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PP2 > GI Patho 2 > Flashcards

GI Patho 2 Flashcards

1
Q

Diarrhoea:

1) Small vs Large volume?
2) How is GIT motility increased?

A

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

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2
Q

What fluids & electrolytes are involved in fine tuning the body?:

1) Absorption?
2) Secretion?

A

1) Water H2O, Na+, Cl-

2) HCO3-, K+

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3
Q

Diarrhoea:

1) Effects?
2) Acidosis (pH<7.35)?
3) ˅ Plasma Na+, Cl-?
4) ˅ Plasma K+?

A

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

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4
Q

Diarrhoea:

Treatment?

A
  • Fluid & Electrolyte Resuscitation
  • Diet: Starch & Simple Proteins
  • Opium-like drugs
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5
Q

Diarrhoea of inflammation:

1) Where is the inflammatory damage?
2) Resulting in?
3) Causes of inflammatory diarrhoea?

A

1) Mucosa
2) - Impairs capacity to absorb
- Exudation (oozing) of Fluid & Protein into Lumen
3) - Invasion infections
- Inflammatory Bowel Disease

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6
Q

Infectious Diarrhoea:

1) Common cause of diarrhoea?
2) How?
3) Pathogens associated with Infectious diarrhoea? (3)

A

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)

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7
Q

Secretory Diarrhoea:

1) When does it occur?
2) Secretory diarrhoea often associate with what?
3) Mortality rate?
4) Effect of fasting on secretory diarrhoea?

A

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.

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8
Q

Inflammatory Bowel Disease:

1) Two IBD diseases?
2) Symptoms? (Both diseases S/S are similar)
3) Treatment? (Both treatment similar)

A

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

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9
Q

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?

A 
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)
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10
Q

Inflammatory bowel disease: Crohn’s Disease:

1) Chronic inflammatory condition involving what part of GIT?
2) Appearance?
3) Deficiencies?

A 
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
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11
Q

Diarrhoea due to altered motility:

How is the rate of water absorption effected?

A

Change in transit time of Chyme/Faecal matter

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12
Q

Irritable Bowel Syndrome:

1) What is it?
2) Acute/Chronic?
3) Where is pain located?
4) Symptoms of altered bowel function? (4)

A

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

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13
Q

Irritable Bowel Syndrome:

1) Diagnosis? (3)
2) Treatment? (3)

A

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

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14
Q

Fermentation:

1) Why does it happen?
2) Gas-producing foods?

A

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

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15
Q

Fermentation: Lactose Intolerance:

1) Lack of what?
2) What happens?
3) But, can consume what?

A

1) Lactase
2) Milk undigested in small intestine;
Fermentation produces gas, resulting in Pain & Flatulence
3) Yoghurt

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16
Q

Constipation:

1) What happens to flow rate?
2) Resulting in what?
3) Cause of ˅ GIT flow rate? (3)
4) Treatment?

A

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)

17
Q

Liver:

1) Connected to & controls body in 2 ways?

A

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)

18
Q

Liver function:
1) Function of liver? (3)

The fate of Bilirubin:

2) How is bilirubin formed?
3) What does the liver convert bilirubin intO/

A

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)

19
Q

Jaundice:

1) What is it?
2) Due to?
3) Major causes of Jaundice? (3)

A

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)

20
Q

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)

A

1) ^ Unconjugated bilirubin levels
2) ^ Conjugated bilirubin

3) ^ ALT & ^ AST
4) ^ ALP & ^ GGT

21
Q

Liver Function Tests:

1) Serum ammonia & urea for what?
2) 3 others?

A 
1) - Detoxification function
( ^ only accompanying renal disease)
2) Serum total Protein & Albumin
Blood haemoglobin
Blood clotting function e.g. Prothrombin time
22
Q

Liver Disorders:

1) What is Hepatitis?
2) What is Cirrhosis?

A

1) Inflammation of liver (acute or chronic)

2) Dead liver cells replaced with (non-functioning) Scar Tissue (irreversible)

23
Q

Hepatitis:

1) Infectious Hepatitis are caused by what?
2) Non-infectious Hepatitis are caused by what? (5)

A

1) Viruses: Hep A to Hep E
2) Alphabetical order:
- Alcohol
- Autoimmune disease
- Drugs
- Toxins
- Tumours

24
Q

Viral Hepatitis:

The clinical course of infections may be? (4)

A

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

25
Q 
Hepatitis:
1) What are the 3 indentifiable stages?
2) Which stage is Acute Hepatitis?
3) Which stages are Viral Hepatitis?
4) Course of HAV & HBV?
(Hep A Virus, Hep V Virus)
A 
1) A) Profromal: [Abrupt (sudden) OR Insidious (gradual)]
B) Icterus: 5 - 10 days
C) Convalescent: 2 - 3 weeks
2) Profromal
3) Icterus & Convalescent
4) Hep A Virus: 9 weeks
Uncomplicated HBV: 16 weeks
26
Q

Acute Hepatitis: Prodromal (abrupt or insidious)

Manifestation?

A
  • Mild right side Abdominal Pain
  • Fatigue
  • Severe Anorexia
  • possibly Nausea/Vomiting, Diarrhoea/Constipation
  • ^ ALT & ^ AST
  • muscle pain
  • joint pain
  • chills and fever may occur with abrupt onset
  • possibly a distaste for smoking in smokers
27
Q

Viral Hepatitis:

1) Icterus (5-10 days) Symptoms?
2) Convalescent (2-3 weeks) Symptoms?

A

1) - Severe Pruritus& Liver Tenderness common
- ^ Bilirubin ^& Jaundice
- Dark Urine – black tea color
- Hep C Virus: Jaundice less likely

2) Increased sense of well-being
˅ Jaundice

28
Q

Hepatitis Vaccines:

Vaccine availability for Hep A-C

A

Hep A: Available
Hep B: Available 0-18 y.o.
Hep C: Not available

29
Q

Hepatitis A:

1) Transmission?
2) Incubation? (development of infection from time pathogen enters body until symptoms first appear)
3) Clinical features?
4) Children symptoms?

A

1) Faecal & Oral
2) 2-6 weeks
3) - As acute hepatitis
- Does not progress to Chronic Hepatitis & carrier state
- life long immunity
4) Asymptomatic

30
Q

Hepatitis B:

1) Transmission?
2) Incubation?
3) Clinical features?
4) Treatment?

A 
1) Body fluids (Blood transfusion, Body piercing, Tattoo)
Perinatal (breast feeding)
2) 4-26 weeks
3) - Acute/Chronic, Cirrhosis, Fulminate
- Carrier state
- Antibody not protective
4) No simple & effective method
31
Q

Hepatitis C (genetically unstable virus):

1) Transmission?
2) Incubation?
3) Clinical features?
3) Treatment?

A

1) Blood-blood
- Drug infusion
- Multiple sex partners
2) 14-180 days (2-26 weeks)
3) - Chronic, Cirrhosis, Cancer
- Carrier state
- Antibody not protective
4) No simple & effective method

32
Q 
Autoimmune Hepatitis:
1) What is it?
2) Characterised by?
3 Autoimmune, therefore?
4) What can trigger self-induced liver damage?
5)  Vaccine available?
A

1) Chronic liver inflammation
2) - Presence of circulatory Auto-Antibodies
- ongoing Liver Tissue damage
3) Genetically Predisposed
4) Certain drugs & viruses
5) Varicella-Zoster Virus:
- Varicella (Chickenpox)
- Herpes Zoster (Shingles)

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