GI Pathology Flashcards
What nerve control reflexes to control the secretions and motility of the GI tract
- Vagus nerve/Vagovagal reflexes
Define dysphagia
- Difficulty in swallowing
Define achalasia
- Condition in which the lower esophageal sphincter fails to relax and food is trapped in the esophagus
What foods can aggravate heartburn
- Fatty foods
- Citrus foods
- Chocolate
- Peppermint
- Alcohol
- Coffee
- Caffeine
What structures are located in the RUQ
- Gall bladder
- R lobe of liver
- Small intestine
- Transverse/ascending colon
- R kidney
What structures are located in the LUQ
- L lobe of liver
- Stomach
- Spleen
- Pancreas
- Small intestine
- Transverse/descending colon
- L kidney
What structures are located in the RLQ
- Appendix
- Lower ascending colon/small intestine
- R ureter
- R ovary/R spermatic cord
What structures are located in the LLQ
- Large portion of small intestine
- Descending colon
- L ureter/L spermatic cord
Symptoms of C. Diff
- Typically associated with antibiotic treatment
- Watery diarrhea
- Fever
- Loss of appetite
- Nausea
- Belly pain and tenderness
What level of precautions are used with C. Diff
- Contact precautions: hand washing, gown, and gloves
Define obstipation
- Intractable constipation with resulting fecal impaction or inability to pass gas & the retention of hard, dry stools in the rectum and colon
- Seen in post surgical pts taking long-term opiates or SCI
What ares can constipation cause pain in
- Abdominal pain and tenderness in the anterior hip, groin, or thigh
What structures refer pain to the midback
- Esophagus
What structures refer pain to the shoulder
- Liver
- Diaphragm
- Pericardium
What structures refer pain to the mid back or scapular regions
- Gallbladder
- Stomach
- Pancreas
- Small intestine
What structures refer pain to the low back, pelvis, or sacrum
- Colon
- Appendix
- Pelvic viscera
Vomit that looks like coffee grounds is consistent with
- Gastric ulcers
- Gastritis
- Esophageal canccer
Bright red blood in stool is associated with
- Lower colon/rectum disorders
Tarry or black stools are more consistent with
- Upper digestive tract disorders
What are the types of hepatitis virus
- Contact precautions
- HAV: contaminated food and water
- HBV: transmission through blood, body fluids, or body tissues
- HCV: transmission through needle sharing
- HDV: dependent on having HBV
Clinical signs and symptoms of hepatitis
- Initial/Preicteric phase: low-grade fever, anorexia, N/V, diarrhea, fatigue, malaise, HA, abdominal tenderness, & myalgia/arthalgia
- Jaundice/Icteric phase: jaundice; ending of earlier sx, amber colored or dark urine
What lab values are elevated for hepatitis
- Hepatic transaminases
- Bilirubin
What is the leading cause of liver CA and common reason for liver transplantation
- Viral hepatitis
Irreversible chronic injury of the hepatic parenchyma as a result of chronic hepatitis
- Cirrhosis
Symptoms of cirrhosis
- Jaundice
- Peripheral edema
- Dupuytren’s contracture
- Palmar erythema
- Angiomas
- Hepatomegaly
- Splenomegaly
- Ascites (fluid accumulation in peritoneal cavity)
What is asterixis a characteristic of
- Characteristic of hepatic encephalopathy, drug overdose, and Wilson’s disease
- “liver flap” iis myoclonus of the hand with the wrist in extension
- Result of liver unable to convert ammonia to urea
Pain in RUQ radiating to R scapula with a positive Murphy’s sign (palpation near R subcostal margin as pt takes deep breathe elicits pain) and pain worsens after a fatty meal describes what pathology
- Cholecystitis/gallstones
Acute “bandlike” pain which radiates to the back and worsens in supine accompanied by hypotension, tachycardia, and N/V describes what pathology
- Acute pancreatitis
Epigastric/LUQ pain with N/V, anorexia, constipation, flatulence (intestinal gas), weight loss, & steatorrhea (greasy stools) describes what pathology
- Chronic pancreatitis
Abdominal pain that radiates to the back, unexplained weight loss, jaundice, dark colored urine, light colored stool, and fatigue describe what pathology
