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Pathophysiology > Gastrointestinal pt. 1 > Flashcards

Gastrointestinal pt. 1 Flashcards

1
Q

anorexia

A
  • lack of desire to eat (not always a disease)
  • nonspecific
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2
Q

anorexia can be caused by

A
  • side effect of medications, cancer, heart disease, kidney disease
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3
Q

emesis

A

forceful emptying of the stomach and interstitial contents

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4
Q

emesis can be caused by

A

extreme pain, stomach or duodenum distention, motion sickness, side effect of medications, trauma

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5
Q

emseis is also know as

A

vomitting

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6
Q

emesis is usually proceeded by

A

nausea

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7
Q

vomiting without nausea is known as

A

projectile vomiting

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8
Q

projectile vomiting can be caused by

A

direct stimulation of the vomiting centre (tumors, aneurysms. .increase inter cranial pressure)

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9
Q

nausea

A
  • subjective
  • abnormal pain, spinning movements, hypersalvation, and tachycardia
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10
Q

consequences of nausea and vomiting

A

FLUID AND ELECTROLYTE IMBALANCES, ACID/BASE DISTURBANCES
- hyponatremia
- hypokalemia
- hypochloremia
- metabolic alkalosis

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11
Q

constipation

A

-difficult or infrequent bowel movements
- subjective (depends on normal bowel habits)

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12
Q

primary constipation is caused by

A

bowel dysfunction or evacuation

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13
Q

secondary constipation

A
  • caused by outside factors
  • diet medication, endocrine or neurogenic disorders, pregnancy
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14
Q

retracting

A

the muscular event of vomiting without the expulsion of vomitus

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15
Q

diarrhea

A
  • presence of loose, watery stool
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16
Q

acute diarrhea

A
  • more than 3 loose stools developing within 24 hours and lasting less than 14 days
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17
Q

persistant diarrhea lasts

A

14 days to 2 weeks

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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
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19
Q

small volume diarrhea

A
  • volume of feces is not increased
  • usually results form excessive intestinal motility
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20
Q

osmotic diarrhea

A
  • nonabsorbale substance in the intestine draws excess water into the intestine and produces large volume diarrhea
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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
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22
Q

secretory diarrhea

A

excessive mucosal secretion of fluid and electrolytes produces large volume diarrhea

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23
Q

secretory diarrhea causes

A

infections (rotavirus), bacterial enterotoxins (coli, cholerae), exotoxins from overgrowth following antibiotic therapy (difficile)

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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

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25
Q

motility diarrhea

A
  • decreased transit time means decreased reabsorption tine
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26
Q

motility diarrhea is caused by

A

resection of the small intestine or surgical bypass (short bowel syndrome), fistula formation, IBS, diabetic neuropathy, hyperthyroidism, laxative abuse

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27
Q

steatorrhea

A

fat in the stool

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28
Q

the small intestine absorbes

A

most of your carbs, fats, minerals, protein, and vitamins

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29
Q

large intestine absorbes

A

water and vitamins

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30
Q

systemic effects of prolonged diarrhea common with all types

A
  • dehydration, electrolyte imbalances and weight loss
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31
Q

systemic effects of prolonged diarrhea due to infection

A

fever, with or without vomiting anf cramping

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32
Q

systemic effects of prolonged diarrhea due to inflammatory bowel disease

A

fever, cramping, bloody stools

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33
Q

systemic effects of prolonged diarrhea due to malabsorption syndrome

A
  • steatorrhea (fat in the stools), bloating, diarrhea
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34
Q

treatment of diarrhea

A
  • 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
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35
Q

abdominal pain is caused by

A

mechanical, inflammatory, or ischemic

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36
Q

abdominal organs are sensitive to

A

stretching and distention (activates nerve endings)

