Gastrointestinal Flashcards
abdominoplasty
“tummy tuck” cosmetic surgery procedure designed to tighten abdominal muscles and remove excess fat from the area for a more toned and flattened appearance.
acanthosis nigricans
condition that causes areas of dark thick velvety skin in body folds and creases. Typically affects armpits, groin, neck, in people with obesity/high blood insulin.
alpha-1-antitrypsin (AAT)
protein produced in the liver that protects body tissues from being damaged by infection-fighting agents released by immune system. If deficient, prone to destruction of lung tissues.
alpha-fetoprotein (AFP)
protein produced by liver and yolk sac of a fetus. Has no normal fxn in adults. Measures/diagnoses/monitors fetal distress or abnormalitis. Can also detect liver disorders and cancers in adults.
atheromatous
fatty material that clogs the arteries leading to plaque buildup and atherosclerosis
Bard Marlex mesh
hernia mesh that was known to lead to severe complications and mesh failure; recalled and no longer in use.
BICAP Bipolar circum-active probe
new endoscopiocally deliverable bipolar electrocoagulator; arrests GI bleeding.
choledocholithiasis
presence of 1(+) gallstone in the common bile duct. Stone may be made of bile pigments or calcium and cholesterol salts. Liver produces bile aiding in fat digestion.
Clostridium (C.) difficile
bacteria that causes infection of colon; diarrhead to life-threatening damage of colon. Illness often occurs after using antibiotics. Mostly affects people in care. Bacteria are not active outside of colon and can cross contaminate through food, water, soil, surfaces.
cystiopathy
bladder small fiber neuropathy; caused by diabetes type 2. Loss of bladder sensation, post-voic residual.
dehiscence
splitting or bursting open of a wound
detrusor muscle
contract during urination to push urine out of the bladder into the urethra. Relaxes to allow storage of urine in the bladder.
diastasis recti
linea alba is overstretched and doesn’t come back together. The left and right sides of the abdominals stay separated. Also called “Ab gap” or ab separation. Often a postpartum condition for vaginal delivery.
diverticulectomy “bowel resection”`
procedure removing the diverticulum from the wall of the intestine. Sometimes a small part of the intestine will also be removed; open ends of the intesting will be sewn or stapled back.
diverticula
small bulging sacs or pouches that form on the inner wall of the intestine. Occur when weak places in the colon give away under pressure. Diverticulitis = inflammation/infection of pouches. Often part of large intestine.
dyspareunia
gential pain during or after intercourse. Can be felt externally on the vulva or internally in vagina, uterus, or pelvis. Often from underlying medical conditions or infections.
hypoalbuminemia
body doesn’t produce enough albumin protein responsible for keeping fluid in the blood vessels. Often a symptom of nephrotic syndromes, hepatic cirrhosis, heart failure, malnutrition.
hypokalemia
low blood potassium levels; often due to excessive loss of potassium in digestive tract due to vomiting, diarrhea, or laxative use. Severe muscle weakness
ileitis
inflammation of the ileum; often by Chron’s disease or other infectious diseases. Abdominal pain, bloating, diarrhea.
jejunostomy tube (J-tube)
soft plastic tube placed through the skin of the abdomen into the middle of the small intestine. Delivers food and medicine until patient is healthy enough to eat by mouth. Used when contraindiction for placement of gastrostomy tube.
menarche
refers to the first time menstruating. Light bleeding, cramping, mood swings. Marks capability of pregnancy.
ERCP endoscopic retrograde cholangio pancreatography
Type of xray that diagnoses and treats problems with the biliary system.
polypectomy
surgical removal of a polyp; via open abdominal surgery or during a colonoscopy. Snip off with forceps or use a snare that burns the base.
pseudomembranous colitis
severe inflammation of the inner lining of the large intestine. Manifests as antibiotic associated inflammatory complication. Most often from Clostridium difficile infection.
