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GI disorders Flashcards

1
Q

hiatal hernia

A

> stomach pushes up through esophageal hiatus and goes into thoracic cavity
- difficulty swallowing/reflux disease
- 2 kinds: sliding and paraoesophageal

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2
Q

hiatal hernia presents

A
  • asymptomatic
  • dysphagia
  • GERD like
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3
Q

hiatal hernia diagnosis

A
  • endoscopy
  • barium swallowing (lights up on xray)
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4
Q

hiatal hernia treatment

A
  • reduce acid in stomach (proton pump/histamine blockers)
  • surgery
  • lifestyle change > small meals
  • surgery: fundoplication
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5
Q

GERD

A

> stomach contents move backward into esophagus
- sphincter opens from relaxing

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6
Q

GERD manifestations

A
  • dysphagia: hard to swallow
  • heartburn/epigastric pain (pyrosis)
  • indigestion after meals
  • laryngitis
  • aspiration pneumonia
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7
Q

GERD diagnosis

A
  • history
  • acid suppression trial
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8
Q

GERD treatment

A

lifestyle changes (no coffee, alc, smoking) - raise HOB, eat early before laying down, small meals
- PPI and H2 blockers
- surgery (fundoplication)

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9
Q

GERD complications

A

Barrett’s esophagus: metaplastic change (squamous to columnar) and can lead to cancer

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10
Q

esophageal cancer

A
  • rare
  • 2 types: top of esophagus (smoking, alc use) and adenocarcinoma in lower esophagus (barrett’s)
  • higher chance with age
  • men is more common > GERD, smoking, drinking
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11
Q

esophageal cancer manifestations

A
  • difficulty swallowing
  • weight loss
  • change in eating patterns
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12
Q

esophageal cancer diagnosis

A
  • endoscopy
  • biopsy
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13
Q

esophageal cancer treatment

A
  • surgical reception of esophagus
  • chemo/radiation
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14
Q

gastritis

A
  • acute: short term, likely to resolve
  • chronic: lasts a long time
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15
Q

acute erosive gastritis

A
  • cause inflammation of stomach lining
  • from: medications (NSAIDS), bacterial infection, steroids, alc, chemo, radiation, stress
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16
Q

acute erosive gastritis manifestations

A
  • epigenetic pain
  • nausea and vomiting
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17
Q

acute erosive gastritis diagnosis/treatment

A
  • history
  • endoscopy
    Tx: remove cause
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18
Q

chronic gastritis

A
  • inflammation to stomach lining
    > helicobacter pylori infection (gram neg bacteria with flagellations)
  • erode mucosa > lead to erosions
  • hispanic, african american, aging people
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19
Q

flagellations

A

allow bacteria to burrow into mucosal lining then secretes ammonia (urease) to protect self from acid

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20
Q

chronic gastritis diagnosis

A
  • endoscopy
  • breath test
  • biopsy
  • test stool antibodies
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21
Q

chronic gastritis treatment

A
  • antibiotics (long term)
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22
Q

chronic gastritis over time

A
  • atrophy of glands in stomach that secrete mucus (protection)
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23
Q

chronic gastritis over time cause

A
  • autoimmune response (attack parietal)
  • intrinsic factor decreased (good for absorption)
  • anemic (cant absorb B12)
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24
Q