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37
Q

abdominal pain is described as

A

sharp, dull or colicky
- hard to give a precise location

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38
Q

parietal (somatic) pain

A
  • from the parietal peritoneum
  • precisely localizzed and intense
  • aggrivated by movement
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39
Q

parietal pain is usually caused by

A

infection

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40
Q

visceral pain

A
  • arises from a stimulus acting on an organ
  • poorly localized, diffuse or vague
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41
Q

visceral pain is caused by

A

damage or disruption

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42
Q

referred pain

A

visceral pain is felt away from the disease or affected organ
- well localized, can be felt in the skin or deeper

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43
Q

upper gastro-intestinal bleeding

A

bleeding in the esophagus, stomach or duodenum

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44
Q

upper gastro-intestinal bleeding is characterized by

A

HEMATEMESIS (bloody vomitus)
- emesis of frank, bright red bleeding or dark, grainy digested blood “coffee grounds”

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45
Q

upper gastro-intestinal bleeding causes

A

bleeding esophageal varices, peptic ulcer tear at the esophageal-gastric junction (Mallory-Weiss syndrome) caused by severe retracting

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46
Q

lower GI bleeding

A
  • bleedign from the jejunum, ileum, colon, or rectum
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47
Q

lower GI bleeding causes

A
  • polyps, diverticultis, inflammatory disease, cancer, hemorrhoids
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48
Q

Lower GI bleeding is characterized by

A

melena and hematochezia

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49
Q

hematemesis

A
  • emesis of frank, bright red bleeding or dark, grainy digested blood “coffee grounds”
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50
Q

melena

A
  • black, sticky, tarry, foul smelling stools characterized by the digestion of blood in the GI tract
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51
Q

hematochezia

A

fresh, bright red blood passes from the rectum

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52
Q

occult bleeding

A

trace amounts of blood in normal appearing stools or gastric secretion

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53
Q

occult bleeding causes

A

slow GI bleeding

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54
Q

blood volume depletion leads to

A

hypovolemic shock

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55
Q

dysphagia

A

difficulty swallowing

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56
Q

dysphagia causes

A
  • mechanical obstruction of the esophagus (tumours, strictures
  • functional disorder (neural or muscular disorders; parkinsons, MS, muscular dystrophy, or achalasia
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57
Q

discomfort occuring 2-4 seconds after swallowing is assoicated with

A

upper esophageal obstruction

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58
Q

discomfort occurring 10-15 seconds after swallowing is associated with

A

obstructions in the lower esophagus

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59
Q

manifestations of dysphagia

A
  • regurgitation of undigested food, unpleasant taste, vomiting, aspiration, and weight loss
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60
Q

Acid reflux

A

LES is weak or doesnt properly close, allowing stomach acid to backup, which irritates the lining of the esophagus

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61
Q

Acid reflux manifestations

A
  • burning sensation in the chest, pressure or pain in chest, sour, bitter, or acidic taste in the back of your throat
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62
Q

acid reflux modifications

A
  • avoid trigger foods, caffeine, alcohol, stay upright after meals and after, lose weight, stop smoking
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63
Q

Gastroesophageal reflux disease (GERD) is

A
  • more serious form of acid reflux
  • reflux of acid and pepsin or bile salts from the stomach into the esophagus
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64
Q

GERD causes

A

esophagitis

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65
Q

GERD causes

A
  • 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
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66
Q

GERD risk factors

A

age, obesity, histal hernia, medications that relax the lower esophageal sphincter

67
Q

histual hernia

A
  • stomach buldges up into your chest through an opening in the diaphragm)
68
Q

GED can trigger

A

an asthma attack or chronic cough due to aspiration of the stomach contents

69
Q

(true/false) GERD changes the lining of the esophagus; which may be a precursor to cancer of the esophagus

A

TRUE

70
Q

intestinal obstruction is caused by

A

any condition that prevents the normal flow of chyme through the intestinal lumen

71
Q

simple obstruction

A
  • most common
  • mechanical blockage o by lesion
72
Q

simple obstruction casues

A

hernia, adhesions, volvulus, intussusception

73
Q

hernia

A

protrusion of the small intestine through weakness in the abdominal muscles or through inguinal ring

74
Q

torsion (volvulus)