NASH non-alcoholic steatohepatitis
advanced form of non-alch fatty liver diseases NAFLD via buildup of fat in the liver. Causes inflammation and damage; scarring of the liver.
thrombocytopenia
platelet count in the blood is too low. Prevents proper blood clotting ;excessive bleeding.
urodynamics
set of tests that measure lower urinary tract function. Pressure and flow rate.
esophageal varices
enlarged veins in the esophagus. Due to blocked blood flow through portal vein from intestine, pancreas, and spleen to the liver.
verrucous
lesions showing keratotic exophytic surface; wart-like growth pattern on the surface of the skin or an organ.
transglutaminase
common food additive; changes characteristics of food production to improve taste and texture. Tissue tests of IgA (tTG-IgA) used to diagnose celiac disease; immune system attacks gluten.
dysphagia
trouble swallowing
aphagia
inability to swallow
odynophagia
painful swallowing
eructation
(belching) when gas is expelled from the stomach through the mouth
achalasia
failure of lower esophageal sphincter muscle to relax. From loss of peristalsis so food doesn’t pass easily and causes the tube to dilate and accumulate food. Balloon dilation often used to force LES open.
GERD gastroesophageal reflux disease
condition caused by abnormal reflux (backflow) of stomach through LES into esophagus; burning pain, belching, nausea, vomiting, dysphagia. Can narrow esophagus, hoarse throat, and can lead to Barret esophagus (precancerous). Treated via antacids and Nissen fundoplication; reconstruct GE junction.
esophageal stricture
narrowing of the esophagus; often due to GERD
Barret esophagus
a change in the cells lining the esophagus caused by chronic reflux. Can progress into cancer.
Nissen fundoplication
Procedure to reconstruct the area of the gastroesophageal junction to help remediate GERD
Schatzki ring
narrowing of the lower part of the esophagus, can cause episodic dysphagia. Caused by mucosal tissue lining the esophagus. Can develop a complete blockage- alleviated with balloon dilator or bougie (cylindrical instrument) dilator.
hernia
potrusion of an organ/part through the muscle that normally contains it. Corrected surgically via herniorrhaphy.
hiatal hernia
upper part of the stomach protrudes through the diaphragm into the chest. Can lead to GERD.
Treatment of peptic disorders
first line includes antacids to neutralize acid and histamine-2 (H2) blockers to promote healing by reducing acid secretion. Proton pump inhibitors usually paired with H2 to block acid production for faster healing. When not remediated, surgical intervention is required.
peptic ulcer disease PUD
ulcers develop in lining of stomach or duodenum. Most often via bacterial infection Helicobacter pylori which eats the mucosal tissue. Also via drugs. Can lead to hematemesis or melena due to stomach bleeding.
antrectomy
surgical removal of lower part of stomach that produces hormone stimulating secretion of gastric juices
gastroduodenostomy / Billroth I procedure
performing an antrectomy and surgically attaching the remaining portion of the stomach to the duodenum
gastrojejunostomy / Billroth II procedure
attaches remaining portion of stomach to the jejunum
Celiac disease / celiac sprue
digestive disease - sensitivity to gluten, protein in wheat, rye, barley. Results in flammation and atrophy of upper small intestine; diarrhea, malabsorption, steatorrhea, nutritional/vitamin deficiencies, failure to thrive/short stature.
steatorrhea
Fatty feces
irritable bowel syndrome IBS
group of GI symptoms associated with stress and tension; diarrhea, constipation, bloating, flatus, and low abdominal pain. On exam intestines appear normal. Medicate, diet, and surgery.
inflammatory bowel disease (Chrohn disease and ulcerative colitis)
inflamed lining of intestines = red and swollen. Becomes ulcerated and bleed; cobblestone appearance. Absorption is impaired and ileus can result. Stricture, fistula, or fissure can occur.
