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HLSC 222 > Gastrointestinal system pt 1 > Flashcards

Gastrointestinal system pt 1 Flashcards

1
Q

Systemic effects of diarrhea include..?

A

dehydration, electrolyte imbalance, & weight loss

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2
Q

(Disorders of the GI tractsigns and symptoms)
Which term refers to the lack of a desire to eat this nonspecific symptom is often associated with nausea, abdominal pain, diarrhea, and psychological stress?

Also, side effects of medications and disorders of other organ systems, including cancer, heart disease, and kidney disease, are often accompanied by this symptom.

A

Anorexia

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3
Q

(Disorders of the GI tract signs & symptoms) Which term refers to the forceful emptying of the stomach and intestinal contents (chyme) through the mouth? Nausea and retching (dry heaves) are distinct events that usually precede ___

Which can be due to extreme pain, stomach or duodenum distension, motion sickness, side effects of medications, the trauma of ovaries, testes, uterus, bladder or kidney

A

Vomiting (emesis)

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4
Q

(Disorders of the GI tract signs & symptoms) Which term refers to a subjective experience associated with various conditions, including abnormal pain and labyrinthine stimulation (i.e., spinning movement)? Also, hypersalivation & tachycardia are common associated symptoms

A

Nausea

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5
Q

(Disorders of the GI tract signs & symptoms) Which term refers to the muscular event of vomiting without the expulsion of vomitus?

A

Retching

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6
Q

(Disorders of the GI tract signs & symptoms) Which term refers to spontaneous vomiting not preceded by nausea or retching, caused by direct stimulation of the vomiting centre by neurological lesions (e.g., increased intracranial pressure, tumours, or aneurysms) involving the brainstem or can be a symptom of GI obstruction (pyloric stenosis)?

A

Projectile vomiting

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7
Q

(Disorders of the GI tract signs & symptoms) The metabolic consequences of vomiting & nausea are…?

A
  • Fluid, electrolyte, and acid–base disturbances, including hyponatremia, hypokalemia, hypochloremia, & metabolic alkalosis
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8
Q

Which term refers to difficult or infrequent defecation, which is particularly prevalent among older adults, and usually means a decrease in the number of bowel movements per week, hard stools, and difficult evacuation?

A

Constipation

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9
Q

List the 3 categories of primary constipation

A
  • Normal transit (functional)
  • Slow transit
  • Pelvic floor dysfunction or outlet dysfunction
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10
Q

Which term refers to a normal rate of stool passage, but there is difficulty with stool evacuation, associated with a sedentary lifestyle, low-residue diet (the habitual consumption of highly refined foods), or low fluid intake?

A

Normal-transit constipation

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11
Q

Which term refers to impaired colonic motor activity with infrequent bowel movements, straining to defecate, mild abdominal distension, and palpable stool in the sigmoid colon?

A

Slow-transit constipation

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12
Q

Which term refers to inability or difficulty expelling stool because of dysfunction of the pelvic floor muscles or anal sphincter? Examples including pelvic floor dyssynergia, rectal fissures, strictures, or hemorrhoids.

A

Pelvic floor dysfunction

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13
Q

Which term refers to constipation that can be caused by diet, medications, or neurogenic disorders (e.g., stroke, Parkinson’s disease, spinal cord lesions, multiple sclerosis, Hirschsprung’s disease) in which neural pathways or neurotransmitters are altered and colon transit time delayed?

Can also be caused by opiates, antacids, iron, that Inhibit motility, endocrine or metabolic disorders (hypothyroidism, Diabetes mellitus), diverticuli, irritable bowel syndrome, & pregnancy

A

Secondary constipation

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14
Q

Indicators of constipation include two of the following for at least 3 months:

(1-4) At least 25 % of the time
(5) fewer than __ bm per week

A

(1) Straining with defecation ; (2) lumpy or hard stools; (3) sensation of incomplete emptying ; (4) manual manoeuvres to facilitate stool evacuation; and (5) fewer than three bowel movements per week.

