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Pathophysiology > Gastrointestinal pt. 2 > Flashcards

Gastrointestinal pt. 2 Flashcards

1
Q

_ in 4_ Canadians are obese

A

1 in 4

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2
Q

Obese BMI

A

> 30

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3
Q

obesity causes

A
  • genetics
  • sedentary lifestyle
    -overeating
  • culture
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4
Q

body weight is a result of

A

genetics, metabolism, behaviour, and culture

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5
Q

Malnutrition

A
  • lack of nourishment from inadequate amounts of food
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6
Q

starvation

A

reduction in food intake

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7
Q

short term starvation

A

several days of total dietary abstinence or deprivation

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8
Q

short term effect

A
  • glycogen in the liver is converted to glucose (glucogenesis)
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9
Q

long term starvation

A
  • follows several days of dietary abstinence
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10
Q

long term starvation effect

A
  • decreased energy expenditure, decreased dependence on glycogenesis, increased use of ketone bodies as cellular energy source
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11
Q

cachexia

A
  • result of chronic progressive diseases such as cancer, AIDS, TB
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12
Q

refeeding syndrome

A

after long term starvation
- with refeeding, insulin release, hypophosphatemia, hypomagnesemia, and hypokalemia can cause life threatening complications

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13
Q

what are the accessory organs

A
  • liver
  • gallbladder
  • pancreas
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14
Q

cirrhosis

A

irreversible inflammatory and fibrotic liver disease

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15
Q

3 causes of liver diseases

A

alcohol misuse, viral hepatitis, nonalcoholic-fatty liver disease, hemochromatosis

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16
Q

what are the three stages of cirrhosis

A
  • steatosis
  • alcoholic steatohepatitis (alcoholic hepatitis)
  • hepatic/alcohol cirrhosis
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17
Q

steatosis

A
  • caused by fatty distribution in the liver
  • lipids from adipose tissue or dietary intake contribute to fat accumulation
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18
Q

is stenosis reversible

A

yes if the client stops drinking

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19
Q

alcoholic steatohepatitis/hepatitis

A
  • increased heptic storage of fat, inflammation, and degeneration and necrosis of hepatocytes
  • stimulate irreversible fibrous characteristics
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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
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21
Q

hepatitis A transmission

A

fecal-oral, parenteral, sexual

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22
Q

hepatitis B transmission

A

parenteral, sexual, placenta

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23
Q

hepatitis C transmission

A

parenteral, sexual, sexual

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24
Q

hepatitis D transmission

A

parenteral, fecal oral, sexual

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25
Q

hepatitis E transmission

A

fecal oral

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26
Q

hepatitis A incubation

A

30 days

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27
Q

hepatitis B incubation period

A

60-180 days

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28
Q

hepatitis C incubation period

A

35-60 days

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29
Q

hepatitis D incubation period

A

30-180 days

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30
Q

hepatitis E incubation period

A

15-60 days

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31
Q

is HEP A chronic

A

no

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32
Q

is HEP B chronic

A

yes

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33
Q

is HEP C chronic

A

yes

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34
Q

is HEP D chronic

A

yes

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35
Q

is HEP E chronic

A

no

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36
Q

which hepatitis are chronic

A

B,C,D

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37
Q

HEP A age group

A

children

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38
Q

HEP B age group

A

any age

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39
Q

HEP C age group

A

adults

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40
Q

HEP D age group

A

any age

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41
Q

HEP E age group

A

young adults

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42
Q

HEP A prevention

A

IG and Vaccine

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43
Q

HEP B prevention

A

IG and vaccine

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44
Q

HEP C prevention

A

education, hygiene

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45
Q

HEP D pervention

A

HBV vaccine

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46
Q

HEP E prevention

A

education, hygiene, safe water

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47
Q

damage to the liver is most severe in which types of hepatitis

A

B and C

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48
Q

prodromal phase of viral hepatitis

A
  • 2 weeks after exposure, end with the apperance of jaundice
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49
Q

