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NPLEX > GI > Flashcards

GI Flashcards

1
Q

Foregut structures and blood supply

A

Week 3 of development

Top portion supplied by celiac artery, gives rise to liver, gallbladder, pancreas, esophagus, stomach, duodenum, spleen

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2
Q

What structures are in Midgut and what is the blood supply?

A

Supplied by superior mesenteric artery and vitelline duct

3rd & 4th sections of duodenum, jejunum, ileum, cecum, appendix, ascending colon, and proximal 2/3 of transverse colon

Physiologic herniation through umbilical ring

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3
Q

Hindgut

A

Distal 1/3 transverse colon, descending colon, sigmoid colon, and upper part of anal canal

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4
Q

Microscopic anatomy of gallbladder (inside to outside)

A

Mucosa contains epithelium (simple columnar cells, highly folded) and lamina propria (dense irregular connective tissue, immune cells, and capillaries)

Tunica muscularis (bundles of smooth muscle randomly oriented

External adventitia connects to the liver and is dense irregular connective tissue

External serosa not attached to liver and made up of loose irregular connective tissue w/ lymphatic vessels, blood vessels, adipocytes, and mesothelium on outside

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5
Q

Microscopic anatomy of esophagus (inside to outside)

A

Mucosa: Epithelium (stratified squamous non-keratinized cells), Lamina propria (dense irregular connective tissue, and Muscularis mucosa (longitudinal smooth muscle)

Submucosa: dense collagenous connective tissue w/ elastin, blood vessels, lymphatic vessels, nerves, and mucosal glands in lower 1/3

Muscularis Propria: inner circular layer and outer longitudinal layer of muscle, 1/3 upper skeletal, middle 1/3 skeletal & SM, Auerbach plexus

Adventitia: connective tissue attach nearby structure

Serosa: last 1-2 cm simple squamous epithelium

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6
Q

Stomach microscopic anatomy

A

Cardia:
Mucosa: simple columnar epithelium that form gastric pits w/ cardiac glands secrete mucus and muscularis mucosa consisting of thin layer of SM
Submucosa: dense irregular CT
Muscularis propria: 3 layers of S muscle inner oblique, circular, and longitudinal
Serosa: loose connective tissue

Fundus:
Mucosa: rugae w/ parietal cells (isthmus, secrete gastric acid and Intrinsic factor), mucous neck cells, chief cells (secrete pepsinogen found in base), and G cells that secrete gastrin)
Submucosa: dense irregular CT
Muscularis propria: 3 layers of S muscle inner oblique, circular, and longitudinal
Serosa: loose connective tissue

Pylorus:
Mucosa: gastric pits 1/2, pyloric glands secrete mucus are shorter, small number G, parietal, and stem cells
Submucosa: dense irregular CT
Muscularis propria: 3 layers of S muscle inner oblique, circular, and longitudinal
Serosa: loose connective tissue

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7
Q

Small Intestine microscopic anatomy

A

All share submucosa (dense irregular CT, meissner’s plexus), muscularis propria (circular, myenteric plexus, and longitudinal), and serosa (loose connective tissue)

Duodenum
Mucosa: long tall villi, enterocytes (simple columnar cells w/ microvilli and goblet cells that secrete mucus), lamina propria (loose connective tissue), crypts of Lieberkuhn (stem cells -> epithelial cells, paneth cells prevent against pathogens), muscularis mucosa
Submucosa: burnner’s glands secrete alkaline mucus

Jejunum
Mucosa: same as duodenum

Ileum
Mucosa: short broader villi, Peyer’s patches within lamina propria, lacteals w/in cores of villi that absorb fat,

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8
Q

Colon Microscopic Anatomy

A

Mucosa: epithelium (enterocytes simple columnar cells w/ microvilli that absorb water and goblet cells secret mucus), lamina propria (plasma cells, lymphocytes, eosinophils, macrophages), crypts of Lieberkuhn, and muscularis mucosa

Submucosa: dense irregular connective tissue, meissner’s plexus, lymphatic vessels, and blood vessels

Muscularis propria: circular, myenteric plexus, longitudinal, tinea coli

Serosa

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9
Q

Liver Microscopic Anatomy

A

HEPATOCYTES: Perform metabolic, synthetic, storage, catabolic and excretory functions. Apical surface of hepatocytes face bile canaliculi. Basolateral surface faces sinusoids.

KUPFFER CELLS: Macrophages, form the lining of sinusoids.. Protect against infection and circulating toxins (e.g., endotoxin), but with higher efficiency. Activated Kupffer cells also release cytokines, such as TNF-α, interleukins, interferons and TGFs α and β

STELLATE CELLS: (Ito cells) have specialized storage capacities. Contain fat, vitamin A and other lipid-soluble vitamins. Secrete extracellular matrix components, including collagens, laminin and proteoglycans. In disease states, can make in great excess, leading to hepatic fibrosis and eventually cirrhosis.

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10
Q

Pancreas Microscopic Anatomy

A

Exocrine: Acini contain secretory cells (pyramid-shaped with rough ER at base and zymogens at apices), centroacinar cell, intercalated duct (simple cuboidal epithelium)

Intralobular duct: stratified cuboidal cells and thicken connective tissue
capsule

Intralobular duct: epithelium that could be simple columnar, stratified columnar, or stratified cuboidal and large CT

Interlobular ducts: epithelium (simple columnar cells, or stratified columnar, or stratified cuboidal) connective tissue

Endocrine: islets of Langerhans (fenestrated capillaries, beta cells, alpha cells, delta cells, and pp cells)

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11
Q

Mastication (mechanism, regulation, and factors)

A

Mechanism: Food gets broken down via masseter, temporalis, medial pterygoid, and lateral pterygoid. Salivary glands secrete saliva that contains salivary amylase, mineral salts, and mucus. Tongue moves side to side pushing between teeth for extra grinding.

Factors: food in mouth, sight of food

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12
Q

Deglutination (mechanism)

A

Mechanism: Starts with voluntary movement of the tongue pushing bolus to oropharynx then mechanoreceptors, thermoreceptors, and taste receptors in upper esophagus detect food -> sensory info via trigeminal, glossopharyngeal, and vagus nerve to the medulla -> motor info via vagus->
soft palate and uvula moves up -> epiglottis covers larynx -> upper esophageal sphincter relaxes-> upper esophageal sphincter closes-> vagus -> peristalsis -> lower esophageal sphincter relaxes

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13
Q

Salivary gland (embryology, location, function, innervation, circulation)

A

Embro: ectoderm

Location:
Parotid- below external acoustic meatus/zygomatic arch, behind masseter, in front of SCM, along angle of mandible, contain facial nerve, retromandibular vein, external carotid artery, superficial temporal artery, facial nerve, parotid duct
Submandibular gland- posterior half of mandible, inferior/deep to body of mandible and superficial/deep to mylohyoid muscle

Function: secrete saliva, keep mouth mucosa hydrated, makes swallowing easier, digestion of starch

Innervation: parasympathetic via glossopharyngeal nerve, sympathetic via superior cervical ganglion

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14
Q

Esophagus (innervation, circulatory pathway,)

A

Innervation: parasympathetic control peristalsis via vagus nerve, sympathetic vis sympathetic trunk from greater splanchnic nerve T5 to T9

Circulatory pathway: inferior thyroid arteries/vein, thoracic aorta/left gastric vein/esophageal veins, left gastric artery

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15
Q

Pharynx (embryo, circulatory pathway, innervation)

A

Embryo: pharyngeal pouch

Circulatory: facial artery, maxillary artery, inferior thyroid artery, and superior thyroid artery

Innervation: pharyngeal plexus, pharyngeal branch of vagus nerve, glossopharyngeal

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16
Q

Liver (circulatory pathway and innervation)

A

Circulatory: hepatic artery and hepatic portal vein

Innervation: hepatic nervous plexus, sympathetic celiac plexus, and parasympathetic from vagal trunk

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17
Q

Pancreas ( circulatory pathway and innervation)

A

Circulatory: (head and uncinate) superior pancreaticoduodenal artery, inferior pancreaticoduodenal artery, and pancreatic artery (body and tail)

Innervation: parasympathetic vagus, sympathetic greater and lesser splanchnic nerves (T5-T12)

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18
Q

Mastication regulation

A

Regulation: muscles are innervated by trigeminal nerve, salivary glands are innervated by glossopharyngeal and facial nerve via parasympathetic activation, mechanoreceptors in periodontal ligaments, taste receptors on tongue, salivatory nuclei in brainstem

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19
Q

Mastication factors

A

Factors: food in mouth, sight of food

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20
Q

Deglutination regulation

A

Regulation: swallowing center in medulla via vagus and glossopharyngeal

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21
Q

Pancreas function

A

endocrine: regulate blood sugar levels,
exocrine: pancreatic amylase to breakdown carbs, trypsin & chymotrypsin breakdown proteins, and lipase breakdown lipids, ductal cells secrete NaK and ClHCO3

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22
Q

Liver function

A

detoxify harmful substances, normal blood glucose level, store Vit A, D, E, K, B12, iron, copper, remove amine group from amino acids, albumin, coagulation factors, regulate lipid metabolism, make VLDL, HDL,), bile synthesis

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23
Q

Pharynx (Micro anatomy)

A

buccopharyngeal fascia, muscular layer (circular and longitudinal part

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24
Q

Pharynx (location)

A

cranial base to the inferior border of the cricoid cartilage anteriorly and the inferior border of the C6 vertebra posteriorly

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25
Q

Pharynx (function)

A

carries air, carries food and fluid for throat

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26
Q

Gallbladder (circulatory pathway and innervation)

A

Circulatory: cystic artery, segmental portal veins

Innervation: hepatic plexus, vagus nerve

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27
Q

Gallbladder function

A

reservoir for bile

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28
Q

Stomach innervation, artery, vein

A

Nerve: parasympathetic from anterior vagal trunk and posterior vagal trunk, sympathetic celiac plexus (T5-T12)

Artery: gastric arteries, gastroomental artery, posterior gastric arteries, gastroduodenal artery

