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Patho Exam #4 > GI > Flashcards

GI Flashcards

1
Q

Backflow of gastric contents into esophagus through LES

Inflammation caused by reflux of highly acidic material (esophagitis)

A

GERD

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2
Q

Any condition or agent that alters closure strength of LES or increases abdominal pressure, fatty foods, caffeine, large amounts of alcohol, cigarette smoking, pregnancy, anatomic features (ex: hiatal hernia)

A

GERD

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3
Q

Clinical manifestations

Heartburn, regurgitation, chest pain, dysphagia

A

GERD

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4
Q

Increasing LES pressure
Enhancing esophageal clearance
Improving gastric emptying
Treatment for _________

A

GERD

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5
Q

Suppressing gastric acidity
Avoiding tobacco and aggravating food and drink
Treatment for _______

A

GERD

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6
Q

Over-the-counter antacids and histamine (H2)-blocking medications used for treatment of ______

A

occasional GERD

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7
Q

Proton pump inhibitors (PPIs) are the mainstays for ______

A

chronic GERD

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8
Q

Upper GI endoscopy for ongoing symptoms
Endoscopic dilatation for strictures
Treatment for _____

A

GERD

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9
Q

Surgical intervention (thoracoscopic Nissan fundoplication) for ________

A

intractable GERD

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10
Q

Columnar tissue replaces normal squamous epithelium of the distal esophagus.
Carries a significant risk for esophageal cancer

A

Barrett esophagus/type of GERD

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11
Q

Progression can lead to ulceration, fibrotic scarring.

Esophageal strictures

A

GERD

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12
Q

Pulmonary symptoms—cough, asthma, and laryngitis—from reflux in breathing passages

A

GERD

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13
Q

Complication of portal hypertension resulting from alcoholic or viral hepatitis

A

Esophageal Varices

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14
Q

In developing countries, Schistosoma species of liver flukes major cause
Affects more than half of cirrhotic patients
High mortality rate

A

Esophageal Varices

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15
Q

Inflammation of the stomach lining

A

Gastritis

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16
Q

Precipitated by ingestion of irritating substances
Example: alcohol and aspirin, NSAIDs, viral, bacteria, autoimmune
______ Gastritis

A

Acute

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17
Q

Clinical manifestations

May be asymptomatic; anorexia, n/v, postprandial discomfort, hematemesis

A

Gastritis

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18
Q

Treatment

Remove offending agent

A

Gastritis

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19
Q

Helicobacter pylori is nearly always a factor
Transmission: person to person, fecal-oral route, reservoir in water sources
in _______

A

chronic gastritis

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20
Q 
Complications
Peptic ulcer disease
Atrophic gastritis
Gastric adenocarcinoma
Mucosa-associated lymphoid tissue lymphoma
Decreased acid and intrinsic factor
A

chronic gastritis

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21
Q

Inflammation of stomach and small intestine (usually self-limiting)

A

Gastroenteritis

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22
Q

_______ gastroenteritis: usually result of another GI disorder

A

chronic

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23
Q

______ gastroenteritis: direct infection by pathogenic bacteria or bacterial toxin
May be caused by imbalance in normal bacterial flora by introduction of unusual bacteria (travel)

A

acute

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24
Q

Disorders of upper GI tract caused by action of acid and pepsin
Injury to the mucosa of the esophagus, stomach, or duodenum
Range from a slight mucosal injury to severe ulceration

A

Peptic Ulcer Disease

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25
Q

Increase in factors that tend to injure the mucosa relative to factors that tend to protect it

A

Peptic Ulcer Disease (PUD)

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26
Q

NSAIDs, stress (glucocorticoids), smoking, genetics

causes of ______

A

PUD

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27
Q

No connection between ______ and PUD

A

diet

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28
Q

Key role in promoting both gastric and duodenal ulcer formation

A

H Pylori

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29
Q

Thrives in acidic conditions
Slow rate of ulcer healing
High rate of recurrence

A

H Pylori

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30
Q

H Pylori a cause of ______

A

PUD

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31
Q

Clearance of H. pylori promotes ulcer healing IN ____

32
Q

Caused by breakdown of protective mucous layer that normally prevents diffusion of acids into gastric epithelia because of chronic irritations
Aspirin, NSAIDs, alcohol, and bile acids

A

Gastric PUD

33
Q

Inappropriate excess secretion of acid

A

Duodenal PUD

34
Q

Increased basal activity of vagus nerve
Stimulates pyloric antrum cells to release gastrin to act on gastric parietal cells to release HCl
Results in high level of HCl

A

Duodenal PUD

35
Q

Epigastric burning pain that is usually relieved by the intake of food (especially dairy products) or antacids

36
Q

Life-threatening complications, such as GI bleeding, may occur with no warning.

37
Q

Pain of _______ulcers typically occurs on an empty stomach but may present soon after a meal.
Pain of _______ulcer classically occurs 2 to 3 hours after a meal and is relieved by further food ingestion.

