G.I Flashcards
Lack of appetite, may be associated with nausea
Anorexia
_______ _____ is located in the medulla
Vomiting Center
_________ _____ located on the floor of the fourth ventricle and mediates emetic effects of blood-borne drugs and toxins
Chemoreceptor center
“white plaque”
Oral leukoplakia
- a precancerous lesion
The _____ is the most common site for oral cancer
Tongue
lift up the tongue and check with finger (gloved) for lesions
Risk factors for oral, head, and neck cancer
- Smoking
- Chewing tobacco
- Heavy alcohol (Ethanol) intake
- Other chronic irritants
Probably due to a weak or incompetent lower esophageal sphincter that allows reflux to occur.
May be associated delayed gastric emptying that is causing the increased pressure and forcing contents upward instead of allowing for normal movement downwards.
G.E.R.D
Gastroesophageal reflux disease (stomach content reflux up the esophagus)
Signs and Symptoms of G.E.R.D
- Heartburn (most severe at night)
- Reflux of stomach contents into mouth
- Pain and hoarseness
- Respiratory symptoms (wheezing, chronic cough, hoarsness)
- Evidence linking asthma and reflux
Treatment for GERD
- Small meals; sit upright after eating
- Avoid foods that lower esophageal tone (caffeine, choco, fats, alcohol, smoking)
- Sleep with head elevated
- Lose weight
- No eating after 5pm
- H2 blockers, Proton Pump inhibitors
Barrett’s Esophagus
Esophageal Cancer (adenocarcinoma
- Dysphagia
- Weight loss
Inflammation of the gastric (stomach) lining
Gastritis
Common factors that can disrupt the mucosal protective barrier: _____, ______, _ _____, ______, __________
- NSAIDS
- Aspirin
- H. pylori
- Alcohol
- Corticosteroids
Aspirins and NSAIDS inhibits __________ _______
Prostaglandin secretion
-improve gastric mucosal blood flow, decrease acid secretion, increase bicarbonate ion secretion and enhance mucous production
Sudden symptoms of inflammation of the gastric mucosa
Acute Gastritis
-Life threatening hemorrhage can occur from NSAIDS w/o warning
- Hemorrhage
- Heartburn
- Hematemesis (bloody vomit)
- violent vomiting
Symptoms of Acute Gastritis
-Treatment: IV fluid replacement, removal of irritant, self limiting in nature
Absence of grossly visible erosions and presence of chronic inflammatory changes, leading to atrophy of the glandular epithelium of the stomach
Chronic Gastritis
3 types of Chronic Gastritis
- Helicobacter pylori
- Autoimmune
- Chemical gastropathy
Treatment of H. pylori difficult; simultaneous two or more antibiotics plus prilosec for 10-14 days
Ulcerative disorder affecting all or some of the stomach layers and the proximal duodenum
Peptic ulcer disease (PUD)
Patho- H. pylori stimulate release of cytokines which increase mucosal damage
PUD:
-Pain is midline, in ________, may radiate to costal margins, into the back and rarely to right shoulder
-Pain is usually relieved by ___ and/or ____
- epigastrum
- food, antacids
GI ulcerations that develop in response to a major physiologic illness
Also called Curling’s ulcer
Stress Ulcers
_______ _____ refers to a similar type of gastric ulcer occurring in those with intracranial tumors, surgery, trauma
Cushing Ulcer
Diffuse inflammation of the gallbladder, with most cases associated with stones
Cholecystitis
- Acute onset of RUQ or epigastric pain, with mild fever, anorexia, N&V
- DX by ultrasound
- Surgery by laparoscopy
Cholecystitis labs:
- Increased WBC’s
- Mild elevations in:
1. AST
2. ALT
3. Alkaline phosphatase
4. Bilirubin
Intolerance to ____ ____, episodes of ______ pain
fatty foods
colicky
Stone in common bile duct
Choledocholithiasis
-can cause jaundice or pancreatitis
Risk factors for Cholelithiasis (gallstones)
Obesity
Female
Multiple pregnancies
Oral contraceptives
Inflammatory process of the pancreatic acini
Acute pancreatitis
- Etiology: Stones in duct, alcohol abuse. More on ppt.
- Complications include MODS, SIRS, Pancreatic psuedocysts
Premature activation of _____ causes autodigestive process of the pancreas, eventually causing multisystem organ failure and SIRS (systemic inflammatory response syndrome)
Trypsin
ACUTE PANCREATITIS
Increased serum ______ and _____
Increased ___
amylase, lipase
CRP
- Fourth leading cause of cancer death in U.S
- Cancer has usually metastasized before diagnosis
- 5 yr survival 20%, only 4% will live 18-20 months
Pancreatic Cancer
-Jaundice, pain, pruritis, development of thrombi due to activation of clotting factors by proteases
