Gastroenterology Flashcards
difficulty/ discomfort with swallowing
Dysphagia
pain upon swallowing
Odynophagia
various description of “burning” chest pain
Heartburn
regurgitation of sour or tasteless fluid
Waterbrush
“burping” or gas regurgitation
Eructation
rapid abdominal fullness or a hunger satisfaction in the beginning of a meal consumption.
Early Satiety
fear of eating (bc it hurts use caution - may be a peptic ulcer, esp in ST)
Sitophobia
vomiting blood (Portal HPT when LV is in trouble)
Hematemesis
vomitus looks like a coffee grind due to digested blood. (suspect intestinal bleeding that has been oxidized)
Coffee ground emesis
bright- bloody stool (indicates either profuse upper GI bleeding or lower GI bleeding (ulcerative cholitis, peptic ulcers in duodenum, etc)
Hematochezia
black tarry stool (suggestive of upper GI bleeding)
Melena
yellow discoloration of the sclera and skin due to bilirubin (bile pigment) deposition (bc of bilirubin conjugation)
Jaundice/ Icterus (pancreatic cancer or gallstones red flag for jaundice)
Itching
Pruritus
collection of intra-peritoneal fluid
Ascites
transaminases are ____ enzymes
LV (ALT most specific) –(also secretes bile)
Bleeding times and clotting factors are specific to the _____
LV
Amylase/lipase are ______ enzymes
Pancreatic
Gastric Acid/gastrin & Pepsin are ____ digestive enzymes.
ST (
several-centimeters-long, circular thickening of smooth muscle that lies inside the anus is known as the _____ ________
Internal sphincter
composed of striated voluntary muscle, surrounds the internal sphincter and is controlled by nerve fibers in the pudendal nerve, which is part of the somatic nervous system and therefore under voluntary control
External sphincter
_______ innervation occurs through the vagus nerve and nerve fibers from sacral segments of the spinal cord; it increases GI motility.
Parasympathetic innervation
_________ innervation/activity occurs through thoracolumbar output from the spinal cord, its paravertebral ganglia, & celiac, superior mesenteric, & inferior mesenteric ganglia. Sympathetic stimulation enhances sphincter fx. & reduces motility by inhibiting the activity of intramural plexus neurons.
Sympathetic
GI hormones and their actions chart
GI Fx. & D/O’s
The Enteric System is composed of the outer myenteric ____________ plexus that is located between the longitudinal and circular layers of smooth muscle cells
(Auerbach) - controls mainly intestinal movements along the length of the gut
The Enteric Plexus is composed of two layers: an inner submucosal__________ plexus that lies between the mucosal and circular muscle layers
(Meissner) concerned mainly with controlling the function within each segment of the intestine
_________ is the narrowing of LES and inability to relax the sphincter. S&S - chest pain when eating, weight loss or regurgirtation of food with LES distention
Achalasia - “Rat’s tail”
Esophageal cancer - no screening test but ________ is a red flag. Barrett’s esophagus is a major cause of esophageal cancer (50-80% of cases). Typical patients are male, btwn 40-60 yrs old.
Dysphagia
Right Heart Atrium receives blood from ______ (Upper body) &______ vena cava (Collects blood from LV & Lower body)
Superior & Inferior Vena Cava (LV)
Chronic Hep B, Chronic Hep C, chronic alcoholism, Cirrhosis of the LV, will all eventually develop into ______ ______
Portal Hypertension
______ ______will include vericose veins in esophagus, hemorrhoids, jaundice, ascites, and caput medusa(distended veins surrounding ABD/umbilicus).
Portal Hypertension (Stagnation phenomenon)
Ulcers (crater like injury of layers of GI tube - or on skin), can be superficial or deep, ______ _____ is so called because of pepsin juice, most common are in the _______ and second most common are in _____. 80% are caused by Helicobactor Pylori - (S-shaped bacteria - two C’s together) - micro-aerophylic partial pressure of Oxygen - only type to survive in gastric juices.
Peptic ulcers; most common in Duodenum and 2nd most common in Stomach.
Gastric juice is a type of ____-_____ immune system that just kills due to non-specific PH and amount of hydrogens dissolved. Secretes Urease to create large amount of ammonia poison and injures barrier of GI tract mucosal barrier.
non-specifc immune
Abuse of Non-steroidal anti-inflammatory drugs, steroids inflammatory drugs, and some also beleive stress caused Hypoxia can be other 20% cause of _____ _____
peptic ulcers
Pain upon eating = ______ ulcers - Sytophobia aka fear of eating because painful
Gastric ulcers - food rubs against wounds in stomach causing pain upon eating - want to eat but can’t because pain
Alleviated by eating = ________ ulcers, bolus of food is being mismatched with HCL acid and being absorbed. Pain goes away.
Duodenal
Most common gastric cancer type is ___________
Adenocarcinoma
anorexia, weight loss, abdominal pain, vomiting, anemia, hemorrhage, altered bowel habits - RED FLAG FOR MEDICAL REFERRAL for what type of cancer? .
Common metastasis: left supra-clavicular lymph node
(Virchow’s node), ovaries - grading needed to determine type Krukenberg’s tumor will show path from Stomach to 2nd stage in Ovaries.
Gastric Cancer - associated with Virchow’s node over ST 12 area. Mostly developed by males in 30-40’s.
is twisting of the gut upon itself or upon a narrow mesenteric pedicle. It may be acute and complete or chronic and intermittent. Midgut ______ is the most common form.
volvulus
________ is a condition in which one part of the intestine tunnels (is “telescoping” into an adjoining section.
Intussusception - newborns, seniors or very ill will suffer this. Red Jelly in poop is a sign.
Most common surgical emergency is ______
Appendicitis
