GI disorders Flashcards
1
Q
what are functions of the GI tract?
A
breaks down ingested food prepares food for uptake by cells provides body with water eliminates waste controlled by hormones and he autonomic nervous system
2
Q
which is the most common manifestation of GI dysfunction?
A
diarrhea
3
Q
diarrhea
A
increased frequency of bowel movements
increased volume, fluidity, weight of the feces
4
Q
what are the major mechanisms of diarrhea?
A
osmotic diarrhea
secretory diarrhea
motility diarrhea
5
Q
what is an example of osmotic diarrhea?
A
indigested lactose
6
Q
what is an example of secretory diarrhea?
A
cholera which is common in less developed countries
7
Q
what is an example of motility diarrhea?
A
post GI surgery
8
Q
secretory diarrheas occur when
A
bexterial toxins enhance colonic secretion
9
Q
what is a cholera cot?
A
a treatment for cholera
oral rehydration therapy
10
Q
what are other clinical manifestations of GI dysfunction other than diarrhea?
A
gastrointestinal bleeding
abdominal pain
11
Q
abdominal pain is a symptom of
A
a number of GI disorders
12
Q
parietal pain, which is a type of abdominal pain results from
A
irritation of the peritoneum
13
Q
parietal pain is more of a ___pain
A
localized
14
Q
visceral pain, which is a type of abdominal pain, results from
A
internal organs
15
Q
visceral pain is generally less ___ and more
A
well localized and more referred pain
16
Q
referred pain
A
from deep within
17
Q
upper gastrointestinal bleeding comes from organs like
A
esophagus
stomach
duodenum
18
Q
lower gastrointestinal bleeding comes from organs like
A
jejunum
ileum
colon
rectum
19
Q
hematamesis
A
bleeding from the upper portion of GI (mouth)
20
Q
melena
A
bleeding from lower portion (proximal small intestine)
21
Q
hematochezia
A
bleeding from the lower Gi (small intestine and anus)
22
Q
the ___ of the blood gives an indication of how hight up
A
color
the darker the blood the higher up except for when it comes out of the mouth
23
Q
dysphagia
A
difficulty swallowing
24
Q
what are the different types of dysphagia?
A
mechanical obstruction
functional obstructions
25
mechanical obstruction dysphagia is when there is a
physical obstruction
26
functional obstruction dysphagia results from a
loss of function
| achalasia
27
what is achalasia?
denervation of smooth muscle in the esophagus and lower esophageal sphincter relaxation which is likely the location of food blockage.
28
what are different ways of assessing disorders of motility
gastroscopy
colonoscopy
"pill camera"
29
gastroscopy looks at the :
esophagus
stomach
proximal SI
30
colonoscopy looks at:
the entire large intestine
31
GERD
gastroesophageal reflux disease
32
GERD is the reflux of chyme from the
stomach to the esophagus
33
when is GERD called reflux esophagitis?
if it causes inflammation of the esophagus
34
reflux esophagitis can cause
esophageal structure
35
How if GERD manifested?
heartburn
regurgitation of chyme
upper abdominal pain within 1 hr of eating
36
hiatal hernias cause
GERD
37
what is a hiatal hernia?
when part of the stomach comes up (herniates) above the diaphragm
38
pyloric obstruction
the blocking or narrowing of the opening between the stomach and the duodenum
39
pyloric obstructions can be acquired or
congenital
40
what are the manifestations of pyloric obstruction?
epigastric (higher up) pain and fullness
nausea
splashing
vomiting
41
what happens if the pyloric obstruction is unresolved?
malnutrition
dehydration
extreme debilitation
42
intestinal obstruction
any condition that prevents the flow of chyme through the intestinal lumen
43
what are the two types of intestinal obstruction?
simple obstruction
| functional obstruction
44
simple intestinal obstruction
mechanical blockage
45
functional intestinal obstruction
failure of motility (ileus)
46
what are the symptoms for small intestinal obstruction
pain
distenstion
vomiting
47
what are the symptoms of large bowel intestinal obstruction?
lower GI pain
distension
constipation
no vomiting
48
gastritis
inflammatory disorder of the gastric mucosa
| there is chronic and acute
49
acute gastritis
superficial erosion of mucosa due to bacteria (H.pylori) or NSAIDs
50
What are the two different types of chronic gastritis
fundal gastritis
| antral gastritis
51
fundal gastritis
autoimmune
more rare
higher up in the stomach
52
antral gastritis
more common
| further down in the stomach
53
what are the different types of inflammatory Bowel diseases?
ulcerative colitis
| crohn disease
54
ulcerative colitis
chronic inflammation disease that causes ulceration of the colonic mucosa
55
what are some suggested causes of ulcerative colitis?
infectious
immunologic (anticolon antibodies)
genetic
dietary
56
what are the symptoms of ulcerative colitis?