A

twisting of the intestine on its mesenteric pedicle, with occulsion of the blood supply

75
Q

adhesions

A

excessive scar tissues after surgery

76
Q

functional obstruction is also called

A

paralytic ileus

77
Q

functional obstruction often occurs after

A

intestinal or abdominal surgery, pancreatitis, or hypokalemia

78
Q

functional obstruction

A
  • inability of the intestines to conduct peristalsis
79
Q

signs and symptoms of small intestine obstruction

A

colicky pains, distention, nausea and vomiting, pain

80
Q

signs and symptoms of ileum obstruction

A
  • more pronounced distention (greater length of intestine is proximal to obstruction), vomiting (late sign), constipation, increased bowel sounds
81
Q

signs and symptoms of large intestine obstruction

A

hypogastric pain, abdominal distention, pain varies, dependent on ischemia and peritonitis, vomiting (late sign)

82
Q

gastritis

A

inflammatory disorder of the gastric mucosa

83
Q

acute gastritis is caused by

A
  • injury fo the mucosal barrier (medications (NSAIDS) chemicals, or H. Pylori
84
Q

acute gastritis signs and symptoms

A

vague abdominal discomfort, epigastric tenderness, and bleeding

85
Q

acute gastritis treatment

A

usually occurs spontaneously
- stop medications causing inflammation, H2 receptor antagonists for healing

86
Q

chronic gastritis usually occurs in

A

older persons

87
Q

chronic gastritis causes

A
  • chronic inflammation, mucosal atrophy, and epithelial metaplasia
88
Q

immune chronic gastritis example

A

fundal gastritis

89
Q

fundal gastritis

A
  • leads to gastric atrophy, which diminishes acid and intrinsic factor, causing pernicious anemia (lack of vit. B absorption)
90
Q

nonimmune chronic gastritis

A
  • involves the antrum only
  • follows acute gastritis
  • greater risk of developing gastric cancer
91
Q

peptic ulcer

A

break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

92
Q

gastric ulcer

A

ulceration in the stomach lining

93
Q

doudenal ulcer

A

ulceration in the upper part of the intestine

94
Q

signs and symptoms of peptic ulcer disease

A

nausea, vomiting, bloating

95
Q

peptic ulcer disease casues

A

H. pylori bacteria, medications

96
Q

peptic ulcer disease risk factors

A
  • over 70
  • alcohol consumption
  • smoking
  • injury or trauma
97
Q

peptic ulcer disease diagnostics

A
  • asses for blood in stool or emesis
  • urea breath test (tests for H. pylori0
  • endoscopy, barium swallow
98
Q

stress ulcer

A

acute from of peptic ulcer that accompanies physiological stress of severe illness or major trauma

99
Q

ischemia ulcers develop

A

within hours of events such as hemorrhage, multisystem trauma, heart failure, sepsis

100
Q

stress ulcers that develop asa result of a burn injury

A

curling ulcers

101
Q

stress ulcer associated with severe brain injury or trauma

A

cushings ulcer

102
Q

what is the primary sign of a stress ulcer

A

bleeding

103
Q

what treatment is used to prevent stress ulcers

A

prophylactic treatment

104
Q

dumping syndrome

A
  • rapid emptying of residual stomach (stomach contents remaining after surgical resection following surgery)
105
Q

dumping syndrome signs and symptoms

A
  • cramping pain, nausea, vomiting, diarrhea, weakness, pallor, hypotension
106
Q

dumping syndrome treatment

A

modify diet habits

107
Q

alkaline reflux gastritis

A
  • stomach inflammation caused by reflux of bile and pancreatic secretions
108
Q

alkaline reflux gastritis signs and symptoms

A
  • nausea, vomiting, bile, epigastic pain
109
Q

alkaline reflux gastritis treatment

A

surgical correction

110
Q

afferent loop obstruction is a result of

A

volvulus, hernia, adhesion, or stenosis

111
Q

afferent loop obstruction symptoms

A

intermittent severe pain and epigastric fullness after eating

112
Q

ulcerative colitis location

A

originates in the rectum, may extend to the entire colon

113
Q

ulcerative colitis

A
  • genetic, stress can aggravate
114
Q

mild ulcerative colitis

A
  • less mucosal involvement
  • fewer bowel movements
115
Q

severe ulcerative colitis

A
  • involves entire colon
  • abdominal pain, fever, tachycardia, diarrhea, bloody stools, continous cramping and pain
116
Q

crohns disease

A

idopathic inflammatory disorder; affects any part of the digestive tract (mouth to anus)

