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PathoPharm 2 > GI dysfxn > Flashcards

GI dysfxn Flashcards

1
Q
  • Nausea Common symptoms:
A

hypersalivation and tachycardia

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2
Q

Steatorrhea

A

fat in the stools

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3
Q

iochemical mediators of the inflammatory response

A

histamine, bradykinin, and serotonin

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4
Q

o Upper GI bleeding location

A

Esophagus, stomach, or duodenum

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5
Q

o Lower GI bleeding locations

A

Below the ligament of Treitz, or bleeding from the jejunum, ileum, colon, or rectum

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6
Q

o Sliding hiatal hernia

A

stomach usually only protrudes into chest cavity on swallowing

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7
Q

o Paraesophageal hiatal hernia

A

stomach bulge protrudes into chest cavity beside esophagus

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8
Q

o An intestinal obstruction is any condition that

A

prevents the flow of chyme through the intestinal lumen or failure of normal intestinal motility in the absence of an obstructing lesion

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9
Q

o An ileus is an obstruction of the

A

intestines

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10
Q

o Functional obstruction

A

loss of function or paralysis commonly seen after surgery, opioids

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11
Q

o Small intestinal obstruction vs Large bowel obstruction s/s

A

pain in cramps and spasms with short (minutes) duration
widespread lower abdominal pain, spasms last longer

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12
Q

Most common of the peptic ulcers

A

Duodenal ulcers

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13
Q

Duodenal ulcers patho

A

 H. pylori infection - Toxins and enzymes that promote inflammation and ulceration
 Hypersecretion of stomach acid and pepsin
 High gastrin levels
NSAIDs,  Acid production by cigarette smoking

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14
Q

Gastric Ulcer: * Tends to develop in the _region of the stomach, adjacent to the acid-secreting mucosa of the body

A

antral

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15
Q

Gastric Ulcer patho

A

primary defect is an increased mucosal permeability to hydrogen ions
o Gastric secretion is normal or less than normal

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16
Q

Ulcers that develop due to increased intracranial pressure which stimulates vagal nerve and triggers increased gastric acid secretion

A

Cushing’s ulcers

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17
Q

Ulcers that develop as a result of a burn injury

A

o Curling’s ulcers

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18
Q
  • Pancreatic insufficiency main problem
A

o Fat maldigestion is the main problem, so the person will exhibit fatty stools and weight loss

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19
Q
  • Bile salt deficiency
A

o Poor intestinal absorption of lipids causes fatty stools, diarrhea, and loss of fat-soluble vitamins (A, D, E, K)

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20
Q

o Conjugated bile salts are synthesized from _in the _

A

cholesterol, liver

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21
Q
  • Fat-soluble vitamin deficiencies A
A

Night blindness

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22
Q

Fat-soluble vitamin deficiencies E

A

Uncertain

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23
Q
  • Fat-soluble vitamin deficiencies D
A

Decreased calcium absorption, bone pain, osteoporosis, fractures

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24
Q
  • Fat-soluble vitamin deficiencies K
A

Prolonged prothrombin time, purpura, and petechiae

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25
Q

Ulcerative Colitis: * Chronic inflammatory disease that causes ulceration of the colonic mucosa

A
  • Sigmoid colon and rectum
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26
Q
  • Increased colon cancer risk demonstrated
A

ulcerative colitis

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27
Q

Crohn Disease

A
  • Idiopathic inflammatory disorder; affects any part of the digestive tract, from mouth to anus. * Causes “skip lesions”, which can be seen as lesion in some haustra but not others. * Ulcerations can produce longitudinal and transverse inflammatory fissures that extend into the lymphatics
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28
Q

Crohn Disease can cause malabsorp of

A

vitamin B12 and folic acid

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29
Q

Asymptomatic diverticular disease

A
  • Diverticulosis
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30
Q

Herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon

A
  • Diverticula
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31
Q

Appendicitis s/s

A

Epigastric and RLQ pain, rebound tenderness. Nausea, vomiting, fever, leukocytosis