Vein: gastric vein, gastroomental vein, posterior gastric vein, and gastroduodenal vein

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29
Q

Stomach function

A

chemical and mechanical digestion of ingested food

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30
Q

Duodenum nerve, artery, vein

A

Nerve: sympathetic greater splanchnic and parasympathetic vagus nerve

Artery: gastroduodenal artery, anterior/posterior/inferior pancreaticoduodenal artery

Vein: duodenal vein

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31
Q

Duodenum Function

A

dilute and neutralise digestive juices, digest and process chyme passed on from the stomach, receive pancreatic enzymes and bile, as well as absorb various nutrients

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32
Q

Jejunum function

A

digestion of nutrient

absorption of lipophilic nutrients and water

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33
Q

Ileum nerve, artery, vein

A

Nerve: coeliac plexus, superior mesenteric plexus, vagus nerve

Artery: straight arteries

Vein: superior mesenteric

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34
Q

Ileum function

A

Enzymatic digestion of nutrient
absorption of vitamin B12, fats, and bile salts
immunological function

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35
Q

Colon nerve, artery, vein

A

Nerve: superior mesenteric plexus, vagus nerve, inferior mesenteric plexus, pelvic splanchnic nerve

Artery; colic and sigmoid arteries

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36
Q

Rectum micro anatomy

A

Mucosa: simple columnar enterocytes, goblet cells, and turns into transitional zone stratified squamous non-keratinized

Lamina propria: CT, blood, lymph, muscle layer

Submucosa: loose CT, blood vessels, lymph follicles, meissner’s plexus,

Muscularis: circular extends to sphincter ani externus muscle, longitudinal muscle etends to corrugator cutis ani muscle, Auerbach’s plexus,

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37
Q

Rectum nerve, artery, vein

A

Nerve: symp inferior mesenteric plexus and para pelvic splanchnic nerve and inferior hypogastric plexs

Artery: superior, middle, inferior rectal arteries

Vein: superior, inferior, middle rectal veins

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38
Q

Rectum function

A

absorption of water and electrolytes and feces storage

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39
Q

Anus micro anatomy

A

Colorectal: simple columnar epithelium, folds

Transitional: simple columnar epithelium and stratified squamous epithelium, crypts of Morgagni, anal glands

Anoderm: stratified squamous non-keratinized epithelium, sensory neurons

Cutaneous: stratified squamous keratinized epithelium, pigmented, sweat glands, sebaceous glands, Pacinian corpuscles, and hair follicles

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40
Q

Anus nerve, artery, vein

A

Nerve: above dentate line (symp inferior mesenteric plexus, para pelvic splanchnic nerve and inferior hypogastric plexus) below ( pudendal)

Artery: above dentate line (superior rectal artery) below (middle/inferior rectal arteries)

Vein: above dentate line (superior rectal vein) below (middle and inferior rectal viens)

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41
Q

Anus function

A

absorption of water and electrolytes and defecation

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42
Q

Colon Function

A

absorption of water from stool
absorbs Na, K, Cl
secrets K
intestinal flora: decomposing indigestible foods, producing Vit K, promoting intestinal peristalsis, supporting immune

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43
Q

Intraperitoneal Organs

A

Stomach, 1st part of duodenum, jejunum, ileum, cecum, appendix, transverse colon, sigmoid colon, liver, gallbladder, tail of pancreas, spleen

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44
Q

Retroperitoneal Organs

A 
Suprarenal (adrenal) glands 
Aorta, IVC
Duodenum
Pancreas 
Ureters 
Colon 
Kidney 
Esophagus (lower 2/3)  
Rectum  
SAD PUCKER
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45
Q

Retroperitoneal Organs

A 
Suprarenal (adrenal) glands 
Aorta, IVC
Duodenum
Pancreas 
Ureters 
Colon 
Kidney 
Esophagus (lower 2/3)  
Rectum  
SAD PUCKER
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46
Q

Gastrin (source)

A

Source: G Cells in antrum of stomach, duodenum

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47
Q

Gastrin Action

A

↑ Gastric H+ secretion
↑ Growth of gastric mucosa
↑ Gastric motility
Stimulates the release of histamine from enterochromaffin-like cells
Stimulates H+ and gastric mucosa (gastric motility)

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48
Q

Gastrin Regulation

A

↑ By stomach distention/alkalinization, amino acids, peptides, vagal stimulation via gastrin-releasing peptide (GRP)

↓ pH < 1.5

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49
Q

Somatostatin source

A

D Cells

Pancreatic islets, GI mucosa

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50
Q

Somatostatin action

A 
↓ Gastric acid secretion
↓ Pepsinogen secretion
↓ Pancreatic secretion
↓ Small intestine fluid secretion
↓ Gallbladder contraction
↓ Insulin + glucagon release
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51
Q

Somatostatin regulation

A

↑ By acid

↓ By vagal stimulation

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52
Q

Cholecystokinin source

A

I Cells

Duodenum, jejunum

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53
Q

Cholecystokinin action

A

↑ Pancreatic secretion
↑ Gallbladder contraction
↓ Gastric emptying
↑ Sphincter of Oddi relaxation (leading to release of pancreatic enzymes + bicarbonate)

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54
Q

Cholecystokinin regulation

A

↑ By fatty acids, amino acids

Acts on neural muscarinic pathways to cause pancreatic secretion

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55
Q

Secretin source

A

S Cells

Duodenum

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56
Q

Secretin Action

A

↑ Pancreatic HCO3- secretion
↓ Gastric H+ secretion
↑ Bile acid secretion in liver
pancreatic enzymes to function

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57
Q

Secretin Regulation

A

↑ By acid, fatty acids in lumen of duodenum

low pH of food mixture from the stomach

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58
Q

Glucose-dependent insulinotropic peptide S

A

K Cells

Duodenum, jejunum

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59
Q

Glucose-dependent insulinotropic peptide A

A

Exocrine:
↓ Gastric H+ secretion

Endocrine:
↑ Insulin release

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60
Q

Glucose-dependent insulinotropic peptide R

A

↑ By fatty acids, amino acids, oral glucose

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61
Q

Motilin Source

A

Small intestine

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62
Q

Motilin Action

A

Produces migrating motor complexes (MMCs)

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63
Q

Motilin Reg

A

↑ In fasting state

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64
Q

Vasoactive intestinal polypeptide Source

A

Parasympathetic ganglia in sphincters, gallbladder, small intestine

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65
Q

Vasoactive intestinal polypeptide action

A

↑ Insteinal water and electrolyte secretion

↑ Relaxation of intestinal smooth muscle and sphincters

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66
Q

Vasoactive intestinal polypeptide reg

A

↑ By distention and vagal stimulation

↓ By adrenergic input

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67
Q

Nitric Oxide source

A

smooth muscle relaxing and vasodilation

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68
Q

Nitric Oxide A

A

↑ Smooth muscle relaxation, including lower esophageal sphincter (LES)

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69
Q

Pathology associated with Vasoactive intestinal polypeptide

A

VIPoma (non-a, non-B islet cell pancreatic tumor that secretes VIP) Associated with Watery Diarrhea, Hypokalemia, Achlorhydria (WDHA syndrome)

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70
Q

What pathology is associated with Gastrin?

A

↑ Chronic PPI use
↑ In chronic atrophic gastritis (eg, H. pylori)
↑↑ In Zollinger-Ellison syndrome (gastrinoma)

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71
Q

Ghrelin S

A

Stomach

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72
Q

Ghrelin A

A

↑ Appetite (“ghrowlin’ stomach”)

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73
Q

Ghrelin R

A

↑ In fasting state

↓ By food

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74
Q

Ghrelin Patho associated

A

↑ In Prader-Willi syndrome

↓ After gastric bypass surgery

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75
Q

Intrinsic Factor S

A

Parietal cells

Stomach

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76
Q

Intrinsic Factor A

A

Vit B12 binding protein

Required for B12 uptake in terminal ileum

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77
Q

Intrinsic Factor patho

A

Autoimmune destruction of parietal cells > Chronic gastritis + pernicious anemia

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78
Q

Gastric Acid S

A

Parietal cells

Stomach

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79
Q

Gastric Acid A

A

↓ Stomach pH

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80
Q

Gastric Acid R

A

↑ By histamine
↑ Vagal stimulation (ACh)
↑ Gastrin

↓ By somatostatin
↓ GIP
↓ Prostaglandin
↓ Secretin

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81
Q

Pepsin S

A

Chief cells
Stomach
pepsinogen to pepsin

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82
Q

Pepsin A

A

Protein digestion

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83
Q

Pepsin R

A

↑ By vagal stimulation (ACh)
↑ Local acid
triggered by presence of H

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84
Q

Bicarbonate S

A

Mucosal cells - Stomach, duodenum, salivary glands, pancreas, trapped in mucus that covers the gastric epithelium

Brunner glands - Duodenum

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85
Q

Bicarbonate A

A

Neutralizes acid

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86
Q

Bicarbonate R

A

↑ By pancreatic and biliary secretion with secretin

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87
Q

Gluconeogenesis

A 
Rate limiting: fructose-1,6-bisphosphate 1
Start: pyruvate 
End: glucose 
Cofactors: biotin, ATP, GTP, Mg, NADH, 
Location: Mitochondria, cytosol,
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88
Q

Beta-oxidation

A 
Rate limiting: carnitine acyltransferase 1
Location: mitochondria
Start: fatty acid 
End: acetyl CoA 
Cofactors:  FAD, NAD
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89
Q

Lipid digestion

A

Fatty acids form globule gets turned in the stomach -> bile salts from liver break up globule -> lipase in saliva, stomach, and pancreas break down into monoglycerides and free fatty acids -> assemble into mixed micelles -> travel to intestinal lumen to enterocytes -> release fatty acids in enterocytes-. resemble into triglycerides -> package into chylomicron (phospholipids, protein, triglyceride, cholesterol, Vit A, D, E,K) -> enters lacteal -> thoracic duct -> dumped into blood -> release fatty acids and monoglycerides into muscle, adipose

