GI Gastritis and forward Flashcards
Inflammatory disorder of the gastric mucosa
gastritis
causes of acute gastritis
Helicobacter pylori, NSAIDs, drugs, chemicals
clinical manifestations of acute gastritis
Vague abdominal discomfort, epigastric tenderness, and bleeding
trmt for acute gastritis
Discontinue injurious drugs.
Administer antacids.
Decrease acid secretion with H2 receptor antagonist and proton pump inhibitor
tell me about chronic fundal gastritis
Immune
Type A
Associated with autoantibodies to parietal cells and intrinsic factor, resulting in gastric atrophy and pernicious anemia
tell me about Chronic Antral Gastritis
Nonimmune
Type B
Associated with H. pylori and NSAIDs
alkaline reflux gastritits
Stomach inflammation caused by reflux of bile and alkaline pancreatic secretions
clinical manifestations of alkaline reflux gastritis
nausea, bilious vomiting, sustained epigastric pain that worsens after eating
what is peptic ulcer disease
A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum
types of peptic ulcers
acute, superficial, superficial, and deep
risk factors for peptic ulcer disease
genetics, H pylori, chronic use of NSAIDS, Excessive use of alcohol, smoking, acute pancreatitis, chronic obstructive pulmonary disease, obesity, cirrhosis, and over 65 years of age
MC peptic ulcer
duodenal
risks for developing duodenal ulcers
lots of parietal cells, high gastrin levels, rapid gastric emptying, smoking
clinical manifestations of duodenal ulcers
chronic intermittent pain in epigastric area 30min-2 hrs after eating, relieved by food
where do gastric ulcers develop
antral region of stomach
how is gastrin secretion in gastric ulcers
normal or less than normal
primary defect in gastric ulcers
inc mucosal permeability to hydrogen ions
trmt for duodenal ulcers
antacids, proton pump inhibitors, antibiotics, surgery
how can you reduce risk of duodenal ulcers
diet high in vitamin A and fiber
cause of gastric ulcers
h pylori
clinical manifestations of gastric ulcers
chronic pain immediately after eating, anorexia, vomiting, weight loss
trmt for gastric ulcers
same as duodenal
stress ulcer?
peptic ulcer related to a severe illness, organ failure, or trauma.
when does an ischemic ulcer develop
within an hour of the event
when does an curling ulcer develop
after burn from ischemia
when does a cushing ulcer develop
head trauma or brain surgery from hypersecretion of HCl from the vagal nuclei
clnical manifestations of stress ulcers
bleeding
trmt for stress ulcers
prophylactic therapy
IBD
Chronic, relapsing inflammatory bowel disorders of unknown cause
types of IBD
ulcerative colitis and Crohns
theories for causes of IBD
Genetics, changes of epithelial barrier functions, reactions to intestinal flora, Abnormal T-cell response
where does ulcerative colitis occur
superficial and only in colonic mucosa
where does chrons occur
transmural and along the entire GI tract
which IBD is granulomatous in character
chrons
risk factors for IBD
genetic, environmental
Immunodulation may be defective in which IBD
chrons
what does Immunodulation lead to
uncontrolled inflammation by cytokines and macrophages
common features to all IBD
mucosal ulceration and inflammation of the GI tract
what is ulcerative colitis?
Is a chronic inflammatory disease that causes ulceration of the sigmoid colon and rectum mucosa
this IDB is common in ppl 20-40 yo of jewish descent
ulcerative colities
causes of ulcerative colitis
infectious, immunologic (anticolon antibodies), dietary, genetics
tell me about the lesions in ulcerative colitis
continuous with no skipped lesions, limited to the mucosa, not transmural
clinical manifestations of ulcerative colitis
Diarrhea (10 to 20 bowel movements per day), bloody stools, cramps, Remission and exacerbations
trmt for ulcerative colitis
5-aminosalicylic acid, steroids and salicylate, immunosuppressives, broad spectrum antibiotics, surgery
Nucleotide-binding oligomerization domains (CARD15/NOD2) gene mutations has a strong association with what
crohns
ulcerations in this disease have a cobblestone appearance
crohns
tell me about the ulcerations in crohns
Longitudinal and transverse inflammatory fissures extend into lymphoid tissue
clinical manifestations of crohns
Abdominal pain and diarrhea (MC signs), more than five stools per day, anemia may result from malabsorption of VB12 and folic acid.
what IBD are skip lesions common in
crohns
what IBD bloody stools common in
ulcerative colitis
what IBD is steatorrhea common in
crohns
what IBD is antineutrophil cytoplasmic antibody common in
ulcerative colitis
what IBD is antisaccharomyces cerevisiae antibody common in
chrons
diverticula
Herniation of mucosa through the muscle layers of the colon wall
diverticulosis
Asymptomatic diverticular disease
diverticulitis
Inflammatory stage of diverticulosis
causes of diverticular diseases of colon
over 60 yo, decreased dietary fiber, increased intracolonic pressure, abnormal neuromuscular function, and changes in intestinal motility
clinical manifestations of diverticular disease of the colon
Low cramping abdominal pain, diarrhea, constipation, distension, flatulence
Diverticulitis: Fever, leukocytosis
functional gastrointestinal disorder with symptoms attributable to the mid or lower gastrointestinal tract not explained by identifiable structural or biochemical abnormalities
functional bowel disorder
mc gi diagnosis in us
IBS
mc referral to gastroenterology
IBS
what is IBS
Bouts of alternating diarrhea and constipation, Abdominal pain , Intestinal spasms, gas, no abnormalities
when do IBS symptoms usually occur
stressful events
main theory of IBS
biopsychosocial disease
diagnostic criteria for IBS
recurrent abdominal pain/discomfort for at least 3 days/month for the last 3 months that (must have 2):improve with pooping, comes with change in poop frequency or appearance
hidden IBS
.