117
Q

crohns most likely effects

A

the large intestine and ileum

118
Q

crohns disease clinical manifestations

A
  • “skip leisions”, fistulas, anemia
119
Q

what is a major symptom of crohns disease

A

diarrhea

120
Q

complications from crohns disease in the ileum

A

malabsorption of folic acid and vitamin D

121
Q

pain in the lower left abdomen is indicative of

A

ulcerative colitis

122
Q

pain in the lower right abdomen is indicative of

A

crohns disease

123
Q

bleeding is common in bowel movements

A

UC

124
Q

inflammation usually only in the colon

A

UC

125
Q

bleeding not common during bowel movements

A

CD

126
Q

inflammation anywhere in the digestive tract

A

CD

127
Q

inflammation in one or more patches

A

CD

128
Q

colon has cobblestone appearance and thickened wall

A

CD

129
Q

granulomas often present

A

CD

130
Q

continous inflammation, not patchy

A

UC

131
Q

colon wall thinned

A

UC

132
Q

ulcers live deep in the colon

A

CD

133
Q

granulomas not present

A

UC

134
Q

ulcers only in the musuc lining of the colon

A

UC

135
Q

complications less frequent

A

UC

136
Q

seen more often in non-smokers

A

UC

137
Q

ulcers are deeper

A

CD

138
Q

complications moe frequent

A

CD

139
Q

smoking can worsen condition

A

CD

140
Q

irritable bowel syndrome

A
  • idopathic with mucliple probabilities
141
Q

IBS is associated with

A

anxiety, depression, and reduced quality of life

142
Q

IBS signs and symptoms

A

lower abdominal pain and bloating

143
Q

symptoms of IBS are usually relieved with

A

dedication

144
Q

diverticulosis

A
  • asymptomatic herniations or saclike outpouching of the mucosa and submucosa
145
Q

Diverticulitis

A

inflammation of the outpatching

146
Q

diverticulosis casues

A

idiopathic
- realted to increased intracolonic pressure, abnormal neuromuscular function and alterations in intestinal mobility

147
Q

diverticulosis predisposing factors

A

older age, obesity, smoking, diet, lifestyle, meds (NSAIDS and asprin)

148
Q

diverticulosis is located

A

anywhere in the digestive tract

149
Q
A
150
Q

diverticulosis sings and symptoms

A

vague or absent
- cramping in the lower abdomen, diarrhea, constipation, distention, or flautlence

151
Q

diverticulosis complications

A

abcesses, fistula, obstruction or perforation

152
Q

diverticulitis signs and symptoms

A

fever, increased WBC, tednerness in the lower quadrent

153
Q

appendicitis

A

inflamamtion of the appendix

154
Q

appendicitis is most common i

A

10-19 years of age

155
Q

appendicitis causes

A
  • 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
Q

appendicitis signs and symptoms

A

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
Q

following rupture of the appendix

A

breif cessation of pain

158
Q

obesity BMI

A

above 30

159
Q

malnutrition

A
  • lack of nourishment from inadequate amounts of food
160
Q

starvation

A

reduction in food intake

161
Q

short term starvation

A

several days of total dietary abstinece or deprivation

162
Q

short term starvation effect

A

increased glucogensis

163
Q

long term starvation

A

follwos several days of dietary abstince

164
Q

long term starvation effect

A

decreased dependence on glucogensis, increased use of ketone bodies

Pathophysiology (22 decks)

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