GI Disorders Flashcards
hormone that is produced in adipose cells
leptin
the most common site affected by UC
rectum and sigmoid colon
client with 5Fs risk factors most likely has…
cholelithiasis
Mother-infant transmission of Hepatitis B Virus (HBV) will have a high vertical transmission rate when the woman is seropositive for both hepatitis B surface antigen (HBsAg) and _______
HBeAg ( Hep B viral protein)
Gastric ulcers are more likely to be seen in patients aged ______
55-65
A colon lesion that may result in obstruction is most likely to be found in the ______
descending colon
The primary diagnostic marker for acute pancreatitis is…
serum lipase
Blockage of the bile duct by gallstones or tumor will result in…
obstructive jaundice
Epigastric pain that is relieved by food is suggestive of…
duodenal ulcer
hereditary nonpolyposis colorectal cancer is an example of a _________ risk factor
non-modifiable
condition caused by reflux of acid and pepsin into the esophagus through the lower esophageal sphincter (LES) that causes erosion of esophageal lining (mucosal injury)
GERD
condition of precancerous lesions in the esophogas which can lead to adenocarcinoma
Barrett’s esophogas
Risk Factors for ______:
Obesity
Hiatal hernia
Drugs that relax the LES (Ca+ channel blockers, nitrates, nicotine)
GERD
Causes of ______:
abnormalities in LES
anything that alters closing strength of LES
increased abdominal pressure
GERD
foods/drink that relax the LES
caffeine
alcohol
fatty foods
chocolate
severity of esophagitis depends on…
composition of gastric contents
exposure time
Heartburn (wet burp/regurgitation) is worse with…
within 1 hour of eating
lying down
increased abdominal pressure
Clinical Manisfestations of \_\_\_\_\_\_: heartburn asthma chronic cough dysphagia w/ weight loss sinusitus laryngitis chest pain
GERD
How GERD is diagnosed?
patient history
clinical manifestations
endoscopy
Findings in endoscopy that confirm \_\_\_\_\_\_: hyperemia edema erosion strictures inflammation poor closure of LES Barrett's (biopsy)
GERD
injury to protective mucosal layer of the stomach resulting in inflammation of the lining (deep or superficial) that occurs with or w/o hemorrhage
gastritis
acute causes of \_\_\_\_\_\_\_: chemicals NSAIDS alcohol histamine metabolic disorders (uremia) h.pylori shock/hypotension
gastritis
NSAIDS cause gastritis by…
being COX1 inhibitors- inhibits mucoasal prostaglandins
prostaglandin action in the stomach
stimulate mucous production
suppress inflammation
h.pylori action in the stomach
inflammation
increased gastric secretions
symptoms of h.pylori in the stomach
pain
n/v
chronic causes of ______:
chronic inflammation
mucosal atrophy
epithelial metaplasia
gastritis
h.pylori results in _____ gastritis
antral
most rare and most severe type of chronic gastritis that affects the fundus and leads to gastric atrophy
Type A: Fundal/Immune
more common type of chronic gastritis that affects the antral
Type B: Antral/Non-Immune
Type B chronic gastritis causes
chronic alcohol use
NSAIDS
tobacco use
Type B chronic gastritis can result in high levels of…
hydrochloric acid
increased secretion of hydrochloric acid leads increases risk of _______
duodenal ulcers
condition when Type B gastritis progresses to include Type A and antrum is more severely involved
Type AB: Pan Gastritis
type of gastritis associated with secretion of bile and pancreatic secretions into the stomach causing chemical injury
Type C Gastritis
break or ulcer of the mucosal lining of the lower esophagus, stomach or duodenum
Peptic Ulcer Disease
Risk Factors for \_\_\_\_\_\_: Genetics H. Pylori ASA & NSAIDS ETOH smoking COPD obesity Stress (unknown why) Age < 65 y.o
Peptic Ulcer Disease (PUD)
most common form of ulcer
duodenal
duodenal ulcers are most commonly caused by…
h.pylori and NSAIDS
duodenal ulcers are negatively associated with…
gastric cancer
symptoms of \_\_\_\_\_\_\_: chronic/intermittent abdominal pain pain occuring 30 min-2 hrs after eating pain relieved by ingestion of food weight gain
