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Patho test 3 > GI > Flashcards

GI Flashcards

1
Q

stomach pH is? secretes? can absorb? puts what is blood?

A

pH 2-denatures proteins, easier to chop up amino acids
secretes: Intrinsic factor IF-need to bind it B12
can absorb: H2O, ETOH, ASA
*dumps HCO3 into blood

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2
Q

duodenum pH

A

8

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3
Q

Sphincter of Oddi goes where, dumps what

A

connects to duodenum

dumps content from Liver, GB, Pancreas

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4
Q

Jejunum absorbs what

A

sugars, proteins

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5
Q

Ileum absorbs what

A

Vit B12, bile salt

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6
Q

Colon absorbs what and reabsorbs what

A

absorbs H2O

reabsorbs Na, Cl, HCO3

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7
Q

Hiatal hernia, where, most common type, s/s

A

esophageal hiatus
sliding hernia more common
regurgitation-heart burn

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8
Q

Achalasia is what, s/s, what is the result of this, and what causes this

A

when lower esophageal sphincter doesn’t open properly–stuff just sits there
dysphagia-pain with eating
can cause: inflamm and ulceration of lower esophagus–leads to squamous cell CA
caused by: peristalsis, incomplete relaxation of lower esoph–Vagus nerve, increased resting tone of lower esoph.

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9
Q

esophageal varies caused by, associates with, big problem when

A

caused by impaired hepatic portal blood flow-increased blood flow through capillaries in lower esophagus
associated with ETOH cirrhosis 2/3 cirrhosis pt
problem: RUPTURE- 20-30% die each episode, 70% recurrence rate
*must tx underlying problem.

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10
Q

esophagitis is what, caused by, leads to

A

GERD
caused by: obesity, hiatal hernia, not enough vagal tone
leads to: heartburn/reflex, barrets esophagus

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11
Q

Barrets esophagus from what, is what, and can lead to

A

long standing GERD
replacement of normal stratified squamous mucosa (which is mechanically strong not chemically) with metaplastic columnar epithelium with goblet cells
leads to Adenocarcinoma

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12
Q

2 esophageal CA, what causes them

A

adenocarcinoma: from barrets, more common in US, lower esophagus
Squamous cell CA: High esophagus, tobacco, ETOH, achalasia, Hot tea, *tumor forms band around esophagus prevent normal mvmt of bolus 1st S/S: dysphagia

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13
Q

stomach has what feature to protect itself from its pH

A

gastic pits-opening covered by mucosal layer

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14
Q

what happens in the parietal cell?

A

CO2+H2O—H2CO3—H+HCO3

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15
Q

stomach acid

A

HCl

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16
Q

bicarb is dumped where from stomach

A

blood,
pancreas and GB to duodenum-where makes contents more alkaline, neutralizes H from stomach
then H then goes to the blood to neutralized the bicarb from the stomach

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17
Q

chronic gastritis is what, caused by, leads to

A

chronic mucosal inflamm
the cells: atrophy, intestinal metaplasia, neutrophil infiltrates
caused by H pyloric
usually asymptomatic but can have upper abd discomfort, N/V, ulcers

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18
Q

H pylori damages what, causes, BUT

A

mucous layer and acid comes in
urease, toxins
causes peptic ulcers 70-90%
BUT: only 10-20% of people with h pylori get ulcers

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19
Q

peptic ulcerations 4 layers

A

necrotic debris
inflamm layer
granulation tissue
fibrous scar

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20
Q

peptic ulcers from what, where, caused by, problems

A

progression of chronic gastritis
anywhere in GI tract exposed to acid-peptic juice **98% in proximal duodenum and stomach (4:1)
caused by h pyloric and smoking, ETOH, corticosteroids, high stress
problems: epigastric pain, N/V, hemorrhage
do NOT progress to CA
** usually impair quality of life rather than shorten it

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21
Q

most random thing about ulcers and their horrible problem

A

hemorrhage leads to hypotension leads to real failure (acute tubular necrosis)

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22
Q

Acute gastritis aka, tx, problems

A

acute ulceration, acute mucosal inflamm (usually 2nd to some other problem)

tx: primary problem
problems: epigastric pain with N/V, hematemesis +/- melena

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23
Q

Acute gastritis causes 10!!

A 
C:Ca Chemo
U:Uremia
T: mechanical Trauma- NG tube 
I: systemic Infections
E: Excessive Etoh
S: heavy Smoking
S: severe Stress ex: burns
I: Ingestion of caustic agents
N: heavy Nsaid
S: Shock and ischemia  
CUTIES SINS
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24
Q

acute gastric stress ulcers are what, caused by (4) tx

A

focal acute gastric mucosal defects resulting from severe stress
caused by: severe trauma (sepsis, major surg), burns, trauma to CNS, gastric irritants
tx: underlying problem and gastric mucosa will recover completely

