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Pathophysiology > GI > Flashcards

GI Flashcards

1
Q

Intestine wall layers include..

A

mucosa
submucosa
muscle layers
serosa

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2
Q

Mucosa is the….
It is made of …. including …. cells
It functions as …. and ….

A

inner layer
epithelium, mucus-producing
lubricant and protectant

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3
Q

Submucosa is ….

It has embedded …, …., …, ….

A 
connective tissue
embedded blood vessels
lymphatics
nerves
secretory glands
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4
Q

Muscle layers include …. and ….

They are responsible for …

A

circular smooth muscle layer
longitudinal smooth muscle layer
peristalsis

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5
Q

Serosa is the … or …..

It is made up of ….

A

outer layer
visceral peritoneum
connective tissue

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6
Q

What are the sphincters associated with esophagus?

A

upper

lower

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7
Q

The initial digestions in the stomach is by … and …

A

pepsin

HCl

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8
Q

Pepsinogen is created by …. cells which is a precursor to pepsin.

A

chief cells

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9
Q 
HCl is produced by... cells. 
Is activated by...
Creates optimal ... for pepsin activity.
Denatures ... to ease digestion.
Protects against.....
A 
parietal cells
pepsinogen
pH
proteins
microbes
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10
Q

Production of intrinsic factor is by …

Intrinsic factor is essential absorption of …

A

parietal cells

vitamin B12 in ileum

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11
Q

Production of gastrin is by the …. cells.
Its initiated by ….
It stimulates … and …. cells.

A

G
food entering stomach
chief and parietal

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12
Q

Lower GI tract:
Duodenum is where ….continues and ….begins.
It containes …., ….enzymes, and bile salts from … and ….ducts.

A 
digestion 
absoprtion 
bicarbonate
pancreatic 
pancreatic 
bile
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13
Q

Lower GI tract:
Jejunum is the major site for …
It is highly …
It contains … and … to increase surface area for absorption.

A

absorption of nutrients
vascularized
villi and microvilli

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14
Q

Lower GI tract:
Ileum is where … continues
There are less ….
…, and bile salts are absorbed here.

A

absorption
blood vessels
B12

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15
Q

Small intestines produce mucus, fluid with neutral pH, enzymes (….,….,…,….,….) and hormones (…,….)

A 
enterokinase
peptidases
nucleases
lipases
sucrases, maltases, lactases
secretin
cholecystokinin
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16
Q

Enterokinase activates…

A

trypsinogen into trypsin

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17
Q

Lower GI tract:
Large intestine is where there is a …. of digestion and nutrient absorption.
There is … and …. reabsorption which maintains the fluid and acid-base balance.
Resident flora …. certain food materials and vitamin …. is synthesized here by bacteria.
Movement is …. to allow for absorption of water and formation of solid feces.

A 
cease
fluid
electrolyte
breaks down 
K 
slow
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18
Q

Liver is where metabolism of …,….,…. happen.
Liver receives blood from … artery which brings oxygen.
Hepatic portal vein transports …. from intestine.

A 
carbs
proteins
lipids
hepatic
nutrients
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19
Q

Liver stores nutrients (9)

A

iron
copper
vitamins A, B6, B12, D, K, folic acid
glycogen

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20
Q

Liver maintains blood glucose level through which processes?

A

glycogenolysis

gluconeogenesis

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21
Q

Glucose–> glycogen is called

A

glycogenesis

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22
Q

Glycogen –> glucose is called

A

glycogenolysis

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23
Q

Proteins, fat –> glucose is called

A

gluconeogenesis

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24
Q

Liver is a blood reservoir, it can ….

A

release blood in general circulation when needed

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25
Q

Liver is site for metabolic processes like conversion of …. into urea, detox, and utilizing products of breakdown of old/damaged…. (examples).

A

ammonia
erythrocytes
iron recycled
bilirubin conjugated and excreted into bile

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26
Q

Liver produces… proteins, … and lipoproteins, and ….

A

plasma
cholesterol
bile

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27
Q

Plasma proteins produce …,….,…

A

blood clotting factors
albumin
immunoglobulins

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28
Q

Bile is a mixture of…

A 
water
conjugated bilirubin (gives pigment)
electrolytes (bicarbonate ion)
cholesterol
bile salts
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29
Q

Bile ….. fat and fat soluble vitamins (…,….,….,…)
It neutralizes acid from …. by increased pH in small intestine.
It is stored in ….