duodenal ulcers
PUD is diagnosed with…
UGI, endoscopy, and h.pylori tests
______ testing is recommended for any peptic ulcer
h.pylori
90% of DU and 80% of GU are caused by…
h.pylori
bacteria that releases toxins and enzymes that promote inflammation and ulcers
h.pylori
h.pylori infections cause increase of…
acid
pepsin
gastrin
pepsinogen
ulcers in the antral portion of the stomach that are more prevalent in adults 55-65 yo caused by defect that increases permeability of hydrogen ions in the mucosa
gastric ulcers
Risk Factors for \_\_\_\_\_\_\_: H. Pylori NSAIDS duodenal reflux Type A: Immune chronic gastritis
Gastric Ulcers
Symptoms of _______:
pain that occurs immediately after eating then relieved
N/V
anorexia
Gastric Ulcers
inflammation of the vermiform appendix due to obstruction by fecalith (stone made of feces)
appendicitis
Symptoms of \_\_\_\_\_\_\_\_: epigastric or peri-umbilical pain in 1st 24 hrs increasing in intensity over 3-4 hrs RLQ pain with rebound tenderness at McBurney's point n/v anorexia fever diarrhea (especially in children) sense of constipation LLQ tenderness leukocytosis (on CBC)
appendicitis
presence of out-pouching herniations of mucosa through the colon muscular wall
diverticular disease
Risk Factors for \_\_\_\_\_\_\_\_\_: Older age (>60) Smoking Obesity Genetic predisposition Diet Physical inactivity ASA /NSAIDS
diverticular disease
Diverticular Disease is most common in…
left colon (descending and sigmoid colon)
chronic inflammatory disease most commonly of the mucosa of the rectum and sigmoid colon, where large ulcers form
Ulcerative Colitis (UC)
UC starts at the rectum but may extend to…
the entire colon
Clinical Manifestations of \_\_\_\_\_: bloody diarrhea water diarrhea passage of purulent mucous lower abdominal pain rare: shock w/ severe blood loss
Ulcerative Colitis (UC)
in acute phase of UC, fever is caused by…
activated macrophages and cytokines
UC for multiple years (7-10) can increase risk of…
colon cancer
Risk Factors for \_\_\_\_\_\_\_: 20-40 yo Family Hx Jewish descent Caucasian and northern European
Ulcerative Colitis (UC)
UC is limited to _____ and does not involve _____
mucosa, skip lesions
in chronic UC, _______ develops from rapidly regenerating epithelium
inflammatory polyps
an idiopathic, autoimmune, inflammatory disorder that may affect any part of the GI tract from the mouth to the anus (ascending and transverse colon most common sites)
Chron’s Disease
inflammatory bowel disorder that results in transmural inflammation and skip lesions (normal areas interspersed with abnormal areas)
Chron’s Disease
progression of Chron’s causes
abscess formation
crypt destruction
cobblestone projections of inflamed tissue/fissures, surrounded by areas of ulceration
Chron’s Disease
Chronic inflammation of all layers of intestinal wall resulting from blockage of lymphoid and lymphatic vessels
Chron’s Disease
Clinical Manifestations of _________:
only sx may be “irritable bowel”
Intermittent bouts of fever, diarrhea (if the diarrhea is bloody, it isn’t as severe or bloody as seen with ulcerative colitis)
> 5 stools per day
RLQ pain and may have RLQ mass and tenderness.
Anemia may occur due to malabsorption of iron, B12 and folic acid
Weight loss
Anal fissure, perianal abscess and fistulas
Steatorrhea (excretion of abnormal amounts of fat with the feces d/t reduced absorption of fat by the intestines)
Chron’s Disease
Diverticula form at _____ in the colon wall
weak points where arteries penetrate
lack of fiber and altered intestinal microbe might contribute to…
diverticular disease
_____ and ______ causes intestinal wall thickening and contributes to increased pressure and herniation
increased collagen and elastin deposits
Symptoms of \_\_\_\_\_\_\_: may be asymptomatic diarrhea constipation flatulence
Diverticulosis
Symptoms of _______:
fever
acute LLQ pain
leukocytosis
Diverticulitis
