Gastrointestinal pt. 2 Flashcards
1
Q
_ in 4_ Canadians are obese
A
1 in 4
2
Q
Obese BMI
A
> 30
3
Q
obesity causes
A
- genetics
- sedentary lifestyle
-overeating - culture
4
Q
body weight is a result of
A
genetics, metabolism, behaviour, and culture
5
Q
Malnutrition
A
- lack of nourishment from inadequate amounts of food
6
Q
starvation
A
reduction in food intake
7
Q
short term starvation
A
several days of total dietary abstinence or deprivation
8
Q
short term effect
A
- glycogen in the liver is converted to glucose (glucogenesis)
9
Q
long term starvation
A
- follows several days of dietary abstinence
10
Q
long term starvation effect
A
- decreased energy expenditure, decreased dependence on glycogenesis, increased use of ketone bodies as cellular energy source
11
Q
cachexia
A
- result of chronic progressive diseases such as cancer, AIDS, TB
12
Q
refeeding syndrome
A
after long term starvation
- with refeeding, insulin release, hypophosphatemia, hypomagnesemia, and hypokalemia can cause life threatening complications
13
Q
what are the accessory organs
A
- liver
- gallbladder
- pancreas
14
Q
cirrhosis
A
irreversible inflammatory and fibrotic liver disease
15
Q
3 causes of liver diseases
A
alcohol misuse, viral hepatitis, nonalcoholic-fatty liver disease, hemochromatosis
16
Q
what are the three stages of cirrhosis
A
- steatosis
- alcoholic steatohepatitis (alcoholic hepatitis)
- hepatic/alcohol cirrhosis
17
Q
steatosis
A
- caused by fatty distribution in the liver
- lipids from adipose tissue or dietary intake contribute to fat accumulation
18
Q
is stenosis reversible
A
yes if the client stops drinking
19
Q
alcoholic steatohepatitis/hepatitis
A
- increased heptic storage of fat, inflammation, and degeneration and necrosis of hepatocytes
- stimulate irreversible fibrous characteristics
20
Q
hepatic/alcohol cirrhosis
A
- chronic alcoholism and malnutrition
- cell damage initiates an inflammatory response that results in excessive collagen formation
- fibrosis and scaring alter the structure of the liver and obstruct bialy and vascular channels
21
Q
hepatitis A transmission
A
fecal-oral, parenteral, sexual
22
Q
hepatitis B transmission
A
parenteral, sexual, placenta
23
Q
hepatitis C transmission
A
parenteral, sexual, sexual
24
Q
hepatitis D transmission
A
parenteral, fecal oral, sexual
25
hepatitis E transmission
fecal oral
26
hepatitis A incubation
30 days
27
hepatitis B incubation period
60-180 days
28
hepatitis C incubation period
35-60 days
29
hepatitis D incubation period
30-180 days
30
hepatitis E incubation period
15-60 days
31
is HEP A chronic
no
32
is HEP B chronic
yes
33
is HEP C chronic
yes
34
is HEP D chronic
yes
35
is HEP E chronic
no
36
which hepatitis are chronic
B,C,D
37
HEP A age group
children
38
HEP B age group
any age
39
HEP C age group
adults
40
HEP D age group
any age
41
HEP E age group
young adults
42
HEP A prevention
IG and Vaccine
43
HEP B prevention
IG and vaccine
44
HEP C prevention
education, hygiene
45
HEP D pervention
HBV vaccine
46
HEP E prevention
education, hygiene, safe water
47
damage to the liver is most severe in which types of hepatitis
B and C
48
prodromal phase of viral hepatitis
- 2 weeks after exposure, end with the apperance of jaundice
49
Prodromal phase of viral hepatitis symptoms
fatigue, anorexia, malaise, nausea, vomiting, headache, cough, low grade fever
50
Icteric phase of viral hepatitis
- 1-2 weeks after the prodromal phase
- lasts 2-6 weeks
51
Icteric phase of viral hepatitis symptoms
- jaundice, dark urine, clay stools, lover is enlarged, tender, any assessment of the liver causes pain
52
recovery phase of viral hepatitis
- resolution of jaundice, liver remains enlarged and tender, rectum of normal liver function
- 2-12 weeks after jaundice
53
which HEP may not have jaundice
B,C, and D
- can be carriers
54
diagnosis of viral hepatitis
specific hepatic antigens
55
portal hypertension
abnormally high blood pressure in the portal veins
56
portal hypertension is caused by
disease that obstructs or impedes blood flow in any part of the portal venous system including the vena cava
EXAMPLE: cirrhosis of the liver, viral hepatitis (inflammation or fibrosis), cardiac disorders
57
varies
- an abnormally dialted (distended) vessel with a tortuous course
- common in the lower esophagus and stomach
58
splenomeglay
- spleen becomes enlarged due to increased pressure in splenic vein
- enlarged spleen hold too many platelets
59
hematemesis
- most common sign of portal hypertension due to esophageal varices
60
risk for portal hypertension
history of jaundice, hepatitis, alcoholism, or cirrhosis
61
ascites
- abnormal buildup of fluid in the abdomen trapped in the peritoneal space; reduces amount of fluid available for normal physiological function
