Gastrointestinal pt. 1 Flashcards
1
Q
anorexia
A
- lack of desire to eat (not always a disease)
- nonspecific
2
Q
anorexia can be caused by
A
- side effect of medications, cancer, heart disease, kidney disease
3
Q
emesis
A
forceful emptying of the stomach and interstitial contents
4
Q
emesis can be caused by
A
extreme pain, stomach or duodenum distention, motion sickness, side effect of medications, trauma
5
Q
emseis is also know as
A
vomitting
6
Q
emesis is usually proceeded by
A
nausea
7
Q
vomiting without nausea is known as
A
projectile vomiting
8
Q
projectile vomiting can be caused by
A
direct stimulation of the vomiting centre (tumors, aneurysms. .increase inter cranial pressure)
9
Q
nausea
A
- subjective
- abnormal pain, spinning movements, hypersalvation, and tachycardia
10
Q
consequences of nausea and vomiting
A
FLUID AND ELECTROLYTE IMBALANCES, ACID/BASE DISTURBANCES
- hyponatremia
- hypokalemia
- hypochloremia
- metabolic alkalosis
11
Q
constipation
A
-difficult or infrequent bowel movements
- subjective (depends on normal bowel habits)
12
Q
primary constipation is caused by
A
bowel dysfunction or evacuation
13
Q
secondary constipation
A
- caused by outside factors
- diet medication, endocrine or neurogenic disorders, pregnancy
14
Q
retracting
A
the muscular event of vomiting without the expulsion of vomitus
15
Q
diarrhea
A
- presence of loose, watery stool
16
Q
acute diarrhea
A
- more than 3 loose stools developing within 24 hours and lasting less than 14 days
17
Q
persistant diarrhea lasts
A
14 days to 2 weeks
18
Q
large volume diarrhea
A
- volume of feces is increased
- generally caused by excessive amounts of water or secretions or both in the intestines
19
Q
small volume diarrhea
A
- volume of feces is not increased
- usually results form excessive intestinal motility
20
Q
osmotic diarrhea
A
- nonabsorbale substance in the intestine draws excess water into the intestine and produces large volume diarrhea
21
Q
osmotic diarrhea causes
A
- lactase and pancreatic enzyme deficiency; excessive ingestion of synthetic nonabsorbable sugars, full strength tube-feeding formulas, dumping syndrome associate with gastric reaction
22
Q
secretory diarrhea
A
excessive mucosal secretion of fluid and electrolytes produces large volume diarrhea
23
Q
secretory diarrhea causes
A
infections (rotavirus), bacterial enterotoxins (coli, cholerae), exotoxins from overgrowth following antibiotic therapy (difficile)
24
Q
small volume diarrhea is usually caused by
A
inflammatory disorder of the intestine (ulcerative colitis, chrons disease, microscopic colitis, colon cancer or fecal impaction
25
motility diarrhea
- decreased transit time means decreased reabsorption tine
26
motility diarrhea is caused by
resection of the small intestine or surgical bypass (short bowel syndrome), fistula formation, IBS, diabetic neuropathy, hyperthyroidism, laxative abuse
27
steatorrhea
fat in the stool
28
the small intestine absorbes
most of your carbs, fats, minerals, protein, and vitamins
29
large intestine absorbes
water and vitamins
30
systemic effects of prolonged diarrhea common with all types
- dehydration, electrolyte imbalances and weight loss
31
systemic effects of prolonged diarrhea due to infection
fever, with or without vomiting anf cramping
32
systemic effects of prolonged diarrhea due to inflammatory bowel disease
fever, cramping, bloody stools
33
systemic effects of prolonged diarrhea due to malabsorption syndrome
- steatorrhea (fat in the stools), bloating, diarrhea
34
treatment of diarrhea
- health history to determine underlying cause and intestinal biospy for persistent diarrhea
- restoration of fluid and electrolyte imbalances, antimotility agents, water absorbent medications, correction of nutritional deficiencies
35
abdominal pain is caused by
mechanical, inflammatory, or ischemic
36
abdominal organs are sensitive to
stretching and distention (activates nerve endings)
37
abdominal pain is described as
sharp, dull or colicky
- hard to give a precise location
38
parietal (somatic) pain
- from the parietal peritoneum
- precisely localizzed and intense
- aggrivated by movement
39
parietal pain is usually caused by
infection
40
visceral pain
- arises from a stimulus acting on an organ
- poorly localized, diffuse or vague
41
visceral pain is caused by
damage or disruption
42
referred pain
visceral pain is felt away from the disease or affected organ
- well localized, can be felt in the skin or deeper
43
upper gastro-intestinal bleeding
bleeding in the esophagus, stomach or duodenum
44
upper gastro-intestinal bleeding is characterized by
HEMATEMESIS (bloody vomitus)
- emesis of frank, bright red bleeding or dark, grainy digested blood "coffee grounds"
45
upper gastro-intestinal bleeding causes
bleeding esophageal varices, peptic ulcer tear at the esophageal-gastric junction (Mallory-Weiss syndrome) caused by severe retracting
46
lower GI bleeding
- bleedign from the jejunum, ileum, colon, or rectum
47
lower GI bleeding causes