Prodromal phase of viral hepatitis symptoms

A

fatigue, anorexia, malaise, nausea, vomiting, headache, cough, low grade fever

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50
Q

Icteric phase of viral hepatitis

A
  • 1-2 weeks after the prodromal phase
  • lasts 2-6 weeks
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51
Q

Icteric phase of viral hepatitis symptoms

A
  • jaundice, dark urine, clay stools, lover is enlarged, tender, any assessment of the liver causes pain
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52
Q

recovery phase of viral hepatitis

A
  • resolution of jaundice, liver remains enlarged and tender, rectum of normal liver function
  • 2-12 weeks after jaundice
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53
Q

which HEP may not have jaundice

A

B,C, and D
- can be carriers

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54
Q

diagnosis of viral hepatitis

A

specific hepatic antigens

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55
Q

portal hypertension

A

abnormally high blood pressure in the portal veins

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56
Q

portal hypertension is caused by

A

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

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57
Q

varies

A
  • an abnormally dialted (distended) vessel with a tortuous course
  • common in the lower esophagus and stomach
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58
Q

splenomeglay

A
  • spleen becomes enlarged due to increased pressure in splenic vein
  • enlarged spleen hold too many platelets
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59
Q

hematemesis

A
  • most common sign of portal hypertension due to esophageal varices
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60
Q

risk for portal hypertension

A

history of jaundice, hepatitis, alcoholism, or cirrhosis

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61
Q

ascites

A
  • abnormal buildup of fluid in the abdomen trapped in the peritoneal space; reduces amount of fluid available for normal physiological function
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62
Q

what is the biggest cause of ascites

A

cirrhosis

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63
Q

ascites is caused by

A

cirrhosis, portal hypertension, heart failure, constrictive pericarditis, abdominal malignancies, nephrotic syndrome, and malnutrition

64
Q

constrictive pericarditis

A

thickened, fibrotic pericardium)

65
Q

nephrotic syndrome

A

pass too much protein in the urine

66
Q

how does portal hypertension contribute to ascites

A
  • 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
Q

hepatic encephalopathy

A
  • decline in brain function that occurs as a result of severe liver disease
68
Q

hepatic encephalopathy is characterized by

A

impaired behavioural, cognitive and motor fucntion

69
Q

hepatic encephalocpathy can develop quickly in

A

hepatitis

70
Q

hepatic encephalopathy can develop slowly in

A

cirrhosis

71
Q

jaundice

A

yellow pigmentation of the skin caused by hyperbilirubinemia

72
Q

jaundice is caused by

A

bile duct occluded by gallstones, tumours or inflammation

73
Q

hemolytic jaundice

A

excessive hemolysis bilirubun appear in urine (dark amber)

74
Q

hepatorenal syndrome

A

functional kidney failure that developes as a complication of advanced liver disease

75
Q

hepatorenal syndrome is caused by

A

advanced liver disease

76
Q

hepatorenal syndrome symptoms

A
  • oliguris, hypotension, peripheral vasodilation, decreased in effective arterial blood volume, decreased blood flow to kidneys
77
Q

cholelithiasis is also known as

A

gallstones

78
Q

gullstones risks

A

obesity, middle age, female gender, use of oral contreceptives, rapid weight loss, first nation ancestory, gallbladder disease, pancreatic disease, ileal disease

79
Q

gallstones are formed from

A

imparied metabolsim of cholesteral and bile acids

80
Q

what are the 3 types of gallstones

A

cholesterol
pigmented
mixed

81
Q

cholesterol gallstones

A

70-80% cholesterol
- supersaturated with cholesterol

82
Q

pigmented gallstones

A

black (hard) and brown (soft) with less than 30% cholesterol

83
Q

gallstones symptoms

A

epigastric and RUQ pain, intolerance for fatty food (heartburn, flatuence, epigastric discomfort, and food intolerances)