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90
Q

Protein digestion

A

Protein reaches stomach-> HCl denatures protein, pepsin cleaves into oligopeptide chains -> move into duodenum where digestive enzyme from pancreas stimulated by CCK break them into tripeptides, dipeptides, and individual amino acids -> peptidases attach them to external surface -> intestine cells di & tri get converted into amino acids -> can be transported via specific transporter -> blood stream to tissues

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91
Q

Fat Soluble Vitamin digestion

A

Location: small intestine

incorporated into micelles along w/ products of lipid digestion and absorbed into enterocytes

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92
Q

Protein Structure

A

Chain of amino acids (central C, amino group, carboxylic acid group, and side chain) -> folded and then different changes might be added

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93
Q

Carb Structure

A 
Glucose: 6 carbon, one double bound w/ O, 6 O molecules 
Fructose: 6 carbon, 
Galactose: 6 carbon 
Lactose: glucose +galactose beta 1-4 
Sucrose: fructose+ glucose alpha 1-2
Maltose: glucose+ glucose alpha 1-4 
monosaccharide: one sugar 
di/oligo/poly-Saccharide: when they linked together via glyosidic bonds 
Starches: oligosaccharide w/ branches
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94
Q

Lipid Structure

A

glycerol (3 carbon backbone) and fatty acid (chain carbon and hydrogen)

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95
Q

Large polysaccharides digestion

A

Amylase breaks down large polysaccharides into small units in mouth and duodenum

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96
Q

Lactose digestion

A

Lactase breaks β-1,4-glycosidic bond between galactose and glucose

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97
Q

Sucrose digestion

A

Sucrase breaks down into fructose and glucose

Fructose -> 2 3 carbon-> glycolysis

glucose move into blood-> ↑ insulin -> ↑ glucose into tissues -> glycogen or use

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98
Q

Maltase digestion

A

Malatse breaks down into glucose x2

Glucose move into blood-> ↑ insulin -> ↑ glucose into tissues -> glycogen or use

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99
Q

How much carbs do you need in diet?

A

45-65 % calories

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100
Q

Unsaturated Fatty acid

A

single bond, only H, straight line, can pack down, solid at room temp

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101
Q

Saturated Fatty acid

A

double bond, don’t pack, liquid at room temp

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102
Q

Triglyceride structure

A

3 sets of glycerol and fatty acid

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103
Q

How many carbons do short chain fatty acids

A

2-5 carbons

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104
Q

How many carbons in medium chain fatty acids

A

6-12 carbons

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105
Q

How many carbons in long chain fatty acids

A

> 13

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106
Q

Which amino acids are nonessential?

A

alanine, asparagine, aspartic acid, glutamic acid, serine

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107
Q

Which amino acids are conditionally essential?

A

arginine, cysteine, glutamine, glycine, proline, tyrosine

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108
Q

Which amino acids are essential?

A

PVT TIM Hall

histidine, isoleucine, leucine, methionine, phenylamine, threonine, tryptophan, valine

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109
Q

How much protein do adults need?

A

0.8 g/kg of body weight

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110
Q

Water-Soluble Vitamins Digestion

A

Location: ileum

cotransport w/ sodium

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111
Q

B12 digestion

A

ingestion -> stomach acidity releases B12 from food -> free B12 binds to haptocorrin (R protein) secreted by salivary glands -> pancreatic proteases degrade R protein in duodenum -> B12 binds to intrinsic factor -> intrinsic factor B12 complex resistant to degradation from pancreatic enzymes -> absorbed in ileum

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112
Q

Iron absorption

A

Location: Small intestine
ferric -> reduced to ferrous -> binds to apoferritin in enterocytes -> transported across basolateral membrane -> binds to transferrin in blood -> transferrin carries to liver

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113
Q

Calcium Absorption

A

cholecalciferol -> 25-hydroxycholecalciferol in liver -> 1,25-dihydroxycholecaliferol in kidney -> synthesizes calbindin D-28K -> promote calcium absorption in ileum and duodenum

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114
Q

Bilirubin Metabolism

A

RBC -> macrophage eat RBC -> breakdown hemaglobin into heme and globin -> heme converted into iron and protoporphyrin -> protoporphyrin converted into unconjugated bilirubin -> unconjugated bilirubin + albumin go to liver -> hepatocytes take it in and conjugate via UGT w/ glucuronic acid -> sent to gallbladder for storage as bile

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115
Q

Gastroschisis

A

extrusion of abdominal contents through abdominal wall defect, guts not covered by peritoneum or amnion

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116
Q

Omphalocele

A

herniation of abdominal contents through umbilicus covered by peritoneum and amnion, trisomies 13 and 18

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117
Q

Congenital umbilical hernia

A

failure of umbilical ring to close after physiological herniation of midgut, protrudes w/ intra-abdominal pressure

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118
Q

Parotitis etiology

A

Staph aureus, mumps, herpes, EBV

DM, tumors, stones, dental issues, HIV, Viral, TB, Sjorgen syndrome, sarcoidosis

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119
Q

Parotitis risk factors

A

close contact w/ mumps, cystic fibrosis, dehydration, HIV/AIDS, medications, not being immunized w/ MMR vaccine, poor oral hygiene, Sjorgen syndrome

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120
Q

Parotitis complication

A

massive swelling, obstruction respiratory dysfunctions, septicemia, facial bone osteomyelitis, septic jugular thrombophlebitis

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121
Q

Parotitis clinical characteristics

A

bacterial: painful swelling, fever
viral: pain, swelling, malaise, anorexia, fever

HIV: nonpainful swelling

TB: nontender swelling

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122
Q

Acute pancreatitis etiology

A

gallstones, hypertriglyceridemia, idiopathic, drug-induced, post-procedural, ampullary stenosis, autoimmune, infection, trauma, congenital anomalies, genetics, hypercalcemia, renal disease, toxins, vasculitis

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123
Q

Acute pancreatitis complication

A 
Sepsis
Necrotic pancreas
Hemorrhagic pancreatitis
Acute respiratory distress syndrome
Renal failure
Pancreatic duct disruption
Pseudocysts
Infected pancreatic necrosis
Pancreatic abscess
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124
Q

Acute pancreatitis pathophys

A

Pancreatic juice enters tissues of pancreas, triggers auto-digestion of gland, inflammation, edema. May lead to hemorrhage and necrosis. Premature activation of trypsinogen to trypsin (digestion mode)

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125
Q

Zymogen

A

inactive enzyme, pH, chemoreceptor, or mechanoreceptor trigger release

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126
Q

GLUT 5

A

fructose transport

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127
Q

GLUT 2

A

cell to blood

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128
Q

Gastric zymogens

A

pepsinogen to pepsin activated via low pH

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129
Q

Pancreas zymogens

A

chymotrypsinogen
trypsinogen
procarboxypeptidase
proelastase

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130
Q

Bile salt

A

amphipathic molecule that come from cholesterol and are made in the liver and secreted by gallbladder in response to CCK
bind to lipids to make them more soluble
simulate micelle formation

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131
Q

Absorption of fatty acids

A

transported into intestinal cells by fatty-acid binding protein on membrane of intestinal cells -> moved to smooth ER via FABP-> triglycerides are resynthesized -> associated w/ protein, small amount of phospholipid and cholesterol are formed in the lumen of smooth ER -> chylomicrons are formed

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132
Q

Amylase

A

cleaves 1,4- bonds of carbohydrates to di and tri-saccharides

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133
Q

Stomach acid

A

gastric proton pump (H/K ATPase) on cell lining of the stomach

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134
Q

A-glucosidase

A

digests maltose and maltotriose

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135
Q

Regulatory substance of stomach

A 
gastrin 
ghrelin 
gastric acid 
intrinsic factor 
pepsin 
bicarbonate 
somatostatin
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136
Q

Regulatory substance of Small Intestine

A 
gastrin 
cholecystokinin 
secretin 
glucose-dependent insulinotropic peptide 
motilin 
vasoactive intestinal peptide 
bicarbonate
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137
Q

Regulatory substance of pancreas

A 
a-amylase
lipase
proteases
trypsinogen 
somatostatin
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138
Q

Intrinsic Factor Reg

A

↑ histamine or vagal input via Ach, gastrin

↓ By somatostatin, GIP, prostaglandin, secretin

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139
Q

Nitric oxide patho

A

loss of NO secretion implicated in increased tone of achalasia

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140
Q

Acute Pancreatitis clinical

A 
Severe epigastric pain (dull, boring, steady, radiates to back) Worse eating, better fasting
Abdominal tenderness/distention
N/V
Loss of appetite 
Fever, chills, 
Tachycardia
Jaundice
Malabsorption (steatorrhea, diarrhea)
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141
Q

Chronic pancreatitis etiology

A

Chronic alcoholism, gallstones, autoimmune disease, tumors, genetics, congenital anomalies, idiopathic

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142
Q

Chronic Pancreatitis pathophy

A

loss and injury to acinar, islet, and ductal cells w/ fibrosis and loss of pancreatic function

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143
Q

Chronic pancreatitis RF

A

alcohol, smoking, obesity, diabetes, FH

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144
Q

Chronic pancreatitis Complication

A

malabsorption, diabetes, pancreatic pseudocyst, mechanical obstruction of bile/duodenum, pancreatic ascites, pleural effusion, gastric varices, splenic vein thrombosis, pancreatic adenocarcinoma

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145
Q

Chronic pancreatitis clinical

A 
Upper abdominal pain worse after eating, better fasting 
Steatorrhea 
Vitamin malabsorption 
Weight loss 
Diabetes
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146
Q

Chronic pancreatitis def

A

continuing inflammatory disease of the pancreas w/ irreversible morphological changes

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147
Q

Acute pancreatitis def

A

inflammation of pancreas

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148
Q

Parotitis def

A

inflammation of parotid gland

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149
Q

Cholestasis def

A

decrease in bile flow due to impaired secretion by hepatocytes or to obstruction of bile flow through intra-or extrahepatic bile ducts

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150
Q

Cholestasis cause

A

gallstones, cysts, tumor, acute hepatitis, alcoholic liver disease, primary biliary cholangitis, drugs, pancreatitis, pregnancy

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151
Q

Cholestasis pathophy

A

impairment of bile formation or impedance of bile flow

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152
Q

Cholestasis RF

A

FH, alcohol

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153
Q

Cholestasis complication

A

mineral bone disease, dyslipidemia, and fat-soluble vitamin deficiency

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154
Q

The pocketlike sacs of the large intestine are called

a. teniae coli
b. haustra
c. epiploic appendages
d. cecae

A

haustra

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155
Q

the esophageal hiatus is found on this organ

a. esophagus
b. stomach
c. diaphragm
d. pharynx

A

diaphragm

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156
Q

Which histological layer of the alimentary canal is also known as the visceral peritoneum?

a. submucosa
b. muscularis
c. serosa
d. mucosa

A

serosa

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157
Q

Which reflexes are we able to voluntarily control in GI system?