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15
Q

Which term refers to hard, dry stool retained in the rectum, associated with rectal bleeding, abdominal or cramping pain, nausea and vomiting, weight loss, episodes of diarrhea, hemorrhoids, itching, & anal fissures?

A

Fecal impaction

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16
Q

Which term refers to he presence of loose, watery stools?

A

Diarrhea

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17
Q

Acute diarrhea is ___
Persistent diarrhea lasts__
& chronic diarrhea lasts __

A
  • more than 3 loose stools within 24 hours lasting less than 14 days
  • between 14 to 30 days
  • longer than 4 weeks
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18
Q

Diarrhea in which the volume of feces is increased is called__? And is generally associated caused by excessive amounts of water or secretions or both in the intestines

Diarrhea in which volume of feces is not increased, which usually results from excessive intestinal motility, is called?

A
  • Large-volume diarrhea
  • Small-volume diarrhea
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19
Q

The 3 major mechanisms of diarrhea are called?

A

Osmotic, secretory, & motile

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20
Q

Which term refers to excessive fluid drawn into the intestinal lumen by osmosis, caused by nonabsorbable sugars, full strength tube feeds, or dumping syndrome? (Producing large volume diarrhea)

A

Osmotic diarrhea

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21
Q

Which term refers to excessive mucosal secretion of fluid & electrolytes, which can be caused by infections or inflammatory disorders?

A

Secretory diarrhea

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22
Q

Which term refers to excessive GI motility which decreases transit time and opportunity for fluid absorption, resulting in diarrhea? Caused by resection of the small intestine (short bowel syndrome), or surgical bypass of an area of the intestine?

A

Motility diarrhea

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23
Q

Systemic effects of prolonged diarrhea include..?

A

Dehydration, electrolyte imbalance (hyponatremia, hypokalemia), & weight loss

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24
Q

Manifestations of acute bacterial or viral infection resulting in diarrhea include..?

A

Fever, with or without vomiting and cramping

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25
Q

Fever, cramping pain, and bloody stools accompany chronic diarrhea caused by..?

A

Inflammatory bowel disease (IBD) or dysentery

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26
Q

Steatorrhea (fat in the stools), bloating, and diarrhea are common signs of …?

A

Malabsorption syndrome

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27
Q

Which term refers to the presenting symptom of a number of GI diseases & can be acute or chronic?

Which can be caused by..?

Where abdominal organs are not sensitive to mechanical stimuli, such as cutting, tearing, or crushing, however, they are sensitive to..?

This pain is described as..?

A
  • Abdominal pain
  • Stretching (mechanical), inflammation, or ischemia (insufficient blood supply).
  • Stretching & distension
  • Sharp, dull, or colicky.
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28
Q

Abdominal pain can either..?

A

Parietal (somatic), visceral, or referred pain

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29
Q

(Abdominal pain) Which term refers from the parietal peritoneum, and is more localized and intense than visceral pain, which arises from the organs themselves?

A

Parietal pain

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30
Q

(Abdominal pain) Which term refers to pain arising from a stimulus (distension, inflammation, ischemia) acting on an abdominal organ, which is poorly localized, diffuse, or vague with a radiating pattern?

A

Visceral pain

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31
Q

(Abdominal pain) Which term refers to visceral pain felt at some distance from a diseased or affected organ, where it is usually well localized and is felt in the skin dermatomes or deeper tissues that share a central afferent pathway with the affected organ?

For example, acute cholecystitis (inflammation of the gallbladder) may have pain referred to the right shoulder or scapula.

A

Referred pain

32
Q

The obvious manifestations of GI bleeding include..?

A
  • Hematemesis (vomiting of blood), melena (dark, tally stools), & hematochezia (frank bleeding from the rectum)
33
Q

(GI bleeding) Which term refers to bleeding in the esophagus, stomach, or duodenum, and is characterized by frank, bright-red bleeding or dark, grainy digested blood (“coffee grounds”) that has been affected by stomach acids?

