Lec 1 - GI disorders Flashcards
What bacteria causes scarlet fever
Group A streptococcus
what does chronic gastritis cause
thinning and degernation of gastric wall
myotomy
cut GE sphincter muscles
what does myxovirus cause
mumps
what is emesis
vominting
Word for “difficulty in swallowing”
Dysphagia
What big symptom does group A streptococcus cause
Strawberry tongue
Describe stomatits
ulcerative inflammation of one or more areas of oral mucosa
what division of the ANS stimulates saliva production
parasympathetic
what gastritis is typically superficial erosion
acute
why can lipid soluble drugs cause gastric bleeding
creates a path through stomach mucosa into blood stream - can allow blood to ente
esophageal hiatus
break in the diaphragm to allow esophagus to enter abdomen
what are PGs
prostaglandins
why is inhibition of PGs bad
they make mucus, and inhibition means less of a barrier for epithelial cells
Another word for a dry mouth
Xerostomia
what is the treatment for acute gastritis
antacids
stopping drugs
antibiotics if H pylori
PPI or H2 blocket for less acid
what type of chronic gastritis is associated with persistent inflammation (h pylori)
antral
Type B
what produces urease
h pylori
what does pepsin do
digest proteins
what stimulates vagus nerve - increases gastric secretions
insulin
what type of chronic gastritis is not associated with function losses
antral
Type B
What are PPIs used for
treating GERD
what is a risk factor for h pylori
age
sympathetic division of ANS ______saliva secretion
inhibits
What does GERD stand for
Gastroesophageal refulx
how do nicotine and caffeine influence the stomach
increase amount and acidity of gastric secretions
What causes strawberry tongue
Scarlet fever
how do corticosteroids or stress influence the stomach
increase acid/pepsinogen secretion
decrease blood flow to stomach wall
Angular stomatits is also known as
Angular chelitis
what type of chronic gastritis is more common
Antral
Type B
what type of chronic gastritis is auto-immune
fundal
Type A
What is esophagitis
inflammation of esophageal mucosa
what hiatal hernia typically needs surgery
rolling - can cut off blood supply to part of the stomach
is reflux common in rolling hiatal hernias?
no, because GE remains below diaphragm
what is manometry
pressure catheter inserted to measure pressure changes in esophagus during swallowing
how do aspirin, alcohol, bile salts influence the stomach
alter permeability of epithelial barrier
cut GE sphincter muscles surgery name
myotomy
why is esophageal cancer so deadly
; usually asymptomatic until unresectable
What causes oral thrush
Candida albicans
how to diagnose esophageal cancer
endoscopy+biopsy
barium swallow
Dysphagia
Difficulty in swallowing
What are esophageal varices
protrusion of esophageal veins into esophageal lumen
veins into lumen
breath tests can diagnose what bacteria
h pylori
what is gravol to H1 receptors
an antagonist
what does helicobacter pylori produce
urease
What is the average saliva output
1000-1500ml/day
What hiatal hernia is sporadic
sliding
What causes mumps
myxovirus
what alter permeability of epithelial barrier
asprin
alcohol
bile salts
what does stress do for achalasia
increase the symptoms
What is achalasia
an uncommon disorder of esophageal motility
what increase acid/pepsinogen secretion
decrease blood flow to stomach wall
corticosteroids
stress
what do NSAIDS do in the stomach
inhibit PG release
^ they make mucus
what is the strongest acid stimulator
histamine
what hiatal hernia is continuous
rolling
what stimulates vomiting
CNS
What are the 3 typical acid stimulators
Gastrin
Histamine
ACh
what are the symptoms of gerd
substernal pain
where does h pylori embed
mucus layer of stomach
Xerostomia
A dry mouth
name some ways to treat achalasia
small meals
dialation of GE sphincter with balloon
Myotomy
Botox
what increase amount and acidity of gastric secretions
caffeine and nicotine
rolling hiatal hernia
part of greater curvature of stomach protrudes through 2nd or enlarged opening in diaphragm
what occurs with achalasia
