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Pathophysiology I > Gastroenterology / GI Disorders > Flashcards

Gastroenterology / GI Disorders Flashcards

1
Q

What are some red flags for immediate medical referral of the patient who presents with certain signs and symptoms of acute gastro-intestinal pathology?

A

dysphagia, early satiety, sitophobia, hematemesis, coffee ground emesis, melena, hematochezia, jaundice, pruritis, ascites

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2
Q

What is dysphagia? What are possible causes?

A

Difficulty and/or discomfort with swallowing

achalasia, esophageal stricture, esophageal cancer, GERD, scleroderma, diffuse esophageal spasm

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3
Q

How is dysphagia diagnosed?

A

Barium X-ray, endoscopy, esophageal manometry, CT scan, MRI

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4
Q

How is hidden blood in the stool identified?

A

Fecal Occult Blood Test

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5
Q

What is melena? What does it suggest?

A

black tarry stool

upper GI bleeding

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6
Q

List major signs and symptoms of GI pathology

A 
adbominal/chest/pelvic pain
nausea and/or vomiting
jaundice
blood in stool
dysphagia and/or odynophagia
pruritus
early satiety
sitophobia
hematemesis
fever and other systemic signs/symptoms
peritoneal signs
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7
Q

List major risk and triggering factors for GERD

A

obesity, hiatal hernia, pregnancy, supine position

gastric distention, fatty food, nicotine, alcohol, coffee, CCK and secretin, progesterone and estrogen, anti-hypertensive medicaiton, some anti-depressants

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8
Q

What are the major complications of GERD?

A 
Barrett's esophagus
Esophageal stricture
otitis media
aspiration pneumonia
chronic cough
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9
Q

What is Barrett’s esophagus?

A

A complication of GERD in which the squamous epithelium of the esophagus is replaced by columnar epithelium (metaplasia)

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10
Q

Barrett’s esophagus is strongly correlated with the development of what disease?

A

esophageal adenocarcinoma

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11
Q

What is achalasia? What is its etiology?

A
  • Disorder in which the lower esophgeal sphincter does not relax when food passes down the esophagus to the stomach
  • Etiology is unknown although some connections have been made to autoimmune disorder triggered by viral infection, heredity, neurodegenerative disorder, genetic disorder
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12
Q

How is achalasia diagnosed?

A

Barium swallow with chest X-ray

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13
Q

What is the major etiology of Peptic Ulcer Disease?

A

Heliobacter Pylori colonization of the stomach

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14
Q

What is the major pathogenesis of Peptic Ulcer Disease?

A

Disruption of GI mucosal barrier

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15
Q

What PUD location is the most common in the US population?

What are clinical differences between presentations of gastric vs. duodenal peptic ulcers?

A

duodenal peptic ulcer

gastric peptic ulcer - pain upon eating

duodenal peptic ulcer - pain when hungry, alleviated by eating

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16
Q

What is portal hypertension? Describe major signs and symptoms

A

Increase in blood pressure in the portal vein system due to blockage in blood flow to liver

hemorrhoids, esophageal varices, caput medusae, splenomegaly, GI bleeding, vomiting blood, ascites, encephalopathy, confusion, forgetfulness, reduced levels of platelets or decreased white blood cell count

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17
Q

List risk factors for gastric cancer

A

diet (preservatives, lack of fresh fruits and vegetables), smoking, H. pylori infection, chronic auto-immune gastritis

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18
Q

What are common clinical presentations of advanced gastric cancer?

A

anorexia, weight loss, abdominal pain, vomiting, anemia, hemorrhage, altered bowel habits

19
Q

What are common metastases of gastric cancer?

A

Virchow’s node, ovaries

20
Q

Describe typical clinical presentation of acute appendicitis

A

initially poorly localized peri-umbilical pain, later pain localized in lower right quadrant, nausea, vomiting, fever, anorexia, constipation, inability to pass gas, abdominal swelling. Positive peritoneal signs

21
Q

List peritoneal signs

A

severe abdominal pain*, abominal wall guarding, vomiting, rebound tenderness, cessation of peristalsis, hard/red abdominal wall

*if there is emesis medulla is already affected

22
Q

What is the most common cause of intestinal adhesions?

A

surgery

23
Q

What is a volvulus?

A

a torsion of the gut upon itself or upon a narrow mesenteric pedicle

24
Q

What is intussusception?

A

a condition in which one part of the intestine tunnels into an adjoining section

25
Q

What is the difference between diverticulosis and diverticulitis?
What is the cumulative term for both?

A

Diverticulosis is formation of outpockets in the colonic mucosa and submucosa
Diverticulitis is inflammation within the diverticula

The cumulative term for both is diverticular disease

26
Q

The two main types of inflammatory bowel disease are _______. How are they similar?

A

Crohn’s disease
Ulcerative colitis

regional enteritis, chronic inflammatory bowel conditions (auto immune), mostly present in Eastern Europeans, Ashkenazi Jews, more common in females

27
Q

What are principal differences between Crohn’s disease and Ulcerative colitis?

A

Crohn’s disease - occurs in any part of GI tract, granulomatous inflammation, affects all layers of GI tube, can lead to fistulas, perforations, strictures

Ulcerative colitis - only occurs in colon, always begins in rectum and spreads up to beginning of colon, diffuse inflammation, only affects mucosa layer, bloody diarrhea

28
Q

List major risk factors for colon cancer development

A

family history of colorectal cancer, smoking, saturated fat and low fiber diet, obesity, sedentary lifestyle, adenomatous familial polyps

29
Q

Describe etiology and pathogenesis of Celiac Disease

A

Etiology is unknown but most probably auto-immune

Pathogenesis - gluten/gliadin-sensitive atrophy of the small intestinal microvilli and infiltration of submucosa by lymphocytes

30
Q

Regional enteritis is also know as ____?

A

Crohn’s disease

31
Q

Diverticulosis is asymptomatic (T/F)

A

TRUE

32
Q

Atrophy of gluten/gliadin sensitive Small Intestine villi leads to the following pathology __________, also known as __________.

A

Celiac aka non-tropical sprue

33
Q

Intestinal obstruction due to twisting is known as ____________

A

Volvulus

34
Q

Highly symmetrical joint pain and stiffness for more than one hour in the morning indicates __________

A

RA

36
Q

Which GI pathology is mostly asymptomatic?

A

Diverticulosis
Gallstone aka silent stones
Cholelithiasis - asymptomatic until acute

38
Q

________ refers to a physical exam maneuver that indicates acute cholecystitis.

A

Murphy’s sign

*it is inflammation of the GB

39
Q

Which of the following choices does not correspond with a red flag for immediate medical referral

a. dysphagia
b. rebound tenderness
c. inaudible peristalsis
d. acute peristalsis

A

d. acute peristalsis

41
Q

Meissner’s plexus is also known as _______ and governs __________

A

submucosal plexus

secretions of the mucosal layer

46
Q

A low body fat index is a major risk factor for cholelithiasis (T/F)

A

False

48
Q

Virchow’s node is the most common metastasis in _________ cancer

A

gastric

49
Q

Auerbach’s plexus is also known as _______ and governs __________

A

myenteric plexus

motility of GI tract

50
Q

Psoas and obturator signs are suggestive of _____?

A

acute appendicitis

  • pain upon passive extension of the leg
  • pain upon passive internal rotation of the flexed thigh
51
Q

when inspiration is arrested upon examination of the mid clavicular line, underneath the rib cage, this is a sign of ______?

A

acute cholecystitis

Pathophysiology I (11 decks)

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