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Pathology Block 11 > GI Disorders > Flashcards

GI Disorders Flashcards

1
Q

Which GI disorder is most likely to be confused with angina?

A

GERD

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2
Q

GERD

A
  • reflux or backwards movement of gastric contents into esophagus
  • occurs during \trnaient relaxation of esophageal sphincter or delayed gastric emptying
  • reflux of acid and pepsin is injurious to esophageal lining
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3
Q

Causative agents of GERD

A

Agents that decrease the tone of esophageal sphincter

  • foods
  • CNS depressants
  • obesity
  • pregnancy
  • hiatal hernia
  • delayed gastric emptying
  • increased gastric volume
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4
Q

Dx of GERD

A

History of reflux symptomatology
Radiographic studies using a contrast medium
Esophagoscopy

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5
Q

TX of GERD

A

Conservative methods

  • avoid positions
  • avoid large meals
  • weight loss
  • drugs
  • small thickened meals and antacids for children
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6
Q

Presentation of GERD

A 
HEartburn
30-60min after eating 
Relieved by sitting upright 
-chest pain (confused with angina) 
-respiratory symptoms
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7
Q

Causes of achalasia

A

Incomplete relaxation of lower esophageal sphincter in response to swelling: functional obstruction with consequent dilation of proximal esophagus

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8
Q

Primary achalsia

A

Mesenteric ganglia that carry vagaries fibers from esophagus are absent

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9
Q

Hiatal hernia

A

Herniation of stomach through the esophageal hiatus of diaphragm

  • small ones are asymptomatic
  • large hernias require surgery
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10
Q

How can GERD or Barretts lead to esophageal cancer

A

Barretts: 30-40% increase in adenocarcinoma because of high grade dysplasia and needs periodic screening

GERD can lead to Barrett;s

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11
Q

How can you prevent or minimize GI disorders

A

Proper nutrition or changes in health practices

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12
Q

Lower sphincter is a ______ sphincter

A

Physiologic

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13
Q

Lower sphincter is a _____ valve

A

One way valve

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14
Q

Types of hiatal hernia

A

Sliding

Paraesophageal

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15
Q

Dx of hiatal hernia

A

Accidental diagnosis

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16
Q

TX of achalasia

A

Antiacids

Then treat surgically

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17
Q

What is GERD associated with

A

Eating

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18
Q

How does GERD present

A
  • heartburn and pyrosis usually related with eating
  • normal mechanism is one way
  • weak or incompetent lower esophageal sphincter causes gastroesopaheal reflux disease or GERD
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19
Q

Why is GERD common in infants

A

Small stomach and lying position
Complications like esophageal damage and secondary respiratory disease
-can cause damage to lungs

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20
Q

Distal esophageal squamous cells replaced by columnar repithelium containing goblet cells

A

Barrett’s esophagus

21
Q

Main problem with GERD

A

Heartburn associated with eating

22
Q

Complication of chronic GERD

A

Barrett’s esophagus

23
Q

What is Barretts common in

A

Males

24
Q

What type of cells are normally in the esophagus

A

Squamous cells

25
Q

Complications of Barrett’s esophagus

A

Strictures and ulcers

26
Q

Esophageal cancer

A
  • uncommon
  • directly related to diet and environment
  • 2 types: adenocarcinoma, squamous cell carcinoma
27
Q

Adenocarcinoma )esophageal cancer)

A

Complications of GERD and BArrett esophagus and occur in the distal third of the esophagus, common in Caucasian males, ratio is 7:1 in males and females

28
Q

Squamous cell carcinoma esophageal cancer

A

Occurs in the middle part of esophagus and risk factors are alcohol, tobacco, injury, achalasia and consumption of hot beverages

29
Q

Main presenting complaint that occurs late in the disease of esophageal cancer

A

Dysphagia

  • weight loss
  • anorexia
  • fatigue
  • pain on swallowing may occur
30
Q

Reservoir to contents entering digestive tract and lies in upper abdomen

A

Stomach

31
Q

Acute gastritis

A

Complaints vary with cause

  • aspirin: no symptoms or heartburn
  • alcohol: abdominal distress, vomiting and hematemesis
  • toxins: staph aureus causes abrupt and violent onset with gastric…distress and vomiting
  • in cases of hemorrhage, black, tarry stool
  • self limiting with complete regeneration within several days of removal of inciting factor
32
Q

Gastric mucosal barrier

A
  • lining impermeable to acid
  • coupled secretion of H+ and HCO3-
  • gastric mucus
  • cells closely packed tight and covered with an impermeable hydrophobic layer
  • no diffusion of ionized water soluble molecules
  • aspirin and bile disrupt
  • PGs protect stomach wall
33
Q

Common causes of gastritis

A
  • aspirin, alcohol, NSAIDs
  • toxins
  • steroids
  • illness or trauma
  • radiotherapy and chemotherapy
34
Q

Chronic gastritis

A

Presence of chronic inflammation leading to atrophy and absence of grossly visible erosions (as compared to acute version)

35
Q

Major types of chronic gastritis

A
  1. Helicobacter pylori gastritis
  2. Autoimmune gastritis
  3. Chemical gastropathy
36
Q

What is the most common cause of chronic gastritis int he US?

A

Helicobacter pylori gastritis

37
Q

Helicobacter pylori is gram neg or pos?

A

Gram negative

Shows up hot pink

38
Q

TX for helicobacter pylori gastritis

A

Combination therapy with two or three ABx with a proton pump inhibitor

39
Q

What does H pylori cause

A

Atrophic mucosa decreases parietal chief cells (MALT)

-B cell lymphoma risk

40
Q

Autoimmune chronic gastritis

A
  • 10% of people
  • Associated with other autoimmune disorders (DM type I)
  • anemia, atrophy leading to adenocarcinoma
  • -macrocytic anemia due to lack of B12 absorption, no intrinsic factor
41
Q

Chemical gastropathy gastritis

A

Chronic injury due to alkaline duodenal reflux (pancreatic secretions and bile)

42
Q

Number one cause of ulcers and predict the most likely cancer it may cause

A

Peptic ulcer disease

Gastronomes

43
Q

Who is most likely to get peptic ulcer disease

A

Blood group O

44
Q

Zollinger-Ellison syndrome

A

Rare condition with irrespective gastrinoma induodenum and pancreas 2/3 are malignant and 1/3 have metastasized at time of Dx

45
Q

Stress ulcers

A

Curling ulcers

Cushing ulcers

46
Q

Risk factors for stomach cancer

A

Genetic predisposition
Carcinogens like N-nitroso compounds in preserved and smoked foods
Autoimmune gastritis
Gastric adenoma and polyps

Symptoms are vague when they occur: detection is difficult

47
Q

What disorder is associated with food and drink not going down

A

Achalasia

48
Q

What cancer is associated with achalasia

A

Esophageal adenocarcinoma

Pathology Block 11 (8 decks)

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