A

GASTRIC; DUODENAL

38
Q

Upper GI barium contrast radiography or by endoscopy

diagnosis for _______

39
Q

_____ ulcers should be visualized with endoscopy and biopsied to rule out malignancy.

40
Q

Testing for H. pylori diagnoses _____
Recommended for ____
Controversial for _____

A

PUD; gastric; duodenal

41
Q

Encourage healing of the injured mucosa by reducing gastric acidity.
Prevent recurrence
H. pylori antibiotics
Treatment for ______

42
Q

H2 antagonists
Proton pump inhibitors
Sucralfate (forms protective coating over injured mucosa)
Treatment for _______

43
Q

Smoking cessation
Avoidance of ASA and NSAIDs
Treatment for _______

44
Q

Stress reduction
Avoid irritating foods that exacerbate symptoms.
Caffeinated beverages and alcohol for ex.

Treatment for ________

45
Q

Complications: perforation, bleeding

46
Q

Chronic inflammatory disease of the mucosa of the rectum and colon
Large ulcers form in mucosal layer of colon and rectum.

A

Ulcerative Colitis

47
Q

Begins as inflammation at base of crypts of Lieberkühn; damage results; abscess formation in crypts; abscesses begin to coalesce, large ulcerations develop in epithelium

A

Ulcerative Colitis

48
Q

Associated with increased cancer risk after 7 to 10 years of disease
Have exacerbations and remissions

A

Ulcerative Colitis

49
Q

Hallmark clinical manifestations are bloody diarrhea and lower abdominal pain.

A

Ulcerative Colitis

50
Q

Mainstay treatment for acute ulcerative colitis is _____

A

corticosteroids

51
Q

Broad spectrum antibiotic
Salicylate analogs
Treatment for ______

A

Ulcerative Colitis

52
Q

Immunomodulating agents
Azathioprine
Mercaptopurine
Treatment for ______

A

Ulcerative Colitis

53
Q

Intravenous followed by oral cyclosporine for refractory
Infliximab (Remicade) for refractory
for treatment of ______

A

Ulcerative Colitis

54
Q

Also called regional enteritis or granulomatous colitis

A

Crohn Disease

55
Q

Affects proximal portion of the colon or terminal ileum

Chronic inflammation of all layers of intestinal wall resulting from blockage and inflammation of lymphatic vessels

A

Crohn Disease

56
Q

Suggestive findings are ulcerations, strictures, fibrosis, and fistulas

A

Crohn Disease

57
Q

Clinical manifestations
Intermittent bouts of fever, diarrhea, if bloody, not as severe as ulcerative colitis; constant, chronic RLQ pain, may have RLQ mass, tenderness

A

Crohn Disease

58
Q

Alleviating and reducing inflammation
Smoking cessation
Drugs similar to ulcerative colitis
Treatment for _______

A

Crohn Disease

59
Q

No cure for ______

A

Crohn Disease

60
Q

Prednisone and sulfasalazine
Antibiotics: metronidazole
Treatment for _______

A

Crohn Disease

61
Q

Azathioprine, 6-mercaptopurine, methotrexate, and biological therapies (refractory)

Antitumor necrosis factor agents infliximab, adalimumab, and certolizumab (refractory)
Treatment for _______

A

Crohn Disease

62
Q

Acute inflammation and necrosis of large intestine

A

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

63
Q

Caused by Clostridium difficile (exposure to antibiotics)

Mediated by bacterial toxins

A

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

64
Q

Clinical manifestations

Diarrhea (often bloody), abdominal pain, fever, leukocytosis, sepsis, colonic perforation (rare)

A

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

65
Q

Stop current antibiotic (if possible).
Treat ischemia.
Treat contributing conditions.
Treatment for ________

A

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

66
Q

Oral antibiotics: metronidazole or vancomycin

Treatment for______

A

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

67
Q

Recurrence common
Rare: fecal transplant (transfer of fecal material from another healthy person to the source patient via enema or gastric tube) or colectomy

A

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

68
Q

Which information is correct regarding pseudomembranous colitis? Pseudomembranous colitis:

develops because of overgrowth of Clostridium difficile.
does not recur following treatment.
is a major cause of diarrhea in premature infants.
may also be called regional enteritis.

A

develops because of overgrowth of Clostridium difficile.

69
Q

Inflammation of the vermiform appendix

Obstruction by fecalith

A

Appendicitis

70
Q

Clinical manifestations
Periumbilical pain, RLQ pain (“McBurney’s point”) (classic, but may be anywhere), nausea, vomiting, fever, diarrhea, RLQ tenderness, systemic signs of inflammation

A

Appendicitis

71
Q

Immediate surgical removal

Antibiotics with fluid/electrolyte replacement

A

Appendicitis

72
Q

Untreated _______may result in rupture of the appendix and subsequent peritonitis.

A

Appendicitis

73
Q

Localized abscesses may be managed with tube drainage and antibiotics.

A

Appendicitis

74
Q

Presence of diverticula (herniations) in the colon: diverticulosis

A

Diverticular Disease

75
Q

Results from low intake of dietary fiber

Results in high intraluminal pressure

A

Diverticular Disease

76
Q

Antibiotics, surgery for abscess

Treatment for _______

A

Diverticular Disease

77
Q

______—asymptomatic

_______ (inflamed diverticuli)—fever, acute lower abdominal pain, leukocytosis

A

Diverticulosis; Diverticulitis

Patho Exam #4 (7 decks)

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