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Advanced Pathology > Gastrointestinal Disorders- Notes from Slideshow (Quiz 4) PART 2 > Flashcards

Gastrointestinal Disorders- Notes from Slideshow (Quiz 4) PART 2 Flashcards

1
Q

Impermeable epithelial cell surface

A

Gastric Mucosal Barrier

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2
Q

Function of the Gastric Mucosal Barrier

A

Mechanisms for selective transport of hydrogen & bicarbonate ions

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3
Q

What protects the gastric mucosa?

A

Mucus

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4
Q

What types of mucus are there?

A
  • water insoluble

- water soluble

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5
Q

Thin, stable gel that adheres to gastric mucosal surface

A

water insoluble mucus

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6
Q

What is the function of water insoluble mucus?

A

protection from proteolytic (protein-digesting) pepsin

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7
Q

How does insoluble mucus protect from pepsin?

A
  • Forms unstirred layer
  • traps bicarbonate
  • forms an alkaline interface b/w luminal contents of stomach & its mucosal surface
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8
Q

Where does water soluble mucous come from

A

washed from mucosal surface

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9
Q

What makes up water soluble mucous?

A

luminal contents

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10
Q

What is the function of water soluble mucous?

A

prevents mechanical damage to mucosal surface

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11
Q

How does water soluble mucous prevent damage?

A
  • viscid nature

- lubricant

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12
Q

Major causes of Gastric Irritation & Ulcer Formation

A
  • NSAIDS/asparin

- H. Pilori

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13
Q

How do NSAIDS/asparin cause gastric iratation and ulcers?

A
  • Irritate gastric mucosa

- inhibit prostaglandin synthesis

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14
Q

What do prostaglandins produce?

A

Hcl

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15
Q

How does H. Pylori cause gastric irritation and ulcers?

A
  • Thrives in acidic environment of stomach

- Disrupts mucosal barrier that protects stomach from harmful effects of its digestive enzymes

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16
Q

Pathophysiology of H. Pylori in stomach

A
  • Low Hcl lowers pH
  • Mucin forms gel
  • Mucin transitions from gal to solid
  • H. Pylori can then swim freely through mucus
  • Attaches to epithelia cells
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17
Q

Types of Gastritis

A
  • Acute

- Chronic

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18
Q

Transient inflammation of gastric mucosa

A

Acute gastritis

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19
Q

What causes Acute gastritis?

A

Local irritants such as

  • bacterial endotoxins
  • alcohol
  • aspirin
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20
Q

Absence of grossly visible erosions & presence of chronic inflammatory changes

A

Chronic Gastritis

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21
Q

Complication of Chronic Gastritis

A

atrophy of glandular epithelium of stomach

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22
Q

Types of Chronic Gastritis

A
  • H. pylori
  • Autoimmune
  • Multifocal atrophic
  • Chemical gastropathy
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23
Q

Symptoms of Chronic Gastritis

A
  • abdominal pain with gnawing sensation
  • pain often made worse w empty stomach
  • night time pain
  • poor apatite
  • weight loss
  • heart burn
  • dyspepsia
  • belching
  • N&V
  • blood in stool
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24
Q

What is dyspepsia

A

indigestion

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25
Q

Disorders of the small and large intestine

A
  • Irritable Bowel Syndrome
  • Inflammatory Bowel Disease
  • Crohn’s & UC
  • Appendicitis
  • Infectious Enterocolitis
  • Viral, Bacterial, Protozoan
  • Diverticular Disease
  • Intestinal Motility
  • Malabsorption Syndrome
  • Celiac Disease (Celiac Sprue)
  • Adenomatous Polyps
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26
Q

Normal anatomy of the large intestine- be able to identify location

A
  • Appendix
  • cecum
  • where small intestine attaches
  • taenia
  • hepatic flexure
  • diverticula
  • splenic flexure
  • haustra
  • ascending colon
  • transverse colon
  • descending colon
  • sigmoid colon
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27
Q

Intestinal disorder causing functional issues but no structure abnormality defined by symptoms.

A

IBS

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28
Q

Cause of IBS

A
  • isn’t well understood

- can be caused by abnormal contractions in muscular layer of bowel

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29
Q

How is diagnosis of IBS made?

A

based on symptoms

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30
Q

Symptoms of IBS

A
  • Abdominal pain (persistent, intermittent, cramps)
  • Altered bowel function
  • Flatulence
  • Bloating
  • Nausea
  • Anorexia
  • Constipation
  • Diarrhea
  • Mucus in stool
  • Anxiety/Depression
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31
Q

How common is IBS?

A

1 in 5

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32
Q

Are male or females more likely to get IBS? How much more likely?