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32
Q

Appendicitis most serious complication

A

peritonitis

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33
Q
  • Blood supply to the stomach and intestine
A

o Celiac axis
o Superior and inferior mesenteric arteries

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34
Q

how many arteries required to cause vascular insufficiency

A

o Two of three must be compromised to cause ischemia

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35
Q
  • Obesity Body fat index
A

> 30

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36
Q
  • Leptin resistance
A

Failure of hypothalamus to react to released leptin

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37
Q
  • Anorexia nervosa o In females, characterized by
A

absence of three consecutive menstrual periods

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38
Q

ANOREXIA - Person can lose _to _% of ideal body weight due to fat and muscle depletion

A

25-30%

39
Q
  • Bulimia nervosa
A

 Two binge-eating episodes per week for at least 3 months

40
Q

o Short-term starvation

A

Glycogenolysis, Gluconeogenesis

41
Q

 Marasmus

A

Protein energy malnutrition seen in absolute food deprivation. Results in dry skin, elimination of fat deposits, irritable behavior

42
Q

 Kwashiorkor

A

Protein deprivation with carbohydrate ingestion. Swollen, bloated abdomen secondary to decreased albuminemia, muscle atrophy, diarrhea.

43
Q

HEPATITIS B: * Maternal transmission if the mother is infected during

A

the third trimester

44
Q
  • Responsible for most cases of post-transfusion hepatitis
A

Hepatitis C

45
Q
  • 50% to 80% of hepatitis C cases result in
A

chronic hepatitis

46
Q

Depends on hepatitis B for replication

A
  • Hepatitis D
47
Q
  • Hepatitis E transmission
A

Fecal-oral

48
Q
  • Acute hepatic failure
A

Acetaminophen overdose

49
Q
  • Irreversible inflammatory disease that disrupts liver function and even structure
  • Decreased hepatic function from nodular and fibrotic tissue synthesis (fibrosis)
  • Biliary channels become obstructed and cause portal hypertension; due to the hypertension, blood shunted away from the liver, and a hypoxic necrosis develops
A

Cirrhosis

50
Q

o Cirrhosis begins in

A

bile canaliculi and ducts

51
Q

Cleft Lip and Cleft Palate are developmental anomalies of the

A

first brachial arch

52
Q

Cleft Lip Is caused by the incomplete fusion of the nasomedial or intermaxillary process during the

A

fourth week of development.

53
Q

Cleft Palate * Results from the incomplete fusion of the primary palatal shelves during the

A

third month of gestation.

54
Q

tends to cause repeated infections of the paranasal sinuses and middle ear.

A

o Cleft palate

55
Q

Tracheoesophageal fistulas o Defective differentiation as the trachea separates from the esophagus during the

A

fourth to sixth weeks of embryonic development

56
Q

Tracheoesophageal fistulas Associated with

A

polyhydramnios (excessive amniotic fluid)

57
Q

Pyloric Stenosis risk factors

A

o Increased gastrin secretion by the mother in the last trimester
o Overproduction of gastric secretions in the infant that may be caused by stress-related factors in the mother
o Exogenous administration of prostaglandin E

58
Q

o Colon remains in the upper right quadrant

A

Intestinal Malrotation

59
Q

Meconium Ileus common in newborns with

A

cystic fibrosis

60
Q

another one a/w cystic fibrosis

A

Distal Intestinal Obstruction Syndrome

61
Q
  • Most common congenital malformation of the gastrointestinal tract
A

Meckel Diverticulum

62
Q

Meckel Diverticulum rule of 2

A

o Occurs in approximately 2% of the population.
o Two percent develop complications usually before 2 years of age.
o Two types of common ectopic tissue (gastric and pancreatic) have been identified.
o Is located within 2 feet of the ileocecal valve.

