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Pathology 2420 Part 2 > Gastrointestinal Health > Flashcards

Gastrointestinal Health Flashcards

1
Q

What are the different parts of the GI Tract?

A
  • Esophagus
  • Stomach
  • Small Bowel
  • Large Bowl
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2
Q

What are the different parts of the Esophagus?

A
  • Proximal
  • Mid
  • Distal
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3
Q

What are the different parts of the Stomach?

A
  • Cardia
  • Antrum
  • Fundus
  • Pylorus
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4
Q

What are the different parts of the Small Bowel?

A
  • Duodenum
  • Jejunum
  • ileum
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5
Q

What are the different parts of the Large Bowel? (6)

A
  • Cecum (+ appendix)
  • Ascending colon
  • Transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum
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6
Q

What connects the Esophagus to the Stomach?

A

The lower esophageal sphincter, also known as the Gastroesophageal Junction

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7
Q

What connects the Stomach to the Small Bowel?

A

Pyloric Valve

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8
Q

What connects the Small Bowel to the Large Bowel?

A

Ileocecal valve

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9
Q

What does the Upper GI tract consist of?

A
  • Esophagus
  • Stomach
  • First part of the small bowel
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10
Q

What does the Lower GI tract consist of?

A
  • rest of the small bowel
  • large bowel
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11
Q

Where does Gastroesophageal Reflux or GERD occur most often?

A

Distal Esophagus

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12
Q

Where does infections by Helicobacter Pylori tend to occur first?

A

The antral part of the stomach

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13
Q

Where does Crohn’s disease commonly occur?

A

Terminal Ileum

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14
Q

Where does Ulcerative Colitis commonly occur?

A

The Rectum and then moves proximally into the colon

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15
Q

What is the Lumen?

A

The hollow space in the GI tract where food passes through

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16
Q

What is the Mucosa?

A

The inner lining, the layer closest to the lumen and has contact with contents that pass through

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17
Q

What is the Muscularis?

A
  • the muscle layer
  • contents move through GI tract through coordinated wave-like contractions (peristalsis)
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18
Q

What are the different layers of the GI Tract?

A
  • Lumen
  • Mucosa
  • Muscularis
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19
Q

What is the Peritoneal Cavity?

A
  • Continuous membrane that forms the lining of the abdominal cavity
  • can involve diseases of the GI tract
  • Can fill with fluid (ascites), or become inflamed (peritonitis)
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20
Q

What are the functions of the GI Tract?

A
  • Digestion
  • Absorption
  • Excretion
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21
Q

What is Digestion?

A

Breaking down food components into smaller constituents
- Enzymes/acids break down food and specific components
- occurs mainly in stomach and duodenum

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22
Q

What is Absorption?

A

taking up nutrients and/or water for use
- nutrient absorption occurs in small bowel
- water and electrolyte absorption occur in large bowel

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23
Q

What is Excretion?

A

expelling waste products of digestion

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24
Q

What are possible Signs and Symptoms of GI diseases? (10)

A
  • pain
  • nausea
  • vomiting
  • loss of appetite
  • diarrhea
  • constipation
  • distention
  • fatigue
  • fever
  • bleeding
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25
Q

What is a GI bleed?

A
  • possible indication of a GI tract pathology
  • Range of possible sources and causes
  • Characterizing the bleed important clinically
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26
Q

What is Hematemesis?

A

vomiting of blood

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27
Q

What is Coffee Ground Emesis?

A

Dark and granular vomitus due to effects of stomach acid on hemoglobin

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28
Q

What is Hematochezia?

A

Bright red blood in stool
- indicates “fresh” bleed, commonly from lower GI tract

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29
Q

What is Melena?

A

Dark, black, tarry stool
- stool colour due to digestion of blood, most commonly from upper GI tract

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30
Q

What is Occult Bleeding?

A

Blood that is not visible, typically found in stool

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31
Q

What tests are done to determine Occult blood?

A
  • Screening stool tests (Fecal blood tests)
  • Bloodwork (Iron deficiency anemia)
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32
Q

What can Infections of the GI tract be caused by?

A
  • Viruses
  • Bacteria
  • Parasites
33
Q

What is Appendicitis?

A

Inflammation of the appendix

34
Q

What is the Pathogenesis of Appendicitis?

A

Often associated with fecalith obstruction (Ischemia) = ulceration = secondary infection

35
Q

What is Ischemia?

A

Obstruction of blood flow

36
Q

What are the risk factors of Appendicitis?

A
  • Extremes of age
  • Family history
  • more common in males than females
37
Q

What are the Signs and Symptoms of Appendicitis?

A
  • Abdominal pain (RLQ/McBurney’s point), Rebound tenderness
  • Nausea/vomiting
  • Fever
38
Q

What are complications that could occur with Appendicitis?

A

Can lead to appendiceal rupture (perforation) = leading to peri-appendiceal abscess or inflammation of the peritoneal cavity (peritonitis)

39
Q

What is treatment of Appendicitis?

A

Surgical treatment is most common treatment for acute cases

40
Q

What is Helicobacter pylori (H. pylori)?

A

A Gram-negative bacteria, that most commonly colonizes stomach
- estimated 50% prevalence worldwide, higher in developing countries

41
Q

What are the signs and symptoms of Helicobacter pylori?

A
  • often asymptomatic
  • abdominal pain (mid-upper)
  • nausea
  • bloating
42
Q

What are some complications of H. pylori and Peptic Ulcer Disease?

A
  • Peptic/duodenal ulcers in 10-15% of cases = leading to bleeding and perforation
  • chronic inflammation = increased risk of lymphoma and cancer
43
Q

How do you diagnose H. pylori infection and Peptic Ulcer Disease?

