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SUMPHYS2 > GI Disorders > Flashcards

GI Disorders Flashcards

1
Q

What is dysphagia?

A

Difficulty swallowing.

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2
Q

What is the term for painful swallowing?

A

Odynophagia

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3
Q

What initiates swallowing? Is this voluntary or involuntary?

A

Skeletal muscle. This is VOLUNTARY.

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4
Q

What is the purpose of the C shaped rings of the trachea in regards to eating?

A

C shaped in order to allow flexibility of the posterior trachea —> bolus of food traveling down can protrude a bit into the trachea.

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5
Q

What are 4 possible causes of dysphagia?

A
  1. Stroke 2. Strictures (narrowing of the esophagus) 3. Connective tissue disease 4. Abnormal esophageal tone
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6
Q

What is the difference between regurgitation and vomiting?

A

Whether or not the food got to the stomach. Esophagus —> mouth = regurgitation. Stomach —> mouth = vomiting **Looks different than when it went in d/t acid and enzymes.

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7
Q

What is an esophageal diverticulum?

A

Outpouching of the muscularis layer of the esophageal wall. **Weakness of the wall of the esophagus —> balloons out.

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8
Q

What complication can occur with an esophageal diverticulum?

A

Food can get stuck due to the diverticulum blocking the space of the esophagus —> regurgitated.

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9
Q

What is achalasia?

A

Motor disorder of the distal third of the esophagus and the lower esophageal sphincter —> loss of peristalsis and relaxation —> narrowing of the esophagus.

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10
Q

How long does it usually take for people with achalasia to get diagnosed?

A

4.7 years.

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11
Q

What are the symptoms of achalasia?

A

Dysphagia of solids (most often) and liquids, regurgitation, difficulty belching, and heartburn (d/t leakage of acid).

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12
Q

What is the classic radiologic finding for achalasia?

A

Bird’s beak shape to the lower esophagus.

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13
Q

What are the possible presentations of GERD?

A

Classic: heartburn or regurgitation. Atypical: - Cough - Asthma - Laryngitis - Chest pain - Hiccups

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14
Q

Why can GERD show up as an asthma exacerbation?

A

Stomach acid is an irritant, and it getting into a hypersensitive airway can lead to an exacerbation.

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15
Q

What are hiccups?

A

Spasm of the diaphragm.

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16
Q

What is the general cause of hiccups?

A

Irritation of the phrenic nerve —> spasm. **This can be caused by a SERIOUS condition. Take chronic hiccups seriously.

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17
Q

What is the prevalence of GERD?

A

1 in 5 people experience heartburn or regurgitation weekly. 2 in 5 experience it monthly. *1/3 of Americans

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18
Q

What is the cause of GERD?

A

Weak or incompetent lower esophageal sphincter.

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19
Q

What kind of cells lie within the mouth and esophagus? The stomach?

A

Stratified squamous cells in mouth and esophagus. Columnar epithelial cells with goblet cells that produce a mucus = stomach.

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20
Q

Where does most of our absorption occur?

A

The intestines. *Only a small amount of absorption occurs in the stomach (alcohol, aspirin, some water). Zero order A.P.E.

21
Q

What is esophagitis?

A

Irritation and damage of the esophagus d/t acidic gastric fluid reflux.

22
Q

What can chronic esophagitis lead to? Describe this condition.

A

Barrett’s esophagus: metaplasia of the distal esophagus. This leads to an increased risk of esophageal cancer. Metaplasia —> neoplasia.

23
Q

What are the 2 types of esophageal cancer? Where do each of these usually occur?

A
  • Squamous cell carcinoma —> proximal 2/3 of esophagus. - Adenocarcinoma (slightly more common) —> distal 1/3 of esophagus.
24
Q

What type of esophageal cancer arises from Barrett’s esophagus?

A

Adenocarcinoma.

25
Q

What are the causes of squamous cell carcinoma of the esophagus?

A
  • Alcohol and tobacco use. - HPV **Can be related to socioeconomic status.
26
Q

What is the treatment of GERD?

A
  1. Raise the head of the bed. Stay upright after meals x30 mins. 2. Diet changes —> limit caffeine (d/t it causing dysfunction of the sphincter), peppermint, alcohol (relaxes the sphincter). 3. More frequent, smaller meals. 4. Pharmacologic treatment: PPIs and H2 blockers (also good for allergies!)
27
Q

How do proton pump inhibitors work?

