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Anatomy and Phyisology > HLTH 2501: lower GI tract disorders > Flashcards

HLTH 2501: lower GI tract disorders Flashcards

1
Q

gliadin

A

a breakdown product of gluten

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2
Q

celiac disease

A

is a malabsorption syndrome that occurs due to a defect in the intestinal enzymes that prevents the digestion of glidin, causing a toxic effect in the intestinal villi

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3
Q

effect of celiac disease on the villi

A

the villi atrophy, resulting in decreased enzyme product and less surface area available for nutrient absorption

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4
Q

effect of celiac disease

A

mainly is malabsorption and malnutrition which manifest as steatorrhea, muscle wasting, failure to gain weight, and irritability and malaise; individuals are at a higher risk for intestinal lymphoma

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5
Q

steatorrhea

A

excessive amounts of fat in your poop

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6
Q

how is celiac dianogsed?

A

blood tests that check for autoantibodies, a duodenal biopsy, and testing a gluten-free diet

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7
Q

how is celiac disease treated?

A

gluten-free diet

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8
Q

what are chronic inflammatory bowel diseases (2)

A

crohn disease and ulcerative colitis

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9
Q

genetic causes of IBD

A

common in white persons, particularly those from Eastern Europe

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10
Q

serum levels of those with IBD

A

high levels of antibodies, human leukocyte antigen, cytoskins, interleukin, and T lymphocytes

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11
Q

differences between Crohn’s and ulcerative colitis

A

Crohn’s develops during adolescence and ulcerative colitis in later years

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12
Q

what areas of the GI tract does Crohn’s effect?

A

the terminal ileum and sometimes the ascending colon

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13
Q

inflammation in Crohn’s disease

A

occurs in skip lesions, which are affected segments clearly separated by areas of normal tissue; initially occurs in the mucosal layer, but will progress to affect all layers of the wall

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14
Q

intestines of those with Crohn’s disease

A

narrow lumen that may become totally obstructed, granulomas may appear, and motility is decreased, thus decreasing the time for digestion and absorption

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15
Q

effects of Crohn’s disease

A

hypoproteinemia, avitaminosis, malnutrition, and possibly steatorrhea; ulcers may also form

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16
Q

signs of Crohn’s disease

A

diarrhea with cramping, melena may occur if the uclers erode blood vessels, pain in the LRQ, anorexia, weight loss, anemia, fatigue, delayed growth, and psychological implications

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17
Q

where does ulcerative colitis occur

A

in the rectum and throughout the colon

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18
Q

inflammation in ulcerative colitis

A

inflammation occurs in the mucosa and the submucosa, and the tissue becomes edematous (swollen) and friable (easily crumbled), and ulcers develops; in an attempt to heal, granulation tissue develops

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19
Q

toxic megacolon

A

occurs in severe acute episodes of ulcerative colitis; inflammation impairs peristalsis, leading to obstruction and dilation of the colon, usually the transverse colon

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20
Q

risks of ulcerative colitis

A

colorectal carcinoma

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21
Q

signs of ulcerative colitis

A

diarrhea with blood and mucus, cramping pain, tenesmus (persistent spasms of the rectum), rectal bleeding, iron-deficiency anemia, fever, and weight loss

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22
Q

treatment of IBD

A

removing physical and emotional stressors, anti inflammatory medications, antimotility agents, nutritional supplements, antimicrobials, immunotherapeutic agents, and surgical procedures such as an ileostomy and colostomy

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23
Q

anti inflammatory drugs for IBDs

A

sulfasalazine or glucocorticoids

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24
Q

antimotility drugs for IBDs

A

loperamide or anticholinergic drugs

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25
Q

recommended diet for IBDs

A

high in protein, vitamins, and calories, but low in fat

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26
Q

antimicrobials for IBDs

A

metronidazole or ciprofloxacin

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27
Q

IBS

A

a gastrointestinal disorder characterized by abdominal pain/discomfort and changes in normal bowel habits

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28
Q

primary symptoms of IBS

A

symptoms of diarrhea, constipation, or pain

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29
Q

different types of IBS

A

abnormal GI motility and secretion, visceral hypersensitivity, post infectious IBS, overgrowth of flora, food allergy or intolerance, and psychosocial factors

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30
Q

abnormal GI motility and secretion IBS

A

diarrhea or constipation that is caused by hypersensitivity or serotonin on the ENS

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31
Q

visceral hypersensitivity IBS

A

increased sensitivity to visceral pain; can be abnormal motility but also activated mast cells and T lymphocytes or the CNS

