Lec 2 - GI disorders Flashcards
stage C2 colon/rectal cancer
B2 to regional lymph nodes
what are both the IBDs associated with
increased risk of colorectal cancer
are hemorrhoids serious
no
name two causes of malabsorption
problems with digestion
difficulty with absorption through intestinal wall
duodenal ulcers tend to develop in what kinds of people
young people
Type O blood
what causes pain with gall stones
contractions of the gallbladder
order of most to least common areas for ulcers
duodenum
stomach
lower esophagus
what happens to the brush borderwhen a celiac patient eats gluten
it becomes thickened and infiltrated with inflammatory cells
what happens when someone who has celiac eats gluten
they lose villous epithelium
what are some potential causes of crohns disease
autoimmune
genetics
diet
smoking
when will pain occur with gastric ulcers
right after eating - eating triggers acid release but theres nothing for the stomach to soak up yet
Describe the extent of damage between the two IBD
crohns: full thickness of wall
Ulcerative colitis: only the mucosa
when do colon and rectal cancer typically onset
after 50 years old
Name 5 ways duodenal ulcers are created
excess parietal cells
prolonged gastrin
too rapid gastric emptying
NSAIDs
cigarette stimulated acid secretion
Crohns disease is a ______ ______ disease
chronic inflammatory
what is the primary defect leading to gastric ulcers
abnormality that increases the permeability of mucosal barrier
what IBD only occurs in the rectum/colon
ulcerative colitis
what does the transport of chloride ions do
helps control the movement of water in tissues - necessary for production of thin mucus
what is a polyp
little outgrowth of tissue into the lumen of the LI
Stage D colon/rectal cancer
metastases in distant sites
Describe the different locations between the two IBD
Crohns: any region of GI tract (typically intestines)
Ulcerative colitis: rectum into colon ONLY
what are neoplams
they produce hormones that stimulate secretion
how do gallstones affect a person
blocks the flow of bile from gallbladder leading to pain
What is liver cirrhosis
end disease - enough damage has been done that it doesnt work anymore
how do we help irritable bowel
identifying personal triggers and avoiding those
what is a neoplasm
a cancer - can block the flow in the GI tract
how do excess parietal cells cause duodenal ulcers
they secrete acid, can cause a lower pH
what is a fistula
passageway that links an area of the SI with another
what ages are most common to have ulcerative colitis
20-40
What does the CFTR protein do
functions as a channel across the membrane of cells that provide mucus, sweat, enzymes etc
What gender is irritable bowel syndrome most common in
females
what can a barium xray do for UC patients
identify loss of haustra
how can pregnancy cause hemorrhoids
progesterone slows down motility of LI - constipation
also relaxes SM in LI and BV making varicosities more common
what is the most common symptom of duodenal ulcers
Pain 30min-2hr after eating
90-95% of stomach malignancies are ____
carcinomas
what are the three kinds of large volume diarrhea
osmotic
secretory
mixed (motility)
how does the body compensate with the removal of the gallbladder
the bile duct enlarges for storage
Name two treatments beside antacids for duodenal ulcers
PPIs
H2 blockers
Name the 5 main types of intestinal obstructions
hernia
volvulus
intussusception
neoplasm
adhesions
when do polyps become malignant and highly invasive
once they traverse the muscularis mucosae
How does alcohol cause cirrhosis
it becomes the primary metabolic feul
affects cell function
generates reactive oxygen species
what causes secretory diarrhea
bacterial endotoxins
neoplasmsw
stage A colon and rectal cancer
confined to mucosa
What does H pylori provoke
inflammatory response - can’t get rid of bacteria and ongoing inflammation damages mucosal cells
name some clinical signs of crohns disease
diarrhea
tenderness
malabsorption of B12
blood in stool
nausea etc
what occurs with appendicitis
the appendix gets blocked and therefore cannot drain - pressure inc
blood flow decreases and it can burst
describe secretory diarrhea
excessive secretion of fluid and electrolytes into intestinal lumen
inhibition of Na or Cl absorption
Describe the nature of lesions between the two IBD
Crohns: skip lesions
Ulcerative colitis: continuous inflammation that can move proximally
what occurs with hemorrhoids
the venous plexus around the rectal area dilates
what is the primary defect for gastric ulcers
abnormality that increases the permeability of the mucosal barrier
what antibodies are activated when gluten is eaten with celiac
anti gliadin
what is obstructive jaundice
yellow bile pigments go to blood and then to skin
what is a vovulus
a twist in the LI that makes a knot and can cause a complete obstruction
what is a sigmoidoscopy
where you go into the distal part of the colon to look at it
what happens to the epithelium when a celiac patient eats gluten
it becomes cuboidal rather than columnar
why are processed meats a carcinogen?