Commonly caused by bleeding varices (varicose veins) in the esophagus most common, peptic ulcers, arteriovenous malformations, or a Mallory-Weiss tear at the esophageal-gastric junction caused by severe retching

A

Upper gastro-intestinal bleeding

34
Q

(GI bleeding) Which term refers to bleeding from the jejunum, ileum, colon, or rectum, can be caused by polyps, diverticulitis, inflammatory disease, cancer, or hemorrhoids?

Which causes ___ & ___

A

Lower gastro-intestinal bleeding
- Melena (black, tarry, foul smelling stool) & Hematochezia (bright red blood passed from rectum)

35
Q

(GI bleeding) Which is usually caused by slow, chronic blood loss that is not obvious and results in iron deficiency anemia as iron stores in the bone marrow are slowly depleted?

With manifestations such as the presence of blood in ordinary stool or gastric secretions, which can only be detected by testing stools or vomitus for the presence of blood.

A

Occult bleeding

36
Q

With massive GI bleeding, blood volume is ___, causing a compensatory constriction of ___ ___. This causes ___ CO, __ Systolic blood pressure, & ___ pulse rate

Leading to….

Decreased blood flow to the skin causes ___. Decreased blood flow to the kidneys causes ___. Decreased blood flow to GI structures causes ___,__,___

Then… ___ acidosis & ___ acidosis are caused.

This compensatory failure leads to decreased blood flow to the brain which causes ___,__,__,___ & decreased blood flow to the heart through the coronary arteries causing ___,__ ___,___

A
  • Depleted; Peripheral arteries; Decreased; Decreased; Increased
  • Pallor; Low urine output; abdominal pain; bowel infarction; liver necrosis
  • Metabolic; Lactic
  • Anxiety, confusion, stupor, coma; Angina, myocardial infarct, heart failure
37
Q

Which term refers to difficulty swallowing, and can result from mechanical obstruction of the esophagus or a functional disorder that impairs esophageal motility?

A

Dysphagia

38
Q

(Dysphagia) –> Mechanical obstruction of esophagus

In intrinsic obstructions originate in the wall of the esophageal lumen (esophageal dysphagia) and include …?

Extrinsic mechanical obstructions originate outside the esophageal lumen and narrow the esophagus by pressing inward on the esophageal wall. The most common cause of extrinsic mechanical obstruction is …?

A
  • Tumours, strictures, & diverticular herniations (outpouchings).
  • Tumours
39
Q

(Dysphagia) –> Functional dysphagia is caused by ..?

Such as cerebrovascular accidents, Parkinson’s disease, multiple sclerosis, muscular dystrophy, or achalasia

A

Neural or muscular disorders that interfere with voluntary swallowing or peristalsis.

40
Q

(Dysphagia)

If obstruction results from a ___ ___, dysphagia begins with difficulty swallowing solids & advances to difficulty swallowing semisolids & liquids.

If ___ ___ is impaired, both solids & liquids are difficult to swallow

A
  • Growing tumour
  • Motor function
41
Q

Regurgitation of undigested food, unpleasant taste sensation, vomiting, aspiration, and weight loss are common manifestations of..?

A

Dysphagia

42
Q

Which term refers to a form of functional dysphagia caused by loss of esophageal innervation in middle and lower portions of esophagus, where the lower esophageal sphincter doesn’t relax which causes obstruction of lower esophagus, causing bulging of esophagus leading to difficulty swallowing both liquids & solids?

A

Achalasia

43
Q

Which term refers to when the Lower Esophagus Sphincter doesn’t properly close, allowing stomach acid to backup, which irritates the lining of the esophagus?

Manifested by a burning sensation in the center of your chest that lasts from several minutes to an hour or two, feeling of chest pressure or pain that is worse if you bend over or lie down, sour, bitter, or acidic taste in the back of your throat, feeling that food is “stuck” in your throat or the middle of your chest

A

Acid reflux (gastroesophageal reflux)

44
Q

Which term refers to the reflux of acid & pepsin or bile salts from the stomach into the esophagus that causes esophagitis?