- Pancreatic cancer
Pathology/symptoms of GERD (gastroesophageal reflux disease)
- Caused by reflux or backward movement of gastric contents of the stomach into the esophagus producing heartburn
- Heart burn commonly occurs 30-60mins after eating & at night when lying down (nocturnal reflux)
Treatment considerations for GERD
- Position pt in more upright positions
- Avoid supine or declined positions
- Avoid jogging/running or other activities that exacerbate sx
- Avoid large meals
- Medications: acid-suppressing proton pump inhibitors (PPIs), H2 blockers, & ant-acids
Protrusion of the stomach upward through the diaphragm (rolling) or displacement of both the stomach and gastroesophageal junction upward into the thorax (sliding)
- Hiatal hernia
Treatment for hiatal hernia
- Conservative or symptomatic treatment is the same as for GERD
- Surgery may be indicated
Risk factors for esophageal cancer
- GERD
- Smoking
- Barrett’s esophagus
- Alcohol
- Diet
- Male
Inflammation of stomach mucosa
- Gastritis
Caused by severe burns, aspirin or other NSAIDs, corticosteroids, food allergies, or viral or bacterial infections
- Acute gastritis
Caused by peptic ulcers, bacterial infection, stomach cancer, pernicious anemia, or with autoimmune disorders (thyroid disease, Addison’s disease)
- Chronic gastritis
Gnawing, burning, or cramp like epigastric pain, pain is aggravated by change in position and absence of food in stomach, and relieved by food or ant-acids
- Peptic ulcers; pain can radiate to back and R shoulder
What two conditions make up inflammatory bowel disease (IBD)
- Crohn’s disease (CD)
- Ulcerative colitis (UC)
- Both result in inflammation of bowel characterized by remissions and exacerbations
Key differences between Crohn’s and ulcerative colitis disease
- Crohn’s: granulomatous type of inflammation that can occur anywhere in the GI tract; areas of adjacent normal tissue called skip lesions are present
- Ulcerative colitis: ulcerative/exudative inflammation of the large intestine and rectum; characterized by varying amounts of bloody diarrhea, mucus, and pus; skip lesions absent
Characterized by abnormally increased motility of the small and large intestines associated with emotional stress and certain foods (high fat content, lactose intolerance)
- Irritable bowel syndrome (IBS)
Symptoms of IBS
- Persistent or recurrent abdominal pain relieved by defecation
- Constipation or diarrhea
- Bloating
- Abdominal cramps
- Flatulence (intestinal gas)
- Nausea
- Anorexia
Characterized by pouch like herniations (diverticula) of the mucosal layer of the colon through the muscular layer
- Diverticular disease
- Diverticulosis (rectal bleeding) can lead to diverticulitis (inflammation of one or more diverticula)
Symptoms of diverticulitis
- Pain and cramping in LLQ
- Nausea and vomiting
- Slight fever
- Elevated WBC
Abrupt pain at onset localized to epigastric or epriumbilical area and increases in intensity overtime, rebound tenderness (positive Blumberg’s sign) present at site distant from painful area, point tenderness at McBurney’s point (point 1/3 distance of ASIS and umbilicus), Roving’s sign (pain elicited in RLQ with pressure applied on LLQ), pain in RLQ with hip extension, Obturator sign (RLQ pain with hip ER and hip/knee flexion to 90º), and Markle’s sign (RLQ pain with jarring landing from up on toes to flat feet)
- Appendicitis
Inflammation of the peritoneum, the serous membrane lining the walls of the abdominal cavity
- Peritonitis
Symptoms of peritonitis
- Abdominal distension (pressure/swelling)
- Severe abdominal pain
- Rigidity from reflex guarding
- Rebound tenderness
- Decreased or absent bowel sounds
- Nausea and vomiting
- Tachycardia
Varicosities in the lower rectum or anus caused by congestion of the veins in the hemorrhoidal plexus
- Hemorrhoids (piles)
Signs and symptoms of hemorrhoids
- Local irritation, pain, and rectal itching
- Straining with defecation, constipation, and prolonged sitting contribute to discomfort
- Pregnancy increases risk