chronic gastritis over time symptoms

A
  • no unique symptoms
  • heartburn/epigastric pain
  • peptic ulcers
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25
chronic gastritis over time diagnosis
- endoscopy - check B12 levels in blood test
26
chronic gastritis over time treatment
- acid reducers - B12 and iron supplement - PPI and H2 blockers
27
peptic ulcer disease
> if gastritis isnt treated - ulcers can be in stomach and small intestine (duodenum) - common with h. pylori and NSAIDS - from stress, alc, smoking, caffeine
28
peptic ulcer disease manifestations
- epigastric pain - burning nawing sensation *RELEIVED BY EATING* - abdominal tenderness - bleeding leads to anemia > black tarry stools
29
peptic ulcer disease diagnosis
- NSAID use - blood sample > endoscopy to find ulcer
30
peptic ulcer disease treatment
- long term > reduce acid levels with PPI and H2 blockers - antibiotics (sucralfate: coats ulcers - take before eating) - lifestyle changes
31
IBS
- functional disorder - colon looks normal - color has spasms > diarrhea, constipation, cramping - nervous system > stress and triggers - younger women - lactose intolerance
32
IBS diagnosis
- symptoms
33
IBS treatment
- bowel movement training - massage therapy - diet management
34
irritable bowel disease: IBD
- Crohn's and ulcerative colitis
35
crohn's
- effect full bowel wall - can effect full GI tract - most common area: distal small intestine and 1st part of large intestine - has SKIP LESIONS not continuous - granulomas - COBBLESTONE look - women 20-30 - erosion of bowel wall which risks peritonitis > fistulas
36
crohn's treatment
> NO CURE - remission is goal - diet therapy - antidiarrhea, immunosuppressor - biologics - surgery (ostomy)
37
ulcerative colitis
-> affects colon (large intestine) - start in anus and moves up GI - no skip lesions > mucosal layer is affected - lesions form in crypts > abscesses - polyps form - pseudopolyps - diarrhea
38
ulcerative colitis treatment
- removal of part of colon - diet management (avoid simple sugars and eat fiber) - steroids - risk for colon cancer
39
enterocolitis
- irritation in stomach - can be caused by bacteria/pathogens/toxin/chemicals - bacterial/virus: person to person and food - mortality - dehydration > cant absorb nutrients - inflammatory diarrhea, secretary diarrhea
40
enterocolitis cause
- norovirus/rotavirus rotavirus: leading cause of diarrhea in kids, 3-20 years old, new vaccine (oral) - bacteria produces endotoxins that destroy mucosal epithelial cells > necrotizing enterocolitis: kids and premature infants - bowel dies and leaks content into peritoneal cavity
41
enterocolitis diagnosis
- stool sample - history
42
enterocolitis treatment
- BRAT food - hydration - probiotics - prevention
43
clostridium difficle colitis: C.diff
- bad diarrhea - very contagious - spores transfer - from antibiotic use > kills good gut bacteria - foul smell *immune to sanitizer*
44
C.diff treatment
- VANC - stool transplant
45
diverticulitis
- small outpouching on outside of the colon > can be permanent - pouches can collect food and stool - diverticula that arent inflamed are asymptomatic - form from gaps in longitudinal muscles
46
diverticulitis risk factors
- low fiber diet
47
diverticulitis manifestations
- pain in LLQ - N/V/D - fever
48
diverticulitis diagnosis
- abd xray - endoscopy - ultrasound - CT
49
diverticulitis treatment
- modify diet - bowel training - colon rest - remove diverticula - antibiotics/antifungal
50
appendicitis
- starts in LRQ - stool and food get stuck in appendix causing infections/inflammation - can rupture
51
appendicitis manifestations
- sudden onset - LRQ pain - abd distention/rebound tenderness - N/V/D, fever, constipation
52
appendicitis diagnosis
- physical exam - ultrasound - xray - CT - blood test (increased WBC)
53
appendicitis treatment
- antibiotics - surgery (removal) - appendectomy
54
peritonitis
- infection in peritoneal cavity from bacteria - gas/air that builds and intestine stops working > creates paralytic alias: stopping of bowel function - sepsis
55
peritonitis manifestations
- abd pain - rebound tenderness - blood/fluid going into cavity - N/V, fever, electrolyte loss - if not treated fast, infection moves to blood
56
peritonitis diagnosis
- abd xray (spree air under diaphragm) - paracentesis (suck out fluid) - CT
57
peritonitis treatment
- clean infection (abd washout) - IV fluids/abx - decompress bowel (nasogastric tube)
58
celiac disease
- gluten sensitivity (barley, rye, wheat) - creates T cells against gluten protein
59
celiac disease risk factors
- type 1 diabetes/autoimmune disease > inflamed areas have reduced ability to absorb nutrients (microvilli) - nutrition deficit/weight loss - small bowel
60
celiac disease manifestation
- exposure to gluten > steatorrhea, malnutrition, hair/nail thinning - weight loss - kids: reduce growth
61
celiac disease diagnosis
- antibody titers (blood test) - biopsy
62
celiac disease treatment
- gluten removal
63
adenomatous polyps
- most common intestinal neoplasm - can lead to cancer - can be flat or raised (precancerous) - the more polyps the higher risk of colon cancer > routine screening - common in olde people, genetics, IBD, smokers, drinkers - remove polyps surgically - NO manifestations
64
colorectal cancer
- common
65
colorectal cancer risk factors
> colon polyps - aging/history/IBD - diet high in fat/sugar/smoked meat and low in fiber
66
colorectal cancer manifestations
- none until advanced stage - bleeding/change in bowel
67
colorectal cancer diagnosis
- colonoscopy - Cologuard - genetic markers - rectal exam
68
colorectal cancer treatment
- surgical removal - chemo/radiation

pathophys (6 decks)

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