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32
Q

postinfectious IBS

A

caused by low-grade inflammation in the gut and an abnormal immune response; often is associated with bacterial enteritis

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33
Q

overgrowth of flora IBS

A

can cause constipation and bloating due to methane gas production which is a result of overgrowth of the normal flora in the gut

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34
Q

food allergy or intolerance IBS

A

certain food antigens activate the immune response in the mucosa, causing a hypersensitivity reactions and IBS symptons

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35
Q

psychosocial factors for IBS

A

IBS symptoms may be caused by emotional stress, which in turn affects the ANS and the neuroendocrine pathway

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36
Q

signs of IBS

A

lower abdominal pain, diarrhea, constipation, alternating diarrhea and constipation, gas, bloating, and nausea

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37
Q

diagnosis of IBS

A

based on the signs and symptoms and the exclusion of any metabolic problems; tests for food intolerances can confirm the diagnosis

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38
Q

rome criteria

A

an established guide for diagnosing IBS

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39
Q

treatment for IBS

A

may include laxatives, fiber supplements, antidiarrheal medication, antidepressants, analgesics for pain, antispasmodic medications, and medication to balance serotonin levels

40
Q

two medications suggested for IBS treatment

A

alosetron (lotronex), this relaxes the colon and slows the movement of waste through the lower bowel; and lubiprostone (amitiza) which works by increasing fluid secretion in the intestine to help with the passage of stool

41
Q

appendicitis

A

is an inflammation and infection in the vermiform appendix

42
Q

how does appendicitis develop?

A

obstruction of the appendiceal lumen, fluid and microorganism buildup in the appendix, inflamed appendiceal wall, purulent exudate forms, ischemia and necrosis of the wall which results in increased permeability, bacteria and toxins escape the wall and which leads to abscess formation or localized bacterial peritonitis, local infection around the appendix which causes pressure, appendix will rupture or has to be removed

43
Q

what obstructs the appendiceal lumen in appendicitis?

A

a fecalith (mass of feces), gallstone, or foreign material

44
Q

abscess

A

a pocket of pus

45
Q

why would the appendix bursting be dangerous?

A

because it would release its contents into the peritoneal cavity

46
Q

signs of appendicitis

A

steady and severe pain and tenderness in the LRQ, nausea and vomiting, low-grade fever, and sometimes tachycardia or hypotension

47
Q

treatment for appendicitis

A

surgical removal and antimicrobial drugs

48
Q

diverticular disease

A

refers to problems related to the development of the diverticula

49
Q

what is a diverticulum?

A

a herniation or outpouching of the mucosa through the muscle layer of the colon wall (commonly in the sigmoid colon)

50
Q

diverticulosis

A

asymptomatic diverticular disease whereas multiple diverticula are present

51
Q

diverticulitis

A

inflammation of the diverticula; common in the Western world

52
Q

where do diverticulum develop?

A

in gaps between bands of longitudinal muscle that coincide with opening in the circular muscle bands, often in the sigmoid colon

53
Q

what causes diverticula?

A

low-residue diets, irregular bowel habits, and aging lead to constipation and then to muscle hypertrophy, leading to the development of diverticula

54
Q

problems that may arise with diverticula

A

intestinal obstruction, perforation with peritonitis, and abscess formation

55
Q

signs of diverticular disease

A

usually is asymptomatic but signs may be mild discomfort, diarrhea, constipation, flatulence, LLQ pain, nausea, and vomiting

56
Q

treatment for diverticula

A

increasing the bulk in the diet and omitting foods such as seeds and popcorn

57
Q

colorectal cancer prevalence

A

common cancer and is the second leading cause of cancer-related deaths

58
Q

polyp

A

is a mass, often on a stem that protrudes into the lumen; as they grow, they carry an increased risk of dysplasia and malignant changes

59
Q

what do most malignant neoplasms result from in colorectal cancer?

A

adenomatous polyps

60
Q

napkin-ring growth

A

carcinomas that commonly develop in the left colon

61
Q

projecting polypoid masses

A

carcinomas that often develop in the right colon

62
Q

what other areas of the body do colorectal neoplasms affect?

A

the mesentery, the abdominal wall, the lymph nodes, and the liver

63
Q

what is staging of colorectal cancer based on?

A

the degree of local invasion, lymph node involvement, and the presence of disant metastases

64
Q

what antigen do adenocarcinomas release into the blood?