A

They suppress gastric acid secretion by blocking the last step of acid production (H+ being released). *Best result when used for several weeks at a time —> long-term result.

28
Q

Should people use PPIs chronically?

A

No! D/t possible development of osteoporosis, pneumonia, C Diff, B12 deficiency, kidney disease, and dementia.

29
Q

What medications are used for acute exacerbations of GERD?

A

Antacids (i.e. Tums).

30
Q

What is acute gastritis?

A

Transient inflammation of the gastric lining, associated with an exposure to irritants —> local inflammatory response —> edema and increased blood flow (hyperemia).

31
Q

What is chronic gastritis?

A

Chronic inflammation of glandular epithelium of the stomach —> atrophy —> loss of normal columnar epithelium, loss of SA.

32
Q

What is a complication of chronic gastritis?

A

Transformation into dysplasia and cancer!

33
Q

What habits are associated with chronic gastritis?

A
  • Alcohol - Tobacco - Chronic use of NSAIDs. **This is d/t prostaglandin inhibition —> thinning of mucosal layer.
34
Q

What are the 3 types of chronic gastritis?

A
  1. Autoimmune —> peptic ulcer, pernicious anemia, gastric carcinoma. 2. H Pylori —> gastric atrophy, metaplasia, and gastric cancer. 3. Chemical gastritis.
35
Q

What is a peptic ulcer?

A

A small round, hole punch erosion in the lining of the stomach.

36
Q

What is the cause of peptic ulcer disease?

A

ASA, NSAIDs, H Pylori, or alcohol damage the gastric mucosa —> disrupting the membrane —> H+ ions move into the tissue and accumulates in the mucosal cells —> intracellular pH decreases —> local ischemia, vascular stasis, hypoxia, and tissue necrosis.

37
Q

Where is the most common location for peptic ulcers to occur? Why?

A

duodenum. This is because Brunner glands that typically protect this area from acid by secreting large amounts of alkaline mucus are strongly influenced by ANS activity. Therefore during sympathetic stimulation, production is decreased significantly —> leaving this area more susceptible to irritation.

38
Q

What population is at the highest risk for peptic ulcer disease?

A

Men. - Early adulthood for duodenal ulcers. - 50-75 y/o for gastric ulcers.

39
Q

What layers of the stomach can be affected with peptic ulcer disease?

A
  • Mucosa - Smooth muscle - Serosa
40
Q

What are the 3 complications that can occur from peptic ulcer disease?

A
  1. Hemorrhage -d/t involvement of the submucosal layer where vessels lie 2. Perforation d/t involvement of the serosa 3. Obstruction d/t edema, spasm, or scar tissue within the smooth muscle layer
41
Q

What is Zollinger-Ellison syndrome?

A

Gastrinoma, or gastrin secreting tumor that is usually found in the pancreas, stomach, or duodenum. Increased gastric acid secretion —> intractable ulcer.

42
Q

What are the symptoms of Zollinger-Ellison Syndrome?

A

Dyspepsia- similar to GERD, recurrent ulcers, and blood in the stool.

43
Q

What are the causes of stress ulcers (aka curling ulcers)?

A
  • Burns - Hemorrhage - Surgery, ICU —> severe dehydration —> hypoperfusion of the stomach lining.
44
Q

What part of the stomach is most likely to be involved in a stress ulcer?

A

fundus of the stomach.

45
Q

What are risk factors for developing stomach cancer?

A
  • Genetic predisposition - N-nitroso compounds i.e. cured meats - Autoimmune gastritis - Gastric adenoma (benign polyps) —> can transform.
46
Q

What tissue changes occur with a malignant ulcer?

A

Large ulcer with either irregular or inverted margins —> loss of rugae, bleeding.

47
Q

What organism is associated with peptic ulcers?

A

H. Pylori! Found in 100% of duodenal ulcers, and in 70% of gastric ulcers. This is correlation, not causation.

48
Q

Is H Pylori without symptoms enough to treat for peptic ulcer disease?

A

NO! It is likely that many people carry H Pylori and don’t get ulcers. If a patient is symptomatic and positive, then treat.

SUMPHYS2 (27 decks)

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