A

defecation reflex

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158
Q

Which hormone relaxes the hepatopancreatic sphincter?

A

CCK

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159
Q

simple columnar epithelium is found in which histological layer of the alimentary canal?

A

mucosa

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160
Q

Function of large intestine

A

absorption of water and electrolytes, elimination of waste, absorption of vitamins produced by bacteria

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161
Q

The membrane that lines the body wall of the abdominal cavity is the

A

parietal peritoneum

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162
Q

Alcoholic Liver Disease def

A

damage to liver and its function due to alcohol

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163
Q

Alcoholic Liver Disease cause

A

alcohol

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164
Q

Alcoholic Liver Disease pathophys

A

excessive alcohol in hepatocytes activates alcohol dehydrogenase which requires NAD -> ↑ NAD ↑fat production -> deposition of fat in liver -> alcoholic fatty liver
alcohol also ↑ ROS
↑ acetaldehyde bind to macromolecules -> acetaldehyde adducts -> neutrophils infiltrate -> damage to cells-> alcoholic hepatitis -> cirrhosis

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165
Q

Alcoholic Liver Disease RF

A

Sustained, long-term consumption of alcohol

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166
Q

Alcoholic Liver Disease complication

A

portal hypertension, varices, ascites, hepatic encephalopathy, infection, liver cancer, bleeding

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167
Q

Alcoholic Liver Disease pathophys

A

excessive alcohol in hepatocytes activates alcohol dehydrogenase which requires NAD -> ↑ NAD ↑fat production -> deposition of fat in liver -> alcoholic fatty liver
alcohol also ↑ ROS
↑ acetaldehyde bind to macromolecules -> acetaldehyde adducts -> neutrophils infiltrate -> damage to cells-> alcoholic hepatitis -> cirrhosis

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168
Q

Non-Alcoholic Fatty Liver Disease def

A

excess fat build up in liver

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169
Q

Non-Alcoholic Fatty Liver Disease cause

A

insulin resistance, hyperlipidemia, obesity

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170
Q

Non-Alcoholic Fatty Liver Disease pathophys

A

insulin resistance -> liver to ↑ fat storage & synthesis & uptake of free fatty acids ↓ fatty acid oxidation and secretion of fatty acids into bloodstream -> ↑ fat in hepatocytes -> fatty acids degrade -> cell death -> NASH ->

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171
Q

Non-Alcoholic Fatty Liver Disease RF

A 
Metabolic syndrome (insulin resistance)
Obesity
HTN
DM
Hypertriglyceridemia
Hyperlipidemia
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172
Q

Non-Alcoholic Fatty Liver Disease complication

A

May cause fibrosis leading to cirrhosis

HCC

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173
Q

Non-Alcoholic Fatty Liver Disease pathophys

A

insulin resistance -> liver to ↑ fat storage & synthesis & uptake of free fatty acids ↓ fatty acid oxidation and secretion of fatty acids into bloodstream -> ↑ fat in hepatocytes -> fatty acids degrade -> cell death -> NASH ->

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174
Q

Cirrhosis cause

A

Alcohol (60-70%), nonalcoholic steatohepatitis, chronic viral hepatitis, AI hepatitis, biliary disease, genetic/metabolic disorders

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175
Q

Cirrhosis pathogen

A

Diffuse bridging fibrosis (via stellate cells) and regenerative nodules
Disrupt normal architecture of liver

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176
Q

Cirrhosis RF

A

alcohol, hepatitis infx, metabolic disease, genetic, HTN,

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177
Q

Cirrhosis def

A

liver damage lading to remodeling, permanent damage, and loss of function

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178
Q

Cirrhosis clinical

A 
Weight loss, weakness, fatigue 
Jaundice 
Asterixis (tremors) 
Increased estrogen - gynecomastia, spider angiomas, testicular atrophy, palmar erythema
Confusion
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179
Q

Gilbert syndrome def

A

benign intertied metabolic disorder causng reccuring unconjugated hyperbilirubinemia jaundice,

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180
Q

Gilbert syndrome pathogen

A

autosomal recessive
Genetic mutation in promoter region of UGT gene -> structurally normal enzyme -> impaired genetic expression of hepatic UGT w/ decreased activity -> decreased conjugation of bilirubin

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181
Q

Gilbert syndrome def

A

benign intertied metabolic disorder causing recurring unconjugated hyperbilirubinemia jaundice,

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182
Q

Gilbert syndrome cause

A

genetics

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183
Q

Gilbert syndrome clinical

A

jaundice

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184
Q

Hepatitis def

A

inflammation of the liver that occurs suddenly and can lead to liver failure

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185
Q

Hepatitis cause

A

medications, drugs, alcohol, toxins, autoimmune, metabolic, hemochromatosis, wilson’s disease

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186
Q

Portal Hypertension def

A

Increased pressure in the portal venous system

> 5-10mmHg

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187
Q

Portal Hypertension comp

A

Hepatic encephalopathy
Most common cause of esophageal varices
Bacterial peritonitis (with ascites)
Build up of ammonia in the blood

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188
Q

Hepatitis cause

A

medications, drugs, alcohol, toxins, autoimmune, metabolic, hemochromatosis, wilson’s disease, Autoimmune Hepatitis, A1-antitrypsin Deficiency

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189
Q

Hepatitis pathogen

A

causative agent causing inflammation or immune complexes attacking liver tissue

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190
Q

Hepatitis RF

A

alcohol, drugs, genetic

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191
Q

Hepatitis comp

A

Liver failure

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192
Q

Hepatitis clinical

A

Abdominal pain
Joint pain
Fever
Fatigue

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193
Q

Portal Hypertension cause

A

Pre-hepatic: Vascular obstruction (eg, portal vein thrombosis)

Intrahepatic: Cirrhosis (most common in western countries), Schistosomiasis, and Sarcoidosis

Post-hepatic: R sided HF, Constrictive pericarditis, and Budd-Chiari syndrome

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194
Q

Portal Hypertension pathogen

A

↑ pressure -> blood is diverted away from portal system -> ↓ blood to liver -> build up of ammonia

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195
Q

Portal Hypertension pathogen

A

↑ pressure -> blood is diverted away from portal system -> ↓ blood to liver -> build up of ammonia

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196
Q

Portal Hypertension clinical

A 
Ascites
Bleeding GI 
Caput medusa (veins on abdomen)
Diminished liver function
Enlarged spleen
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197
Q

Cholecystitis def

A

inflammation of gallbladder

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198
Q

Cholecystitis cause

A

gallstone, bacterial infx in bile duct, tumor, reduced blood supply to gallbladder, gallbladder sludge

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199
Q

Cholecystitis pathogen

A

obstruction of biliary outflow tract by stone -> gb tries to squeeze -> bile causes mucosal wall to secrete mucus and inflammatory enzymes -> causing inflammation -> E coli, enterococci, Bacteroides fragilis, clostridium can build up in GB/wall -> stone fall or stays stuck -> cell death

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200
Q

Cholecystitis RF

A 
age 40
female 
hormonal changes 
obesity 
DM 
FHx
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201
Q

Cholecystitis comp

A 
Cell death 
Rupture 
Sepsis 
Infection 
Jaundice
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202
Q

Cholecystitis clinical

A

RUQ pain radiate to right scapula or shoulder
N/V
Fever

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203
Q

Cholecystitis comp

A 
Cell death 
Rupture 
Sepsis 
Infection 
Jaundice 
gallbladder adenocarcinoma
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204
Q

Cholelithiasis def

A

presence of gallstone in GB

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205
Q

Cholelithiasis cause

A

cholesterol: obesity, pregnancy, gallbladder stasis, drugs, genetics

Black: sickle cell anemia, hereditary spherocytosis, beta-thalassemia,

brown: intraductal stasis, bacteria, postsurgical biliary strictures, choledochal cysts

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206
Q

Cholelithiasis path

A

cholesterol, bilirubin, calcium, heme in bile are present in concentrations that approach the limit of their solubility causing them to form crystals

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207
Q

Cholelithiasis comp

A

acute cholecystitis
overgrowth of bacteria
fibrosis of GB
gallbladder adenocarcinoma

208
Q

Cholelithiasis RF

A

Fat
Female
Fertile
Forty

209
Q

Cholelithiasis comp

A 
acute cholecystitis 
overgrowth of bacteria 
fibrosis of GB 
gallbladder adenocarcinoma 
double duct sign
210
Q

Cholelithiasis clinical

A 
biliary colic 
epigastrium or RUQ pain
indigestion 
dyspepsia 
belching 
bloating
211
Q

Achlorhydria cause

A

pernicious anemia, ant secretory meds, H. pylori, gastric bypass, VIPomas, hypothyroidism, radiation to stomach, gastric cancer

212
Q

Achlorhydria path

A

parietal cells or K channels on apical membrane get damaged

213
Q

Achlorhydria RF

A 
>60 
autoimmune disease 
prior gastric surgery 
h. pyloir infection 
hypergastrinemia 
gastric carcinoid
214
Q

Achlorhydria comp

A

Iron deficiency
Vitamin-B12 deficiency
Vitamin-D and calcium deficiency leading to osteoporosis and bone fracture
Gastric adenocarcinoma
Gastric carcinoid tumor
Small intestinal bacterial overgrowth syndrome