84
Q

cholecystitis

A
  • 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
Q

cholecystitis signs and symptoms

A

fever, leukocytosis, rebound tenderness, abdominal muscle guarding

86
Q

pancreatitis risk factors

A

cholelithiasis, alcoholism, obesity, peptic ulcers, trauma, dyslipidemia, hypercalcemia, smoking, some meds and genetics

87
Q

acute pancreatitis treatment

A
  • usually mild and resolves spontaneously
88
Q

acute pancreatis develops because

A
  • develops because of obstruction to the outflow of pancreatic digestive enzymes caused by pancreatic and bile obstruction
89
Q

acute pancreatitis can result from

A

alcohol, medications or viral infection

90
Q

acute pancreatitis secretions

A

back up of pancreatic secretion and activation and release of enzymes. Enzymes cause autodigestion of pancreatic cells and tissues, resulting in inflammation

91
Q

autodigestion causes

A

inflammation, vascular damage, coagulation and fat necrosis

92
Q

pancreatitis signs and symptoms

A
  • constant mild to severe epigastric pain which may radiate to the back
  • fever, increased WBC count, nausea, vomiting, and jaundice
93
Q

acute pancreatitis is caused by

A

edema, chemical irritation, obstruction of the biliary tract, inflamamtion of the nerves

94
Q

chronic pancreatitis

A

progressive fibrotic destruction of the pancrease

95
Q

what is the most common cause of chronic pancreatitis

A

chronic alcohol abuse

96
Q

what are the causes of chronic pancreatitis

A

chronic alcohol use, gallstones, smoking, genetics

97
Q

chronic pancreatitis process

A

pancreatic parenchyma is destroyed and replaced by fibrous tissues, strictures, calcification, ductal obstruction, and pancreatic cysts

98
Q

what is the only cancer that is at higher risk for women developing than men

A

pancrease

99
Q

risk factors for esophagus cancer

A

malnutrition, alcohol, tobacco

100
Q

esophogeal cancer sings and symptoms

A

chest pain, dysphagia

101
Q

stomach cancer risk factors

A

salty food, meat, nitrates

102
Q

stomach cancer signs and symptoms

A

anorexia, weight loss, vomiting, occult blood, RUQ pain

103
Q

colorectal cancer risk factors

A
  • polyps, IBD, diverticulitis, high refined carbs, low fiber diet, red meat, processed meat, fatty foods
104
Q

colorectal cancer signs and symptoms

A

pain, palpable mass, anemia, bloody stool, distention, change in bowel routine

105
Q

liver cancer risk factors

A

Hep B,C, D, cirrohisis

106
Q

liver cancer signs and symptoms

A

pain, anorexia, weight loss, ascites, jaundice

107
Q

pancreas cancer risk factors

A

chronic pancreatitis, smoking, alcohol, diabetes in women

108
Q

pancreatic cancer signs and symptoms

A

weight loss, weakness, neausea and vomiting, abdomen pain, depression, juandice

109
Q

polups

A

abnormal tissue growths

110
Q

hyperplastic

A
  • benign growth
  • projection arising from mucosal epithelium
111
Q

neoplastic

A
  • adenomatous polyps
  • premalignant lesions
112
Q

later the polyps =

A

greater the risk

113
Q

tumour initiation

A
  • starts with an adenomatous polyps
114
Q

tomour progression

A
  • moves to carcinoma may take 8-10 years
115
Q

colon cancer stage 0

A

Carcinoma in situ
- cancer is only in the inner lining of the colon or rectum (mucosa)

116
Q

colon cancer stage 1

A
  • cancer has grown into the submucosa or into the thick outer muscle layer (muscularis propria)
  • though the muscle layer
117
Q

colon cancer stage 2

A
  • involves the serosa
118
Q

colon cancer stage 3

A
  • cancer cells are in the lymph nodes near the colon or rectum
119
Q

stage 4 colon cancer

A
  • cancer spread to other parts of the body (distant metastasis) such as the liver or lungs
  • cancer may be in the peritoneum
120
Q

