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pathophysiology > gi objective 6 and esophagus_ulcers_gastric conditions - Sheet1 > Flashcards

gi objective 6 and esophagus_ulcers_gastric conditions - Sheet1 Flashcards

1
Q

How does the liver receive its blood supply?

A

The liver receives oxygenated blood from the hepatic artery and deoxygenated blood from the inferior and superior mesenteric veins and the splenic vein (portal system).

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2
Q

What percentage of the liver’s blood supply comes from the portal venous system?

A

0.7

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3
Q

What do hepatocytes secrete?

A

Electrolytes, lipids, bile acids, cholesterol, and plasma proteins.

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4
Q

What is the role of lipocytes in the liver?

A

Lipocytes store lipids.

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5
Q

What are Kupffer cells, and what is their function?

A

Kupffer cells are liver phagocytes that destroy bacteria and process old red blood cells (RBCs).

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6
Q

What does bile contain?

A

Conjugated salts (for fat emulsification and absorption), cholesterol, bilirubin, electrolytes, and water.

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7
Q

How is bilirubin produced and processed?

A

Bilirubin is a byproduct of red blood cell destruction. Kupffer cells and the spleen break down hemoglobin into heme and globin. Their components are recycled to produce future RBCs.

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8
Q

How are bile salts recycled?

A

Bile salts are absorbed in the terminal ileum and returned to the liver via portal circulation.

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9
Q

What are some additional important functions of the liver?

A

Blood reservoir, destruction of intestinal bacteria (Kupffer cells), production of clotting factors and thrombopoietin, fat synthesis, protein synthesis, glucose release (hypoglycemia), glycogen/fat storage (hyperglycemia), and detoxification.

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10
Q

What vitamins and minerals are stored in the liver?

A

Iron, copper, vitamin B12, vitamin D, vitamin A, vitamin E, and vitamin K.

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11
Q

What happens to bile when a person is not eating?

A

The liver secretes bile into the common bile duct, but the closed sphincter of Oddi redirects it to the gallbladder for storage and concentration.

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12
Q

What happens to bile 30 minutes after eating?

A

The gallbladder contracts, and the sphincter of Oddi relaxes, allowing bile to enter the duodenum.

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13
Q

What enzymes does the pancreas secrete, and what do they digest?

A

Alpha-amylase (digests carbs) and lipase (digests fats).

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14
Q

What other substances does the pancreas produce?

A

Enzymes to protect itself from its own digestive effects, insulin, glucagon (promotes glycogen breakdown to glucose), somatostatin (inhibits GI growth hormone), and bicarbonate.

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15
Q

What is esophagitis?

A

Esophagitis is inflammation of the esophagus.

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16
Q

What are the etiologies of esophagitis?

A

Most commonly GERD. Other causes include infectious esophagitis in the immunosuppressed and consumption of caustic agents.

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17
Q

What are the complications of esophagitis?

A

Esophageal stricture, esophageal cancer, and Mallory-Weis tear.

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18
Q

What are the manifestations of esophagitis?

A

Dysphagia, painful swallowing, heartburn, and chest pain.

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19
Q

How is esophagitis diagnosed?

A

History and physical examination (H&P), esophagogastroduodenoscopy (EGD).

20
Q

What is an esophageal fistula?

A

An abnormal tract between the esophagus and trachea.

21
Q

What causes esophageal fistulas?

A

Often related to cancer or a surgical complication, but can also result from diseases like esophagitis.

22
Q

What are the complications of esophageal fistulas?

A

Tracheomalacia and recurrent aspiration pneumonias.

23
Q

What are the manifestations of esophageal fistulas?

A

Increased gastric or tracheal secretions and an enlarged stomach (air inflation).

24
Q

How are esophageal fistulas diagnosed?

A

CT scan of the chest, EGD, and bronchoscopy.

25
Q

What is peptic ulcer disease (PUD)?

A

Erosion of GI mucosa caused by the digestive action of HCl acid and pepsin.

26
Q

Where do ulcers commonly develop in PUD?

A

Lower esophagus, stomach, duodenum, and the margin of gastrojejunal anastomosis after surgical procedures.

27
Q

What are the complications of PUD?

A

Damage to blood vessels causing hemorrhage, gastrointestinal wall perforation, and upper GI bleeding.

28
Q

What are the risk factors for PUD?

A

H. pylori, smoking, NSAIDs, alcohol, high stress.

29
Q

What are typical manifestations of PUD?

A

Asymptomatic, epigastric pain, heartburn.

30
Q

How is PUD diagnosed?

A

H&P and EGD.

31
Q

What is a stress ulcer?

A

Acute form of peptic ulcer caused by severe illness, trauma, or neurological injury.

32
Q

What are the etiologies of stress ulcers?

A

Ischemic ulcers from hemorrhage, trauma, severe burns (Curling’s ulcers), heart failure, sepsis, and head trauma or neurosurgery (Cushing’s ulcers).

33
Q

How are stress ulcers diagnosed?

A

H&P and EGD.

34
Q

What is gastritis?

A

Inflammation of the gastric mucosa, one of the most common stomach problems.

35
Q

What are the classifications of gastritis?

A

Acute or chronic, diffuse or localized.

36
Q

What are the risk factors for gastritis?

A

Drugs (NSAIDs, aspirin, corticosteroids), heavy alcohol consumption, spicy foods, H. pylori, infections, surgical changes, prolonged vomiting, emotional stress, CNS lesions.

37
Q

What is the mechanism of gastritis?

A

Breakdown of the mucosal barrier allows HCl acid and pepsin to diffuse back into the mucosa, leading to tissue damage, capillary wall disruption, edema, and bleeding.

38
Q

What are the manifestations of gastritis?

A

Anorexia, nausea/vomiting, epigastric tenderness, fullness, hemorrhage.

39
Q

How is gastritis diagnosed?

A

H&P, EGD, CBC to assess blood loss, occult blood test. Radiologic studies are not helpful.

40
Q

What is gastric cancer?

A

Adenocarcinoma of the stomach.

41
Q

What are the risk factors for gastric cancer?

A

Minority ethnicities/races, male gender, age ≥65 years.

42
Q

What are the common etiologies of gastric cancer?

A

Mucosal injury due to H. pylori, auto-immune inflammation, or repeated exposure to irritants like tobacco.

43
Q

What is the mechanism of gastric cancer?

A

Repeated mucosal injuries lead to cellular dysplasia and cancer development.

44
Q

What are the manifestations of gastric cancer?

A

Unexplained weight loss, indigestion, abdominal discomfort/pain, anemia, transaminitis, and elevated pancreatic enzymes (with metastases).

45
Q

How is gastric cancer diagnosed?

A

EGD with biopsy, CT or PET scan to check for metastases.

pathophysiology (54 decks)

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