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PHAR 123 > Gastrointestinal Pathophysiology > Flashcards

Gastrointestinal Pathophysiology Flashcards

1
Q

What is Esophagitis?

A

Inflammation of the Esophagus

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2
Q

Who is most likely to experience infection such as Candidiasis?

A

HIV/AIDS, Immunosuppressed, Immunodeficient

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3
Q

The most common cause of irritation and inflammation in the esophagus?

A

Gastro esophageal reflux disease

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4
Q

What type of medications can irritate the esophagus due to not remaining in an upright position after administration?

A

Bisphosphonates

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5
Q

What are the three treatments of GERD?

A

H2 receptor Antagonists
PPI
Antacids (Rebound)

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6
Q

What does H2 receptor antagonists do? and target cells

A

Reducing H+/K+ ATPase activity in the Gastric Parietal cells

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7
Q

What is the MOA of PPI?

A

Bind to H+/K+ ATPase of gastric parietal cells and preventing acid secretion

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8
Q

What are some examples of H2 receptor blockers? (4)
RFCN

A

ranitidine, famotidine, cimetidine, nizatidine

-Tidine

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9
Q

What are some examples of PPIs? (5)

A

pantoprazole, omeprazole, rabeprazole, esomeprazole, lansoprazole

Prazoles

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10
Q

What is the function of the parietal cells?

A

Secrete acid into the stomach

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11
Q

What is the function of the ECL cells?

A

Enterochromaffin-Like cells secrete histamine and peptide hormones

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12
Q

What is the function of muscarinic receptors?

A

Bind Ach from nerve cells and are located on parietal cells and ECL cells

Stimulate secretion generally

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13
Q

What is the function of Histamine H2?

A

Stimulate Parietal cells to secrete acid

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14
Q

Which site do PPI act on?

A

Site of acid production blocking the effect of stimulation by both histamine and muscarinic receptors

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15
Q

Why is long term use of PPI contraindicated?

A

Can cause long lasting impacts on the body

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16
Q

What is gastritis?

A

Infection or inflammation of the stomach

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17
Q

What medications can cause gastritis or worsen it?

A

NSAIDS

by blocking prostaglandin synthesis, they reduce production of protective mucous in the stomach

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18
Q

What are some autoimmune causes of gastritis?

A

+pernicious anemia with B 12 deficiency

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19
Q

What organism typically causes Chronic Gastritis?

A

H. pylori

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20
Q

How do we treat H. pylori?

A

Triply antibiotic therapy with the addition of a PPI+

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21
Q

What medications should be avoided after eating an acidic or spicy food?

A

H2 Blockers, antacids

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22
Q

What are the three treatments we could use to treat gastric ulcers?

A

One/Two antibiotics
Addition of Bismuth
H2 Antagonist or PPI

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23
Q

What is the typical timeframe for Gastric Ulcer treatment?

A

2-3 weeks

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24
Q

What causes the highest incidence of pancreatitis?

A

Alcohol and Gallstones

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25
Q

What are some of the critera for acute pancreatitis?

A

Goes away within a few days
Gallstones/Alcohol use
Mild
Short hospital stay

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26
Q

What are some of the criteria for chronic pancreatitis?

A

Many years to develop
Frequent flare ups or persistent symptoms
Calcifications of the pancreas
Good outlook if they follow a treatment regimen

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27
Q

What do NSAIDS do?

A

Blocking prostaglandin synthesis hence reducing the production of protective mucous in stomach

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28
Q

What are the three parts of the pancreas?

A

Tail, Body, Head

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29
Q

What part of the pancreas secretes into the Duodenum?

A

Head

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30
Q

What are some symptoms of acute pancreatitis?

A

Severe epigastric pain that radiates to the upper back, nausea & vomiting

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31
Q

What is the main symptoms of chronic pancreatitis?

A

poor digestion, pain upon eating, greasy/smelly stools, malnutrition.

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32
Q

Bacterial infections are usually associated with

A

Travel and food-borne illness

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33
Q

When should Diarrhea be referred? (6)

A

Bloody diarrhea
>7 days duration
Travel-associated
Immunocompromised
Fever, severely ill, debilitated  Complex patient
Very young or very old

34
Q

What is Atresia?

A

Birth defect

Part of the esophagus and throat are not connected properly

35
Q

What is a Volvulus of the intestine?

A

Twisting of the intestine

36
Q

What is a neoplasm of the intestine?

A

New abnormal growth

37
Q

What is intussusception?

A

It is where we have telescoping of the intestine.

38
Q

What is the most common tumour in the intestine?

A

Epithelial Tumors

39
Q

What are some of the symptoms of IBD

A

Abdominal pain. mouth/stomach ulcers, diarrhea, rectal bleeding, fever, weight loss

40
Q

What are some long term complications of IIBD?

A

Malnutrition, anemia, fistula, eye soreness, osteoperosis

41
Q

What is Focal ulceration?