215
Q

Achlorhydria clinical

A 
Epigastric pain
Weight loss
Heartburn
Nausea
Bloating
Diarrhea
Abdominal pain
Acid regurgitation
Early satiety
Vomiting
Postprandial fullness
Constipation
Dysphagia
Glossitis
Decreased position and vibration sense
216
Q

Gluten-Sensitive Enteropathy (Celiac disease) def

A

inability to digest certain proteins

217
Q

Gluten-Sensitive Enteropathy (Celiac disease) path

A

intestinal inflammation d/o gliadin, glutenin, and secalin not being able to be broken down -> damage to intestinal epithelial cells in jejunum -> inability to absorb other nutrients

218
Q

Gluten-Sensitive Enteropathy (Celiac disease) cause

A

genetics (HLA DQ2 and DQ8)

219
Q

Gluten-Sensitive Enteropathy (Celiac disease) path

A

gliadin, glutenin, and secalin go to lumen of SMI-> get into lamina propria of these cells -> tissue transglutaminase cuts of amide -> deaminated gluten proteins are eaten by macrophages and presented on MHC class II -> T cells release TNF and Interferon gamma -> B cells make anti-tTG and anti-gliadin antibodies -> CD8 T kill cells

220
Q

Gluten-Sensitive Enteropathy (Celiac disease) RF

A

infectious gastroenteritis (viral or non-viral)

221
Q

Gluten-Sensitive Enteropathy (Celiac disease) comp

A

GI cancers, fractures,

222
Q

Gluten-Sensitive Enteropathy (Celiac disease) clinical

A

Asymptomatic
Bloating, chronic diarrhea, constipation, gas and bloating, N/V, abdominal pain, anemia, Dermatitis herpetiformis, osteoporosis, ataxia

223
Q

Lactase Deficiency def

A

being unable to break down lactose

224
Q

Lactase Deficiency cause

A

genetics, congenital autosomal recessive, damage to small intestine

225
Q

Lactase Deficiency path

A

downregulation of lactase production -> lactose doesn’t get broken down -> in colon gut flora break down lactose

226
Q

Lactase Deficiency RF

A

African, Asian, Hispanic, and American Indian descent, premature birth

227
Q

Lactase Deficiency clinical

A

diarrhea
gas
bloating

228
Q

Appendicitis def

A

inflammation of appendix

229
Q

Appendicitis cause

A

fecalith, undigested seeds, pinworm infection, lymphoid follicle,

230
Q

Appendicitis path

A

obstruction -> fluid and mucus builds up -> ↑ pressure causing nerves to be compressed -> E coli or Bacteroides fragilis can multiply -> immune system calls WBC forming pus in appendix ->

231
Q

Appendicitis Rf

A

FH, cystic fibrosis

232
Q

Appendicitis comp

A 
Cell death 
Rupture 
Peritonitis 
Peri-appendiceal abscess 
Subphrenic abscess
233
Q

Appendicitis clinical

A 
Fever, N/V, RLQ pain, abdominal guarding  
P- pain 
A- anorexia, N/V
T- tenderness 
E- elevated temperature 
L- leukocytosis 
L- lying still
A- asleep
234
Q

Barrett Esophagus def

A

metaplasia of cells lining lower esophagus

235
Q

Barrett Esophagus cause

A

GERD

236
Q

Barrett Esophagus path

A

Chronic acid exposure -> reflux esophagitis -> Specialized intestinal metaplasia - replacement of nonkeratinized stratified squamous epithelium in distal esophagus (replaced with nonciliated columnar epithelium- goblet cells).
Z-line and gastroesophageal junction

237
Q

Barrett Esophagus RF

A 
Chronic GERD
Bulimia
Previous chemical damage
Smoking
Hiatal hernia
238
Q

Barrett Esophagus comp

A

Esophageal adenocarcinoma

239
Q

Barrett Esophagus clinical

A 
Asymptomatic or 
Heartburn, Dysphagia, Regurgitation
Hematemesis
Epigastric pain
Weight loss
240
Q

achalasia def

A

esophageal SM fibers fail to relax so lower esophageal sphincter remains closed

241
Q

achalasia cause

A

idiopathic autoimmune triggered by infx, genetic, neurodegenerative disease
esophageal cancer, Chagas disease

242
Q

achalasia patho

A

progressive degeneration of ganglion cells in mesenteric plexus w/in esophageal wall -> lower esophageal sphincter fails to relax -> loss of peristalsis in distal esophagus
lack noradrenergic noncholinergic, inhibitory ganglion cells -> imbalance excitation and relaxation -> incomplete LES relaxation, increase LE tone, lack of esophageal peristalsis

243
Q

achalasia RF

A

genetics, autoimmune, herpes simplex

244
Q

achalasia comp

A

aspiration pneumonia, esophageal perforation, esophageal cancer

245
Q

Adynamic ileus def

A

when food or drink do not pass through bowel due to loss of peristaltic movement

246
Q

Adynamic ileus cause

A

stress response from abdominal or pelvic surgery, gastroenteritis, pancreatitis, peritonitis, diverticulitis, electrolyte imbalances, vascular/neural impairment, meds

247
Q

Adynamic ileus path

A

surgery activates stress response that immobilize the digestive tract

248
Q

Adynamic ileus RF

A

long surgery

249
Q

Adynamic ileus comp

A

toxic megacolon

rupture

250
Q

Adynamic ileus clinical

A

asymptomatic

abdominal discomfort, bloating, constipation, N/V, abdominal tenderness

251
Q

Hernia def

A

abdominal organ protrudes through the abdominal wall

Types: epigastric, umbilical, inguinal, femoral

252
Q

Hernia cause

A

surgery, congenital (indirect inguinal), weakening due to age (direct inguinal),

253
Q

Hernia path

A

↑ pressure in abdominal cavity can lead abdominal organs pas through the tissue

254
Q

Hernia path

A

↑ pressure in abdominal cavity can lead abdominal organs passing through the tissue

255
Q

Hernia comp

A

strangulation- redness, N/V

256
Q

Hernia clinical

A

asx or pain, visible, palpable budge,

257
Q

Intussusception def

A

part of the intestine folds into another part of the intestine, most common children

258
Q

Intussusception cause

A

idiopathic

adult: polyp, tumor
babies: lymphoid hyperplasia

Meckel’s diverticulum

259
Q

Intussusception path

A

A: growth due to peristalsis gets grabbed and pulled ahead of itself leading to the ileum folding into the cecum

B: infection enlarges lymph nodes (roto or norovirus) become a lead point that grabs ileum into cecum

260
Q

Intussusception RF

A

having one previously, having sibling w/ one, having intestinal malrotation

261
Q

Intussusception comp

A

Death of tissue - blood, mucus, intestinal mucosa into stool
Sepsis
volvulus

262
Q

Intussusception clinical

A

intermittent abdominal pain worsen w/ peristalsis
Vomiting
hard, sausage-like mass in abdomen
red currant jelly stool

263
Q

Volvulus def

A

obstruction caused by a loop in the intestine that twists around itself and its mesentery

264
Q

Volvulus cause

A

sigmoid: pregnancy, chronic constipation, Hirschsprung disease, abdominal adhesions
cecal: congenital

Midgut: abnormal intestinal development

265
Q

Volvulus path

A

anything that can act as pivot point allowing the colon to twist and pinch the lumen shut causing bowel obstruction

266
Q

Volvulus RF

A

Hirschsprung disease, intestinal malrotation enlarged colon, pregnancy, abdominal adhesions

267
Q

Volvulus comp

A

Death to intestinal wall

Sepsis

268
Q

Volvulus clinical

A 
Cramping abdominal pain 
Distention
Obstipation 
Constipation 
N/V
Constant abdominal pain
269
Q

Megacolon def

A

abnormal dilation of colon that is not cause by mechanical obstruction

270
Q

Megacolon cause

A

infection (Clostridium difficile, Salmonella, Shigella, Campylobacter, Trypanosoma cruzi and Entamoeba histolytica), meds, Hirschsprung’s disease, surgery, diabetic neuropathy, Parkinson disease, muscular dystrophies, scleroderma, SLE, idiopathic

271
Q

Megacolon patho

A

damage to ANS, reduced SM activity due to inflammation leading severely decreased intestinal motility causes a buildup of feces, air, and intestinal secretions in the colon, which presents as dilation of the colon.

272
Q

Megacolon patho

A

damage to ANS, reduced SM activity due to inflammation leading severely decreased intestinal motility causes a buildup of feces, air, and intestinal secretions in the colon, which presents as dilation of the colon.