A

CEA

65
Q

risk population for colorectal cancer

A

those 55+, Western countries, familial multiple polyposis, long-term ulcerative colitis, genetic factors, and diets high in fat, sugar, and red meat, and low in fibre

66
Q

signs of colorectal cancer in the rectosigmoid area

A

is often asymptomatic but can be obstruction in the proximal colon, vague cramping pain, ribbon stool, and feelings of incomplete emptyings

67
Q

signs of colorectal cancer in the right colon

A

liquid fecal material, fatigue, weight loss, and iron-deficiency anemia

68
Q

treatment for colorectal cancer

A

surgical removal of the involved area, usually requiring a colostomy; chemotherapy and radiation therapy may be used after surgery

69
Q

colostomy

A

an artificial opening into the abdominal wall where feces may be collected in a bag

70
Q

intestinal obstruction

A

refers to a lack of movement of the intestine contents through the intestine; more common in the small intestine than the large

71
Q

two forms of intestinal obstruction

A

mechanical or functional

72
Q

mechanical obstructions

A

result from tumors, adhesions, hernias, scar tissue, volvulus, or other tangible obstructions

73
Q

functional obstructions

A

result from neurological impairment such as a spinal cord injury or a lack of propulsion

74
Q

paralytic ileus

A

refers to functional intestinal obstructions resulting from neurological impairment

75
Q

sequence of events for mechanical intestinal obstruction

A

gases and fluids accumulate, strong contractions occur to move contents, increased pressure leads to more secretions into the intestines, persistent vomiting, ischemic and necrotic intestinal wall, decreased peristalsis, rapid reproduction of bacteria, and generalised peritonitis

76
Q

sequence of events for functional obstruction

A

peristalsis cease, fluids and electrolytes accumulate in the intestine, and reflex spasms do not occur; the result of the process is similar to mechanical obstruction

77
Q

causes of functional intestinal obstructions

A

spinal cord injuries, after abdominal surgeries due to anesthesia combined with inflammation and ischemia, pancreatitis, peritonitis, ro infection in the abdominal cavity, and hypokalemia

78
Q

volvulus

A

twisting of a section of intestine on itself

79
Q

hirschsprung disease

A

a condition which parasympathetic innervation is missing from a section of the colon; can cause mechanical intestinal obstruction

80
Q

how would Crohn’s or diverticulitis lead to mechanical intestinal obstruction?

A

chronic inflammation of the GI tract

81
Q

signs of intestinal obstruction

A

abdominal pain, constipation, borborygmi, vomiting, restlessness, diaphoresis, tachycardia, dehydration and weakness due to electrolyte imbalances

82
Q

borborygmi

A

audible rumbling sounds caused by movement of gas in the intestine

83
Q

treatment for intestinal obstruction

A

treating the underlying causes and replacing fluids and electrolytes

84
Q

peritonitis

A

an inflammation of the peritoneal membrane that may result from chemical irritation or from bacterial invasion; chemical irritation will lead to bacterial peritonitis

85
Q

why might the peritoneal membrane be inflamed?

A

chemical irritants, chyme, or foreign objects in the cavity; this inflammation then increases permeability, allowing enteric bacteria to enter the cavity; necrosis of perforation also allows for bacterial entry

86
Q

what initially occurs when local inflammation develops in the abdominal cavity?

A

the peritoneum and omentum produce a thick, sticky exudate to seal the area and localize the problem

87
Q

peritoneum anatomy

A

a large sterile expanse of highly vascular tissue that covers the viscera and lines the abdominal cavity

88
Q

results of peritonitis

A

increased permeability of vessels leads to large volumes of fluid in the cavity, followed by hypovolemic shock; fluid, proteins, and electrolytes are not circulating

89
Q

causes of peritonitis

A

chemical peritonitis, bacterial peritonitis. abdominal surgery, and pelvic inflammatory disease

90
Q

signs of peritonitis

A

generalized abdominal pain, vomiting, hypovolemia, dehydration, decreased skin turgor, dry buccal mucosa, pallor, low BP, tachycardia, fever, and decreased bowel sounds

91
Q

treatment for peritonitis

A

surgery is often required to correct the cause and drain infection sites, antimicrobials, fluid and electrolyte replacement, and sometimes nasogastric suction

92
Q

fistulas

A

form in those with Crohn’s when ulcers may erode through the abdominal wall; occur often between loops of intestine

93
Q

immunotherapeutic agent for IBD

A

azathioprine

94
Q

what in general does celiac disease cause?

A

a digestive block and an immune response

95
Q
A

Anatomy and Phyisology (94 decks)

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