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Clinical Science 2016 > GIT > Flashcards

GIT Flashcards

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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
Peptic ulcers
acidic component that is causative in the disease progression mucosal ulceration of stomach or duodenum
26
risk factors of peptic ulcers
smoking, alcoho, RA, cirrhosis, anti-inflammatory drugs, h.pylori, NSAIDS, aspirin
27
types of peptic ulcers
duodenal gastric stress
28
duodenal ulcers
increased gastrin which increases HCl production | symptoms: collicky, pain when stomach is empty
29
gastric ulcers
developed in antrum of stomach gastric secretion normal or reduced pain after eating
30
stress ulcers
develops after stress/trauma due to ischaemia ischaemic: develops hours after heamorrhage cushing: develops from reduced blood, increased HCl production
31
portal hypertension
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
causes of portal hypertension
pre-hepatic: blockage before blood enters the liver intra-hepatic: blockage within the liver post-hepatic: blockage outside the liver
33
consequences of portal hypertension
varices ascites hepatic encephalopathy
34
oesophageal varices
rupture of varices due to erosion by gastric acid and increased venous pressure leads to haemorrhage
35
ascites
accumulation of fluid in peritoneal cavity | fluid is trapped and cannot escape due to portal hypertension and reduced plasma proteins
36
ascites are caused by:
cirrhosis, congestive heart failure, pancreatitis
37
hepatic encephalopathy
complex neurologic syndomre characterised by impaired cerebral function, ECG changes, confusion, loss of consciousness coma and death
38
colitis
ulceration of colonic mucosa usually from colon to rectum
39
patho of colitis
primary lesion limited to mucosa, inflammation usually occurs in colon, mucosa becomes haemorrhagic - ulceration and necrosis follows
40
ulcerative colitis (UC)
chronic inflammatory disease causing ulceration, abscess formation, necrosis of colonic and rectal mucosa ONLY
41
symptoms of UC
cramping pain, bleeding, diarrheoa, dehydration and weight loss
42
crohn disease
affects large and small inestines but also oesophagus to rectum ulceration involves all layers of lumen
43
symptoms of crohn disease
abdo tenderness and weight loss
44
diverticular disease
outpouching of colonic mucosa through muscle layers of colon wall leading to weak wall
45
divertiulosis: diverticulitis:
presence of outpouching | inflammation of diverticula
46
appendicitis
inflammation of appendix
47
symptoms of appendicitis
nausea, pain, low grade fever
48
Intestinal obstruction
mechanical obstruction of bowel lumen
49
causes of intestinal obstruction
hernia | neoplasia
50
polyps
benign growth into lumen of large intestine can be: neoplastic - adenamatous (proliferation of crypt cells) non-neoplastic - hyperplastic (raised lesions on colonic mucosa)
51
haemorrhoids
dilation of venous plexus surrounding rectal and anal areas | dilated venous sacs protrude into rectal and anal canals: exposed, ulcerate, bleeding
52
haemorrhoids are due to
constipation | pregnancy
53
Cancer of oesophagus risk factors:
``` smoking alcohol malnutrition reflux sliding hiatal hernia ```
54
symptoms of oesophageal cancer
dysphagia | chest pain
55
cancer of the stomach
associated with high salt intake, food preservaties
56
symptoms of stomach caner
weight loss | upper abdo pain
57
colon and rectal cancer
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
symptoms of colon and rectal caner
pain bloody stools change of bowel habits and movement
59
jaundice
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
hepatorenal syndrome
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
cirrhosis
irreversible inflammatory disease | disrupts liver structure and function
62
liver cancer
caused by metastic spread from primary site elsewere in the body primary carcinoma: hepatocellular (in hepatocytes) cholangiocellular (in bile ducts)
63
viral hepatitis
inflammation of liver with necrosis of hepatocytes | infection with hepatovirus
64
pancreatitis
inflammation of pancreas
65
causes of pancreatitis
alcoholism | peptic ulcers
66
chronic and acute pancreatitis
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
manifestation of pancreatitis
``` recurring episodes of epigastric and upper lieft quadrant pain anorexia nausea and vomiting constipation flatulence diabetes malabsorption syndrome ```
68
pancreatic cancer
adenocarcinoma arising in exocrine cells/ducts of the head, body and pancreatic tail mortality 100%
69
causes of pancreatic caner
``` smoking diet diabetes chronic pancreatitis genetic ```
70
protective factorss against pancreatic cancer
dietary fiber vitamin C fresh fruits and veggies no preservatives
71
manifestations of pancreatic cancer
pain - dull epigastric pain and back pain, relieved by sitting forward jaundice weight loss nausea and vomiting
72
cholelithiasis
formation of gallstones | may retain in gallbladder or be ejected with bile into systic duct
73
cholecystitis
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
pigment stones
black stones - pts in a state of increased unconjugated bilirubin brown stones - infection of biliary tree
75
risk factors of gallbladder dysfunction
``` Forty Fat Female Fertile Family Hx ```
76
Gallbladder cancer
primary carcinoma rare, mainly caused by metastasis | usually associated with cholelithiasis (stone formation)

Clinical Science 2016 (9 decks)

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