273
Q

Megacolon types

A

Toxic: systemic toxicity,

chronic: permanent dilation of colon, congenital, neuro/msk, CT
acute: acute dilation, post surgery

274
Q

Megacolon comp

A 
blood loss 
sepsis 
perforation 
shock 
death
275
Q

Megacolon clinical

A

constipation, bloating, abdominal pain or tenderness, hard fecal mass,
might have fever, tachycardia, shock

276
Q

Diverticulosis def

A

small pouches, or sacs, form and push outward through weak spots in the wall of colon

277
Q

Diverticulosis RF

A

genetics, low fiber, low physical activity, NSAIDs, obesity, smoking, aging, male, FH, obesity, marfan syndrome, ehlers-danlo syndrome, ADPKD,

278
Q

Diverticulosis comp

A

Blood vessels weaken
Diverticulitis
Segmental colitis

279
Q

Diverticulosis clinical

A

no symptoms, stomach pain, altered bowel habits, rectal bleeding

280
Q

Diverticulitis def

A

small pouches, or sacs, form and push outward through weak spots in the wall of colon that become inflamed or infected

281
Q

Diverticulitis cause

A

fecalith

erosion of diverticula

282
Q

Diverticulitis path

A

increased intraluminal pressure -> erosion -> inflammation, focal necrosis -> macro perforation

283
Q

Diverticulitis RF

A

diverticula present

284
Q

Diverticulitis comp

A

fistula, stricture, intestinal obstruction, perforation, abscess, peritonitis

285
Q

Diverticulitis clinical

A

fever, diarrhea, constipation, abdominal pain LLQ, urinary urgency, freq, dysuria

286
Q

Enteritis def

A

Inflammation of the small intestine

287
Q

Enteritis cause

A

contaminated food or water, Crohn disease, NSAIDs, cocaine, radiation therapy, celiac disease, tropical sprue, Whipple disease

288
Q

Enteritis RF

A

recent travel, exposure to unclean water, recent stomach flu

289
Q

Enteritis path

A

bacteria or virus multiples in the sm intestine causing immune system recruitment and inflammatory cytokines plus tissue destruction

290
Q

Enteritis comp

A

Dehydration

291
Q

Enteritis clinical

A

abdominal pain, diarrhea, loss of appetite, vomiting, blood in stool

292
Q

Enteritis Organisms

A 
Campylobacter 
E coli 
Salmonella 
Shigella 
Staph aureus
293
Q

Esophageal Ulcers def

A

mucosal damage to the esophagus

294
Q

Esophageal Ulcers cause

A

GERD, bulimia nervosa, Candida species, Herpes simplex, and cytomegalovirus, NSAIDs, bisphosphonates, some antibiotics, acidic foods

295
Q

Esophageal Ulcers path

A

excessive reflux of acid and pepsin result in necrosis of surface layers of esophageal mucosa

296
Q

Esophageal Ulcers clinical

A

pyrosis, regurgitations, dysphagia, Globus sensation, odynophagia, nausea, vomiting, weight loss, hematemesis, coffee ground emesis, substernal chest pain radiating to the back

297
Q

Esophageal Ulcers comp

A

upper gastrointestinal bleeding, in rare cases
recurrent peptic ulcers
esophageal strictures that narrow the esophagus
esophageal cancer
excessive weight loss due to appetite loss and difficulty swallowing
esophageal rupture
death in the rare cases of ulcer hemorrhage or perforation

298
Q

Peptic Ulcer Disease def

A

chronic mucosal ulceration of stomach/duodenum that extends into muscularis mucosa

299
Q

Peptic Ulcer Disease def

A

chronic mucosal ulceration of stomach/duodenum that extends into muscularis mucosa, gastric or duodenal

300
Q

Peptic Ulcer Disease path

A

↑ acid secretion ↓protective mechanisms -> mucosal damage -> ulceration

301
Q

Peptic Ulcer Disease path

A

↑ acid secretion ↓protective mechanisms -> mucosal damage -> ulceration

302
Q

Peptic Ulcer Disease comp

A 
“An Outstanding Physician Prevents Catastrophe”
Anemia/hemorrhage
Obstruction
Penetration
Perforation
Carcinoma in a gastric ulcer
303
Q

Peptic Ulcer Disease clinical

A 
asymptomatic or 
epigastric pain after meal, worse at night, relieved by food/antacids radiates to back, chest, LUQ/RUQ
N/V, coffee ground emesis 
bloating 
weight loss
304
Q

Gastric Ulcers def

A

sores that develop on lining of stomach

305
Q

Gastric Ulcers cause

A

H pylori, NSAIDs, acidic food

306
Q

Gastric Ulcers path

A

↑ acid secretion ↓protective mechanisms -> mucosal damage -> ulceration

307
Q

Gastric Ulcers RF

A

NSAIDs, FH, alcohol, smoking,

308
Q

Gastric Ulcers comp

A

In lesser curvature > can erode into L gastric artery and cause upper GI bleed

Malignant gastric ulcers:
Gastric MALT lymphoma
Gastric adenocarcinoma

Hemorrhage, obstruction

309
Q

Gastric Ulcers clinical

A

Epigastric pain worse 30 mins after meal > Anorexia > weight loss
heartburn, indigestion

310
Q

Duodenal Ulcers def

A

chronic mucosal ulceration of duodenum that extends into muscularis mucosa,

311
Q

Duodenal Ulcers cause

A

H pylori, Zollinger-Ellison Syndrome

312
Q

Duodenal Ulcers path

A

H. pylori colonization and persistent inflammation lead to the weakening of the mucosal surface layer causing it to be vulnerable to exposure to gastric acid
SAIDs causes a significant and persistent decrease in prostaglandins leading to susceptibility to mucosal injury

313
Q

Duodenal Ulcers RF

A

alcohol, h. pylori, radiation, NSAIDs, stress, tobacco

314
Q

Duodenal Ulcers comp

A

Hemorrhage, obstruction,

Perforation

315
Q

Duodenal Ulcers clinical

A

Pain improves with eating

Weight gain

316
Q

Esophagitis (Non-infectious) def

A

Inflammation of esophagus

317
Q

Esophagitis (Non-infectious) cause

A

GERD, pill induced, eosinophilic, radiation

318
Q

Esophagitis (Non-infectious) cause

A

GERD, pill induced (NSAIDS, doxycycline, potassium chloride, bisphosphonate), caustic (strong acid or basic) eosinophilic, radiation

319
Q

Esophagitis (Non-infectious) RF

A

Caffeine, alcohol, smoking, Antihistamines, Ca2+ channel blockers
Obesity, pregnancy, Zollinger-Ellison Syndrome, FH, asthma, climate, older age

320
Q

Esophagitis (Non-infectious) comp

A

scarring or narrowing of esophagus
Barrett’s esophagus
cancer
Tearing

321
Q

Esophagitis (Non-infectious) comp

A

scarring or narrowing of esophagus
Barrett’s esophagus
cancer
Tearing/perforation

322
Q

Acute Gastritis def

A

Inflammation of gastric mucosa

323
Q

Acute Gastritis def

A

Inflammation of gastric mucosa

324
Q

Acute Gastritis patho

A

causative agent causing decrease in defensive mechanism, inflammation, erosion to the mucosa lining

325
Q

Acute Gastritis patho

A

causative agent causing decrease in defensive mechanism, inflammation, erosion to the mucosa lining with neutrophil infiltration

326
Q

Acute Gastritis clinical

A

Epigastric pain, N/V,

327
Q

Chronic gastritis def

A

Chronic inflammation of gastric mucosa leading to gastric atrophy and metaplasia or dysplasia

328
Q

Chronic gastritis cause

A

Type a: Autoimmune: body and fundus

Type B: H. Pylori antrum

329
Q

Chronic gastritis path

A

A: type IV hypersensitivity to H/K ATPase and intrinsic factor on parietal cells, chief are lost

B: inflammation decreases # of delta cells, decrease pH

330
Q

Chronic gastritis RF

A

old age, stress, alcohol, autoimmune,

331
Q

Chronic gastritis comp

A

Neuroendocrine tumors
Gastric adenocarcinoma
gastric MALT lymphoma

332
Q

Chronic gastritis clinical

A

Asx
Epigastric pain
N/V

333
Q

GERD def

A

stomach acid flows back into esophagus

334
Q

GERD path

A

reflux -> inflammation, edema, erosion and remodeling -> wall thickens & lumen is smaller

335
Q

GERD RF

A

Caffeine, alcohol, smoking
Antihistamines, Ca2+ channel blockers
Obesity, pregnancy, Zollinger-Ellison Syndrome, fatty food, hiatal hernia , scleroderma

336
Q

GERD comp

A 
Esophagitis
Esophageal strictures
Barrett’s esophagus
Esophageal adenocarcinoma
Pulmonary fibrosis  
laryngitis 
asthma 
Pneumonia
337
Q

GERD clinical

A

Retrosternal chest pain
Heartburn
Regurgitation
Dysphagia
All worse after eating, bending down, leaning over
Acidic taste in mouth, sore throat, chronic cough, hoarseness
In mouth: Damage tooth enamel

338
Q

Crohn Disease def

A

inflammation and destruction anywhere along the GI tract, terminal ileum and colon

339
Q

Crohn Disease def

A

inflammation and destruction anywhere along the GI tract, terminal ileum and colon with areas that are unaffected

340
Q

Crohn Disease path

A

infection by mycobacterium paratuberculosis, pseudomonas, listeria activates immune system via antigen presentation -> unregulated th1 and cytokines -> macrophages, free radicals, proteases, platelet-activating factor -> lots of tissue destruction

341
Q

Crohn Disease RF

A

Black pts, genetics

342
Q

Crohn Disease comp

A 
malabsorption/malnutrition 
colorectal cancer 
fistulas 
phlegmon/abscesses
strictures
perianal disease
343
Q

Crohn Disease clinical

A

Diarrhea w/or w/o blood

pyoderma gangrenous, erythema nodosum, uveitis, episcleritis, oral ulceration, arthritis

344
Q

Crohn Disease clinical

A

Diarrhea w/or w/o blood

pyoderma gangrenous, erythema nodosum, uveitis, episcleritis, oral ulceration, arthritis

345
Q

Ulcerative Colitis def

A

inflammation of the colon forming ulcers in mucosa and submucosa along the lumen, circumferential and continuous from rectum to colon

346
Q

Ulcerative Colitis cause

A

autoimmune, stress, diet

347
Q

Ulcerative Colitis path

A

t cells destroying the cells lining the large intestine

348
Q

Ulcerative Colitis RF

A

women, FH, white

349
Q

Ulcerative Colitis comp

A

toxic megacolon, perforation, fulminant colitis, malabsorption, malnutrition, colorectal cancer

350
Q

Ulcerative Colitis clinical

A

Attacks of bloody, mucousy diarrhea
Abdominal pain
pyoderma gangrenous, erythema nodosum, uveitis, episcleritis, oral ulceration, arthritis

351
Q

Esophageal Atresia def

A

esophagus doesn’t develop

352
Q

Esophageal Atresia cause

A

congenital

353
Q

Esophageal Atresia path

A

defective lateral separation of foregut into the esophagus and trachea

354
Q

Esophageal Atresia RF

A

diaphragmatic hernia, duodenal atresia, imperforate anus, congenital heart problems, Trisomy 13, 18, or 21