Ileus
obstruction
fistula
abnormal passage
Chrohn disease
open sores affecting lining of small and/or large intestine characterized by flareups and symptom remission; diarrhea, severe abdominal pain, fever, anorexia, weakness, weight loss
ulcerative colitis
ulcerated (sores breaching epithelium lining) inflammation of the top layer of the large intestine; hematochezia, mucosal sores, abdominal pain, diarrhea. Often spreads to entire colon - PANCOLITIS. Medicate, diet, surgery.
stricturoplasty
widens narrowed areas of intestines due to scarring.
small bowel resection
removes diseased portions of intestines, and the two healthy ends are rejoined with anastomosis
ileostomy
prevents intestine from performing normal digestive fxns; brings the end of the small intestine out through a stoma (surgical opening) and the intestine contents are expelled into an ostomy bag.
ileal pouch anal anastomosis
colon and rectum are removed and an internal pouch (J pouch) is created from the ileum. It is attached to the anus to keep the pouch inside of the body.
intussusception
intestinal obstruction typically in children 3 mo - 6 yrs. Bowel collapses into opening of another segment; irritation, swelling, difficulty digesting. Eventually blood supply is cut off. Can sometimes self correct but often surgical removal of section is required.
diverticular disease
disorder of large intestine where small pouch-like herniations form in the muscular wall of the colon (diverticula). Diverticulitis = fecal matter trapped in the pouch causing inflammation and rupture. Pain and rectal bleeding.
hemorrhoids
swollen twisted blood vessels in the rectum; internal or external. Pregnancy and chronic constipation = pressure on anal veins = cause.
Volvulus
twisting of the intestines; can cause obstruction, pain, nausea, and emesis. Surgical correction needed.
Most common GI cancer sites
Colon and rectum. Usually begin with formation of polyps; sessile = sits directly on mucous membrane, pedunculated = short stalk polyp. An adenoma is a polyp that can become cancerous. Polypectomy can prevent escalation.
cirrhosis
chronic liver disease; hepatomegaly, ascites, jaundice, spider angioma, palmar erythema (red and blotchy palms), and xanthomas (yellow lumps on eyes/elbows/hands). Brain damage can occur via change in blood composition. Internal bleeding - portal hypertension => splenomegaly and esophageal varices. Often alcohol excess or strains of hepatitis.
hepatitis
liver inflammation; acute or chronic.Most severe = viruses begin replicating. NASH = nonalcoholic steatohepatitis related to the presence of fats.
Viral Hepatitis
A: most common, via fecal-oral contamination. B: Spread by blood and bodily fluids. C: slowly progressing spread by infected blood/contamination. No vaccine, treated via antiviral interferon alpha.
interferon
protein naturally produced to fight viruses and boost immune system; in medicine - interferon alpha to treat Hepatitis C
cholelithiasis
presence of gladdbladder stones w/ biliary colic (pain). Usually associated with cholecystitis - inflammation of gladdbladder. Gallstones are formed by cholesterol. Drugs can help dissolve, extraction, often surgery - laparoscopic cholecystectomy
cholecystitis
inflammation of the gallbladder
endoscopic retrograde cholangiopancreatography ERCP
procedure the view the ducts and perform procedures to relieve obstructions of biliary or pancreatic ducts.
pancreatitis
inflamm pancrteas; alcohol abuse, drug toxicity, bile obstruction, infections. Acute or chronic. Often subsides with symptomatic treatment only.
pancreaticoduodenectomy / Whipple procedure
surgical removal of portion of pancreas, duodenum, and portion of stomach. Combats cancer of pancreas.