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25
stomach CA was most common in 1930 due to what
lack of fridge
26
2 types of stomach CA
intestinal-adenocarcinoma, have decreased in frequency! | diffuse carcinoma: was not as prominent to begin with did NOT decrease
27
causes of intestinal adenocarcinoma
nitrates, smoked food, pickled food, low fruit/veggie, chronic gastritis, h pylori
28
walls of intestine include
innermost layer: single columnar epithelial layer lamina propria muscular mucosa: surrounds innermost layer, makes sure that contests are continuously turned so that all nutrients can be absorbed.
29
enteric plexus is where, causes what
myenteric plexus is btwn muscularis layer, circle and longitudinal layers cause peristalsis which is a big wave starting in stomach all they way to cecum
30
purpose of peristalsis
clears out intestine, happens once every hr
31
mesenteric layer is what
serosal layer-visceral peritoneum
32
lactose breaks down to what
glucose and galactose
33
sucrose breaks down to what
glucose and fructose
34
who controls insulin
glucose bc it has appropriate transporters | galactose and fructose go along for ride
35
breaking down protein into what, with what
into amino acids, secrete protease(pepsin) which is from pancreas *amino acids are only thing release into blood
36
how does the pancreas make enzymes
as proenzymes to protect itself | enzymes activated when peace pancreas
37
what do the brush border of microvilli do
have enzymes that further chop polypeptide until amino acids
38
whats a triglyceride
glycerol molecule and 3 fatty acids
39
what kind of fat can we absorb
monoglyceride or glycerol
40
superior mesenteric art supplies
sm intestine to lg intest up to splenic flexure
41
inferior mesenteric art supplies
splenic flexure to rectum
42
danger area for ischemia in bowel
splenic flexure
43
hirschsprug is what, from what, causes fixed by
congenital megacolon from caudal migration of neural crest cells failing to reach the anus- this leaves Aganglionic segment of the distal colon *lack both messier and auerbach mystery plexus causes: no innervation means no peristalsis, *Obstruction, enterocolitis, perforation fixed by: removal of aganglionic section *if section is sm no problem, but if large section then don't have much colon and won't reabsorb H2O--chronic diarrhea
44
ischemic bowel disease is what
acute occlusion or hypoperfusion which results in infarction
45
what causes ischemic bowel disease5
arterial thrombosis arterial embolism venous thrombosis Non-occlusive ischemia-HR, shock, dehydration, vasoconstrictive drugs mechanical obstruction: volvulus stricture herniation
46
mild infraction ok if what
only kill mucosal cells | as long as stem cells are still alive they will be replaced
47
transmural bowel infarctions bad bc why?
if goes through wall, weak part can rupture, fecal matter leaks out can get sepsis or peritonitis *high mortality Pt usually have other comorbidities
48
hemorrhoids from what, caused by,
persistently elevated venous pressure in the hemorrhoidal plexus causes variceal dilations caused by: straining during defecation, preg, hepatic portal HTN
49
Secretory: Vibrio cholerae-Cholera what happening in cells, s/s, where do you get it
causes epithelial cells secrete Cl into sm intestine so impedes Na absorption and then can absorb H2O s/s: voluminous water diarrhea places where don't have clean drinking water ***can loose up to 1L/hr
50
osmotic: gut lavage ex golytely, how it work
overwhelms GI tract with polyethylene glycol (PEG) which is not absorbed and it holds on to H2O--osmotic diuretic- cleans out colon
51
Exudative diarrhea destroys what, examples are
destruction of epithelial layer: infected mucosal cell-kill cell slough off and acts as osmotic agent so holding on to H2O, have diarrhea despite not eating shigella, salmonella, campylobacter
52
Malabsorption diarrhea examples and what does it do
Giardia, lymphatic, obstruction, defective absorption ex: can't absorb lactose by itself, but bacteria in colon can. bacteria replicate and make gas, bloating, diarrhea due to intolerance
53
deranged motility caused by what and what happens
surgery, hyperthyroidism | GI tract hypermobile, not enough time to reabsorb all water--diarrhea
54
Idiopathic inflammatory bowel diseases 2
slide 34 Ulcerative Colitis Crohn's common s/s: diarrhea, loss appetite, painful BM, frequent BM, wt loss, fatigue
55
Ulcerative Colitis is what, get what where?
inflam of colon starts at rectum continuous section of colon that is involved. get pseudopolyps: mucosal layer eroded by doesn't get past muscularis layer *ulcer in colon, rectal bleeding
56
Crohn's is what, where does it happen
inflam of affected parts: sections called skip lesions. Anywhere mouth-anus deep fissured that go through mucosal layer can even cause fistulas
57
whats a fistula
improper connection from lumen of intestine to peritoneal space.
58
hookworm for crohns
in order for it to survive in gut must turn off immune system which alleviates some of the symptoms
59
diverticula is what from what
diverticulosis- just the out pouching of intestine as feces become more and more solid it takes more and more pressure to squeeze things through colon this pressure causes the out pouching
60
Diverticulitis is what, what are the problems, tx
the inflammation of the out pouching problems: LLQ discomfort- bc worse in descending colon, bleeding, perforation, fistula formation tx: eat more fiber/prevention
61
bowel obstructions 4
herniation, adhesions, intussusception, volvulus
62
bowel obstructions: adhesions is what | volvulus is what
A: post abd surg, scar tissue can bind 2 parts of bowel together, can't move as well V: twisting of intestines
63
pseudo-obstructions: 3 "types"
1Paralytic ileus: bowel doesn't work, after surg/GA bowel doesn't move, maybe 1-2 days before starts moving 2Bowel infarction: if muscle damaged then won't have peristalsis in the damaged spot, Bowel won't progress further. 4myopathies and neuropathies ex: hirschsprung
64
polyp
tumorous mass protruding into the lumen
65
pedunculated
having a stalk
66
sessile
not having a stalk
67
hyperplastic
increased # of cells- no cancer
68
non-neoplastic
not CA
69
neoplastic
abnormal disorganized growth-can be CA
70
Adenoma
neoplastic polyps arising from epithelial | proliferation and dyslasia
71
Adenocarcinoma
CA arising form adenomatous polyps 98% colorectal CA
72
Colon CA s/s differ with R and L... what are they and why
R: blood on guaiac test, won't see in stool. Anemia bc won't see blood and will bleed for long time....blood gets diluted L: no anemia bc see blood in stool

Patho test 3 (4 decks)

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