GI System Flashcards
what secretes HCL
parietal cells
is there increased or decreased gastric acidity with aging?
decreased
what secretes GIF
parietal cells
what happens when we do not have enough GIF as we age
we cannot absorb vitamin B12 which leads to atrophic gastritis, hematologic disorders, pernicious anemia (macrocytic, normochromic)
chronic lack of GIF =
atrophic gastritis
pernicious anemia is caused by what
lack of GIF
can Atrophic Gastritis (chronic lack of GIF) lead to neurlogical disorders
yes
what are the types of neurological disorders that can occur with Atrophic Gastritis
Peripheral Neuropathy
Subacute combined dengeration (affects dorsal white matter columns and SC Motor Pathways)
Megaloblastic Madness occurs with what
B12 deficiency
sypmtoms of esophageal disorders
- ) Dysphagia- tough time swallowing
- Pyrosis- burning feeling in neck and chest
- Odenphagia- painful swallowing
- Waterbrush- reflux of acid up from stomach and mixing with saliva (can lead to pneumonia aspiration)
Type of esophagitis that comes from eating or drinking too much and goes away in 24-48 hours
Acute Esophagitis
When acid from stomach splashes up to the Lower Esophagus. The lower esophageal sphicter is not working well
Chronic Esophagitis
what can chronic esophagitis lead to
Barrett’s esophagus
what is usually not working well with GERD (or chronic esophagitis)
the LES
what are cells normally in the esophagus and what are they changed to with Barrett’s esophagus
normally they are stratified squamous. change to simple columnar with barretts
herniation of the stomach thru the diaphragm
hitial hernia
does the LES close when not swallowing with both a rolling and a sliding (most common) hiatial hernia
no
how does scleroderma lead to an esophageal issue
the esophageal collagen hardens and this leads sto esophageal dysmotility and dysphagia.
what will a cork screw esophagus be seen in
Esophagitis
what is a slack esophagus with loss of muscle tone seen in
Scleroderma
Waterbrush is seen with what
Esophageal Tumors
where are most of esophageal tumors located
the lower 1/3 of the esophagus
risk factors for esophageal disorders
- smoking
- alcohol excess
- GE Reflux
- Age
- Being male
what is esophageal achalasia
failure of the LES to relax when swallowing, so food accumulates in the esophagus and causes esophageal dilatation
loss of the myenteric plexus
Auerbach’s
loss of submucosal plexus
Meissner’s
what is Mallory Weiss Syndrome (MWS)
LES bleeding from mucosal tears
what is the major cause of Mallory Weiss Syndrome (MWS)
Bulimia (occasionally alcohol and antibiotics)
What is a Tracheo-esophageal Fistula with Esophageal Atresia
an opening between the esophagus and trachea.
what can a tracheo-esophageal fistual lead to
aspiration penumonia
What are the 3 C’s of Tracheo-esophageal fistula
Cough, choke, cyanosis
common things that can lead to acute gastritis
- Overindulgence in alcohol or eating
- NSAIDS, ASA
- GI viral infection
- Antibiotics
- Oral Corticosteriods
is acute gastiris focal or diffuse inflammation
diffuse
Does eating help or make pain worse with acute gastritis
makes it better (pain relief food pattern seen with acute gastitris)
what causes Peptic Ulcer Disease
H. Pylori
Is a peptic ulcer focal or diffuse
focal lesion in the duodenum of the stomach
how does H. pylori cause peptic ulcers (describe the whole process)
by eroding the mucosa of the stomach. This causes HCL to get into the mucosa of the stomach which leads to ECL cells being stimulated.