A

emulsifies
A, D, E, K
stomach
gallbladder

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30
Q

Gallbladder squeezes bile into …. through ….duct to aid in food digestion. It is connected with common bile duct through …. duct.

A

duodenum
common bile
cystic

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31
Q

Pancreas is an exocrine and endocrine gland how?

A

exocrine through ducts

endocrine through circulation

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32
Q

Exocrine pancreas secretes …. which are precursors of pancreatic proteases like …. and ….
Some examples of these enzymes….
Exocrine pancreas also secretes…like …ions.

A 
digestive enzymes 
trypsinogen 
chymotrypsinogen 
carboxypeptidase
ribonuclease
pancreatic amylase
lipase
electrolytes 
bicarbonate
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33
Q

Neural control to the GI system is by … and …

A

PNS

SNS

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34
Q

How does the PNS impact GI?

How does SNS?

A

PNS- primarily through vagus
it increases motility and secretions
SNS- inhibits GI activity

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35
Q

Hormones that control GI:

One secreted by stomach and two from small intestine

A

gastrin
secretin
cholecystokinin

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36
Q 
Gastrin is secreted by 
It is initiated by .... of stomach.
It stimulates ... and ... cells.
It increases gastric ....
Promotes ....by relaxing pyloric sphincter.
A 
G cells
distention 
chief and parietal 
motility
stomach emptying
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37
Q

Secretin decreases ….

It increases …. ion in pancreatic secretions and bile to increase …

A

gastric secretions
bicarbonate
pH

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38
Q

Cholecystokinin inhibits ….

It stimulates digestion of … and …with this … secretion is stimulated and contraction of … is stimulated.

A

gastric emptying
proteins and fat
pancreatic
gallbladder

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39
Q

Carbs are broken down into ….
Digestion of them starts in the … by ….
It continues in the small intestine by ….

A

monosaccharides
mouth
salivary amylase
pancreatic amylase

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40
Q

Proteins are broken into … then ….
Digestion of these starts in the … by …
It continues in the small intestine-… by …,…,….

A 
peptides 
amino acids 
stomach
pepsin
duodenum
trypsin
chymotrypsin
peptidases
41
Q

Lipids are emulsified by .. prior to chemical breakdown in intestines.
They are broken down by lipases to … and …

A

bile
glycerol
free fatty acids

42
Q

Water soluble vitamins are … and …
They diffuse in blood.
…. requires intrinsic factor for absorption.

A

B, C

B12

43
Q

Minerals … in blood.

A

diffuse

44
Q

Electrolytes are absorbed by … or … into blood.

A

active transport

diffusion

45
Q

Drugs are primarily absorbed in …

Some like … are absorbed in stomach.

A

intestine

aspirin

46
Q

Early stage of vomiting induce metabolic ….

Late stages induce…

A

alkalosis

acidosis

47
Q

Steatorrhea is…

A

fatty diarrhea

48
Q

Two types of diarrhea…

A

large volume or small volume

49
Q

Large volume diarrhea is caused by ….

Small volume diarrhea is caused by…

A

increased secretions into intestines

IBD

50
Q

In dehydration, fluid shifts from blood to digestive tract which leads to …. and over time this can lead to …. and ultimately …

A

hypovolemia
decreased tissue perfusion
hypovolemic shock

51
Q

Sodium can be lost in …
Potassium..
Chloride..

A

both vomiting and diarrhea
both vomiting and diarrhea
in vomiting

52
Q

Outpouching of the esophageal wall can be due to … or …

Food can accumulate in these pouches which leads to …

A

congenital defects
inflammation
obstruction of food flow, irritation, inflammation, scarring of the wall, ulcers

53
Q

In gastritis, stomach mucosa is ….
It loses … glands and there is a reduced production of ….
….infection is often present.

A

atrophied
secretory
intrinsic factor
helicobacter pylori

54
Q

Gastroenteritis is the ….
Caused by …
Examples…
Can also be caused by..