stage 4 colon cancer is also called

A

metastatic colorectal cancer

121
Q

hepatocellular carcinoma

A
  • developes in hepatocytes
  • main functioning cells of the liver
122
Q

hepatocellular carcinoma signs and symtoms

A
  • neausea and vomitng, fullness, pressure, dull ache in RUQ, sudden worsening of portal hypertension, ascites if obstructed
123
Q

nodular hepatocellular carcinoma

A
  • multiple discrete nodules
124
Q

massive hepatocellular carcinoma

A

large tumour mass with several satelite nodules

125
Q

diffuse hepatocellular carcinoma

A
  • small nodule distributed throughout the liver
126
Q

cholangiocellular carcinoma

A
  • develops in the bile duct
127
Q

lover cancer stage 1

A
  • one section involved
128
Q

stage 2 liver cancer

A

one or two sections involved

129
Q

stage 3 liver cancer

A

two or three sections involved

130
Q

stage 4 liver cancer

A

4 stages involved

131
Q

pancreatic cancer stage 0

A

cancer in situ
- top layer of pancreatic duct cells

132
Q

pancreatic cancer stage 1

A
  • confined to pancrease <2 cm or <4cm
133
Q

pancreatic cancer stage 2

A
  • confined to pancrease >4cm
134
Q

pancreatic cancer stage 3

A

spread to 4 or more lymph nodes or grown outside of pancrease with no lymph nodes involved

135
Q

stage 4 pancreatic cancer

A
  • spread to distant sites
  • any size
136
Q

Cleft lip and palate risks

A

maternal alcohol and tobacco use, maternal diabetes mellitus, folate deficiency

137
Q

cleft lip and palate prevention

A

periconceptional vit, B, folate and folic acid, decreased alcohol and smoking

138
Q

cleft lip and palate complications

A
  • difficultly feeding because cant generate negative pressure in sucking
139
Q

cleft lip and palate is caused my

A

multifactorial inheritence
- incomplete fusion during second month of development

140
Q

pyloric stenosis

A
  • narrowing and distal obstruction of the pylorus
  • muscle fibers thicken so the pyloric spincter becomes enlarged and inflexiable
141
Q

pyloric stenosis signs and cancer

A
  • forceful nonbilous vomiting immediatly after feeding
142
Q

untreated pyloric stenosis can lead to

A

severe fluid and electrolyte imbalances, malnutrition, weight loss

143
Q

Hirschsprung Disease

A
  • most common cause of colon obstruction
  • absense of colon in part of the colon; causes decreased peristalsis
144
Q

sings and symptoms of Hirschsprings disease

A
  • mild to moderate constipation
  • poor feeding, poor weight gain, increasing distention, watery diarrhea
145
Q

Intussusception

A
  • telescoping of proximal segement of the intestine
  • most common cause of bowel obstruction in children
146
Q

what most commonly telescopes in intussusception

A

ileum telescopes into the cecum of the asceding colon through the ileocecal valve

147
Q

intussusception signs and symptoms

A

colicky abdominal pain, irritability, knees drawn to chest, abdominal mass, vomiting and bloodu stools

148
Q

Hernia are most common in

A

newborns

149
Q

hernias

A

bulge in teh groin or scrotum

150
Q

hernias are caused by

A

weakness in the abdominal muscles

151
Q

cystic fibrosis effect on GI

A
  • disfunction of protein located in the epithelial membranes
  • regulates chloride and sodium ion channels
  • pancreatic ducts blocked
152
Q

cystic fibrosis signs and symptoms for GI

A
  • partial intestinal obestruction, severe cramping pain, absense of pancreatic enzymes, malabsorption of foot (fatty, bulky stools), decreased vitamin absorption, glucose intolerance, fatty liver
153
Q

children have lower ______ than adult

A

fluid reserves
- need to monitor closer for dehydration

154
Q

acute diarrhea in children

A

remain less than 4 weeks

155
Q

chronic diarrhea is children

A

longer than 4 weeks

156
Q

lactose intolerance

A
  • inability to digest milk sugar
  • inadequate production of lactase enzyme

Pathophysiology (22 decks)

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