GI Cont. Flashcards
This is a much deeper peptic ulceration of the stomach wall
-may burrow through the muscular wall
Chronic peptic ulceration
What commonly causes Chronic peptic ulceration?
-H. Pylori
-NSAIDS
-Aspirin use
(damage the mucosal barrier)
______ junctions of the _______ cell lining of the stomach help prevent acidic stomach contents from damaging the deeper layers of the stomach wall
- Tight junctions
- Epithelial cell lining
What are prostaglandins used for in the stomach?
- Improving local blood flow in the stomach
- Allows mucus production and bicarbonate secretion
- This COUNTERBALANCES H+ secretion
What do aspirin and NSAIDS do to prostaglandin synthesis?
- Inhibit arachadonic acid metabolic pathways
- Decrease prostaglandin synthesis
- Gastric mucosa=vulnerable
What are 3 ways hemorrhage can present with?
- Melena (black poop)
- Hematochezia
- Hematemesis
- Anemia
Ulcers increase the risk for _______
Adenocarcinoma of the stomach
Ulcer=loss of _______
mucosa
What does the floor of the ulcer contain
- granulation tissue
- inflammatory debris
Describe the rim of the ulcer
- Erythemateous
- Edematous
What are more likely, duodenal or gastric ulcers?
Duodenal ulcers
_______ is a rare disease characterized by a gastrinoma in the pancreas.
Zollinger Ellison syndrome
Excessive gastrin causes increased acid production =
recurrent ulcers in the stomach
What is the most common form of stomach cancer?
-Adenocarcinomas
What are risk factors for adenocarcinoma of the stomach?
- Chronic atrophic gastritis
- Smoked/pickled foods
- Nitrate food preserves
- Low fruit/veggie diets
This is a rare outpocketing of the jejunum
Meckel diverticulum
This is failure of the anterior abdominal wall to form and the intestines protrude
Gastroschisis
This is a less severe case of gastroschisis with less bowel protruding
Omphalocele
This is a very small deficit at the umbilicus
Umbilical hernia
This results from localized, genetic absence of the autonomic ganglionic plexus in the colon wall that controls peristalsis
Hirschsprung Disease
What effects does Hirschsprung’s disease have on the body
- No peristalsis
- Impaired fecal movement
- Poop backs up upstream
- Overgrowth of bacteria
- Severe inflammation
These are dilated anal varices?
-Internal and external hemorrhoids
S&S of hemorrhoids
- Bleed regularly
- Leave bight red blood on stool surface
- Painful
- Itchy
Who commonly has hemorrhoids?
- Older people
- Pregnancy (due to increased BV and venous stasis)
- Portal hypertension
This is the twisting of the bowel
-Volvulus
Describe the internal and external infarcted bowel
Infarcted bowel is EDEMATOUS
- Internal= extensive hemorrhage in the mucosa and submucosa
What happens to the damaged wall?
-Becomes leaky
What results from the leaky damaged wall
- Peritonitis
- Septicemia
This occurs when C. Difficle overgrows
Pseudomembranous colitis
Describe C. Dif
- Gram Positive
- Anaerobic
- Spore forming bacteria
Can C. Dif be part of the normal flora?
Yes
What is a major cause of C. Dif infection?
-Broad spectrum antibiotic use
because it kills normal flora
Pathogenesis of C. Diif
- Secretes enterotoxin
- Binds to epithelium of the colon
- Causes an inflammatory response
- Produces cellular, purulent exudate
- Causes necrosis of colonic mucosa
What is the #1 cause of nosocomial diarrhea
C. Dif
-secretes enterotoxin and produces a cellular purulent exudate and causes necrosis
This is the poor absorption of fats, electrolytes, minerals, and water
Malabsorption
This is malabsorption with fatty stools
Sprue
S&S of Malabsorption
- Large, bulky, greasy stools
- Excessive bowel gas
- Distention
Describe luminal malabsorpion
- Happens in the lumen
- Usually due to deficiency of pancreatic or liver function
- no lipase or defective bile acids
What are causes of intestinal malabsorpion
- Surgically shortened bowel
- Lack of brush border enzyme
- Gluten sensitivity
Complications common to sprue
- Anemia (poor B12, iron, or folate)
- Bleeding (from decreased vitamin K)
- Brittle, weak bones (from decreased Ca and Vitamin D)
- Osmotic edema (from decreased proteins)
Diverticula have a very _____ wall composed of _____ and ______ only
Thin wall
- Mucosa and submucosa only
- NO MUSCLE present
Where do the mucosa and submucosa extrude through the musclular walls?
-Points where small arteries penetrate from the external surface
T/F- Colonic diverticulosis is uncommon in people who eat a traditional diet rich in grains, fruits, and veggies
True
Diets with small amounts of non-digestible bulk= more compact feces=
Easier to pass
Straining at stool causes…
Increased pressure
Stasis=
INFECTION
Pathogenesis of a blockage in the lumen
- Blockage
- Increase pressure
- Decreased blood flow
- Ischemia
- Infarction
- Necrosis
- Infection/inflammation
What are complications for diverticulosis
- Perforation
- Peritonitis
- Abcess
- Hemorrhage
- Fistulas
- Stenosis
Pathogenesis for appendicitis
- Obstruction of orifice
- Distension of lumen
- Pressure increases
- Stasis and ischemia
- Proliferation of bacteria
- Necrosis and perforation
- Complications
What is the most common cause of an abdominal emergency?
Appendicitis
S&S of appendicitis
- Periumbilical carmping/pain
- Localizes to RLQ
- Nausea, vomiting, anorexia
- RLQ tenderness= irritated peritoneum –> ilius