A 
stomach and intestine
infection, microbes transmitted by fecally contaminated food, soil and/or water
staph aureus
e coli 
salmonella 
allergic reactions to foods or drugs
55
Q

Ulcer is the …..
Can appear as a single, small ….
Develops due to … or …
Most common locations…

A 
erosion in mucosa
round cavities
H. pylori infection
acid-pepsin gastric juice irritation 
antrum of stomach (gastric ulcers)
proximal duodenum (duodenal ulcers)
56
Q

Peptic ulcer development:
Exposure to .. or … which causes inflammtion, which causes ….of mucosa so that there is …diffusion into the submucosa which deepens the ulceration into the muscular layer and finally a …of the wall which can lead to food in the peritoneal cavity.

A 
H. pylori infection 
gastric juice 
erosion
acid
perforation
57
Q

An increase in acid-pepsin secretions can be due to …

A

increased gastrin secretion, vagal stimulation, sensitivity to vagal stimuli, number of acid-pepsin secretory cells in stomach, alcohol, caffeine, certain foods.

58
Q

Some additional factors that lead to damage of the mucosa and form ulcers can be …., …., ….

A

inadequate blood/oxygen supply
excessive meds and ulcerogenic substances
atrophy of gastric mucosa

59
Q

Inadequate blood/oxygen supply with peptic ulcers is due to…
This will interfere with ….

A 
vasoconstriction
circulatory impairment in older adults 
scar tissues 
anemia
rapid regeneration of epithelium
60
Q

Erosion from peptic ulcers can damage … and later develop …

A

blood vessels

scar tissue

61
Q

Stress ulcers have a … onset.
Multiple … may form within hours. This is due to reduced blood flow that leads to ….,…
The first indicator is … and …

A

rapid
ulcers
reduced mucus secretion, epithelium regeneration
hemorrhage and severe pain

62
Q

Gastric cancer is mostly in the …
The early stages are confined to … and …
Later stages involved the …. and it will eventually invade … and spread to … nodes.
It is often … in early stages and the prognosis is … on diagnosis.

A 
antrum
mucosa 
submucosa 
muscular layer 
serosa 
lymph 
asymptomatic 
poor
63
Q

Wheat allergy is determined by what Ig?

A

IgE

64
Q

Celiac disease is a small intestine disorder where the intestinal lining is ….
It is a …. syndrome.
It’s onset is primarily in …
It may occur in …
It is an … disease in genetically susceptible people.

A 
atrophied
malabsorption 
childhood
middle age
autoimmune
65
Q

Gluten sensitivity is usually a sensitivity to …

Once this accumulates it causes inflammation, … and …

A

gliadin

malabsorption and malnutrition

66
Q

Cholecystitis is inflammation of …. and …
Cholangitis is …
Cholelithiasis is …
Choledocholithiasis is …

A

gallbladder and cystic duct
bile ducts due to infection
presence of gallstones
obstruction of biliary ducts by gallstones

67
Q

Gallstones are formed in …

They may consist of …

A

bile
cholesterol and bilirubin
calcium salts

68
Q

Jaundice is called …

It is caused by …

A

hyperbilirubinemia

increased levels of bilirubin in blood

69
Q

Prehepatic jaundice is … in blood.
It is the result of …
It is a characteristic of ..

A

unconjugated bilirubin elevated in blood.
excessive destruction of RBCs
hemolytic anemias or transfusion reactions

70
Q

Intrahepatic jaundice is …

It occurs with … like … and ..

A

both unconjugated and conjugated bilirubin in blood
disease or damage to hepatocytes
hepatitis and cirrhosis

71
Q

Posthepatic jaundice is …

It is caused by …. like …

A

conjugated bilirubin in blood
obstruction of bile flow into gallbladder or duodenum
tumor, cholelithiasis

72
Q

Blood tests for liver function usually tests enzymes….

A 
alanine aminotransferase 
aspartate aminotransferase
alkaline phosphatase
albumin
total protein
total bilirubin 
unconjugated bilirubin (or indirect)
conjugated bilirubin (or direct)
73
Q

Alanine aminotransferase is found mostly in … but small amts in kidneys, heart, muscles and pancreas.
Aspartate aminotransferase is found in …
Alkaline phosphatase is related to..

A

liver
liver, heart, muscles
bile ducts

74
Q

Albumin is a …
It is decreased in..
It is increased in…

A

protein made in the liver
malnutrition, liver disease, pregnancy, overhydration
dehydration

75
Q

Mild hepatitis results in …

Sever results in …

A

impaired hepatocyte function

necrosis due to obstruction of blood flow and bile flow

76
Q

Viral hepatitis can cause damage by direct action like in … or cell-mediated immune response like in …

A

C

B

77
Q

Hep A is called …
It is a small … virus
It is transmitted by … in areas of inadequate sanitation or hygiene.
Vaccine available.