A

An ulcerative development that leads to the narrowing of the intestines

42
Q

What are skip areas of Crohns disease?

A

These are areas of normal flesh with focal ulceration lesions

43
Q

What are the three types of ulcerative colitis?

A

Proctitis: Rectum
Left sided colitis (Left side of L-intestine)
Pancolitis: All L- Intestine

44
Q

What are the risk factors of Ulcerative colitis?

A

Genetics
Environmental (Infection, smoking, AB, NSAIDS)
Dysregulated Immune response in GI tract

45
Q

What is the progression of ulcerative colitis?

A

Starts at rectum and starts to extend further up the colon and into the L-intestine

46
Q

What are most of the symptoms of ulcerative colitis?

A

Frequent washroom usage
Small stools
Fatique
Low energy
Rarely fever (Due to active immune response)

47
Q

What are symptoms felt outside of the normal GI tract? for ulcerative cholitis

A

Joint pain
Liver inflammation
Osteoperosis
Skin problems
Mouth/eye problems
Anemia

48
Q

What is the peak age of Crohn’s disease?

A

15-25

49
Q

What is the main difference between crohns and ulcerative colitis?

A

Crohns= segmental
Ulcerative = Diffuse, colon only

50
Q

Which disease (Ulcerative or Crohn’s) has high rates of transmural effects? (Inflammation of intestinal wall)

A

Crohn’s disease

51
Q

Which disease (Ulcerative or Crohn’s) has high rates of granuloma?

A

Crohn’s

52
Q

Which disease (Ulcerative or Crohn’s) has high rates of Fistula probability?

A

Crohn’s

53
Q

Which disease (Ulcerative or Crohn’s) has high rates of megacolon?

A

Ulcerative colitis

54
Q

What is mega colon?

A

Distension of the colon

55
Q

Which disease (Ulcerative or Crohn’s) has a higher incidence of cancer?

A

Both, more in ulcerative colitis

56
Q

What are the 5 classes of medications used to treat IBD?

ACIAB

A

Aminosalicylates,
Corticosteroids,
Immunomodulators,
Antibiotics,
Biologics

57
Q

What are some common classes of biologics used to treat IBD?

A

Anti-TNFa monoclonal AB
Leukocyte trafficking inhibitors
T-Cell depletion

58
Q

What are some TNFa blockers?

A

Infliximab
Adalimumab
Golimumab
Certolizumab

59
Q

What are some leukocyte trafficking drugs?

A

Natalizumab
Vedolizumab
Etrolizumab

60
Q

What are some T-Cell Depletion drugs?

A

Ustekinumab

61
Q

How does therapeutic monitoring work for MAB treatment?

A

Measuring the level of the biologic in the blood and sometimes measuring antibodies against the biologic that the patient may be making in relation to the biologic.

62
Q

What does Fecal calprotection measure?

A

High levels mean high levels of intestinal inflammation and low levels mean biologics are working

63
Q

What is GERD as risk factor for?

A

Barrets esophagus leading to esophageal cancer

64
Q

What is the MOA of H2 antagonists?

A

Bind to the H2 receptors in the gastric parietal cells reducing the H+/K+ ATPase activity

65
Q

What is an autoimmune cause of gastritis?

A

Pernicious with B12 deficiency

66
Q

What medications should be avoided with people who have gastritis?

A

NSAIDS and certain antibiotics

67
Q

What is the 4 part treatments for gastric ulcers?

A

One or Two antibiotics
Bismuth (element)
H2 antagonist or PPI
Long term treatment

68
Q

What are the exocrine functions of the pancreas?

A

Produce acid neutralizing bicarbonate and digestive enzymes to break down fats carbs and proteins

69
Q

What is acute pancreatitis?

A

Caused by Acinar cell injury that leads to duct obstruction, leading to enzyme releases in the pancreas causing autodigestion of pacnreas

70
Q

What are the symptoms of acute pancreatitis?

A

Severe epigastric pain that radiates to the upper back. NV

71
Q

What becomes elevated in pancreatitis?

A

Serum amylase and lipase

72
Q

What increases GI secretions and motility?

A

Gastric filling

73
Q

What are the functions of the blue mesenteric veins?

A

drainage which is incorporate into the portal vein system heading to the liver.

Carry nutrient-rich blood from intestine to the liver

74
Q

What are the treatments of diarrhea? Drug

A

Loperamide

75
Q

Which bacteria forms due to reheating rice?

A

Bacillus cereus

76
Q

What are the two main causes of Chronic inflammation?

A

Crohn’s disease and ulcerative colitis

77
Q

What is the common distribution of inflammation in Crohns?

A

Skip areas

78
Q

What are aminosalicylates?

A

Anti-inflammatory drugs used to treat ulcerative cholitis

Mesalamine

79
Q

What is the most common side effect of TNFa therapy?

A

Tolerance development

80
Q

What do Natalizumab, Vedolizumab, etrolizumab, and do?

A

They inhibit leukocyte trafficking

PHAR 123 (11 decks)

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