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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
Gastric Motility
Can be accelerated, delayed or absent; | Several hundred mls of gastric fluid can be produced hourly;
26
Accelerated gastric motility can accompany. . .
Dumping syndrome
27
Delayed or absent gastric motility can indicate . . .
Gastroparesis
28
How often does the stomach normally empty
90 minutes
29
What is Dumping Syndrome?
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
Symptoms of Dumping Syndrome
Cramping abdominal pain; Hypovolemia; Hypotension; Hypoglycemia; Diarrhea
31
What is a Gastrectomy?
Surgical removal of the stomach/ food reservoir; | Can lead to dumping syndrome and loss of intrinsic factor
32
What does a loss of intrinsic factor after gastrectomy mean for the body?
Vitamin B12 may not be able to be absorbed. Replacement may be necessary.
33
Gastroparesis | Causes
Acute Illness/injury Neuropathy: Diabetes; Chronic Renal Failure; Spinal cord injury; Neuromuscular Disorders
34
What is gastroparesis?
Inadequate emptying of stomach contents. | Retained gastric content leads to abdominal distention which leads to nausea, vomiting and/or aspiration
35
GERD Etiology
Backflow of gastric contents into the esophagus; Relaxation of the lower esophageal sphincter; Acidity of gastric contents
36
GERD - Pediatrics
Common yet most often minor problem; | Resolved by age 6-24 months
37
Complications of GERD - Pediatrics
Malnutrition; Pulmonary Aspiration; | Asthma; Esophagitis
38
GERD - Adults | Clinical Manifestations
Hoarseness; Heartburn after eating (worse when supine); Chest pain (can radiate to throat, shoulders, and back)
39
GERD - Adults | Complications
Esophagitis; Asthma; Laryngeal Injury; Barrett Esophagus
40
What is Barrett’s Esophagus?
Cellular precursor to esophageal cancer
41
Congenital Pyloric Obstruction
Seen During infancy; | Characterized by projectile vomiting
42
Acquired pyloric obstruction
Peptic ulcer disease; Cancer; Esophageal fullness; Gastric Distention; Vomiting
43
Common site of intestinal obstruction
``` Small bowel (common); Can also be in large bowel ```
44
Acute intestinal obstruction r/t. . .
Mechanical cause; | Ex. Surgery, injury, trauma
45
Chronic intestinal obstruction r/t. . .
functional cause
46
Intestinal Obstruction Etiology
Hernia; Intussuseption; Torsion; Diverticulosis; Tumor; Ileus; Volvulus; Adhesions
47
What is a malabsorption syndrome?
abnormality of the mucosa prevents the uptake of nutrients in the small bowel
48
Malabsorption - Etiologies
Intestinal Parasites; Gastrectomy; Celiac Sprue; Enteritis; Cholecystitis/cholelithiasis
49
What is Celiac Sprue also known as?
Gluten sensitive enteropathy
50
Celiac Sprue - Etiology
Immune-mediated reaction to gluten protein
51
Celiac Sprue | Manifestations
Inflamed bowel; damaged mucosa; loss of vili for digestion; | Osmotic and Secretory diarrhea; Cramping; Nausea/Vomiting; Malabsorption -> Malnutrition
52
GI Inflammatory Disorders
Esophagitis; Gastritis; | Peptic Ulcer Disease; Gastric, Duodenal, Stress Ulcers; Pancreatitis; Cholecystitis
53
Esophagitis
Gastro-esophageal Reflux; | Irritation by gastric acid; Hiatal Hernia often present
54
Gastritis
Disruption of the mucosal barrier of stomach allows auto digestion of the mucosa by HCl
55
Gastritis | Etiology
Aspirin; NSAIDs; Alcohol Ingestion; H. Pylori; Smoking; Physiologic Stress; Hypersecretion of HCl
56
Acute Gastritis
Few Hours to few Days; Self limiting; Complete healing of the mucosa expected; remove cause; Treat symptoms
57
Chronic Gastritis
Repeated Episodes; Increases w/ age; Chronic Exposure to causative agents
58
Peptic Ulcer disease | PUD
Ulceration of the GI tract due to acid-pepsin activity; | Esophagus, duodenum, stomach (locations)
59
PUD Etiology
Infection w/ H. Pylori (leading cause); Increased pepsin secretion; Interruption of the mucosal barrier; Overuse of aspirin/NSAIDs
60
PUD | Clinical Manifestations
Pain; Occult GI bleeding; Dark stools
61
Inflammatory Bowel Disease | Types
Ulcerative Colitis; | Chrons Disease
62
Chron Disease
Can occur in any site of the GI tract; | Can erode through all tissue layers
63
Ulcerative Colitis
Only in the colon; | Erodes innermost colon layer
64
Chron Disease | Etiology
Unknown; Familial; Stress related
65
Chron’s Pathophysiology
Lesions Identifies by endoscopy; | Fistulas in bowel, skin, bladder, vagina
66
Chron’s Clinical Manifestations
Non-bloody Diarrhea; Malabsorption; weightloss; Lower abdominal pain; Increased risk of colon cancer; Anemia; hypoalbuminemia; frequent fistula formation
67
Ulcerative Colitis Etiology
Similar to Chron’s; Familial; Stress-related; Emotional triggers
68
Ulcerative Colitis | Pathophysiology
Rectum and Sigmoid colon affected; Mucosal edema, erosion; Mucosal thickening; Bleeding, abscesses
69
Ulcerative Colitis | Clinical Manifestations
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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