62
what is the biggest cause of ascites
cirrhosis
63
ascites is caused by
cirrhosis, portal hypertension, heart failure, constrictive pericarditis, abdominal malignancies, nephrotic syndrome, and malnutrition
64
constrictive pericarditis
thickened, fibrotic pericardium)
65
nephrotic syndrome
pass too much protein in the urine
66
how does portal hypertension contribute to ascites
- decreased synthesis of albumin in the liver with portal hypertension will cause capillary hydrostatic pressure to exceed capillary osmotic pressure pushing water into the peritoneal cavity
67
hepatic encephalopathy
- decline in brain function that occurs as a result of severe liver disease
68
hepatic encephalopathy is characterized by
impaired behavioural, cognitive and motor fucntion
69
hepatic encephalocpathy can develop quickly in
hepatitis
70
hepatic encephalopathy can develop slowly in
cirrhosis
71
jaundice
yellow pigmentation of the skin caused by hyperbilirubinemia
72
jaundice is caused by
bile duct occluded by gallstones, tumours or inflammation
73
hemolytic jaundice
excessive hemolysis bilirubun appear in urine (dark amber)
74
hepatorenal syndrome
functional kidney failure that developes as a complication of advanced liver disease
75
hepatorenal syndrome is caused by
advanced liver disease
76
hepatorenal syndrome symptoms
- oliguris, hypotension, peripheral vasodilation, decreased in effective arterial blood volume, decreased blood flow to kidneys
77
cholelithiasis is also known as
gallstones
78
gullstones risks
obesity, middle age, female gender, use of oral contreceptives, rapid weight loss, first nation ancestory, gallbladder disease, pancreatic disease, ileal disease
79
gallstones are formed from
imparied metabolsim of cholesteral and bile acids
80
what are the 3 types of gallstones
cholesterol
pigmented
mixed
81
cholesterol gallstones
70-80% cholesterol
- supersaturated with cholesterol
82
pigmented gallstones
black (hard) and brown (soft) with less than 30% cholesterol
83
gallstones symptoms
epigastric and RUQ pain, intolerance for fatty food (heartburn, flatuence, epigastric discomfort, and food intolerances)
84
cholecystitis
- acute or chronic
- caused by gallstone lodged in the cystic duct
- obstruction causes gallbladder to become distended and inflamed. pressure against distended wall of gallbladder can cause decreased blood flow, ischemia, necrosis, and perforation
85
cholecystitis signs and symptoms
fever, leukocytosis, rebound tenderness, abdominal muscle guarding
86
pancreatitis risk factors
cholelithiasis, alcoholism, obesity, peptic ulcers, trauma, dyslipidemia, hypercalcemia, smoking, some meds and genetics
87
acute pancreatitis treatment
- usually mild and resolves spontaneously
88
acute pancreatis develops because
- develops because of obstruction to the outflow of pancreatic digestive enzymes caused by pancreatic and bile obstruction
89
acute pancreatitis can result from
alcohol, medications or viral infection
90
acute pancreatitis secretions
back up of pancreatic secretion and activation and release of enzymes. Enzymes cause autodigestion of pancreatic cells and tissues, resulting in inflammation
91
autodigestion causes
inflammation, vascular damage, coagulation and fat necrosis
92
pancreatitis signs and symptoms
- constant mild to severe epigastric pain which may radiate to the back
- fever, increased WBC count, nausea, vomiting, and jaundice
93
acute pancreatitis is caused by
edema, chemical irritation, obstruction of the biliary tract, inflamamtion of the nerves
94
chronic pancreatitis
progressive fibrotic destruction of the pancrease
95
what is the most common cause of chronic pancreatitis
chronic alcohol abuse
96
what are the causes of chronic pancreatitis
chronic alcohol use, gallstones, smoking, genetics
97
chronic pancreatitis process
pancreatic parenchyma is destroyed and replaced by fibrous tissues, strictures, calcification, ductal obstruction, and pancreatic cysts
98
what is the only cancer that is at higher risk for women developing than men
pancrease
99
risk factors for esophagus cancer
malnutrition, alcohol, tobacco
100
esophogeal cancer sings and symptoms
chest pain, dysphagia
101
stomach cancer risk factors
salty food, meat, nitrates
102
stomach cancer signs and symptoms
anorexia, weight loss, vomiting, occult blood, RUQ pain
103
colorectal cancer risk factors
- polyps, IBD, diverticulitis, high refined carbs, low fiber diet, red meat, processed meat, fatty foods
104
colorectal cancer signs and symptoms
pain, palpable mass, anemia, bloody stool, distention, change in bowel routine
105
liver cancer risk factors
Hep B,C, D, cirrohisis
106
liver cancer signs and symptoms
