GI Patho 2 Flashcards
Diarrhoea:
1) Small vs Large volume?
2) How is GIT motility increased?
1) Small: Colicky pain & Urgency
Large: Painless & Water type
2) - Increased substances that retain water
(Excess Fats, Salts, Dried fruits)
- Irritants in food; Inflammation; Microbial growth; Toxins from bacteria
What fluids & electrolytes are involved in fine tuning the body?:
1) Absorption?
2) Secretion?
1) Water H2O, Na+, Cl-
2) HCO3-, K+
Diarrhoea:
1) Effects?
2) Acidosis (pH<7.35)?
3) ˅ Plasma Na+, Cl-?
4) ˅ Plasma K+?
1) Same as vomiting:
˅ BP
˅ Perfusion of tissues (blood)
˅ O2 & other nutrient delivery to cells
˅ Removal of CO2 & wastes from cells
2) ^ H due to ˅ HCO3
˅ Enzyme function (esp in Brain/Nervous tissue)
3) Fatigue; Loss of appetite; Dehydration
4) Cardiac dysrhythmias & Muscle weakness
Diarrhoea:
Treatment?
- Fluid & Electrolyte Resuscitation
- Diet: Starch & Simple Proteins
- Opium-like drugs
Diarrhoea of inflammation:
1) Where is the inflammatory damage?
2) Resulting in?
3) Causes of inflammatory diarrhoea?
1) Mucosa
2) - Impairs capacity to absorb
- Exudation (oozing) of Fluid & Protein into Lumen
3) - Invasion infections
- Inflammatory Bowel Disease
Infectious Diarrhoea:
1) Common cause of diarrhoea?
2) How?
3) Pathogens associated with Infectious diarrhoea? (3)
1) PATHOGENS disrupt epithelium of intestine
2) Loss of absorptive properties of epithelium –> Water is Retained in Lumen
3) - Bacteria:
(Salmonella; E. Coli; Campylobacter)
- Viruses
- Protozoa:
(Cryptosporium; Giardia)
Secretory Diarrhoea:
1) When does it occur?
2) Secretory diarrhoea often associate with what?
3) Mortality rate?
4) Effect of fasting on secretory diarrhoea?
1) When secretion of water into intestinal lumen exceeds absorption.
2) Cholera
3) Quickly treated cholera patients: <1%
Untreated cholera patients: 50-60%
4) Secretory diarrhoea does NOT stop after fasting.
Inflammatory Bowel Disease:
1) Two IBD diseases?
2) Symptoms? (Both diseases S/S are similar)
3) Treatment? (Both treatment similar)
1) Ulcerative Colitis & Crohn’s Disease
2) - fever
- Abdominal pain
- diarrhoea
- dehydration
- blood and mucus in stools
- weight loss
- periods of remission and exacerbation
3) - anti-inflammatory drugs
- antibiotics
- i.v. fluids
- surgery in severe cases
Inflammatory bowel disease: Ulcerative Colitis:
1) Where is ulceration located?
2) Stools contain blood and mucus because of?
3) Frequent diarrhoea due to?
4) 3 types?
1) Mucosa of colon (usually in Sigmoid colon or Rectum) 2) Pinpoint mucosal haemorrhages & pus 3) Inflammation as it makes colon empty 4) 3 types of IBD: - Mild chronic - Chronic intermittent - Acute fulminating (explode violently or flash like lightning)
Inflammatory bowel disease: Crohn’s Disease:
1) Chronic inflammatory condition involving what part of GIT?
2) Appearance?
3) Deficiencies?
1) Entire intestinal wall: Most commonly: ileum (end of small intestine); Large intestine (Colon & Rectum); can occur Any part of GIT 2) "Cobblestone" 3) Nutritional deficiencies
Diarrhoea due to altered motility:
How is the rate of water absorption effected?
Change in transit time of Chyme/Faecal matter
Irritable Bowel Syndrome:
1) What is it?
2) Acute/Chronic?
3) Where is pain located?
