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Pathophysiology Final Exam (Exam 4) > GI System > Flashcards

GI System Flashcards

1
Q

what secretes HCL

A

parietal cells

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2
Q

is there increased or decreased gastric acidity with aging?

A

decreased

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3
Q

what secretes GIF

A

parietal cells

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4
Q

what happens when we do not have enough GIF as we age

A

we cannot absorb vitamin B12 which leads to atrophic gastritis, hematologic disorders, pernicious anemia (macrocytic, normochromic)

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5
Q

chronic lack of GIF =

A

atrophic gastritis

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6
Q

pernicious anemia is caused by what

A

lack of GIF

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7
Q

can Atrophic Gastritis (chronic lack of GIF) lead to neurlogical disorders

A

yes

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8
Q

what are the types of neurological disorders that can occur with Atrophic Gastritis

A

Peripheral Neuropathy

Subacute combined dengeration (affects dorsal white matter columns and SC Motor Pathways)

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9
Q

Megaloblastic Madness occurs with what

A

B12 deficiency

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10
Q

sypmtoms of esophageal disorders

A
  1. ) Dysphagia- tough time swallowing
  2. Pyrosis- burning feeling in neck and chest
  3. Odenphagia- painful swallowing
  4. Waterbrush- reflux of acid up from stomach and mixing with saliva (can lead to pneumonia aspiration)
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11
Q

Type of esophagitis that comes from eating or drinking too much and goes away in 24-48 hours

A

Acute Esophagitis

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12
Q

When acid from stomach splashes up to the Lower Esophagus. The lower esophageal sphicter is not working well

A

Chronic Esophagitis

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13
Q

what can chronic esophagitis lead to

A

Barrett’s esophagus

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14
Q

what is usually not working well with GERD (or chronic esophagitis)

A

the LES

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15
Q

what are cells normally in the esophagus and what are they changed to with Barrett’s esophagus

A

normally they are stratified squamous. change to simple columnar with barretts

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16
Q

herniation of the stomach thru the diaphragm

A

hitial hernia

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17
Q

does the LES close when not swallowing with both a rolling and a sliding (most common) hiatial hernia

A

no

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18
Q

how does scleroderma lead to an esophageal issue

A

the esophageal collagen hardens and this leads sto esophageal dysmotility and dysphagia.

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19
Q

what will a cork screw esophagus be seen in

A

Esophagitis

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20
Q

what is a slack esophagus with loss of muscle tone seen in

A

Scleroderma

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21
Q

Waterbrush is seen with what

A

Esophageal Tumors

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22
Q

where are most of esophageal tumors located

A

the lower 1/3 of the esophagus

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23
Q

risk factors for esophageal disorders

A
  1. smoking
  2. alcohol excess
  3. GE Reflux
  4. Age
  5. Being male
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24
Q

what is esophageal achalasia

A

failure of the LES to relax when swallowing, so food accumulates in the esophagus and causes esophageal dilatation

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25
Q

loss of the myenteric plexus

A

Auerbach’s

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26
Q

loss of submucosal plexus

A

Meissner’s

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27
Q

what is Mallory Weiss Syndrome (MWS)

A

LES bleeding from mucosal tears

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28
Q

what is the major cause of Mallory Weiss Syndrome (MWS)

A

Bulimia (occasionally alcohol and antibiotics)

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29
Q

What is a Tracheo-esophageal Fistula with Esophageal Atresia

A

an opening between the esophagus and trachea.

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30
Q

what can a tracheo-esophageal fistual lead to

A

aspiration penumonia

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31
Q

What are the 3 C’s of Tracheo-esophageal fistula

A

Cough, choke, cyanosis

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32
Q

common things that can lead to acute gastritis

A
  1. Overindulgence in alcohol or eating
  2. NSAIDS, ASA
  3. GI viral infection
  4. Antibiotics
  5. Oral Corticosteriods
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33
Q

is acute gastiris focal or diffuse inflammation

A

diffuse

34
Q

Does eating help or make pain worse with acute gastritis

A

makes it better (pain relief food pattern seen with acute gastitris)

35
Q

what causes Peptic Ulcer Disease

A

H. Pylori

36
Q

Is a peptic ulcer focal or diffuse

A

focal lesion in the duodenum of the stomach

37
Q

how does H. pylori cause peptic ulcers (describe the whole process)

A

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

38
Q

where do most of the peptic ulcers occur

A

in the duodenal bulb (proximal part of the duodenum)

