GIT Flashcards

1
Q

3 regions of the stomach

A

cardiac region - surrounds the cardiac orifice
body - midportion of the stomach
pyloric region - made up of the antrum and canal which terminates at the pylorus

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2
Q

Secretory cells of the gastric glands

A

chief cells - pepsinogen
parietal cells - HCl and intrinsic factor
mucous neck cells - mucous
enteroendocrine cells - secrete gastrin

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3
Q

Regulation of Gastric secretion

A

cephalic phase: central cortex, sight smell thought of food
Gastric phase: as food enters, stomach distension, reflexes, chemical and hormonal stimuli
Intestinal phase: low pH in stomach releases intestinal hormones (cholecystokinin and secretin)

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4
Q

Name the 4 accessory structures

A

salivary glands
liver
gall bladder
pancreas

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5
Q

Function of salivary glands

A

cleanses the mouth
moistens and dissolves food chemicals
aids in bolus formation
enzymes secretion that break down starch (amylase)

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6
Q

Function of Liver

A

produces bile

cleanses and detoxifies - anything that is ingested goes through the liver

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7
Q

COMposition of bile

A

bile salts
pigments
cholesterol
lecithin

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8
Q

Gallbladder function

A

stores extra bile

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9
Q

Pancreas function

A

secretes digestive enzymes

regulation of bile secretion both hormonally and chemically

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10
Q

disorders of motility

A
dysphagia
gastroeosophageal reflux
oesophageal diverticulum 
hiatal hernia 
pyloric obstruction
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11
Q

Dysphagia

A

difficulty swallowing
mechanical or functional obstruction of oesophagus
reduced muscle tone and peristaltic function, reduced food in stomach

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12
Q

Gastroesophageal Reflux

A

regurgitation of chyme from stomach into oesophagus

Can result in inflammation due to repeated exposure to acids and enzymes

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13
Q

symptoms of gastroeosophageal reflux

A

oedema
erosion
ulceration

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14
Q

Oesophageal diverticulum

A

outpouching of the oesophagus
food may be trapped
can lead to dysphagia and regurgitation

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15
Q

hiatal hernia

A

protrusion of upper part of stimach through hiatus at GI junction

sliding: congenital short oesophagus, trauma, weak diaphragmatic muscles
paraoesophageal: greater curvature of stomach herniates alongside oesophagus, creates a small balloon on its own

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16
Q

pyloric obstruction

A

narrowing or blockage of pylorus (between stomach and duodenum)

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17
Q

causes of pyloric obstruction

A

congenital defect
tumour
peptic ulcers

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18
Q

symptoms of pyloric obstruction

A

epigastric fullness
nausea
epigastric pain

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19
Q

Malabsorption syndromes (3)

A

pancreatic insufficiency
lactose enzyme deficiency
bile salt deficiency

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20
Q

Pancreatic insufficiency

A

insufficient enzyme production of CHO, ,fat and protein digestion
fat maldigestion leads to fat in stools
absence of HCO leads to reduced pH which prevents activation of pancreatic enzymes

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21
Q

lactose enzyme deficiency

A

inhibits lactose breakdown into mono-CHO which prevents lactose digestion and absorption

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22
Q

bile salt deficiency

A

bile salts necesary for fat digestion

causes fat malapsorption and steotorrhea

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23
Q

Gastritis

A

inflammation of gastric mucosa

acute: superficial erosions
chronic: thinning and degradation of stomach wall

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24
Q

types of gastritis

A

fundul: degeneration of fundus and stomach mucosa
antral: caused by helicobactor pylori bacteria

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25
Q

Peptic ulcers

A

acidic component that is causative in the disease progression
mucosal ulceration of stomach or duodenum

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26
Q

risk factors of peptic ulcers

A

smoking, alcoho, RA, cirrhosis, anti-inflammatory drugs, h.pylori, NSAIDS, aspirin

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27
Q

types of peptic ulcers

A

duodenal
gastric
stress

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28
Q

duodenal ulcers

A

increased gastrin which increases HCl production

symptoms: collicky, pain when stomach is empty

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29
Q

gastric ulcers

A

developed in antrum of stomach
gastric secretion normal or reduced
pain after eating

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30
Q

stress ulcers

A

develops after stress/trauma due to ischaemia

ischaemic: develops hours after heamorrhage
cushing: develops from reduced blood, increased HCl production

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31
Q

portal hypertension

A

increased BP in portal venous system caused by increased resistance to venous flow in portal vein, sinusoids and hepatic vein
blood finds alternative channels from portal vein to inferior vena cava thus bypassing the liver

32
Q

causes of portal hypertension

A

pre-hepatic: blockage before blood enters the liver
intra-hepatic: blockage within the liver
post-hepatic: blockage outside the liver

33
Q

consequences of portal hypertension

A

varices
ascites
hepatic encephalopathy

34
Q

oesophageal varices

A

rupture of varices due to erosion by gastric acid and increased venous pressure leads to haemorrhage

35
Q

ascites

A

accumulation of fluid in peritoneal cavity

fluid is trapped and cannot escape due to portal hypertension and reduced plasma proteins

36
Q

ascites are caused by:

A

cirrhosis, congestive heart failure, pancreatitis

37
Q

hepatic encephalopathy

A

complex neurologic syndomre characterised by impaired cerebral function, ECG changes, confusion, loss of consciousness coma and death

38
Q

colitis

A

ulceration of colonic mucosa usually from colon to rectum

39
Q

patho of colitis

A

primary lesion limited to mucosa, inflammation usually occurs in colon, mucosa becomes haemorrhagic - ulceration and necrosis follows

40
Q

ulcerative colitis (UC)

A

chronic inflammatory disease causing ulceration, abscess formation, necrosis of colonic and rectal mucosa ONLY

41
Q

symptoms of UC

A

cramping pain, bleeding, diarrheoa, dehydration and weight loss

42
Q

crohn disease

A

affects large and small inestines but also oesophagus to rectum
ulceration involves all layers of lumen

43
Q

symptoms of crohn disease

A

abdo tenderness and weight loss

44
Q

diverticular disease

A

outpouching of colonic mucosa through muscle layers of colon wall leading to weak wall

45
Q

divertiulosis:
diverticulitis:

A

presence of outpouching

inflammation of diverticula

46
Q

appendicitis

A

inflammation of appendix

47
Q

symptoms of appendicitis

A

nausea, pain, low grade fever

48
Q

Intestinal obstruction

A

mechanical obstruction of bowel lumen

49
Q

causes of intestinal obstruction

A

hernia

neoplasia

50
Q

polyps

A

benign growth into lumen of large intestine
can be: neoplastic - adenamatous (proliferation of crypt cells)
non-neoplastic - hyperplastic (raised lesions on colonic mucosa)

51
Q

haemorrhoids

A

dilation of venous plexus surrounding rectal and anal areas

dilated venous sacs protrude into rectal and anal canals: exposed, ulcerate, bleeding

52
Q

haemorrhoids are due to

A

constipation

pregnancy

53
Q

Cancer of oesophagus risk factors:

A
smoking
alcohol
malnutrition
reflux
sliding hiatal hernia
54
Q

symptoms of oesophageal cancer

A

dysphagia

chest pain

55
Q

cancer of the stomach

A

associated with high salt intake, food preservaties

56
Q

symptoms of stomach caner

A

weight loss

upper abdo pain

57
Q

colon and rectal cancer

A

pre-existing polyps highly associated with adenocarcinoma of colon
tumours of ascending colon usually large and bulky, tumours of descending and sigmoid colon develops as small button like masses

58
Q

symptoms of colon and rectal caner

A

pain
bloody stools
change of bowel habits and movement

59
Q

jaundice

A

yellow or greenish pigmentation of skin or sclera of eyes due to hyperbilirubinemia
can be obstructive - obstruction of bile canaliculi or ducts
haemolytic - destruction of RBC affects the livers abiilty to metabolise unconjugated bilirubin

60
Q

hepatorenal syndrome

A

functional kidney failure caused by advanced liver disease with portal hypertension
renal failure caused by reduced blood flow to kidneys usually due to massive GI haemorrhage or liver failure

61
Q

cirrhosis

A

irreversible inflammatory disease

disrupts liver structure and function

62
Q

liver cancer

A

caused by metastic spread from primary site elsewere in the body
primary carcinoma: hepatocellular (in hepatocytes)
cholangiocellular (in bile ducts)

63
Q

viral hepatitis

A

inflammation of liver with necrosis of hepatocytes

infection with hepatovirus

64
Q

pancreatitis

A

inflammation of pancreas

65
Q

causes of pancreatitis

A

alcoholism

peptic ulcers

66
Q

chronic and acute pancreatitis

A

chronic: due to structural or functional impairment of pancreas. recurrent abdo pain and digestive disorder
acute: causes - gallstones, alcohol abuse. assoc with hyperlipidaemia, hyperparathyroidism, viral infection, abdo and surgical trauma, drugs

67
Q

manifestation of pancreatitis

A
recurring episodes of epigastric and upper lieft quadrant pain 
anorexia
nausea and vomiting
constipation
flatulence
diabetes
malabsorption syndrome
68
Q

pancreatic cancer

A

adenocarcinoma arising in exocrine cells/ducts of the head, body and pancreatic tail
mortality 100%

69
Q

causes of pancreatic caner

A
smoking
diet
diabetes
chronic pancreatitis
genetic
70
Q

protective factorss against pancreatic cancer

A

dietary fiber
vitamin C
fresh fruits and veggies
no preservatives

71
Q

manifestations of pancreatic cancer

A

pain - dull epigastric pain and back pain, relieved by sitting forward
jaundice
weight loss
nausea and vomiting

72
Q

cholelithiasis

A

formation of gallstones

may retain in gallbladder or be ejected with bile into systic duct

73
Q

cholecystitis

A

acute or chronic inflammation of gallbladder or cystic duct
occurs due to gall stones lodged in cystic duct
gallbladder becomes distended or inflammed with pain similar to gallstones

74
Q

pigment stones

A

black stones - pts in a state of increased unconjugated bilirubin
brown stones - infection of biliary tree

75
Q

risk factors of gallbladder dysfunction

A
Forty
Fat
Female
Fertile
Family Hx
76
Q

Gallbladder cancer

A

primary carcinoma rare, mainly caused by metastasis

usually associated with cholelithiasis (stone formation)