pain, anorexia, weight loss, ascites, jaundice
107
pancreas cancer risk factors
chronic pancreatitis, smoking, alcohol, diabetes in women
108
pancreatic cancer signs and symptoms
weight loss, weakness, neausea and vomiting, abdomen pain, depression, juandice
109
polups
abnormal tissue growths
110
hyperplastic
- benign growth
- projection arising from mucosal epithelium
111
neoplastic
- adenomatous polyps
- premalignant lesions
112
later the polyps =
greater the risk
113
tumour initiation
- starts with an adenomatous polyps
114
tomour progression
- moves to carcinoma may take 8-10 years
115
colon cancer stage 0
Carcinoma in situ
- cancer is only in the inner lining of the colon or rectum (mucosa)
116
colon cancer stage 1
- cancer has grown into the submucosa or into the thick outer muscle layer (muscularis propria)
- though the muscle layer
117
colon cancer stage 2
- involves the serosa
118
colon cancer stage 3
- cancer cells are in the lymph nodes near the colon or rectum
119
stage 4 colon cancer
- cancer spread to other parts of the body (distant metastasis) such as the liver or lungs
- cancer may be in the peritoneum
120
stage 4 colon cancer is also called
metastatic colorectal cancer
121
hepatocellular carcinoma
- developes in hepatocytes
- main functioning cells of the liver
122
hepatocellular carcinoma signs and symtoms
- neausea and vomitng, fullness, pressure, dull ache in RUQ, sudden worsening of portal hypertension, ascites if obstructed
123
nodular hepatocellular carcinoma
- multiple discrete nodules
124
massive hepatocellular carcinoma
large tumour mass with several satelite nodules
125
diffuse hepatocellular carcinoma
- small nodule distributed throughout the liver
126
cholangiocellular carcinoma
- develops in the bile duct
127
lover cancer stage 1
- one section involved
128
stage 2 liver cancer
one or two sections involved
129
stage 3 liver cancer
two or three sections involved
130
stage 4 liver cancer
4 stages involved
131
pancreatic cancer stage 0
cancer in situ
- top layer of pancreatic duct cells
132
pancreatic cancer stage 1
- confined to pancrease <2 cm or <4cm
133
pancreatic cancer stage 2
- confined to pancrease >4cm
134
pancreatic cancer stage 3
spread to 4 or more lymph nodes or grown outside of pancrease with no lymph nodes involved
135
stage 4 pancreatic cancer
- spread to distant sites
- any size
136
Cleft lip and palate risks
maternal alcohol and tobacco use, maternal diabetes mellitus, folate deficiency
137
cleft lip and palate prevention
periconceptional vit, B, folate and folic acid, decreased alcohol and smoking
138
cleft lip and palate complications
- difficultly feeding because cant generate negative pressure in sucking
139
cleft lip and palate is caused my
multifactorial inheritence
- incomplete fusion during second month of development
140
pyloric stenosis
- narrowing and distal obstruction of the pylorus
- muscle fibers thicken so the pyloric spincter becomes enlarged and inflexiable
141
pyloric stenosis signs and cancer
- forceful nonbilous vomiting immediatly after feeding
142
untreated pyloric stenosis can lead to
severe fluid and electrolyte imbalances, malnutrition, weight loss
143
Hirschsprung Disease
- most common cause of colon obstruction
- absense of colon in part of the colon; causes decreased peristalsis
144
sings and symptoms of Hirschsprings disease
- mild to moderate constipation
- poor feeding, poor weight gain, increasing distention, watery diarrhea
145
Intussusception
- telescoping of proximal segement of the intestine
- most common cause of bowel obstruction in children
146
what most commonly telescopes in intussusception
ileum telescopes into the cecum of the asceding colon through the ileocecal valve
147
intussusception signs and symptoms
colicky abdominal pain, irritability, knees drawn to chest, abdominal mass, vomiting and bloodu stools
148
Hernia are most common in
newborns
149
hernias
bulge in teh groin or scrotum
150
hernias are caused by
weakness in the abdominal muscles
151
cystic fibrosis effect on GI
- disfunction of protein located in the epithelial membranes
- regulates chloride and sodium ion channels
- pancreatic ducts blocked
152
cystic fibrosis signs and symptoms for GI
- partial intestinal obestruction, severe cramping pain, absense of pancreatic enzymes, malabsorption of foot (fatty, bulky stools), decreased vitamin absorption, glucose intolerance, fatty liver
153
children have lower ______ than adult
fluid reserves
- need to monitor closer for dehydration
154
acute diarrhea in children
remain less than 4 weeks
155
chronic diarrhea is children
longer than 4 weeks
156
lactose intolerance
- inability to digest milk sugar
- inadequate production of lactase enzyme