- polyps, diverticultis, inflammatory disease, cancer, hemorrhoids
48
Lower GI bleeding is characterized by
melena and hematochezia
49
hematemesis
- emesis of frank, bright red bleeding or dark, grainy digested blood "coffee grounds"
50
melena
- black, sticky, tarry, foul smelling stools characterized by the digestion of blood in the GI tract
51
hematochezia
fresh, bright red blood passes from the rectum
52
occult bleeding
trace amounts of blood in normal appearing stools or gastric secretion
53
occult bleeding causes
slow GI bleeding
54
blood volume depletion leads to
hypovolemic shock
55
dysphagia
difficulty swallowing
56
dysphagia causes
- mechanical obstruction of the esophagus (tumours, strictures
- functional disorder (neural or muscular disorders; parkinsons, MS, muscular dystrophy, or achalasia
57
discomfort occuring 2-4 seconds after swallowing is assoicated with
upper esophageal obstruction
58
discomfort occurring 10-15 seconds after swallowing is associated with
obstructions in the lower esophagus
59
manifestations of dysphagia
- regurgitation of undigested food, unpleasant taste, vomiting, aspiration, and weight loss
60
Acid reflux
LES is weak or doesnt properly close, allowing stomach acid to backup, which irritates the lining of the esophagus
61
Acid reflux manifestations
- burning sensation in the chest, pressure or pain in chest, sour, bitter, or acidic taste in the back of your throat
62
acid reflux modifications
- avoid trigger foods, caffeine, alcohol, stay upright after meals and after, lose weight, stop smoking
63
Gastroesophageal reflux disease (GERD) is
- more serious form of acid reflux
- reflux of acid and pepsin or bile salts from the stomach into the esophagus
64
GERD causes
esophagitis
65
GERD causes
- abnormalities in the llower esophageal sphincter function (resting tone in lower than normal), esophageal motility, gastric motility or emptying
--> vomiting, coughing, lifting bending, obesity, or pregnancy
66
GERD risk factors
age, obesity, histal hernia, medications that relax the lower esophageal sphincter
67
histual hernia
- stomach buldges up into your chest through an opening in the diaphragm)
68
GED can trigger
an asthma attack or chronic cough due to aspiration of the stomach contents
69
(true/false) GERD changes the lining of the esophagus; which may be a precursor to cancer of the esophagus
TRUE
70
intestinal obstruction is caused by
any condition that prevents the normal flow of chyme through the intestinal lumen
71
simple obstruction
- most common
- mechanical blockage o by lesion
72
simple obstruction casues
hernia, adhesions, volvulus, intussusception
73
hernia
protrusion of the small intestine through weakness in the abdominal muscles or through inguinal ring
74
torsion (volvulus)
twisting of the intestine on its mesenteric pedicle, with occulsion of the blood supply
75
adhesions
excessive scar tissues after surgery
76
functional obstruction is also called
paralytic ileus
77
functional obstruction often occurs after
intestinal or abdominal surgery, pancreatitis, or hypokalemia
78
functional obstruction
- inability of the intestines to conduct peristalsis
79
signs and symptoms of small intestine obstruction
colicky pains, distention, nausea and vomiting, pain
80
signs and symptoms of ileum obstruction
- more pronounced distention (greater length of intestine is proximal to obstruction), vomiting (late sign), constipation, increased bowel sounds
81
signs and symptoms of large intestine obstruction
hypogastric pain, abdominal distention, pain varies, dependent on ischemia and peritonitis, vomiting (late sign)
82
gastritis
inflammatory disorder of the gastric mucosa
83
acute gastritis is caused by
- injury fo the mucosal barrier (medications (NSAIDS) chemicals, or H. Pylori
84
acute gastritis signs and symptoms
vague abdominal discomfort, epigastric tenderness, and bleeding
85
acute gastritis treatment
usually occurs spontaneously
- stop medications causing inflammation, H2 receptor antagonists for healing
86
chronic gastritis usually occurs in
older persons
87
chronic gastritis causes
- chronic inflammation, mucosal atrophy, and epithelial metaplasia
88
immune chronic gastritis example
fundal gastritis
89
fundal gastritis
- leads to gastric atrophy, which diminishes acid and intrinsic factor, causing pernicious anemia (lack of vit. B absorption)
90
nonimmune chronic gastritis
- involves the antrum only
- follows acute gastritis
- greater risk of developing gastric cancer
91
peptic ulcer
break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum
92
gastric ulcer
ulceration in the stomach lining
93
doudenal ulcer
ulceration in the upper part of the intestine
94
signs and symptoms of peptic ulcer disease
nausea, vomiting, bloating
95
peptic ulcer disease casues
H. pylori bacteria, medications
96
peptic ulcer disease risk factors
- over 70
- alcohol consumption
- smoking
- injury or trauma
97
peptic ulcer disease diagnostics
- asses for blood in stool or emesis
- urea breath test (tests for H. pylori0