355
Q

Esophageal Atresia comp

A

esophageal stricture, GERD, recurrent pneumonia, obstructive and restrictive ventilatory defects, and airway hyperreactivity

356
Q

Esophageal Atresia clinical

A

choking, respiratory distress, or cyanotic episodes during feeding

357
Q

Esophageal Webs and Rings def

A

thin structures that partially occlude the esophageal lumen

358
Q

Esophageal Webs and Rings cause

A

Plummer-Vinson syndrome
Eosinophilic esophagitis
Sliding hiatal hernia
Chronic reflux

Plummers enter sliding crevasse

359
Q

Esophageal Webs and Rings path

A

congenital or inflammation irritating esophageal wall

360
Q

Esophageal Webs and Rings RF

A

Plummer-Vinson syndrome

361
Q

Esophageal Webs and Rings comp

A

food impaction, perforation by solid food/esophageal probe insertion

362
Q

Esophageal Webs and Rings clinical

A 
Asx 
Dysphagia
Food getting stuck 
odynophagia 
retrosternal pain
363
Q

Meckel Diverticulum def

A

abnormal pouch on antimesenteric side of ileum

364
Q

Meckel Diverticulum cause

A

congenital

365
Q

Meckel Diverticulum path

A

incomplete obliteration of the omphalomesenteric duct in the developing embryo

366
Q

Meckel Diverticulum RF

A

other congenital anomalies

367
Q

Meckel Diverticulum comp

A

diverticulitis, ulcers, perforation, food impaction, lithiasis, peritonitis, peritoneal adhesions, intussusception, volvulus, neoplasm

368
Q

Meckel Diverticulum clinical

A

asymptomatic or abdominal pain, distention, melena, vomiting, constipation

369
Q

Pyloric Stenosis def

A

narrowing of the opening bw the stomach and duodenum

370
Q

Pyloric Stenosis cause

A

genetics

371
Q

Pyloric Stenosis path

A

SM of pyloric antrum undergoes hypertrophy and hyperplasia causing a blockage

372
Q

Pyloric Stenosis RF

A

boys, macrolide antibiotics

373
Q

Pyloric Stenosis comp

A

dehydration
jaundice
failure to thrive

374
Q

Pyloric Stenosis clinical

A

olive in RUQ
peristalsis felt or seen
vomiting

375
Q

Ascites def

A

fluid collects in the spaces w/in the abdomen

376
Q

Ascites cause

A

cirrhosis (most common), heart failure, kidney failure, cancer, infection

377
Q

Ascites path

A

portal hypertension and increased activity of RAAS leads to fluid accumulation

378
Q

Ascites RF

A

alcohol, obesity, hepatitis infection, metabolic disease

379
Q

Ascites comp

A

peritonitis

380
Q

Ascites clinical

A

asymptomatic, weight gain, abdominal discomfort

381
Q

Peritonitis def

A

peritonitis inflammation of the peritoneum

382
Q

Peritonitis cause

A

bacteria, leakage of GI contents, foreign material, endometriosis, peritoneal dialysis, adhesions form surgery

383
Q

Peritonitis path

A

inflammation causing neutrophilic infiltration, formation of fibrinopurulent exudate

384
Q

Peritonitis RF

A

liver cirrhosis, appendicitis, Crohn’s disease, stomach ulcers, diverticulitis and pancreatitis

385
Q

Peritonitis comp

A

enterocutaneous fistula, abdominal compartment syndrome, and enteric insufficiency

386
Q

Peritonitis clinical

A

Fever, chills, tachycardia, ascites, abdominal distention, abdominal rigidity, spider angiomata, jaundice, anorexia, N/V, diarrhea, encephalopathy, delirium, confusion, cognitive decline

387
Q

Esophageal varices def

A

dilated submucosal distal esophageal veins connecting the portal and systemic circulations

388
Q

Esophageal varices cause

A

portal hypertension, cirrhosis

389
Q

Esophageal varices path

A

↑ pressure -> blood is diverted away from portal system -> ↓ blood to liver -> build up of ammonia -> remodeling and dilation of blood vessels

390
Q

Esophageal varices RF

A

alcohol

391
Q

Esophageal varices comp

A

Variceal rupture

392
Q

Esophageal varices clinical

A

Hematemesis, melena, or hematochezia, Weight loss, Anorexia, Abdominal discomfort, Jaundice, Pruritus

393
Q

Hemorrhoids def

A

swollen veins in anus

394
Q

Hemorrhoids cause

A

straining during BM, constipation

395
Q

Hemorrhoids path

A

increased pressure causes veins to swell

396
Q

Hemorrhoids RF

A

constipation, strenuous defecation, diarrhea, prolonged sitting, aging, increased intra-abdominal pressure, pregnancy, intra-abdominal mass, ascites, portal hypertension

397
Q

Hemorrhoids comp

A

bleeding w/ BM, prolapsing, incarceration, strangulation, and itching

bleeding, acute thrombosis, itching, hygiene difficulties

398
Q

Hemorrhoids clinical

A

itching, bleeding w/ BM, pain, mucous discharge, perianal mass

399
Q

Infarction def

A

reduced blood supply to GI tract

400
Q

Infarction cause

A

Thrombus, thromboembolism, tumor, hernia, volvulus, intussusception, hypovolemia, after MI

401
Q

Infarction path

A

reduced blood supply to GI tract -> lack of oxygen -> cell death

402
Q

Infarction RF

A

atherosclerosis, age, smoking, COPD, meds, blood clot disorders,

403
Q

Infarction comp

A

Sepsis

404
Q

Infarction clinical

A

abdominal pain, vomiting, bloody diarrhea, distension

405
Q

Esophageal Adenocarcinoma RF

A

Obesity, smoking, achalasia, chronic GERD, Barrett’s esophagus, age >60, male

406
Q

Esophageal Adenocarcinoma clinical

A

Dysphasia, first solids then liquids

odynophagia, pyrosis, pain in chest/back, vomiting, weight loss

407
Q

Esophageal Squamous Cell Carcinoma def

A

cancer arising from the squamous epithelium of the esophagus, all along esophagus

408
Q

Esophageal Adenocarcinoma def

A

cancer arising from columnar glandular epithelium

409
Q

Esophageal Adenocarcinoma path

A

chronic aid exposure -> intestinal metaplasia -> mutation in tumor suppressor gene/proto-oncogenes -> tumor

410
Q

Esophageal Adenocarcinoma comp

A

obstruction, fistula

411
Q

Esophageal Squamous Cell Carcinoma cause

A

alcohol and smoking

412
Q

Esophageal Adenocarcinoma cause

A

GERD

Barrett’s esophagus

413
Q

Esophageal Squamous Cell Carcinoma RF

A

alcohol, smoking, hot fluids, age >60, achalasia, caustic strictures, plummer-vinson syndrome, palmoplantar keratoderma

414
Q

Esophageal Squamous Cell Carcinoma comp

A

Fistula, obstruction

415
Q

Esophageal Squamous Cell Carcinoma clinical

A

Dysphasia, first solids then liquids, odynophagia, pyrosis, pain in chest/back, vomiting, weight loss

416
Q

Gastric Adenocarcinoma def

A

cancer originating in the columnar glandular epithelium

417
Q

Gastric Adenocarcinoma cause

A

H. pylori or mutation in CDH1 gene

418
Q

Gastric Adenocarcinoma path

A

h. pylori releases cagA goes into the epithelium and cause damage -> immune system detects damage causing inflammation -> chronic infection leads to more inflammation, damage, and repair -> metaplasia develops -> mutations in tumor suppressor/ proto-oncogenes > cancer

CDH1 cause cells to not stick together and divide

419
Q

Gastric Adenocarcinoma comp

A

metastasis
paraneoplastic syndrome (keratinocytes inc)
polyarteritis nodosa (inflammation/necrosis of medium ateries)
thrombosis
pseudoachalasia syndrome

420
Q

Gastric cancer types

A

lymphomas: lymphocytes in MALT due to chronic h. pylori
carcinoid: neuroendocrine cells, g cells, polyp
leiomyosarcoma: smooth muscles cells

421
Q

Gastric cancer RF

A

FH, smoking, alcohol, obesity, older

422
Q

Gastric Adenocarcinoma RF

A

male, h. pylori, type A blood, diet high in nitrates, salt, smoked foods, autoimmune gastritis,

423
Q

Gastric cancer clinical

A

malaise, loss of appetite, dyspepsia, epigastric pain, N/V, weight loss, anemia, hematemesis, melena

424
Q

Gastrinoma def

A

neuroendocrine tumor that secretes gastrin

425
Q

Gastrinoma cause

A

MEN1 gene mutation

426
Q

Gastrinoma path

A

uncontrolled division and replication of G cells

427
Q

Gastrinoma RF

A

chronic pancreatitis, FH, alcohol

428
Q

Gastrinoma comp

A

metastases, bleeding

429
Q

Gastrinoma clinical

A

abdominal pain, chronic diarrhea, dyspepsia, gastroesophageal reflux, gastrointestinal bleeding, and weight loss

430
Q

Liver cancer types

A

Hepatocellular carcinoma
Angiosarcoma
Cavernous hemangioma
Hepatic adenoma

431
Q

Hepatocellular carcinoma def

A

cancer in hepatocytes

432
Q

Hepatocellular carcinoma cause/RF

A

alcoholic hepatitis, hemochromatosis, primary biliary cirrhosis, alpha 1- antitrypsin deficiency, chronic hep B and C, aflatoxins,

433
Q

Hepatocellular carcinoma path

A

mutation in a hepatocytes to chronic conditions that cause damage and repair

434
Q

Hepatocellular carcinoma comp

A

metastases

death

435
Q

Hepatocellular carcinoma clinical

A

asymptomatic

abdominal pain and fever

436
Q

Oral cancer types

A

squamous cell carcinoma
adenocarcinoma
melanoma
lymphoma

437
Q

Leukoplakia def

A

white flat raised patch in mouth that is precancerous

438
Q

Leukoplakia RF

A

tobacco use, alcohol

439
Q

Leukoplakia comp

A

squamous cell carcinoma

440
Q

Leukoplakia clinical

A

white raised patches

441
Q

Oral Squamous cell Carcinoma def

A

cancer from stratified squamous epithelium

442
Q

Oral Squamous cell Carcinoma path

A

mutation to proto-oncogenes or tumor suppressor genes

443
Q

Oral Squamous cell Carcinoma RF

A 
tobacco smoke, alcohol, chewing betel quid's/ paan
UV radiation 
exposure to metal dust or chemicals 
vitamin and mineral deficiencies 
immune deficiencies 
HPV 16
444
Q

