and E
- the sequence (speed through stages is difference fro each type)
what is the 1) prodromal phase of hepatitis?
fatigue, anorexia, nausea
what is the 2) icteric phase or hepatitis?
jaundice, dark urine
-itchiness
what is 3) recovery phase of hepatitis?
-quick, tend of have full recovery in most cases expect chronic
what is cirrhosis?
- end stage of chronic liver disease
- due to hepatitis
- much of the liver is replaced by fatty deposits and eventually degeneration
- diffuse scarring
- death of liver cells
consequences of cirrhosis of liver?
- portal hypertension
- ascites
- jaundice
what is portal hypertension?
- abnormally high bp in the portal venous system
- the portal venous system is a big vein that drain into the liver
- it drains from the stomach, small intestine, large intestine, and then goes to the liver to be filtered.
-hypertension in this vein is because of liver failure or scarring of liver
what can portal hypertension lead to?
- back pressure cases congestion of ALL the veins
- can cause esophageal varices -distended vein in the esophagus
- ascites
- hemorrhoids
- complications are potentially life threatening
what is ascites?
- accumulation of fluid in the peritoneal cavity
- caused by high blood pressure than pushed albumin (made my liver -is a plasma protein) into the abdomen
- will need to drain and fix liver