Diarrhea for up to 10-20 days
bloody stool (bright red)
cramping
57
what is the treatment for ulcerative colitis
antibiotics and steroids
immunosuppressive agents
surgery
58
Crohn Disease
idiopathic inflammatory disorder
| affect any part of the digestive tract from mouth to anus
59
which organs does Crohn disease more most commonly affect
distal small intestine
| proximal large colon
60
crohn disease causes__ lesions
skip
61
what is a skip lesion
when one portion is affected followed by a patch that is not affects (healthy) they're like patchy
62
in crohn disease, ____ may result due to ____ of vit B12 and folic acid
pernicious anemia
malabsorption of B12 and folic acid
cells can't divide so you dont have enough RBC
63
treatment for crohn disease is similar to treatment for:
ulcerative colitis
64
irritable bowel syndrome (IBS) affects ___ of people
7-20%
65
irritable bowl is more common in
women
66
what are the subtypes that IBS is classified into?
diarrhea
constipation
pain
67
IBS may arise from
abnormal motility
allergies/sensitivities
gut bacteria
68
what is the treatment for IBS?
it varies
counseling
dietary intervention
probiotics
69
what are the two classes of malabsorption syndromes?
maldigestion
| malabsorption
70
maldigetsion
failure of the chemical processed of digestion
71
malabsorption
failure of the intestinal mucosa to absorb digested nutrients
72
maldigestion is malabsorption frequently___
occur together
| maldigestion can lead to malabsorption but not the other way around
73
what are different types of malabsorption syndromes?
pancreatic insufficiency
lactase deficiency
bile salt deficiency
fal-sol vits deficiencies
74
in pancreatic insufficiency...
the pancreas isn't doing it's job
| there are insufficient pancreatic enzyme production
75
which enzyme are low in pancreatic insufficiency?
lipase
amylase
trypsin
chymotrypsin
76
what causes pancreatic insufficiency?
pancreatitis
pancreatic carcinoma
pancreatic resection
cystic fibrosis
77
fat maldigestion is the main problem of pancreatic insufficiency so the patient will have ___ stool and ___
fatty stool
(steatorrhea)
and weight loss
78
what is the treatment for pancreatic insufficiency?
oral enzyme replacement which may damage and scar intestines
79
lactase deficiency
the inability to break down lactose into monosaccharides
80
the fermentation of lactose by bacteria causes
gas
cramping pain
flatulence
osmotic diarrhea
81
why are bile salts necessary?
conjugated bile salts are needed to emulsify and absorb fats
82
where are conjugated bile salts synthesized?
they are synthesized from the cholesterol in the liver
83
what causes bile salt deficiency?
liver disease and bile obstructions
84
if you inhibit ___ you also inhibit bile production
cholesterol
85
what are the manifestations of bile salt deficiency?
poor intestinal absorption of lipid causes:
fatty stools
diarrhea
loss of fat soluble vitamins
86
what is the consequence of vit A deficiency?
night blindness
87
what are the consequence of vitamin D deficiency?
decreased Ca absorption
bone pain
osteoporosis
fractures
88
what are the consequences of vitamin K deficiency?
prolonged prothrombin time
pupura (easily bruised)
petachiae (spots)
89
what are the consequences of vit E deficiency?
slow growth
| muscle weakness
90
what are the different liver disorders?
hepatitis
cirrhosis
varices
91
hepatitis
inflammation of hepatocytes which causes infiltration of WBC
92
what are the different types of hepatitis?
acute
| chronic
93
Acute hepatitis
hepatocytes vary from impaired to necrosis
94
acute hepatitis is open caused by
acetaminophen overdose
95
chronic hepatisis
chronic liver infection/inflammation
96
what is a common form of chronic hepatitis?
viral hepatitis
97
hepatitis
viral disease that primarily affects the liver
98
Which type of hepatitis is known as infectious hepatitis?
hep A
99
which form of hepatitis if known a serum hepatitis?