A

infection hepatitis
RNA
fecal-oral route

78
Q

Hep B was formerly called …
It is a … virus.
There is a long … period.
Transmission is primarily by …

A

serum hepatitis
DNA
incubation
infected blood

79
Q

Hep C is a … virus.
It is the …. type transmitted through blood transfusion.
Half of the cases enter … state.
Increases risk of …

A

RNA
most common
chronic
hepatocellular carcinoma

80
Q

Hep D is also called …
It is incomplete … (requires … to replicate and produce active infection).
HDV infection increases severity of HBV infection.
Transmitted by..

A

delta virus
RNA
HBV
blood

81
Q

Hep E is a … virus.

It is transmitted by … route.

A

RNA

oral-fecal

82
Q

Chronic hepatitis can be treated with …

A

interferon

83
Q

Hepatotoxins cause … of liver.
Mode of action…
Types…
May result from ….

A

inflammation and necrosis
direct effect of toxins, immune response
drugs, chemicals
sudden exposure to large amounts or from lower dose and long-term exposure

84
Q

Biliary cirrhosis is common in …
Post-necrotic cirrhosis is linked with …
Metabolic cirrhosis is usually caused by…

A

autoimmune disease
chronic hepatitis or long-term exposure to toxins
genetic metabolic storage disorders

85
Q

Structural changes of cirrhosis includes..

A

fibrosis and loss of lobular organization

86
Q

In cirrhosis there is a decrease in production of … which causes a decrease in digestion and absorption of nutrients. There is decrease in… and removal of bilirubin. There is decrease in production of …. mostly blood clotting factors. There is decrease in detoxification of … and …
…and … metabolism. Decrease in conversion of …. to urea. Decrease in storage of .. and …

A 
bile
conjugation
proteins 
drugs 
toxic substances
glucose and glycogen 
ammonia 
iron and vitamin B12
87
Q

Most common tumor of liver …
Secondary or metastatic cancer of liver arises from areas served by ….
Initial signs are .. and …
Diagnosis usually occurs with …

A

hepatocellular carcinoma
hepatic vein
mild and general
advanced stages

88
Q

Inflammation of pancreas in acute pancreatitis results from … which is caused by …

A

autodigestion of tissue

premature activation of pancreatic proenzymes

89
Q

Acute pancreatitis spreads to surrounding tissue because ..

A

pancreas lacks fibrous capsule

90
Q

Acute pancreatitis is

A

a medical emergency

91
Q

Most common form of pancreatic cancer..

Arises from … in ducts.

A

adenocarcinoma

epithelial

92
Q

Crohns affects … of GI. Most frequently …
It is progressive … and … which obstructs …. and thick .. .walls develop. There is impaired …. and inflammation stimulates ….

A 
any area
small intestine (ileum)
inflammation and fibrosis 
lumen 
fibrotic 
processing and absorption of food 
intestinal motility
93
Q

Inflammation in Crohns occurs in characteristic distribution…
Other complications include..

A

skip lesions

adhesions between loops may form and fistulas may develop

94
Q

UC, inflammation starts in the … it progresses through the … the mucosa and submucosa are inflamed and … develop. The tissue destruction interferes with … of … and … in colon.

A

rectum
colon
ulcerations
absorption of fluid and electrolytes

95
Q

IBS is a …. disorder.
It affects ….
It does not cause …
Affects … more.

A

chronic, long-term disorder
large intestine
change in bowel tissue
women

96
Q

Diverticula development is most common in …
Weaker areas … when pressure increases.
Stasis of material in diverticulum leads to … and …
….is asymptomatic diverticular disease.
…is inflammation of diverticula.

A 
sigmoid colon
bulge
inflammation and infection
diverticulosis
diverticulitis
97
Q

Most malignancies of colon cancer develop from ….

A

adenomatous polyp

98
Q

Chemical peritonitis may result from..

A 
enzymes released with pancreatitis
urine leaking from ruptured bladder
chyme spilled from perforated ulcer
bile escaping from ruptured gallbladder
blood
99
Q

Bacterial peritonitis is caused by

A

direct trauma affecting intestine
ruptured appendix
intestinal obstruction and gangrene

Pathophysiology (20 decks)

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