atrophy of smooth muscle
degeneration of esophageal ganglion cells
how does insulin influence the stomach
stimulates vagus nerve - increases gastric secretions
what causes esophageal varices
portal hypertension (cirrhosis)
who typically has chronic gastritis
elderly people
What are the two kinds of gastritis, and the two places it affects
acute
chronic
fundus
antrum
Which is more common: sliding or hiatial hernia
sliding (90%)
What can GERD cause long term
esophagitis
barretts esophagus
what are 3 potential causes for hiatal hernias
defect in diaphragm
weakening of diaphragm muscles
increased abdominal pressure
what kind of drugs can easily cross stomach mucosa into blood
lipid soluble
like asprin
concerns with prolonged vomiting
dehydration
acid base balance
What is the target of achalasia treatment
The GE sphincter
Barretts esophagus
cells lining esophagus change into simple columnar (same as stomach)
what percent of hiatal hernias are rolling
10
what decreases output of mucus by gastric mucosa
asprin
What is a side effect of relaxing the GE sphincter
GERD
What are the symptoms of infections/ stones in salivary glands
Pain and swelling when getting ready to eat - saliva production
why are we concerned with vein rupture with esophageal varices
because the veins are so thin walled
What do PPIs act on
the proton pump
What is an H2 blocker
Histamine - 2 blocker
(2nd receptor is the one responsible for making acid in the stomach)
Where is the GE sphincter supposed to lie
at the level of the diaphragm
Esophageal cancer prognosis
16%, very poor
Barretts esophagus increases the risk of:
adenocarcinoma
cancer
what is acute gastritis typically from
injury of mucosal barrier via drugs or H pylori
what are the symptoms of gastritis
abdominal disconfort
bleeding
epigastric tenderness
what center in the brain activates emesis
emetic center in medulla
sliding hiatal hernia
stomach + GE sphincter slide through esophageal hiatus (when lying down or abdominal pressure increases)
What can longterm use of PPIs lead to
malabsorption of B12, iron, magnesium, calcium
what represents 5-10% of GI malignancies
esophageal cancer
what type of chronic gastritis is most severe
fundal
Type A
what does emetic center do (3)
muscles of abdominal wall and diaphragm contract
GE spincter relaxes
soft palate rises to close nasal passages
pressure catheter inserted to measure pressure changes in esophagus during swallowing
Manometry
What are NSAIDS
non steroidal anti inflammatory drugs
inflammation of gastric mucosa
gastritis
what is the mortality for ruptures esophageal varices
40%
what is the most effective way to diagnose GERD
pH measurement and biopsy
what disease causes GE tone loss
Achalasia
What does candida albicans cause
Oral thrush
Name the 5 most common symptoms of GI disorders
Dysphagia
Esophageal/abdominal pain
Vomiting (emesis)
Gas
Diarrhea/constipation
What is gastritis
inflammation of gastric mucosa
What makes GERD pain worse
lying down (supine)
what are the symptoms of esophageal cancer
mild dysphagia
weight loss
how can breath tests detect h pylori
drink urea with radioactive carbon
urease (h pylori) turns it into NH3 and CO2
breath out radioactive CO2
Achalasia is a _______ disease
progressive
what digests proteins
pepsin
name 3 things caused by achalasia
(i) decreased peristalsis of esophagus
(ii) loss of tone of GE sphincter in between meals
(iii) decreased relaxation of GE sphincter in response to swallowing
how do you diagnose achalasia
barium swallow
Manometry
what is a concern for esophageal varices
ruptured veins, tremendous bleeding into GI system
how does gravol reduce nausea
reduces activation of vestibular/emetic centers via histaminergic neural pathways
what is fundal chronic gastritis
body makes antibodies to parietal/ gastric cells or intrinsic facts
What causes angular chelitis
B12 vitamin deficiency
what is type A and type B chronic gastritis
a - fundal
b - antral
who does achalasia affect
older individuals
what reaction does urease catalyze
urea -> NH3 and CO2