Heo B
100
what is the sequence of events for viral hepatitis?
incubation phase
prodromal (preicteric) phase
icertic phase
recovery phase
101
what are manifestations of the prodromal phase of hepatitis?
fatigue
fever
hyperalgesia
vomiting
102
in the icteric phase the liver is damaged enough
where you see manifestations like jaundice
103
cirrhosis
irreversible inflammatory disease that disrupts liver function and structure
104
what are general manifestation of cirrhosis?
decreased hepatic function
biliary channels become obstructed and cause portal hypertension
hypoxic necrosis develops
105
what are two types of cirrhosis?
alcoholic
| biliary
106
Alcoholic cirrhosis
the oxidation of alcohol damages hepatocytes which causes massive lipid accumulation
107
biliary cirrhosis begins in
the bile canaliculi and ductules
108
what is primarily biliary cirrhosis?
autoimmune
109
what is secondary biliary cirrhosis?
obstruction
| gall stones, tumors
110
portal hypertension
abnormally high blood pressure in the portal venous system
111
what is considered high blood pressure?
greater than 10mmHg
112
what causes the high blood pressure in portal hypertension?
resistance to portal blood flow
113
prehepatic portal hypertesion
narrowing of vessels preceding liver
114
intrahepatic portal hypertension
cirrhosis
115
posthepatic portal hypertension
cardiac disorders
| harder time getting back to the heart and through the liver so clearing the blood from the liver
116
which form of portal hypertension is most common?
intrahepatic due to cirrhosis
117
where can problems originate in prehepatic portal hyper tension?
blood flow from the heart to the spleen, stomach, and intestines or blood from those organs to the liver
118
where can problems originate in intrahepatic portal hypertension?
the liver
119
where can problems originate in posthepatic portal hypertension?
in the veins on the way back to the heart
120
what are the consequences of portal hypertension?
varices
splenomegaly
ascites
hepatic encephalopathy
121
varices
distended veins usually in the lower esophagus, stomach, and rectum
122
what is the most common manifestation of varices?
esophageal bleeding
123
spenomegaly is especially common with which type of portal hypertension
intrahepatic
124
splenomegaly can result in
platelet accrual
125
hepatic encephalopathy
CNS disturbances
126
ascites almost always accompanies
cirrhosis
127
altered pressue that takes place during ascites leads to
overflow into peritoneal cavity
128
hepatic encephalopayhy
a neurologic syndrome of impaired cognitive function, flapping tremor, and EEG changes
129
what is the cause of hepatic encephalopathy?
cells in the bervous system are vulnerable to neurotoxins absorbed from the GI tract that , due to liver dysfunction, circulate to the brain
130
what is the progression of dysfunction of nonalcoholic fatty liver disease
```
steatosis (fatty liver)
nonalcoholic steatohepatitis (NASH fatty and inflamed)
NASH=fibrosis (scarred)
cirrhosis (scarred and inflamed)
cancer
```
131
what are treatment options for NAFLD?
increase insulin sensitivity
diet
weight loss
metformin
132
what is the best treatment for NAFLD
improved insulin sensitivity
133
most common assessment of liver function involves:
analysis of plasma proteins
134
what are normal levels of albumin?
4-5 g/dl
135
what are normal levels of alanine transaminase(ALT)?
10-50 IU/L
136
what are normal levels of aspartate transaminase(AST)?
5-45 IU/L
137
which has more AST? muscle or liver?
muscle
138
some liver enzyme are expressed in
skeletal muscle
139
why does weight loss, which improves insulin sensitivity, increase risk of gallstones?
because people generally eat less to loss weight and if they are eating less they are not using all heir bile so its sitting in their gallbladder and when its just in there it can cause stones.
140
what does consuming fat decrease your chance of gallstones?
it increases the movement of bile in the system
141
peptic ulcer disease
a break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum
142
superficial peptic ulcers
erosions
| erodes mucosa but not muscularis mucosae
143
deep peptic ulcer
deep
| true ulcer
144
the timing of pain can tell of what about an ulcer?
where it is.gastric or duodenal
145
gastric ulcers
tend to develop in the antral region of the stomach, adjacent to the acid-secreting mucosa of the body
146
what are the developmental factors of duodenal ulcers
H. pylori infection
use of NSAIDs
high gastrin levels
acid production by cigarette smoking
147
what do NSAIDs do?
they inhibit bicarbonate and mucin production
148
stress ulcer
an acute ulcer that is related to severe illness, neural injury, or systemic trauma
not caused by bacteria
149
ischemic ulcer
a type of stress ulcer that develops within hours of hemorrhage, trauma, heart failure or sepsis
150
cushing ulcers
stress ulcers that develop as a result of a burn injury
151
what kind of ulcer would you expect to see with H. pylori infection?
any kind of peptic ulcer
152
Lipopolysaccharide ____ fat oxidation and ___ fat storage
reduces fat ox and increases storage
153
which type of meals increase blood toxins?
high fat, high carb
154
obesogens
a compound that can increase weight gain
155
exposure to which compounds can increase risk of infant and future obesity?
estrogen like compounds
| ex: bisphenol A and diethylstilbestrol which is found in plastics and detergents
156
what are some obesogens?
BPA
DES
MSG
157
fructose increases ___ more than glucose
hepatic lipogenesis
158
populating gut with ____ may prevent fat gain and maintains insulin sensitivity
"good" bacteria