Causes of such disease include..?

Also, vomiting, coughing, lifting, bending, obesity, or pregnancy increases abdominal pressure, contributing to the development of reflux esophagitis

A

Gastroesophageal reflux disease (GERD)

  • Abnormalities in lower esophageal sphincter function (resting tone is lower than normal), esophageal motility, gastric motility or emptying
45
Q

Age, obesity, hiatal hernia (stomach bulges up into your chest through an opening in diaphragm), medications that relax the lower esophageal sphincter are all risk factors for..?

Said disease may trigger ___ or ___

A

Gastroesophageal reflux disease (GERD)

  • Asthma attack or chronic cough
46
Q

If GERD is left untreated what may it cause? Which is when the stomach acid changes the lining of the esophagus & may be a precursor to cancer

A

Barrett’s Esophagus

47
Q

Which term refers to a type of diaphragmatic hernia with protrusion (herniation) of the upper part of the stomach through the diaphragm and into the thorax?

A

Hiatal hernia

48
Q

Which term can be caused by any condition that prevents the normal flow of chyme through the intestinal lumen, where these obstructions can occur in either the small or the large intestine?

This term is classified by cause as either ___ or ___

A

Intestinal obstruction

  • Simple; functional
49
Q

(Intestinal obstruction) Which term refers to the mechanical blockage of the lumen by a lesion and it is the most common type of intestinal obstruction?

A

Simple obstruction

50
Q

(Intestinal obstruction) Which term refers to a failure of intestinal motility often occurring after intestinal or abdominal surgery, acute pancreatitis, or hypokalemia?

A

Paralytic ileus, or functional obstruction

51
Q

(Intestinal obstruction)
Acute obstructions usually have mechanical causes, such as ___ or ___

A
  • Adhesions (Affecting 9 out of 10 people who have surgery)
  • Hernias (A protrusion of intestine through weakness in abdominal muscles or through inguinal ring, affecting more men than women, elederly person’s and pregnant women)
52
Q

Hernias, tumours, ischemia, inflammatory disorders - Crohn’s disease, volvulus, intussusception (in children); Are all common causes for …?

A

Intestinal obstruction

53
Q

(Intestinal obstruction)

Colicky pains caused by intestinal distension followed by nausea and vomiting. Pain intensifies for seconds or minutes as a peristaltic wave of muscle contraction meets the obstruction. Pain may be continuous with severe distension and then diminish in intensity. If ischemia occurs, the pain loses its colicky character and becomes more constant and severe. Sweating and tachycardia occur as a sympathetic nervous system response to hypotension. Fever, severe leukocytosis, abdominal distension, and rebound tenderness develop as ischemia progresses to necrosis, perforation, and peritonitis. –> Eventually leading to sepsis

These are all signs & symptoms of …?

A

Small intestinal obstruction

54
Q

(Intestinal obstruction)

___ ___ __ __ ____ ___ causes more pronounced distension because a greater length of intestine is proximal to the obstruction. In this case, vomiting may not occur early but may occur later and contain fecal material. Complete obstruction usually causes constipation only (rarely diarrhea), increasing the number of bowel sounds as well

A

Lower obstruction in the small intestine

55
Q

(Intestinal obstruction)

___ ___ ___ usually presents with hypogastric pain & abdominal distension. Pain can vary from vague to excruciating, depending on the degree of ischemia and the development of peritonitis. Vomiting occurs late in the obstructive process.

A

Large intestine obstruction

56
Q

Which term refers to an inflammatory disorder of the gastric mucosa? & it can be acute or chronic and affect the superficial mucosa of the fundus or antrum, or both.

A

Gastritis

57
Q

(Gastritis)
___ ___is caused by injury of the protective mucosal barrier caused by medications, chemicals, or Helicobacter pylori infection.

Manifestations of said term are…?