A
  • Via endoscopy + biopsies
  • bloodwork
  • urea breath test
44
Q

What is the treatment for H. pylori infections and Peptic Ulcer Disease?

A

Triple-therapy (antibiotics and protein-pump inhibitors)

45
Q

What is Inflammatory Bowel Disease (IBD)?

A

A disease of unknown etiology, characterized by inflammation of the bowel
- age onset typically 15-35

46
Q

What are the common symptoms of IBD? (5)

A
  • diarrhea (+/- blood) and urgency
  • abdominal pain
  • Fever
  • Weight loss/fatigue
  • +/- extra-intestinal problems (liver, joints, skin, eyes)
47
Q

What are the two types of IBD?

A
  • Crohn’s Disease
  • Ulcerative Colitis
48
Q

What are the distinguished characteristics of Crohns’s Disease? (4)

A

Sites of Involvement:
- Ileum and colon
- Can involve any part of GI tract
- patchy involvement
Hematochezia:
- uncommon
Complications:
- Abscesses, strictures, fistulas, and perianal disease more common
Degree of Inflammation:
- Transmural with fissuring ulcers

49
Q

What are the distinguished characteristics of Ulcerative Colitis? (4)

A

Sites of involvement:
- starts at rectum + moves proximally
- Limited to colorectum
- continuous involvement
Hematochezia:
- Common
Complications:
- greater risk of colon cancer
Degree of Inflammation:
- Superficial
Pseudopolyps more common

50
Q

What are the treatment options for Crohns and Ulcerative Colitis?

A
  • medications to reduce inflammation (anti-inflammatories, immune system modulators, biologics)
  • nutritional support to help relief stool symptoms
  • Surveillance endoscopy
51
Q

What are the surgery options for Crohn’s and Ulcerative Colitis?

A

Crohn’s disease: removal of damaged sections, management of abscesses/fistulas
Ulcerative Colitis: removal of colon/rectum

52
Q

What is a Diverticulum?

A

Outpouching of bowel wall

53
Q

What is Diverticular Disease?

A

Presence of Diverticula

54
Q

Where is Diverticular Disease most common?

A

Sigmoid Colon in North America, and in the Right Colon in Asia

55
Q

What is the cause of Diverticular Disease?

A

Increased luminal pressure (low fiber, high fat diets) + weak points in gut wall

56
Q

What is Diverticulitis?

A

Inflammation of Diverticula

57
Q

What are the symptoms of Diverticulitis?

A
  • fever
  • worsening abdominal pain (LLQ)
58
Q

What are the complications of Diverticulitis?

A
  • Abscess formation
  • perforation
  • strictures
  • fistulas
59
Q

What is the treatment for Diverticulitis?

A
  • Antibiotics
  • surgery (depending on severity)
60
Q

What is a Bowel Obstruction?

A
  • Blockage that prevents the passage of food/liquids
  • Can occur across all age groups, with a variety of causes
61
Q

What are the common signs and symptoms of bowel obstruction?

A
  • abdominal distention
  • vomiting
  • constipation
62
Q

What is a Herniation?

A

bowel obstruction that is a pouch-like protrusion of the peritoneum

63
Q

What are Adhesions?

A

bowel obstruction that is a fibrosis/scar tissue forming between loops of bowel
Commonly seen in pts who’ve had multiple surgeries

64
Q

What is a Volvulus?

A

Bowel obstruction that is the twisting of the bowel on itself + mesentery

65
Q

What is an Intussusception?

A

Bowel obstruction that is the telescoping of the bowel into adjacent segment
In children, the most common site is at the ilioceal valve

66
Q

What is the third most commonly diagnosed cancer in Canada?

A

Colorectal Cancer

67
Q

What is the most common type of colorectal cancer?

A

Adenocarcinoma

68
Q

What are the different stages of Colorectal Cancer?

A
  • Stage I + II = confined to bowel
  • Stage III = metastasis to local lymph nodes
  • Stage IV = metastasis to distant organ/sites
69
Q

What is the Pathogenesis of Colorectal Cancer?

A
  • mutations in the bowel mucosa may result in pre-cancerous lesions = polyps
  • Additional mutations may accumulate that result in local invasion or metastasis (cancer)
  • not all polyps result in cancer transformation
70
Q

What are the symptoms of Colorectal Cancer? (6)

A
  • Rectal/stool bleed
  • change in bowel habits
  • abdominal discomfort
  • weakness
  • fatigue
  • weight loss
71
Q

What are the risk factors for Colorectal Cancer? (7)

A
  • family history/known familial syndromes
  • age
  • inflammatory bowel disease
  • Diet
  • Obesity
  • Smoking
  • exercise
72
Q

What are the different screening types for Colorectal Cancer?

A
  • Fecal immunochemical test (FIT): stool test to detect blood
  • Endoscopy: procedure to directly examine the bowel and identify premalignant or malignant lesions
73
Q

What is the most common Esophageal Cancer in Canada?

A

Adenocarcinoma

74
Q

What is the most common Esophageal Cancer worldwide?

A

Squamous cell carcinoma

75
Q

Where is the most common place that Esophageal Cancer occurs?

A

Distal third of the esophagus

76
Q

What is the Pathogenesis of Esophageal Adenocarcinoma? (3)

A
  • often arises in a background of chronic GERD
  • 10% patients with symptomatic GERD, develop Barrett’s esophagus
  • Greater risk of developing dysplasia and maligancy
77
Q

What are the signs and symptoms of Esophageal Adenocarcinoma?

A
  • pain or dysphagia
  • weight loss
  • chest pain
  • vomiting
78
Q

What are the risk factors of Esophageal Adenocarcinoma?

A
  • GERD
  • Tobacco use
  • Obesity
  • Radiation

Pathology 2420 Part 2 (6 decks)

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