A
  • women

- 2-3 times more likely

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33
Q

Treatment for IBS

A
  • Medications
  • Diet
  • Exercise
  • Psychotherapy
  • Stress release
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34
Q

What medications are used to treat IBS?

A
  • laxatives
  • antispasmodics
  • tricyclic antidepressants
  • serotonin antagonists
  • serotonin agonists
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35
Q

What can be used in the diet to improve IBS?

A

prune juice

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36
Q

Are irritable bowel syndrome and inflammatory bowel disease the same thing?

A

No

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37
Q

Major types of inflammatory bowel disease

A
  • Ulcerative Colitis (UC)

- Crohn disease (CD)

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38
Q

What is the major difference between UC and CD?

A

UC- colonic mucosa only

CD- any segment of the GI (mouth to the anus)

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39
Q

Defining characteristics of CD

A
  • skip lesions

- transmural

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40
Q

UC vs CD: location

A

UC: begins in rectum and continues continuously toward cecum
CD: most common in terminal ileum w/ patches through all layers of bowel

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41
Q

UC vs CD: etiology

A

UC: unknown
CD: unknown

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42
Q

UC vs CD: peak age

A

UC: 15-25 and 55-65
CD: 15-40

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43
Q

UC vs CD: number of stools

A

UC: 10-20
CD: 5-6

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44
Q

UC vs CD: consistency of stool

A

UC: liquid
CD: loose

45
Q

UC vs CD: blood in stool

A

UC: yes
CD: no

46
Q

UC vs CD: complications

A

UC: hemorrhage
CD: fistula

47
Q

UC vs CD: nutritional deficiency

A

UC: yes
CD: yes

48
Q

UC vs CD: surgery

A

UC: infrequent
CD: frequent

49
Q

An inflammation of the digestive tract, involving enteritis of the small intestine and colitis of the colon.

A

Infectious Enterocolitis

50
Q

How is Infectious Enterocolitis classified?

A

By type of organism causing the infection

51
Q

What are the different types of Infectious Enterocolitis?

A
  • Viral
  • Bacterial
  • Protozoan
52
Q

Which virus often causes Infectious Enterocolitis?

A

Rotavirus

53
Q

Which bacteria often causes Infectious Enterocolitis?

A
  • C-diff

- E. Coli

54
Q

Characteristics of C-diff colitis

A
  • infectious diarrhea

- pseudomembranous colitis

55
Q

Pathophysiology of C-diff colitis

A
  • toxin-induced cytokines

- cause inflammatory response

56
Q

Symptoms of C-diff

A
  • fever
  • increase WBCs
  • bandemia
  • abdominal pain
  • can have diarrhea but not always
57
Q

How high are WBCs in C-diff colitis?

A

often as high as 50,000 or more

58
Q

Too many white blood cells being released by bone marrow into the bloodstream

A

bandemia

59
Q

What causes C-diff colitis?

A
  • The elimination of normal flora

- Allowing C-diff to grow

60
Q

What often causes the elimination of normal flora that causes C-diff colitis?

A

Antibiotics

61
Q

How long after antibiotic therapy does it take for C-diff colitis to occur?

A

Up to 8 weeks after therapy

62
Q

Number one risk factor for C-diff colitis

A

ANTIBIOTICS

63
Q

Which antibiotics most commonly cause C-diff colitis?

A
  • penicillin
  • clindamycin
  • cephalosporins
64
Q

Other risk factors for C-diff colitis

A
  • prolonged hospital stay
  • infected roommate
  • repeated enemas
  • prolonged NG tube
  • GI tract surgery
65
Q

Why is the C-diff colitis WBC count significant?

A

Most infectious/inflammatory conditions do not typically elevate WBCs over 25,000

66
Q

Symptoms of Rotavirus

A
  • severe watery diarrhea
  • vomiting
  • fever
  • abdominal pain
67
Q

Transmission of Rotavirus

A
  • fecal-oral route

- enters mouth by feces contaminated hands, surfaces or objects

68
Q

Complications of Rotavirus

A

can become severely dehydrated and die

69
Q

Who gets rotavirus?

A

Most common in infants and children

70
Q

When are infants and children most likely to get Rotavirus?

A

6-24 mo

71
Q

Is Rotavirus still relevant today?

A

Yes, it is still a significant cause of death

72
Q

How many are hospitalized by Rotavirus worldwide?

A

2 million

73
Q

How can Rotavirus be prevented?

A

Rotavirus vaccine by mouth

74
Q

A condition in which small, bulging pouches develop in the digestive tract.