A

Acute gastritis
- Vague abdominal discomfort, epigastric tenderness, & bleeding

58
Q

(Gastritis)
___ ___ tends to occur in older adults and causes chronic inflammation, mucosal atrophy, & epithelial metaplasia.

___ ___ is classified as ___, ___, or ___, ____, depending on the pathogenesis and location of the lesions.

A

Chronic gastritis

  • Type A, immune (fundal); Type B, nonimmune (antral)
59
Q

(Gastritis)
Which term refers to the rarest form of gastritis and is associated with loss of T lymphocyte (T cell) tolerance & development of autoantibodies to gastric H+–K+ ATPase, where the gastric mucosa degenerates extensively in the body and fundus of the stomach, leading to gastric atrophy?
Also, loss of parietal cells diminishes acid and intrinsic factor secretion, where pernicious anemia can develop from decreased vitamin B12 absorption.

It occurs along other ___ ___, such as …. & is a risk factor for ___ ___

A

Chronic immune (fundal) gastritis

  • Autoimmune disorders; Gastric carcinoma (cancer)
60
Q

(Gastritis)
Which term generally involves the antrum only and is more common than fundal gastritis, & is caused by H. pylori bacteria and it also is associated with use of alcohol, tobacco, and NSAIDs?

& follows acute gastritis

A

Chronic nonimmune (antral gastritis)

61
Q

Which term refers to a break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum, developing when mucosal protective factors are overcome by erosive factors commonly caused by NSAIDs and H. pylori infections?

Also, how do the causes listed affect the mucosal linings?

Risk factors include:…?

A

Peptic ulcer
- Age > 70 yrs, alcohol consumption, smoking, or injury or trauma

-H. pylori: Affects mucous & allows stomach acid to damage lining

  • NSAIDS: Irritate & damage lining
62
Q

Peptic ulcers can be single or ___, ____ or chronic, and superficial or ____

Superificial ulcers are called…?

Zollinger-Ellison syndrome is called a …?

A

multiple; acute; deep

  • Erosions
  • True ulcer since its deep
63
Q

Which term refers to an ulceration in upper part of small intestine?

Which term refers to ulceration in stomach lining, where the primary defect is an increased mucosal permeability to hydrogen ions therefore gastric secretion tends to be normal or less than normal?

A
  • Duodenal ulcers
  • Gastric ulcers
64
Q

Manifestations and treatment of ___ and ___ ulcers are the same except eating that relieve pain in ___ ulcer

These manifestations include..?

A

Gastric; Duodenal; Duodenal

  • Nausea, vomiting, bloating; where 75% don’t have symptoms
65
Q

Which term refers to an acute form of peptic ulcer that tends to accompany the physiological stress of severe illness or major trauma?

& are classified as ___ ulcers or __ ulcers

A

Stress-related mucosal disease (stress ulcer)

  • Curling; Cushing
66
Q

Stress ulcers that develop as a result of burn injury are often called ___? The most common site is___?

Stress ulcer associated with severe brain trauma or brain surgery are often called ___? The most common site is ___

A
  • Curling ulcers; duodenum
  • Cushing ulcers; stomach
67
Q

What is the primary sign of a stress ulcer?

A

Bleeding

68
Q

Which term refers to a medical procedure where all or part of the stomach is surgically removed, which is a surgical intervention for peptic ulcers, gastric carcinomas, or extreme obesity?

& what is the primary objective of said surgery?

A

Gastrectomy
- To reduce stimuli for acid secretion, decrease the number of acid-secreting cells in the stomach, & correct complications of ulcer disease

69
Q

Indications for gastrectomies include..?

