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Pathophysiology > GI Disorders > Flashcards

GI Disorders Flashcards

1
Q

Functions of the GI System

A

Ingestion and Digestion of Nutrients
Absorption of Nutrients
Elimination of Wastes
Protection of Immunity

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2
Q

Etiologies of GI Disorders

A

Gut perfusion and motility
Nutrient Absorption
Structural Integrity
Neoplasia

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3
Q

6 GI Tissue Layers

A
  1. Mesentery
  2. Serosa
  3. Enteric Plexus
  4. Submucosa
  5. Mucosa
  6. Muscularis
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4
Q

GI Mucus Cell Turnover

A

Rapid (3-4 Days)

More rapid during stress

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5
Q

GI Translocation

A

Cells aren’t getting enough food -> Tissue erodes from outermost layer -> Byproducts may leak into the abdomen and cause infection/ Pathogens escape from inside gut structures and get into lymph, blood vessels, and abdominal cavity.
Source of MODS

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6
Q

Clinical Manifestations of GI Alterations

A

Abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting, bleeding

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7
Q

Diarrhea

Definition

A

Inconsistent clinical definition

> 500 mls of watery stool x 2 days (working clinical definition)

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8
Q

Diarrhea - Etiology

A 
Enzyme deficiencies; 
Infection;
Ischemia; 
Fecal Impaction; 
Intake of Highly osmotic substances
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9
Q

What is meant by “highly osmotic substances”?

A

Big molecules that pull water into the gut.

Ex. Sugar, Colloids

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10
Q

Why is it undesirable to give a popsicle to someone with diarrhea?

A

Popsicles contain a lot of sugar which is a highly osmotic substance. Therefore, it pulls more water into the gut and makes diarrhea worse.

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11
Q

Clinical Manifestations of Diarrhea

A

Fluid and Weight loss;
Electrolyte imbalance;
Discomfort (physical and/or embarrassment)

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12
Q

Causes for Abdominal Pain

A

Mechanical;
Inflammatory;
Ischemic

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13
Q

Mechanical Abdominal Pain

A

Rapid Distention/ Stretching

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14
Q

Inflammatory Abdominal Pain

A

Chemical Mediators;

Edema

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15
Q

Ischemic Abdominal Pain

A

Thrombosis;

Tissue Metabolites

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16
Q

Hematemesis

A

Vomiting Blood

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17
Q

Melena

A

Black, tarry stool

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18
Q

Hematochezia

A

Bright red bleeding in stool

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19
Q

Occult Bleeding

A

Cannot see w/ eye

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20
Q

What lab test can indicate GI Bleeding before onset of outward signs?

A

Blood urea nitrogen (BUN);

Free RBCs in the gut releasing globin. Excess nitrogen being picked up in circulation

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21
Q

Increased BUN and normal Creatinine indicates. . .

A

Not kidney related

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22
Q

Increased BUN and Everything normal indicates . . .

A

GI Bleed

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23
Q

Motility Alterations

A

Dysphagia; GERD; Hiatal Hernia;

Gastroparesis; Pyloric and/or Intestinal Obstruction

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24
Q

What are bowel sounds?

A

Function of passage of air, food, and fluid through the GI tract

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25
Q

Gastric Motility

A

Can be accelerated, delayed or absent;

Several hundred mls of gastric fluid can be produced hourly;

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26
Q

Accelerated gastric motility can accompany. . .

A

Dumping syndrome

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27
Q

Delayed or absent gastric motility can indicate . . .

A

Gastroparesis

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28
Q

How often does the stomach normally empty

A

90 minutes

29
Q

What is Dumping Syndrome?

A

Rapid movement of partially digested food/fluid into the small bowel. -> Bowel Brings in large volumes of fluid to compensate.
Rapid changes of electrolytes and fluid within the bowel.

30
Q

Symptoms of Dumping Syndrome

A

Cramping abdominal pain;
Hypovolemia; Hypotension; Hypoglycemia;
Diarrhea

31
Q

What is a Gastrectomy?

A

Surgical removal of the stomach/ food reservoir;

Can lead to dumping syndrome and loss of intrinsic factor

32
Q

What does a loss of intrinsic factor after gastrectomy mean for the body?

A

Vitamin B12 may not be able to be absorbed. Replacement may be necessary.

33
Q

Gastroparesis

Causes

A

Acute Illness/injury
Neuropathy: Diabetes; Chronic Renal Failure; Spinal cord injury;
Neuromuscular Disorders

34
Q

What is gastroparesis?

A

Inadequate emptying of stomach contents.

