GI Disorders

Question 1

what are the functions of the GI tract

Answer 1

1. digestion
2. absorption
3. excretion
4. host defense

Question 2

what does the Upper esophageal schpinter do

Answer 2

important for swallowing

Question 3

what does the lower esophageal schpinter do

Answer 3

where esophagus meets stomach

Question 4

what is GERD

Answer 4

reflux of gastric contents into the esophagus

caused by Gastroparesis

Question 5

what are the contributing factors to GERD

Answer 5

-incompetnet LES
-impaired gastric emptying
-hiatal hernia
-alcohol abuse
-more common in kids w developmental delays

Question 6

what are the complications of GERD

Answer 6

-regurgitation/malnutrition
-esophagitis
-barrets esophagus= increased risk for esoph cancer
-respiratory compromise: associated w asthma and COPD

Question 7

what does the stomach do

Answer 7

1. reservoir function: controll release of chyme into small intenstine
2. mechanical digestion: gastric motility
3. chemical digestion: digestive enzymes continue digestion of protein and fats
4. HCL: activates pepsin and immune defense
5. intrinsic factor: binds to B12 for small intenstine absorption. deficiency leads to pernicious anemia

Question 8

what do surface mucuosui cells do

Answer 8

secrete mucus

Question 9

what do mucuous neck cells do

Answer 9

secrete mucus

Question 10

what do parietal cells do

Answer 10

secretes HCl and IF

Question 11

what is gastric defense

Answer 11

protective barrier function
1. compact epithelial cell lining
2. mucus covering
3. bicarbonate ions
4. blood flow

Question 12

what is gastritis

Answer 12

inflammation of inner lining of stomach
-acute
-excessive acid production > gastric defense
NSAIDs, aspirin, alcochol
-stress induced
common in critical illness

Question 13

what is peptic ulcer disease

Answer 13

increased acid secretions and digestive enzymes erode gastric mucosa.
-helicobacter pylori infection >70%
-complications: hemorrhage, perforation, peritonitis, scarring
-can occur from non-steroidal medications like Bayer
ASA

defined by site of origin

Question 14

3 types of NSAIDs

Answer 14

1. acetyslalicylic acid: Aspirin
2. traditional NSAIDs: ibuprofen, naproxen
3. COX-2 inhibitiors: celebrex- causes heart attacks and strokes

15% of long term NSAID users develop PUD

Question 15

talk about ASA (aspirin) and traditional block COX-1 and COX-2

Answer 15

pain relief with increased GI bleeding risk

Question 16

talk about celebrex and vioxx and being selective for COX-2 only

Answer 16

pain relief with decreased GI bleeding
but increased CVA/MI risk

Question 17

what does COX 1 and 2 do

Answer 17

facilitate pain

Question 18

what does COX-1 do

Answer 18

facilitated blood clotting, so if blocked..you decrease blood clottingq

Question 19

what are red flags of GI bleed

Answer 19

-syncope
-hypotension
-pallor
-sweating
-tachycardia

Question 20

what are other symptoms to expect of a GI bleed

Answer 20

-fatigue/weak
-SOB
-ab discomfort

Question 21

what is a GI bleed

Answer 21

-decrease in hematocrit and hemoglobin
-vomiting of blood or coffee ground emesis that originates from UGIB

melena: can be UGIB or LGIB

Question 22

what is the fucntion of the small intestine

Answer 22

1. chemical digestion
   endocrine cells and exocrine function
   hormones regular gastric, pancreatic and gall bladder function
2. absorption
   villi and microvilli

Question 23

what is the function of the large intestine

Answer 23

main= water absorption
-final stage of digestion through bacterial action
-ferment carbs, produces some B vitamins and Vit K
-mucus is major secretion; no enzymes
-epithelial cells absorb salts
-water flows by osmosis

Question 24

talk about Crohn’s disease

Answer 24

-patchy inflammation that may occur anyhwere along digestive tract
-invovles entire bowel wall
-pain is commonly experienced in the lower right abdomen

Question 25

talk about ulcerative colitis

Answer 25

-inflammation is continuous through affected large intestine
-invovles innermost lining
-pain is common in lower left abdomen

Question 26

what are the common presentations of crohns and ulceratiev colitis

Answer 26

-abdominal cramping and pain, diarrhea, obstruction, fatigue, malapsoprtion leading to weight loss
-joint pain, anemia

medical management:
medications
srugical resection of affected bowel part

Question 27

talk about IBS

Answer 27

disturbed bowel function without structural abnormalities
-spasmoditic motility pattern
-malabsorption
-nutrition deficiency and loose stools

-etiology uknown, but realted to colonic sensitivity

Question 28

talk about celiac disease

Answer 28

autoimmune disorder that occur in genetically predisposed people where the ingestion of gluten leads to damage in small intestine
-leads to malabrsoption and symtpoms that include: bloat, diarrhea, gas, fatigue
-other issues: anemia and osteoporosis

Question 29

what is a hiatal hernia

Answer 29

gastro-esophageal junction moves above the diaphragm with some of the stomach

Question 30

what is a ventral hernia

Answer 30

an incision related hernia where abdominal contents protrude through linea alba

Question 31

what is an inguinal hernia

Answer 31

protrusion of abdominal contents through inguinal canal

Question 32

what is acute abdomen

Answer 32

periotonitis
-life threatnening
-refers to sudden, severe abdominal pain <24 hours

causes: appendcitis, pancreatitis, AAA, etc

physical exam:
-identifyt location
-palpation reveals rigitidy, rebound tenderness
-bowel sounds unusuall, absent

Question 33

what is colorectal cancer

Answer 33

-progression often start wtih benign polyp
early detection: colonoscopy

-symptoms: bleeding, pressure/pain with poo, change in elimination

associated with: age, family history, diet, exercise, crohnis, ultercative colotisi

3rd most common CA and 3rd leading cause of death