A
  • Recurrent or uncontrolled bleeding, & perforation of stomach or duodenum
70
Q

Complications of gastrectomies or Postgastrectomy syndromes are signs and symptoms that occur after gastric resection, caused by natomical and functional changes in the stomach and upper small intestine and include the following:

___ ___ is the rapid emptying of chyme from the residual stomach, which causes an osmotic shift of fluid from the vascular compartment to the intestinal lumen, which decreases plasma volume. Symptoms include, cramping pain, nausea, vomiting, diarrhea, weakness, pallor, hypotension – modify diet habits

__ __ ___ is a stomach inflammation caused by reflux of bile and pancreatic secretions from the duodenum into the stomach. Symptoms include, nausea, vomiting bile, & epigastric pain. Where surgical interventions may be required

___ ___ ___ is an obstruction of the duodenal stump on the proximal side of a gastrojejunostomy. Biliary and pancreatic secretions accumulate in the stump, causing distension, intermittent pain, and vomiting.

__ is frequent loose stools, related to rapid gastric emptying

___ ___ caused by inadequate caloric intake due to reduced stomach cannot handle complete meal & has decreased ability to digest food

__ Iron malabsorption due to decreased acid secretion

A
  • Dumping syndrome
  • Alkaline reflux gastritis
  • Afferent loop obstruction
  • Diarrhea
  • Weight loss
  • Anemia
71
Q

(Inflammatory bowel disease)

Which term refers to a chronic inflammatory disease that causes ulceration of the colonic mucosa, most commonly in the rectum and sigmoid colon? (restricted to large intestine)

Which term refers to an idiopathic inflammatory disorder that affects any part of the GI tract from the mouth to the anus? Where the distal small intestine & proximal large intestine most common sites.

Which term refers to
a symptom-based disease characterized by recurrent abdominal pain with altered bowel habits (constipation and diarrhea)
?

A
  • Ulcerative colitis
  • Crohn’s disease
  • Irritable bowel syndrome (IBS)
72
Q

(Inflammatory bowel disease) This disease is characterized with:

  • Peak occurrence 20-40 years of age and then between 50-70, men>women
  • Possibly related to abnormal immune response in the GI tract – genetic factors
  • Stress doesn’t cause the disorder – but can increase severity
  • Originates in the rectum – may extend to the entire colon
  • The course of ___ ___ consists of intermittent periods of remission and exacerbation

What is the disease called?

A

Ulcerative Colitis

73
Q

(IBD)

Mild ulcerative colitis involves less ___, with fewer __ __

Severe forms of ulcerative colitis involve the entire ___, and are characterized by __ __, fever, __, frequent diarrhea, __ __, & __ ___ pain

A
  • Mucosa; bowel movements
  • Colon; abdominal pain; tachycardia; bloody stools, continuous cramping
74
Q

(IBD) Crohn’s disease

Inflammation begins in the intestinal submucosa and spreads with discontinuous transmural involvement (“__ ___”), unlike colitis which progresses from the rectum

Also one side of the intestine may be affected, but not the other

The ulcerations of CD can produce ____ that extend inflammation into lymphoid tissue. ____ may form in the perianal area between loops of intestine or extend into the bladder, rectum, or vagina.

If the ileum is involved, the individual may be ___ as a result of malabsorption of vitamin ___.
There also may be deficiencies in ___ ___ & __ ___ absorption.

A
  • Skip lesions
  • Fissures; fistulae
  • Anemic; B12; folic acid;vitamin D
75
Q

(IBD) Manifestations of Crohn’s disease include..?

A

May be asymptomatic for several years, where symptoms are similar to ulcerative colitis.

  • Diarrhea is major symptom – can also have weight loss and abdominal pain
76
Q

(IBD) Irritable bowel syndrome

Is more common in ___

Alternating between __ & ___, but one condition can be the dominant or more frequent condition

Pain occurs during the day with stress or 1-2 hours after meals - Pain is relieved with ____

IBS is associated with ___, ___, & __ ___ _ __

Symptoms include ___ ___ __ or ___ & ___. Symptoms are usually relieved with defecation and do not interfere with sleep

A
  • Females
  • Constipation; diarrhea
  • Defecation
  • Anxiety; depression; reduced quality of life
    -Lower abdominal pain; discomfort; bloating

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