GI Pathophys (Digestive Tract) Flashcards
GI Signs & Sx
sign vs sx
- sign: effect of health problem that can be observed (objective)
- symptom: effect noticed and experienced only by person affected (subjective)
GI Signs & Sx
4 categories of signs & describe them
“not necessarily testing on this”
- prognostic signs: signs that point to the future or predict outcome for pt
- anamnestic signs that give insight to pt’s medical history (ex: acne scars on face)
- diagnostic signs: signs that help medical provider recognize and identify current health problems (ex: PSA antigen)
- pathognomonic signs: signs linked to medical condition w/ full certainty (ex: uvular deviation w/ peritonsillar abscess)
GI Signs & Sx
3 main types of symptoms & describe
- Remitting: sx that improve or resolve completely
- Chronic: long lasting or recurrent
- Replasing: sx that resolve and return
GI Signs & Sx
dysphagia describe
- oropharyngeal dysphagia: problems in transferring food bolus from oropharynx to the upper esophagus
- esophageal dysphagia: impaired transport of food bolus through body of esophagus, may be accompanied by feeling of food getting “stuck”
GI Signs & Sx
Odynophagia describe/causes
- sharp pain on swallowing that may limit PO intake
- caused by Candida, herpesvirus, CMV, caustic ingestions
GI Signs & Sx
Pyrosis describe
- heart burn
- feeling of substernal burning (often radiates to neck)
- caused by reflux of gastric contents into esophagus
GI Signs & Sx
describe dyspepsia
- aka indigestion
- persistent or recurrent pain/discomfort in upper abdomen
- Commonly described as early satiety, postprandial fullness, gnawing or burning
- usually indicates underlying problem
- Types: ulcer, dysmotility, reflex
describe three types of dyspepsia
- Ulcer: pain localized in epigastrium, frequently occurs before meals and is relieved by eating foods, antacids, or H2 blockers
- Dysmotility: discomfort rather than pain along w/ early satiety, postprandial fullness, nausea, vomiting, bloating; worsened by food
- Reflux: heartburn, acid regurgitation
GI Signs & Sx
dyspepsia contributing factors
4 components
- overeating
- eating too quickly
- drinking too much alc/coffee
- meds (ASA, NSAIDs, abx, DM meds, HTN meds)
GI Signs & Sx
alarm sx of dyspepsia
7
- wt loss
- odynophagia
- progressive dysphagia
- constant/severe pain
- persistent vomiting
- hematemesis, melena
- failure to respond to therapy
GI Signs & Sx
what is manometry?
measurement of esophageal pressures
GI Signs & Sx
key hx components of dyspepsia
- clarify chronicity, location, and quality of pain
- determine relationship of pain w/ meals
GI Signs & Sx
key labs/dx for dyspepsia
- labs: CBC w/ diff, BMP, FOBT
- C14-urea breath test (screening for H. pylori, < 45 yrs w/ no alarm symptoms)
- Upper endoscopy: pts > 60 or 45-59 w/ alarm sx
- biopsy for H. pylori
- esophageal manometry & pH studies
GI Signs & Sx
describe nausea
vague sensation of sickness or queasiness
often followed by vomiting
GI Signs & Sx
describe vomiting
- forceful expulsion of gastric contents produced by involuntary contractions of the abd musculature when the gastric fundus and lower esophageal sphincter are relaxed
- controlled by the brainstem (medulla)
GI Signs & Sx
4 causes of vomiting
w/ examples w/in each category
- visceral afferent stimulation (biliary or GI distention, irritation, dysmotility, infection, irritants)
- vestibular disorders (meniere syndrome, motion sickness)
- CNS disorders (sights, smells, emotional experiences, migraines, infections, increase ICP)
- Irritation of chemotherapy trigger zones (drugs, chemo, toxins, hypoxia, uremia, acidosis, rad therapy)
GI Signs & Sx
what is rumination
usually involuntary regurgitation of small amounts of food from stomach that occurs 15-30 min after eating (most common in infants)
GI Signs & Sx
what is obstipation?
and not just constipation spelled funny hehe
complete or severe constipation
GI Signs & Sx
Labs dx for patients w/ n/v
- Urine preg in any female of child bearing age
- UA, CBC< CMP (if severe vomiting, or for >1d, signs of dehydration)
- Flat and upright abdomen xray if signs/sx of obstipation or perforation
- chronic vomiting: referral to GI for upper endoscopy, small bowel xrays, assessment of gastric emptying
GI Signs & Sx
n/v tx
- NPO for 4-6 hrs then trial clear liquids (IV hydration PRN)
- antmiemetic meds
GI Signs & Sx
Anti-emetic meds
- Serotonin 5-HT3-receptor antagonists (odansetron- zofran)
- Dopamine antagonists (induce sedation- metoclopramide, promethazine)
- Antihistamines or anticholinergics (for CNS conditions, meclizine, transdermal scoplamine)
- Cannabinoids (marijuana)
GI Signs & Sx
what can cannabis use lead to?
prolonged use can lead to nausea, vomiting, abd pain
cannabinoid hyperemesis syndrome
GI Signs & Sx
Hiccups
- usually benign and self limited
- causes: gastric distention, sudden temperature changes, alcohol ingestion, emotional states
GI Signs & Sx
when are hiccups scary?
- > 48 hrs
- often result of irritation of vagus or phrenic nerve (ex: liver cancer, pancreatitis, disorders of stomach/esophagus, uremia, pleurisy of diaphragm)