63
Q

Meckel Diverticulum - Most common symptom

A

Painless rectal bleeding

64
Q

Meckel Diverticulum Develops when the _duct fails to obliterate

A

omphalomesenteric

65
Q

Congenital Aganglionic Megacolon Hirschsprung disease: * Functional obstruction of the colon caused by an absence of the_ with inadequate motility by PSNS

A

enteric ganglia (Meissner and Auerbach plexuses)

66
Q

first sign of hirschsprung

A

Diarrhea

67
Q

currant jelly stool sign

A

intussusception

68
Q

most common scenario of intussusception

A

Ileum invaginating into the cecum

69
Q

in newborns, reflux is

A

normal

70
Q

Cystic Fibrosis mutation of

A

long arm of chromosome 7

71
Q

Cystic Fibrosis * Classic triad

A

o Deficiency of pancreatic enzyme - beta cell damage to DM
o Overproduction of mucus in the respiratory tract
o Abnormally elevated sodium and chloride concentrations

72
Q

o 72-hour stool fat measurements: Determines the extent of pancreatic function
o Carbon-13 (13C) mixed triglyceride breath test: Simple, noninvasive way of assessing the need for pancreatic enzyme supplementation in children

A

Cystic Fibrosis eval

73
Q

o Causes T cell–mediated autoimmune injury to the intestinal epithelial cells.

A

Gluten-Sensitive Enteropathy (Celiac Sprue or Disease)

74
Q
  • Dermatitis herpetiformis
A

specific cutaneous manifestation of gluten-sensitive enteropathy.
o Involves transglutaminase 3 immunoglobulin A (IgA) autoantibodies.
o IgA autoantibodies circulate to the skin and interact with antigens produced by keratinocytes.
o Antigen-antibody complex activates neutrophils in the papillary dermis, causing blister formation.

75
Q

kwashiorkor vs marasmus

A
  • Presence of subcutaneous fat, hepatomegaly, and fatty liver
76
Q

Failure to Thrive eval

A

Falls below the third percentile on the growth curve or falls off a previously established growth curve

77
Q

most common gastrointestinal emergency of the newborn.

A

Necrotizing Enterocolitis

78
Q

Necrotizing Enterocolitis: The more, the greater the risk

A

premature

79
Q

Necrotizing Enterocolitis: s/s

A

o Abdominal pain, unstable temperature, bradycardia, apnea

80
Q

Necrotizing Enterocolitis:tx

A

o Cessation of feeding formula milk
o Avoidance of H2-receptor antagonists
o Initiation of enteral feeding started as soon as possible
o Gastric suction: To decompress the intestines
o Maintenance of fluid and electrolytes
o Administration of antibiotics: To control sepsis

81
Q

leading cause of severe diarrhea in infants and young children worldwide.

A

rotavirus

82
Q
  • Chronic diarrhea
A

Lasts longer than 2 weeks.

83
Q

o Zinc supplements and children

A

Not used in children younger than 6 months of age

84
Q

o Most common cause of jaundice in newborn

A

Hemolytic disease of the newborn

85
Q
  • Kernicterus
A

Chronic bilirubin encephalopathy

86
Q

Physiologic Jaundice of the Newborn EVAL

A

Total serum bilirubin greater than 20 mg/dl or Indirect bilirubin greater than 15 mg/dl

87
Q
  • Primary clinical manifestation of biliary atresia
A

Jaundice

88
Q

o Main cause of portal hypertension in children
most common sign

A

Obstruction of the portal vein
splenomegaly

89
Q

Wilson disease genetics

A

autosomal recessive . loss of ATP7B gene expression located on chromosome 13.

90
Q

 Kayser-Fleischer rings

A

Accumulation of copper in the limbus of the cornea, causing a greenish-yellow ring

91
Q

Wilson Disease ABNORM

A

toxic levels of copper to accumulate in the liver, brain, kidneys, and corneas. Failure to insert copper into ceruloplasmin, which is a glycoprotein that transports copper in the blood ( Low ceruloplasmin levels)

92
Q

Only therapy for Wilson disease

A

o Liver transplantation

93
Q

ALOSETRON

A

only approved serotonin antagonist for last chance in women with IBS

PathoPharm 2 (3 decks)

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