39
Q

do peptic ulcers hurt more during the day or night

A

night

40
Q

do peptic ulcers get worse or better with eating

A

better (pain relief food pattern)

41
Q

where do stress ulcers most often form

A

the fundus of stomach

42
Q

how do stress ulcers in the stomach occur

A

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

43
Q

what is usually present with stomach cancers

A

H.pylori

44
Q

most common type of gastric cancer

A

Gastric Adenocarcinoma-Excavated

45
Q

gastric cancer that is invaginated growth

A

Gastric Adenocarciona

46
Q

gastic cancer that may form a poyp and invades the stomach wall

A

gastric squamous cell carcioma

47
Q

which type of gastric cancer is most commonly seen with H. pylori

A

MALT

48
Q

where does MALT originate from

A

B lymphocytes

49
Q

is MALT slow or fast moving

A

slow (indolent)

50
Q

gastric neuroendorcine tumor that causes a wide range of symptoms and chemicals are secreted into the bloodstream

A

Carcinoid

51
Q

when the entire wall of the stomach is thick and fibrous and cannot undergo peristalsis

A

Linitis Plastica

52
Q

signs and symptoms of Gastric Neoplasia

A 
Epigastric Pain
Weight Loss
Bloating
Dysphagia
Nausea
Vomiting Blood
Black "tarry" stools
53
Q

what is Regional Enteritis (Crohn’s Dz) and where does it occur

A

Autoimmune disease of the terminal ileum. Basically this is a narrow and inflammed ileum

54
Q

what induces Celiac Disease (spure)

A

gluten

55
Q

what is the issue in Celiac Disease

A

villi/microvilli are lost

56
Q

signs and symptoms of Malabsorption Syndrome

A 
weight loss
diarrhea
steatorrhea (fatty stools)
flatulence
nocturia
fatigue
Anemia (megaloblastic anemias....folic acid deficiency and pernicious anemia
Neuro issues (B12) 
Brusing (Ecchymosis)
57
Q

physiological causes of obstructive syndrome (can also be due to a mechanical obstruction….volvulus, intusseuspetion, or tumor)

A

loss of peristalsis (ileus)

fecal impaction

58
Q

what is a volvulus

A

mechanical obstruction. twisted intestines

59
Q

what is an intussusception

A

intestinal folding so there is partial obstuction and things cannpt pass thru as easily

60
Q

where is a common place to see an intussception

A

Ileo-cecal area

61
Q

What is Hirschpsrung’s Disease (aka Congential Megacolon)

A

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)

62
Q

what is senile ileus

A

degeneration of the plexi that cause peristaliss as we age

63
Q

what a paralytic ileus due to

A

SCI and parastmpathetic loss to the lower bowel (S2-S4)

64
Q

signs and symptoms of bowel obstruction

A

cramping/abdominal pain
abdominal distention and bloating
Nausea/vomiting
alternating constipation and diarrhea

65
Q

altered stool size or color is commonly seen with what

A

colon disorders

66
Q

hematochezia is commonly seen with what

A

colon disorders

67
Q

alternating constipating and diarrhea is seen wit hwhat

A

small bowel obstructive disorders OR IBS

68
Q

what nerve levels innervate the small bowel and cause ileus

A

s2-s4

69
Q

where is McBurneys point

A

between the right ASIS and the navel (closer to ASIS tho)

70
Q

describe Blumberg’s sign

A

lie the pt. down on back and press into mcburneys point. if they have pain when you let go then this is postivie

71
Q

where does most diverticulosis occur

A

90% occur in the sigmoid colon

72
Q

what is diverticulosis

A

associated with aging. weakneing in the bowel wall

73
Q

true or false: hematochezia can be seen with diverticulitis

A

true

74
Q

potential outcomes of diverticulitis

A
  1. resolution
  2. bleeding
  3. necrosis
  4. rupture
75
Q

what is idiopathic Ulcerative Colitiis (IUC)

A

an autoimmune disease that is more common in females and affects the mucosa only

76
Q

too much clostridium difficile can come from what

A

taking antibiotics killing other bacteria so this stuff takes over leading to pseudomembranous colitis

77
Q

what is a way to treat a C. Difficile infection

A

fecal transplant to have normal bacteria displace the abnormal ones

78
Q

where does carcionoma of the colon most often occur

A

the left side in the rectosigmoid colon

79
Q

a tumor on which side of the colon is tougher to detect with bleeding

A

right side (ascending colon)

80
Q

alternating hyperactivity/spasm/sluggishness

A

IBS

Pathophysiology Final Exam (Exam 4) (7 decks)

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