they have nitrites which turn into nitrosamine which is a carcinogen
Name the intestinal obstruction:
telescoping of one area, a part pushes back into another and narrows the pathway
Intussusception
what are some clinical signs of celiac disease
weight loss
lots of stinky and fatty poo
hypo-proteinemia
what are gastric ulcers typically associated with
gastric atrophy - mucus is mostly water
Stage B2 colon and rectal cancer
to serosa but not lymph nodes
how does lactose cause diarrhea
it stays in the SI and pulls water with it (it creates osmotic gradients)
how does high serum gastrin cause duodenal ulcers
strong simulator of acid secretion by parietal cells
*can be caused by H pylori
what might be lacking in gastric atrophy secretions
intrinsic factor
Name the intestinal obstruction:
things pushing down from the outside ie muscle and narrowing the passageway
adhesion
how is diverticulitis caused
strong contractions push some of the lumen out inbetween the 3 bands of longitudinal muscle in the LI
what is an intussusception
telescoping of one area, a part pushes back into another and narrows the pathway
what are ascites
fluid that builds up in the abdominal cavity
How does lactose cause gas
as lactose goes into the LI, the bacteria digest it, but gas is produced as a byproduct
what is fibrosis caused by
increased production of ECM components
Name the intestinal obstruction:
a twist in the LI that makes a knot and can cause a complete obstruction
a volvulus
Stage C1 colon/rectal cancer
B1 to regional lymph nodes
Where do we get lactase from
it’s a brush border enzyme from the SI
True or false: Crohns disease can affecct any segment of the GI tract
True
what hormones can alter intestinal motility
ones at the end of the luteal phase of cycle
what is mixed diarrhea
the rate of transit through intestine is too quick to allow water to be reabsorbed
what is the relationship between CF and the pancreas
The lack of CFTR makes very thick mucus and blocks the ducts - causing fibrosis, lack of enzymes, incomplete digestions and then nutritional deficiencies
celiac occurs more often in which gender
women
what part of the SI can cause malabsorption of B12 in crohns disease
ileum
what are polyps associated with
increased risk of colon and rectal cancer
Name the intestinal obstruction:
a cancer - can block the flow in the GI tract
a neoplasm
what happens with crohns disease
an inflammaotyr response occurs that goes through the whole thickness and can cause perforations and get part of the intestines stuck to another
what happens to epithelial villi when a celiac patient eats gluten
they get flattened or absent
whats the treatment for duodenal ulcers
anything to make the environment less acidic and allow the ulcer to heal
PPI
H2 blocker
antibiotics *h pylori
ulcer coating agents
what can cause hemorrhoids
constipation
pregnancy
what does fibrosis lead to
protal hypertension
what kind of tenderess is present with appendicitis
rebound
name 3 key causes of liver cirrhosis
alcoholism
viral hepatitis
nonalcoholic fatty liver disease
which are more chronic - gastric or duodenal ulcers
gastric - they also cause more anorexia, vomiting and weight loss
Stage B1 colon/rectal cancer
muscularis but not to serosa
what is an adhesion
things pushing down from the outside ie muscle and narrowing the passageway
what ages are typically affected by gastric ulcers
55-65
what is the most common site of ulcers
duodenum
what is the only definitive diagnosis method for gastric carcinoma
gastric biopsy
what does lactase do
turns lactose (a disaccharide) into a monosaccharide so we can digest it
How can a lack of fiber cause diverticulitis
it increases the risk of constipation, which means you’ll be straining more to poop
why does gastric carcinoma have such a low survival rate?
because there are no automatic red flags that say cancer
where does ulcerative colitis occur
rectum or colon
what are some clinical signs of appendicitis
pain in the lower right quadrant
nausea
vomiting
low-grade fever
how does bile get more concentrated in the gallbladder
water and salts get reabsorbed by the lining of the gallbladder - lipid soluble parts get concentrated
what is the origin of crohns disease thought to be
autoimmune
what is a major cause of duodenal ulcers
H pylori - but typically not enough
what are the two inflammatory bowel diseases
crohns disease
ulcerative colitis
what is the most common surgical emergency
appendicitis
whats the releationship between CF and CFTR
CFTR is missing an amino acid, and therefore breaks down - cannot reach the cell membrane to transport chloride ions
what is appendicitis
inflammation of vermiform appendix
what is a hernia
a little bit of the intestine gets pushed through the abdominal wall and gets stuck there
How do bacteria in our digestive system get their nutrition
by digesting carbohydrates that we cannot
what is an adenocarcinoma
cancer of the epithelial cells
what are some clinical signs of UC
pooping more often
bleeding
pain
fever
how do you diagnose celiac
do blood work to look for antibodies
get an intestinal biopsy
what is different between irritable bowel and colitis
irritable bowel doesnt damage the intestinal wall nor does it have an increased risk of colorectal cancer
who do gastric ulcers affect most
55-65 year olds
describe osmotic diarrhea
a non-absorbable substance in intestine draws water into lumen by osmosis
Name the intestinal obstruction:
a little bit of the intestine gets pushed through the abdominal wall and gets stuck there
Hernia
how many bands of longitudinal muscle are there in the large intestine
3
How do you diagnose duodenal ulcers 3
barium xray films
flexible endoscopy
gastric biopsy (h pylori)
whats the main line of treatment for crohns
to supress the immune response