- endoscopy, barium swallow
98
stress ulcer
acute from of peptic ulcer that accompanies physiological stress of severe illness or major trauma
99
ischemia ulcers develop
within hours of events such as hemorrhage, multisystem trauma, heart failure, sepsis
100
stress ulcers that develop asa result of a burn injury
curling ulcers
101
stress ulcer associated with severe brain injury or trauma
cushings ulcer
102
what is the primary sign of a stress ulcer
bleeding
103
what treatment is used to prevent stress ulcers
prophylactic treatment
104
dumping syndrome
- rapid emptying of residual stomach (stomach contents remaining after surgical resection following surgery)
105
dumping syndrome signs and symptoms
- cramping pain, nausea, vomiting, diarrhea, weakness, pallor, hypotension
106
dumping syndrome treatment
modify diet habits
107
alkaline reflux gastritis
- stomach inflammation caused by reflux of bile and pancreatic secretions
108
alkaline reflux gastritis signs and symptoms
- nausea, vomiting, bile, epigastic pain
109
alkaline reflux gastritis treatment
surgical correction
110
afferent loop obstruction is a result of
volvulus, hernia, adhesion, or stenosis
111
afferent loop obstruction symptoms
intermittent severe pain and epigastric fullness after eating
112
ulcerative colitis location
originates in the rectum, may extend to the entire colon
113
ulcerative colitis
- genetic, stress can aggravate
114
mild ulcerative colitis
- less mucosal involvement
- fewer bowel movements
115
severe ulcerative colitis
- involves entire colon
- abdominal pain, fever, tachycardia, diarrhea, bloody stools, continous cramping and pain
116
crohns disease
idopathic inflammatory disorder; affects any part of the digestive tract (mouth to anus)
117
crohns most likely effects
the large intestine and ileum
118
crohns disease clinical manifestations
- "skip leisions", fistulas, anemia
119
what is a major symptom of crohns disease
diarrhea
120
complications from crohns disease in the ileum
malabsorption of folic acid and vitamin D
121
pain in the lower left abdomen is indicative of
ulcerative colitis
122
pain in the lower right abdomen is indicative of
crohns disease
123
bleeding is common in bowel movements
UC
124
inflammation usually only in the colon
UC
125
bleeding not common during bowel movements
CD
126
inflammation anywhere in the digestive tract
CD
127
inflammation in one or more patches
CD
128
colon has cobblestone appearance and thickened wall
CD
129
granulomas often present
CD
130
continous inflammation, not patchy
UC
131
colon wall thinned
UC
132
ulcers live deep in the colon
CD
133
granulomas not present
UC
134
ulcers only in the musuc lining of the colon
UC
135
complications less frequent
UC
136
seen more often in non-smokers
UC
137
ulcers are deeper
CD
138
complications moe frequent
CD
139
smoking can worsen condition
CD
140
irritable bowel syndrome
- idopathic with mucliple probabilities
141
IBS is associated with
anxiety, depression, and reduced quality of life
142
IBS signs and symptoms
lower abdominal pain and bloating
143
symptoms of IBS are usually relieved with
dedication
144
diverticulosis
- asymptomatic herniations or saclike outpouching of the mucosa and submucosa
145
Diverticulitis
inflammation of the outpatching
146
diverticulosis casues
idiopathic
- realted to increased intracolonic pressure, abnormal neuromuscular function and alterations in intestinal mobility
147
diverticulosis predisposing factors
older age, obesity, smoking, diet, lifestyle, meds (NSAIDS and asprin)
148
diverticulosis is located
anywhere in the digestive tract
149
150
diverticulosis sings and symptoms
vague or absent
- cramping in the lower abdomen, diarrhea, constipation, distention, or flautlence
151
diverticulosis complications
abcesses, fistula, obstruction or perforation
152
diverticulitis signs and symptoms
fever, increased WBC, tednerness in the lower quadrent
153
appendicitis
inflamamtion of the appendix
154
appendicitis is most common i
10-19 years of age
155
appendicitis causes
- Obstruction of the lumen with stool, tumours, or foreign bodies – bacterial infection
- Obstruction does not allow drainage– perforation follows
- If perforation occurs, contents spill into abdominal cavity – causing peritonitis – most common and dangerous complication
156
appendicitis signs and symptoms
initially: vague epigastric pain, cramping sensation
Over 24 hours :pain becomes more localized in RLQ
- Will also see anorexia, nausea or vomiting, low-grade fever, rebound tenderness on palpation
157
following rupture of the appendix
breif cessation of pain
158
obesity BMI
above 30
159
malnutrition
- lack of nourishment from inadequate amounts of food
160
starvation
reduction in food intake
161
short term starvation
several days of total dietary abstinece or deprivation
162
short term starvation effect
increased glucogensis
163
long term starvation
follwos several days of dietary abstince
164
long term starvation effect
decreased dependence on glucogensis, increased use of ketone bodies