4) Symptoms of altered bowel function? (4)
1) Psychological & Physiological stress (dysregulates intestinal motor & sensory functions modulated by CNS)
2) Chronic & Recurrent
3) Persistent recurrent Lower Abdominal Pain
4) - Flatulent, Bloating
- Nausea, Anorexia
- Abdominal pain relieved by Defecation
- Change in consistency/frequency of stools
Irritable Bowel Syndrome:
1) Diagnosis? (3)
2) Treatment? (3)
1) - 12 weeks of abdominal discomfort (continuous/recurrent symptoms)
- OR pain in past 12 months
- 2-3 accompanying features:
- relief with defecation
- change in bowel frequency
- change in form of stool
2) *** Manage psychological & Physiological stress
- Diet:
- Adequate fibre intake
- Avoid fat, Gas-producing food, Alcohol, Caffeine
- Antispasmodic & Anticholinergic drugs
Fermentation:
1) Why does it happen?
2) Gas-producing foods?
1) - Oligosaccharides: very poorly digested in small intestine
- Passed into large bowel: undergo bacterial fermentation
* *** Fermentation is major source of intestinal gas!
2) Corn; Capsicum; Cabbage; Cauliflower; Bread; Egg; Beer; Raisin; Milk
Fermentation: Lactose Intolerance:
1) Lack of what?
2) What happens?
3) But, can consume what?
1) Lactase
2) Milk undigested in small intestine;
Fermentation produces gas, resulting in Pain & Flatulence
3) Yoghurt
Constipation:
1) What happens to flow rate?
2) Resulting in what?
3) Cause of ˅ GIT flow rate? (3)
4) Treatment?
1) Decreases
2) ^ contact time –> ^ absorption of water & ions –> Hard Stools
3) ˅ Fibre intake
˅ Water-retaining substances
- Weak abdominal muscles (inactivity, bed rest, pregnancy)
˅ parasympathetic nervous system stimulation
4) *** Relieve the cause
- Laxatives & Enemas
(do Not use regularly)
Liver:
1) Connected to & controls body in 2 ways?
1) Blood vessels & Circulation:
(Receives absorbed nutrients directly from GIT –> sends them out to all parts of body via Bloodstream
- Biliary tree and Bile:
(Bile transported to duodenum via Biliary tree)
Liver function:
1) Function of liver? (3)
The fate of Bilirubin:
2) How is bilirubin formed?
3) What does the liver convert bilirubin intO/
1) - Metabolism: Glucose, Lipid, Protein
- Synthesis: Bile, Albumin, Haemoglobin, Precursors (steroid hormone, clotting factors)
- Detoxification: Bilirubin, Ammonia, Toxins
2) Haemoglobin (from RBCs) becomes bilirubin
3) Bile (Conjugated bilirubin)
Jaundice:
1) What is it?
2) Due to?
3) Major causes of Jaundice? (3)
1) Ywllowing of Skin & sclera (whites) of Eyes
2) Hyperbilirubinemia
3) - Prehepatic Factors: Excess haemolysis of RBCs
- Intrahepatic Factors: Impaired hepatocyte function of:
- conjugation of bilirubin
- bilirubin uptake (hepatitis, cirrhosis, liver cancer)
- Posthepatic Factors: Blocked bile flow (Gallstones/Tumors)
Liver Function Tests:
Serum Bilirubin (total, conjugated, unconjugated):
1) Liver damage?
2) ˅ Bile flow?
Serum Liver Enzymes (ALT, AST, ALP, GGT):
3) Released from damaged liver cells? (2)
4) Bile flow is decreased? (2)
1) ^ Unconjugated bilirubin levels
2) ^ Conjugated bilirubin
3) ^ ALT & ^ AST
4) ^ ALP & ^ GGT
Liver Function Tests:
1) Serum ammonia & urea for what?
2) 3 others?
1) - Detoxification function ( ^ only accompanying renal disease) 2) Serum total Protein & Albumin Blood haemoglobin Blood clotting function e.g. Prothrombin time
Liver Disorders:
1) What is Hepatitis?
2) What is Cirrhosis?
1) Inflammation of liver (acute or chronic)
2) Dead liver cells replaced with (non-functioning) Scar Tissue (irreversible)
Hepatitis:
1) Infectious Hepatitis are caused by what?
2) Non-infectious Hepatitis are caused by what? (5)
1) Viruses: Hep A to Hep E
2) Alphabetical order:
- Alcohol
- Autoimmune disease
- Drugs
- Toxins
- Tumours
Viral Hepatitis:
The clinical course of infections may be? (4)
1) Asymptomatic: a carrier state without clinical features (e.g. Hep B aka HBV)
(Serologic evidence Only)
2) Acute
3) Chronic (with or without) Cirrhosis
4) Fulminating (rapid, sudden, & severe) disease with Rapid onset of Liver Failure