Retained gastric content leads to abdominal distention which leads to nausea, vomiting and/or aspiration

35
Q

GERD Etiology

A

Backflow of gastric contents into the esophagus;
Relaxation of the lower esophageal sphincter;
Acidity of gastric contents

36
Q

GERD - Pediatrics

A

Common yet most often minor problem;

Resolved by age 6-24 months

37
Q

Complications of GERD - Pediatrics

A

Malnutrition; Pulmonary Aspiration;

Asthma; Esophagitis

38
Q

GERD - Adults

Clinical Manifestations

A

Hoarseness;
Heartburn after eating (worse when supine);
Chest pain (can radiate to throat, shoulders, and back)

39
Q

GERD - Adults

Complications

A

Esophagitis;
Asthma; Laryngeal Injury;
Barrett Esophagus

40
Q

What is Barrett’s Esophagus?

A

Cellular precursor to esophageal cancer

41
Q

Congenital Pyloric Obstruction

A

Seen During infancy;

Characterized by projectile vomiting

42
Q

Acquired pyloric obstruction

A

Peptic ulcer disease;
Cancer; Esophageal fullness; Gastric Distention;
Vomiting

43
Q

Common site of intestinal obstruction

A 
Small bowel (common); 
Can also be in large bowel
44
Q

Acute intestinal obstruction r/t. . .

A

Mechanical cause;

Ex. Surgery, injury, trauma

45
Q

Chronic intestinal obstruction r/t. . .

A

functional cause

46
Q

Intestinal Obstruction Etiology

A

Hernia; Intussuseption; Torsion; Diverticulosis; Tumor; Ileus; Volvulus; Adhesions

47
Q

What is a malabsorption syndrome?

A

abnormality of the mucosa prevents the uptake of nutrients in the small bowel

48
Q

Malabsorption - Etiologies

A

Intestinal Parasites; Gastrectomy;
Celiac Sprue; Enteritis;
Cholecystitis/cholelithiasis

49
Q

What is Celiac Sprue also known as?

A

Gluten sensitive enteropathy

50
Q

Celiac Sprue - Etiology

A

Immune-mediated reaction to gluten protein

51
Q

Celiac Sprue

Manifestations

A

Inflamed bowel; damaged mucosa; loss of vili for digestion;

Osmotic and Secretory diarrhea; Cramping; Nausea/Vomiting; Malabsorption -> Malnutrition

52
Q

GI Inflammatory Disorders

A

Esophagitis; Gastritis;

Peptic Ulcer Disease; Gastric, Duodenal, Stress Ulcers; Pancreatitis; Cholecystitis

53
Q

Esophagitis

A

Gastro-esophageal Reflux;

Irritation by gastric acid; Hiatal Hernia often present

54
Q

Gastritis

A

Disruption of the mucosal barrier of stomach allows auto digestion of the mucosa by HCl

55
Q

Gastritis

Etiology

A

Aspirin;
NSAIDs; Alcohol Ingestion; H. Pylori;
Smoking; Physiologic Stress; Hypersecretion of HCl

56
Q

Acute Gastritis

A

Few Hours to few Days; Self limiting;
Complete healing of the mucosa expected; remove cause;
Treat symptoms

57
Q

Chronic Gastritis

A

Repeated Episodes;
Increases w/ age;
Chronic Exposure to causative agents

58
Q

Peptic Ulcer disease

PUD

A

Ulceration of the GI tract due to acid-pepsin activity;

Esophagus, duodenum, stomach (locations)

59
Q

PUD Etiology

A

Infection w/ H. Pylori (leading cause);
Increased pepsin secretion;
Interruption of the mucosal barrier;
Overuse of aspirin/NSAIDs

60
Q

PUD

Clinical Manifestations

A

Pain;
Occult GI bleeding;
Dark stools

61
Q

Inflammatory Bowel Disease

Types

A

Ulcerative Colitis;

Chrons Disease

62
Q

Chron Disease

A

Can occur in any site of the GI tract;

Can erode through all tissue layers

63
Q

Ulcerative Colitis

A

Only in the colon;

Erodes innermost colon layer

64
Q

Chron Disease

Etiology

A

Unknown;
Familial;
Stress related

65
Q

Chron’s Pathophysiology

A

Lesions Identifies by endoscopy;

Fistulas in bowel, skin, bladder, vagina

66
Q

Chron’s Clinical Manifestations

A

Non-bloody Diarrhea; Malabsorption; weightloss;
Lower abdominal pain; Increased risk of colon cancer;
Anemia; hypoalbuminemia; frequent fistula formation

67
Q

Ulcerative Colitis Etiology

A

Similar to Chron’s;
Familial; Stress-related;
Emotional triggers

68
Q

Ulcerative Colitis

Pathophysiology

A

Rectum and Sigmoid colon affected;
Mucosal edema, erosion; Mucosal thickening;
Bleeding, abscesses

69
Q

Ulcerative Colitis

Clinical Manifestations

A

Large volume of watery diarrhea w/ blood and/or purulent mucus;
Cramping abdominal pain;
Urge to stool; Increased risk of malignancy after 10 years duration

Pathophysiology (5 decks)

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