A

Diverticular Disease

75
Q

Types of Diverticular Disease

A
  • Diverticul(OSIS)

- Diverticul(ITIS)

76
Q

What is the difference between diverticulosis and diverticulitis?

A

diverticulosis-small, bulging pouches (diverticula) develop in the digestive tract

diverticulitis-when one or more of these pouches become inflamed or infected

77
Q

Symptoms of Diverticular Disease

A
  • Pain LLQ
  • N&V
  • tenderness in LLQ
  • Slight fever
  • Elevated WBCs
78
Q

When appendix becomes inflamed, swollen, & gangrenous, and can eventually perforate if not treated

A

Appendicitis

79
Q

What causes Appendicitis

A
  • intraluminal obstruction with a fecalith
  • gallstones
  • tumors
  • parasites
  • lymphatic tissue
80
Q

hard piece of stool

A

fecalith

81
Q

Symptoms of Appendicitis

A
  • loss of appetite
  • flatulence
  • fever
  • pain in rectum
  • RLQ pain
  • diarrhea
  • constipation
  • bloating
  • N&V
82
Q

Types of Intestinal Obstruction

A
  1. Mechanical

2. Paralytic/adynamic

83
Q

absence of force

A

adynamic

84
Q

Difference between mechanical and paralytic/adynamic intestinal obstruction

A
  • Mechanical: result from post-op cause (ex: external hernia, postop adhesions)
  • Paralytic/adynamic: results from neurogenic or muscular impairment of peristalsis
85
Q

Symptoms of Intestinal Obstruction

A
  • fecal smelling/malodorous vomit
  • abdominal distention
  • constipation w/ failure to pass flatus
86
Q

Complications of intestinal obstruction r/t vomiting

A
  • hypovolemia

- loss of of electrolytes

87
Q

Bowel sounds with intestinal obstruction

A

increased to silent:

-high pitched at fist then they go silent

88
Q

Inflammation of the membrane lining the abdominal wall and covering the abdominal organs.

A

peritonitis

89
Q

Severity of peritonitis

A

Severe and often life threatening

90
Q

Cause of peritonitis

A

Usually caused by bacterial infection via

  • blood
  • after rupture of an abdominal organ
91
Q

In what situation would an abdominal organ rupture causing peritonitis

A
  • perforated peptic ulcer
  • ruptured appendix
  • perforated diverticulum
  • gangrenous bowel
  • pelvic inflammatory disease
  • abdominal trauma/wounds
92
Q

What surface is inflamed in peritonitis

A

serosal surfaces

93
Q

Characteristics of peritonitis

A

Throughout abdomen

  • fecal matter
  • purulent material
94
Q

Pathophysiology of peritonitis

A
  • rapid absorption of bacterial toxins
  • causes spreading of contaminants
  • causes inflammatory response
95
Q

Autoimmune disorder that can occur in genetically predisposed people where ingestion of gluten leads to damage in small intestine

A

Celiac Disease

96
Q

What is another name for Celiac Disease

A

Celiac Sprue

97
Q

How common is Celiac Disease worldwide?

A

1 in 100

98
Q

How many Americans go undiagnosed with Celiac Disease?

A

2.5 mil

99
Q

Why is it bad to go undiagnosed for Celiac Disease?

A

risk for long-term health complications

100
Q

Pathophysiology of Celiac Disease

A
  • ingestion of gluten

- immune response that attacks small intestines’

101
Q

gluten

A

protein found in

  • wheat
  • rye
  • barley
102
Q

Complications of autoimmune response in Celiac Disease

A
  • damage/atrophy of the villi

- nutrients cannot be absorbed properly

103
Q

Who gets Celiac Disease?

A

-hereditary

104
Q

Risk factor for Celiac Disease if in family

A

-Pts with first degree relative have a 1 in 10 risk

105
Q

first degree relative

A

family member who shares about 50 percent of their genes with a particular individual in a family

106
Q

Who do we share about 50 percent of out genes with?

A
  • parents
  • offspring
  • siblings
107
Q

Symptoms of Colon Cancer

A

Change in BM habits:

  • diarrhea
  • constipation
  • stool consistency change

Bleeding:

  • rectal bleeding
  • blood in the stool

Persistent abdominal discomfort:

  • cramps
  • gas
  • pain
  • Feeling of bowel not emptying completely
  • Weakness/fatigue
  • Weight loss
108
Q

How long does diarrhea or constipation or a change in the consistency of the stool last to be considered for colon cancer?

A

> 4 weeks

109
Q

Characteristics of Symptoms of colon cancer

A
  • many have no symptoms with early stages

- when symptoms appear, they vary (depending on the cancer size & location)

Advanced Pathology (27 decks)

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