H2 receptors on the ECL cells release histamine leading to bleeding and vasodilatation. The histamine released from the H2 receptors on the ECL cells also sitimulate the pariteal cells to make more HCL which further leads to damage of this one part of the duodenum of stomach
where do most of the peptic ulcers occur
in the duodenal bulb (proximal part of the duodenum)
do peptic ulcers hurt more during the day or night
night
do peptic ulcers get worse or better with eating
better (pain relief food pattern)
where do stress ulcers most often form
the fundus of stomach
how do stress ulcers in the stomach occur
major trauma, SCI, serious illness or other stress causes blood to be routed elsewhere in the body, so there can be generalized GI ischemia bc not enough blood flow to the stomach
what is usually present with stomach cancers
H.pylori
most common type of gastric cancer
Gastric Adenocarcinoma-Excavated
gastric cancer that is invaginated growth
Gastric Adenocarciona
gastic cancer that may form a poyp and invades the stomach wall
gastric squamous cell carcioma
which type of gastric cancer is most commonly seen with H. pylori
MALT
where does MALT originate from
B lymphocytes
is MALT slow or fast moving
slow (indolent)
gastric neuroendorcine tumor that causes a wide range of symptoms and chemicals are secreted into the bloodstream
Carcinoid
when the entire wall of the stomach is thick and fibrous and cannot undergo peristalsis
Linitis Plastica
signs and symptoms of Gastric Neoplasia
Epigastric Pain Weight Loss Bloating Dysphagia Nausea Vomiting Blood Black "tarry" stools
what is Regional Enteritis (Crohn’s Dz) and where does it occur
Autoimmune disease of the terminal ileum. Basically this is a narrow and inflammed ileum
what induces Celiac Disease (spure)
gluten
what is the issue in Celiac Disease
villi/microvilli are lost
signs and symptoms of Malabsorption Syndrome
weight loss diarrhea steatorrhea (fatty stools) flatulence nocturia fatigue Anemia (megaloblastic anemias....folic acid deficiency and pernicious anemia Neuro issues (B12) Brusing (Ecchymosis)
physiological causes of obstructive syndrome (can also be due to a mechanical obstruction….volvulus, intusseuspetion, or tumor)
loss of peristalsis (ileus)
fecal impaction
what is a volvulus
mechanical obstruction. twisted intestines
what is an intussusception
intestinal folding so there is partial obstuction and things cannpt pass thru as easily
where is a common place to see an intussception
Ileo-cecal area
What is Hirschpsrung’s Disease (aka Congential Megacolon)
Congential Ileus caused by failure to form nerve networks that allow for peristalsis to occur. The colon is usually seeen as enlarged and static (rectal collapse can also be seen with this)
what is senile ileus
degeneration of the plexi that cause peristaliss as we age
what a paralytic ileus due to
SCI and parastmpathetic loss to the lower bowel (S2-S4)
signs and symptoms of bowel obstruction
cramping/abdominal pain
abdominal distention and bloating
Nausea/vomiting
alternating constipation and diarrhea
altered stool size or color is commonly seen with what
colon disorders
hematochezia is commonly seen with what
colon disorders
alternating constipating and diarrhea is seen wit hwhat
small bowel obstructive disorders OR IBS
what nerve levels innervate the small bowel and cause ileus
s2-s4
where is McBurneys point
between the right ASIS and the navel (closer to ASIS tho)
describe Blumberg’s sign
lie the pt. down on back and press into mcburneys point. if they have pain when you let go then this is postivie
where does most diverticulosis occur
90% occur in the sigmoid colon
what is diverticulosis
associated with aging. weakneing in the bowel wall
true or false: hematochezia can be seen with diverticulitis
true
potential outcomes of diverticulitis
- resolution
- bleeding
- necrosis
- rupture
what is idiopathic Ulcerative Colitiis (IUC)
an autoimmune disease that is more common in females and affects the mucosa only
too much clostridium difficile can come from what
taking antibiotics killing other bacteria so this stuff takes over leading to pseudomembranous colitis
what is a way to treat a C. Difficile infection
fecal transplant to have normal bacteria displace the abnormal ones
where does carcionoma of the colon most often occur
the left side in the rectosigmoid colon
a tumor on which side of the colon is tougher to detect with bleeding
right side (ascending colon)
alternating hyperactivity/spasm/sluggishness
IBS