Oral Squamous cell Carcinoma clinical

A

numbness or change in sensation, hoarse voice, pain or difficulty w/ chewing or swallowing, painless & painful lumps, sores, or discolorations

445
Q

Pancreatic cancer types

A

Adenocarcinoma
Acinar
Cystadenocarcinoma

446
Q

Pancreatic Adenocarcinoma def

A

cancer arising from the epithelial cells of exocrine gland

447
Q

Pancreatic Adenocarcinoma comp

A

metastasis

obstructive common bile duct

448
Q

Pancreatic Adenocarcinoma clinical

A

nausea, vomiting, fatigue, weight loss, mid-epigastric pain, trousseau sign, gallbladder enlarged

449
Q

Pancreatic cancer type

A 
VIPoma
Gastrinoma 
Glucagonoma 
Insulinoma 
Acinar 
cystadenocarcinoma
450
Q

Colorectal cancer types

A

adenocarcinoma

451
Q

Colorectal adenocarcinoma def

A

cancer of epithelial cells in colon

452
Q

Colorectal adenocarcinoma cause

A

mutations, adenomatous polyposis coli gene (APC)

453
Q

Colorectal adenocarcinoma path

A

APC -> mutated cells don’t die and divide/replicate (polyp) -> more replication/mutations -> adenocarcinoma

454
Q

Colorectal adenocarcinoma RF

A

elder, male, APC mutation, IBD, smoking, red meat, lack of fiber, obesity, Familial adenomatous polyposis, hereditary nonpolyposis

455
Q

Colorectal adenocarcinoma comp

A

metastasis

456
Q

Colorectal adenocarcinoma clinical

A

ascending: abdominal pain, weight loss, anemia
descending: lumen narrowing, colicky abdominal, hematochezia

457
Q

Esophagitis def

A

inflammation of esophagus due to

458
Q

Esophagitis def

A

inflammation of esophagus due to

459
Q

Esophagitis cause

A

Candida
Herpes Simplex Virus
Cytomegalovirus
Human Immunodeficiency Virus

460
Q

Esophagitis RF

A

immunocompromised states, AIDS, diabetes

461
Q

Esophagitis clinical

A

fever, dysphagia or difficulty in swallowing, odynophagia or painful swallowing, and retrosternal chest pain
Candida: small white raised plaques
HSV: small rounded vesicles, lesions in mouth
CMV: large superficial ulceration
HIV: large ulcerations

462
Q

Gastroenteritis def

A

inflammation of the gastrointestinal tract that involves the stomach and small intestine

463
Q

Gastroenteritis cause

A

rotavirus (kids), norovirus, astrovirus, adenoviruses

464
Q

Gastroenteritis path

A

viruses -> epithelium damage

465
Q

Gastroenteritis RF

A

children, elderly, immunocompromised individual, daycare center, cruise ship, contaminated food/water

466
Q

Gastroenteritis comp

A

server dehydration

467
Q

Gastroenteritis clinical

A

watery diarrhea, N/V, abdominal cramp, pain, fever, malaise, dry lips, skin turgor, tachycardia

468
Q

Gingivitis def

A

inflammation of gums

469
Q

Periodontitis def

A

inflammation and destruction of structures around the teeth

470
Q

Gingivitis/Periodontitis cause

A

Prevotella intermedia, alpha-hemolytic streptococci, Actinomyces species

471
Q

Gingivitis/Periodontitis cause

A

lack of competition or ineffective immune response, fusobacterium nucleatum, preuotella intermedia, porphyromonas gingivalis

472
Q

Gingivitis/Periodontitis RF

A

poor oral care, smoking, older age, dry mouth, poor nutrition, dental restorations that don’t fit properly

473
Q

Gingivitis/Periodontitis comp

A

tooth loss

474
Q

Gingivitis/Periodontitis clinical

A

no sx, redness, swelling, bleeding

475
Q

Oral thrush def

A

infection of the oral mucosal membrane by candida spp

476
Q

Oral thrush cause

A

Candida albicans

477
Q

Oral thrush RF

A

young age, dentures, xerostomia, antibiotics, DM, malnutrition, immunosuppression due to chemo, corticosteroids, HIV/AIDS

478
Q

Oral thrush path

A

Overgrowth of yeast on the oral mucosa leads to desquamation of epithelial cells and accumulation of bacteria, keratin, and necrotic tissue

479
Q

Stomatitis def

A

swelling and redness of the oral mucosa or discrete, painful ulcers

480
Q

Stomatitis cause

A 
Recurrent aphthous stomatitis
herpes simplex and herpes zoster
Candida albicans and bacteria
Trauma
Tobacco or irritating foods or chemicals
Chemotherapy and radiation therapy
Systemic disorders
481
Q

Stomatitis path

A

T cell mediated immune dysfunction, neutrophil, and mast cell-mediated destruction of the mucosal epithelium

482
Q

Stomatitis RF

A 
Poor oral hygiene.
Smoking.
Alcohol.
Trauma.
Psychological stress.
H. pylori.
Sensitivity to food.
Nutritional abnormalities.
483
Q

Stomatitis comp

A

Meningoencephalitis, recurrent skin and mouth infections, dissemination of the infection, and teeth loss

484
Q

Stomatitis clinical

A

red patches, blisters, swelling of the mouth, oral dysaesthesia, ulcers,

485
Q

Hepatitis A def

A

inflammation of liver parenchyma due to hepatitis A

486
Q

Hepatitis A cause

A

Fecal-oral route shellfish
Personal contact
Sexual contact
Illicit drug use

487
Q

Hepatitis A def

A

inflammation of liver parenchyma due to hepatitis A

488
Q

Hepatitis A RF

A

traveling to endemic areas
chronic liver disease or clotting factor disorders
MSM

489
Q

Hepatitis A clinical

A

Jaundice, Fever/chills, Fatigue/weakness, Headache, Myalgias, RUQ

Phase II: Anorexia, N/V, Arthralgia, Malaise, Urticaria, Dark urine, Hepatomegaly

Phase III: Dark urine, Pale-colored stools, Gastrointestinal sx, Malaise, Hepatomegaly/ splenomegaly

490
Q

Hepatitis E def

A

inflammation of liver parenchyma due to hepatitis E

491
Q

Hepatitis E cause

A

Transfusion of infx blood

fecal-oral route

492
Q

Hepatitis E def

A

inflammation of liver parenchyma due to hepatitis E

493
Q

Hepatitis E RF

A

contamination of water supplies, poor sanitation, ingestion of undercooked meat and shellfish, travel to regions where HEV is endemic, and chronic liver disease.

494
Q

Hepatitis E clinical

A 
Jaundice
Malaise
Anorexia
N/V
Abdominal pain
Fever
Hepatomegaly
495
Q

Hepatitis E comp

A

fulminant hepatitis in pregnant women

496
Q

Hepatitis E comp

A

fulminant hepatitis in pregnant women

chronic in immunocompromised

497
Q

Hepatitis B def

A

inflammation of liver parenchyma due to hepatitis B

498
Q

Hepatitis B RF

A

IV drug users, needle stick accidents, dialysis, blood transfusion

499
Q

Hepatitis B comp

A 
chronic hepatitis (90% in children) 
fulminant hepatitis
500
Q

Hepatitis B clinical

A

Prodrome: malaise, fever, arthralgias, lymphadenopathy, pruritis, rash

501
Q

Hepatitis B comp

A 
chronic hepatitis (90% in children), cirrhosis 
fulminant hepatitis, aplastic anemia, membranous glomerulonephritis, membranoproliferative glomerulonephritis
502
Q

Hepatitis B clinical

A

Prodrome: malaise, fever, arthralgias, lymphadenopathy, pruritis, rash

HBsAG -> IgM -> total anti-HBs -> anti-HBs surface antigen antibody 6 month

503
Q

Hepatitis D def

A

inflammation of liver parenchyma due to hepatitis D, coinfection w/ HBV

504
Q

Hepatitis D path

A

cytotoxic killing of hepatocytes -> inflammation -> liver damage

505
Q

Hepatitis D clinical

A 
Sx 3-7 wks after infxn 
Fever
Fatigue
Anorexia
N/V
Abdominal pain
Dark urine
Clay-colored stool
Joint pain
Jaundice
506
Q

Hepatitis D RF

A

Injection drug users.
Persons with hemophilia.
Infants/children of immigrants from areas with high rates of HBV infection.
Household contacts of chronically infected persons.
Persons with multiple sex partners or diagnosis of a sexually transmitted disease.
Men who have sex with men.

507
Q

Hepatitis D comp

A

cirrhosis, liver failure, and liver cancer, chronic hepatitis

508
Q

Hepatitis C def

A

inflammation of liver parenchyma due to hepatitis C

509
Q

Hepatitis C cause

A

hepatitis c

510
Q

Hepatitis C cause

A

hepatitis c, childbirth, sex

511
Q

Hepatitis C RF

A

IV drugs, sexual contact, from mother to child in neonatal period, chronic hemodialysis

512
Q

Hepatitis C comp

A

cirrhosis, hepatocellular carcinoma, renal dysfunction

513
Q

Hepatitis C clinical

A

low grade fever, malaise, lethargy, anorexia, fatty stool, dark urine, jaundice, hepatomegaly, icterus, pruritus

514
Q

Which hepattitis can become chronic?

A

B, C, D, E

515
Q

Which hepatitis can become chronic?

A

B, C, D, E

516
Q

Where is the quadrate lobe located between?

A

bw left lobe and gallbladder

NPLEX (28 decks)

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