GI and GU Emergencies

Question 1

What are the 4 layers of the GI tract? List in order from deepest to most superficial.

Answer 1

1. Mucosa
2. Submucosa
3. Muscularis
4. Serosa

Question 2

Where in the body does digestion begin? Bonus point if you know what enzyme begins this process!

Answer 2

Begins in the mouth when salivary amylase mixes with food.

Question 3

What are the 3 named parts of the stomach? List in order from most superior to most inferior (anatomically. I’m not saying one is better than the other).

Answer 3

1. Fundus (just like in the uterus!)
2. Body
3. Pylorus

Question 4

What is the function of the ligament of Treitz?

Answer 4

To attach the small intestine to the spine and maintain its position. Also marks the separation between the upper and lower GI tract.

Question 5

What is the function of the liver?

Answer 5

To filter the blood, aid in digestion, store glucose as glycogen, and metabolize nutrients/drugs in the bloodstream.

Question 6

What does glycogenolysis mean? What drug causes this?

Answer 6

Breakdown of glycogen into glucose to move sugar from the cells to the bloodstream. Glucagon stimulates this.

Question 7

What structure controls the release of bile from the gall bladder (at the duodenum)?

Answer 7

The sphincter of Oddi (what a fun name!)

Question 8

What causes gall stones?

Answer 8

Blockage to the ducts connecting the gall bladder to the GI tract.

Question 9

What other health condition (besides gallstones) can arise if the passage of bile from the gall bladder to the GI tract is blocked?

Answer 9

Backed up bile can be reabsorbed into the bloodstream by the liver and cause jaundice.

Question 10

What is the difference in symptom presentation between esophageal varices and Mallory-Weiss syndrome?

Answer 10

Mallory-Weiss syndrome: small amounts of blood in emesis.
Esophageal varices: no emesis, just torrents of blood… Like a horror movie. Shit’s whack.

Question 11

Both hematochezia and melena describe blood in the stool. What part of the GI tract does each originate from?

Answer 11

Hematochezia: lower GI tract
Melena: upper GI tract

Question 12

What are haemorrhoids?

Answer 12

Swelling of blood vessels around the rectum. Can present with itching and small amounts of blood (hematochezia).

Question 13

How will we be able to tell that a patient is severely constipated?

Answer 13

Massive abdominal distension, pain, and history indicating lack of bowel movements. Even shit coming out of their mouth in the late stages (fun!)

Question 14

What is the underlying mechanism which causes the esophagal vein distension present in a patient with esophageal varices? Knowing this, what are some risk factors that might be associated?

Answer 14

Damage to the liver caused by alcoholism and medication misuse, as well as traumatic injury, causes the blood to back up in the esophageal veins.

Question 15

What causes Mallory-Weiss syndrome? Describe the mechanism, not the conditions which could cause this.

Answer 15

Excessive vomiting weakens and eventually tears the lumen of the esophagus, allowing blood to leak in and be expelled with the emesis.

Question 16

What is Boerhaave syndrome? What are 2 life-threatening complications that can arise from this?

Answer 16

The esophagus ruptures and spills the GI contents (+a lot of blood) into the thoracic cavity. This can cause severe sepsis and pneumothorax.

Question 17

What is a peptic ulcer? How about a gastric ulcer?

Answer 17

Peptic ulcer: a sore on the inner lining of the esophagus, stomach, or small intestine
Gastric ulcer: a sore on the inner lining of the stomach only

Question 18

What is going to be the main pre-hospital indicators that a patient might be experiencing a peptic ulcer?

Answer 18

A burning pain in the chest or abdomen that may be dulled when eating.

Question 19

What is cholecystitis? What palpable sign indicates this?

Answer 19

An inflammation of the gall bladder. A positive Murphy’s sign will indicate this.

Question 20

What significant history question can we ask someone if we suspect they may be experiencing cholecystitis?

Answer 20

What was the last thing you ate? Do you regularly eat meals high in protein and/or fat?

Question 21

What is appendicitis? What palpable signs indicate this?

Answer 21

Accumulation of shit in the appendix which has gotten infected and inflamed. A positive Rovsing’s sign or pain at McBurney’s point will indicate this. Can also use the Iliopsoas test or the obturator test.

Question 22

What is pancreatitis? What mechanism causes this?

Answer 22

Inflammation of the pancreas. Usually, a duct blockage causes autodigestion of the pancreas by its own secreted digestive enzymes.

Question 23

What is Cullen’s sign? What can it indicate?

Answer 23

Bruising around the umbilicus. Can indicate internal hemorrhage into the abdominal cavity in the case of pancreatitis but also from ectopic pregnancy rupture and splenic rupture.

Question 24

What is Grey Turner’s sign? What can it indicate?

Answer 24

Bruising in the flanks. Can indicate acute pancreatitis but may also be present in the case of retroperitoneal hemorrhage from other causes.

Question 25

What is diverticulosis? How about diverticulitis?

Answer 25

Diverticulosis: Small, bulging pouches which can form on the large intestine
Diverticulitis: Infection or inflammation of one or more diverticuli

Question 26

What is colitis? What main 2 mechanisms/pathologies cause this?

Answer 26

Colitis: generally describes any inflammation or irritation of the large intestine

Caused by ulcerative colitis or Chron’s disease.

Question 27

What causes Chron’s disease?

Answer 27

A genetic autoimmune disorder. Not something you can just catch lol

Question 28

What is hepatitis? What usually causes this?

Answer 28

Inflammation of the liver usually caused by viral infection from Hep A, B, C, D, E

Question 29

What are the 3 main functions of the urinary system? Think in general terms.

Answer 29

1. Excretion of liquid waste
2. Filtration of blood
3. Maintain homeostasis