Liver function tests / liver panel
Series of blood chemistry tests measuring enzymes secreted by liver: albumin, ALP, ALT/SGPT, AST/SGOT, bilirubin, globulin, blood, total cholesterol, total protein
Pancreatic studies (2 tests)
serum amylase test: measures amount of amylase in blood /// serum lipase test: measure amount of lipase in blood
Stool Analysis ( 4 tests)
fecal fat test: elevated fats indicate malabsorption /// stool culture: abnormal bacteria check /// stool guaiac: detect occult or fecal blood /// Hemoccult test: fecal occult blood test for possible GI bleed
fecal occult blood (FOB) / Hemoccult test
card test examined under microscope looking for blood not visible to naked eye
Gastroccult test
rapid test performed on gastric aspirate to detect occult blood in small intestine and determine pH levels
Gram stain
rapid stool test looking for bacterial infection
Helicobacter pylori blood test
tests for antibody positivity; also available as urea breath test and a stool antigen test
pancreatic elastase test
fecal marker test; pancreatic insufficiency - predictor of gallbladder problems, diabetes, pancreatic issues
polymerase chain reaction (PCR test)
secondary blood test if test is positive for hepatitis C to see if virus is still present
stool for O&P
(ova and parasites) stool test looking for parasitic infection
urea breath test/C-breath test
test after ingestion of urea to check for presence of H pylori infection
Wright stain/fecal luekocyte smear
stool test looking for white blood cells in stool; sign of shigella, campylobacter, etc
24-hour esophageal pH monitoring
measures acidity or alkaline nature of gastric acid from stomach refluxed into esophagus for GERD; catheter through nostril into esoph for 24hrs and monitored.
anorectal manometry
measure contraction of anus and rectum via inserting balloon and sensor; measures rectal sphincteric reflex
barium beefsteak meal
x-ray performed after patient
eats a barium containing meal; taken as stomach digests food over time
Bernstein test
procedure in GI lab reproducing GI reflux using hydrochloric acid introduced to the stomach
T-tube cholangiogram
x-ray done with contrast dye to visualize bile duct during or following surgery
Sitzmark study/colorectal transit study
x-ray tracking a swallowed capsule. Used to determine how long it takes food to travel through digestive tract; several day process.
defecography
x-ray procedure documenting changes in rectum and anus during bowel movement
esophageal manometry
tube insertion connected to a monitor that measures contractility of esophagus
radioisotope gastric-emptying study
nuclear medicine study after ingestion of radioisotope tracer; visualize how quickly the stomach empties into the small intestine
epigastrium
upper part of abdomen below rib cage (one of the 9 quadrants, above umbilical and above hypogastric)
Tru-Cut liver biospy
piece of tissue removed from liver to be viewed under microscope to look for damage/disease
dyspepsia
indigestion; stomach pain, overfullness, bloating
hematemesis
vomiting blood
ileus
intolerance of oral intake due to inhibition of gastrointestinal movement without signs of mechanical obstruction. Often due to inflammation and opiod use.
enterotomy
surgical incision into an intestine; may be for complications of surgery of laparotomies or hernia repair.
hiatal hernia
a part of the stomach portrudes through the diaphragm at the opening where the esophagus normally passes through
antigliadin antibody
antibodies of IgA and IgG class found in serum of celiac disease patients; presence of antibodies that attack gliadin, a protein found in gluten
endomysial antibodies (EMA)
These autoantibodies cause the intestine to swell. Can prevent body from absorbing nutrients from food. Specific to celiac disease.
splenic flexure
bend where the transverse colon and descending colon meet in the upper left part of the abdomen; highest point colon reaches into the body
abdominal pannus
excess skin and fat begin to hang down from the abdomen; via pregnancy or weight changes
rolling hernia / paraesophageal hiatus hernias
part of the stomach pushes up through the hole in the diaphragm next to the esophagus
mesentery
attaches intestines to the wall of the abdomen; keeps intestines in place, prevent from collapsing down into pelvic area.
ligament of Treitz
thin band of tissue (peritoneum) that connects and supports end of duodenum and beginning of jejunum in the small intestine.
pneumoperitoneum
presence of air or gas in the abdominal cavity. Can be instigated with insufflation for a laparoscopic procedures to examined abdominal organs.
Barnett continent intestinal reservoir BCIR
surgery that creates an internal pouch after proctocolectomy (removal of colon and rectum).
enterocele
Occurs when small intestine prolapses or drops, causing a bulge in the vagina. Postmeno women who have given birth are more likely to develop.
Puestow procedure
lateral pancreaticjejunostomy; surgical technique to relieve chronic pancreatitis; side-to-side anastomosis of jejunum and pancreas.
ERCP Endoscopic retrograde cholangiopanreatography
procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas.
