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MLSCI 263 > LECTURE - GI Function Testing > Flashcards

LECTURE - GI Function Testing Flashcards

1
Q

Dyspepsia

A

Indigestion

  • upper abdominal pain related to eating
  • affects up to 25-30% of Canadians

Symptoms:

  • heartburn, regurgitation (reflux)
  • excessive burping, belching
  • fullness, bloating
  • nausea
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2
Q

secretion of gastric acid

A
  • cephalic: stimulatory via vagus nerve and Ach
  • gastric: stimulatory via gastrin and histamine
  • intestinal: stimulatory via gastrin, inhibitory via enterogastrones (somatostatins, VIP = vasoactive intestinal peptide)
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3
Q

endoscopy

A

visually assess tissue and collect biopsies

- via esophageal gastro duodenal scope

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4
Q

common infection that colonizes gastric mucosa

A

H. pylori

>50% of worldwide population

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5
Q

this causes chronic active gastritis

A
  • usually asymptomatic; affects lining of stomach
  • can cause pain = dyspepsia = peptic ulcer disease (PUD)
    > duodenal (90%) or lower gastric area (75%)
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6
Q

this is associated with gastric cancer and MALT lymphoma

A

H. pylori

can lead to this if not treated ith antibiotics, etc.

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7
Q

urea breath test

A
  • detects active infection

- 13C/UBT

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8
Q

serology for H. pylori

A
  • detects Abs to H, pylori
  • 15% false pos; only useful if negative
  • cannot prove erdication
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9
Q

stool Ag test

A

detects H. pylori Ag

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10
Q

biopsy for H. pylori

A
  • rapid urease test: a time of endoscopy
  • send to pathology: histology
  • send to microbiology: culture
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11
Q

serum gastrin conctn may be increased due to:

A 
- increased production by G cells
 > hyperplasia,hyperfunction, adenoma
- decreased acid inhibition
 > pernicious anemia, PPI therapy (goes too far)
- decreased excretion
 > renal failure
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12
Q

backwash of acid enters esophagus

A

GERD

gastro esophageal reflux disease

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13
Q

Celiac disease

A

significant malabsorption due to loss of microvilli
- autoimmune disease of bowel triggered by immune response to
gluten protein that cross-reacts with small bowel tissue
=> inflammation => flattening of villi => malabsorption

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14
Q

symptoms of Celiac disease

A

weight loss, diarrhea, flatulence, abdominal distension, nutritional defs

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15
Q

treatment of Celiac disease

A 
- removal of dietary gluten 
barley
rye
oats
wheat
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16
Q

serum tests for Celiac disease

A

done hwen daily diet contains gluten

  • ATTG = IgA (anti-humn tissue transglutaminase)
  • EMA = IgA (endomysal antibody)
17
Q

list off malabsorption diseases

A
  • Celiac
  • CF
  • inflammatory bowel disease
    > Crohn’s
    > ulcerative colitis
  • short bowel syndrome
18
Q

Cystic Fibrosis

A
  • autosomal recessive

- gene mutation…

19
Q

sweat chloride test

A
  • elevate [Cl-] in sweat and tears in cystic fibrosis
    > elevated dramatically in people with CF
    > done with pad; electric current to draw Cl- to pad
20
Q

IBD

A
  • inflammatory bowel disease
  • Crohn’s/Ulcerative Colitis
    > inflammation, unknown etiology
    > intermittent diarrhea, rectal bleeding
  • string signs = diagnostic for Crohn’s
21
Q

calprotectin

A
  • compromises 60% of cytosolic proteins in neuts
  • neust accumulate at sites of GI inflammation; shed into stool where mucosa architecture is disrupted
  • [calprotectin] directly correlates with extent of inflammation
    > evenly distributes in stool
    > distinguishes IBD from Irritable Bowel Syndrome
    > distinguishes active from inactive IBD
22
Q

short bowel syndrome

A
  • decrease absorptive surface area (<2 m present)
  • can be congenital
  • or acquired ( some of bowel has been removed or resected bc of disease)
23
Q

irritable bowel syndrome

A
  • commonest cause of chronic diarrhea in otherwise healthy persons
  • overlap in syndromes
  • symptoms; pain plus an altered bowel habit
24
Q

colorectal cancer

A
  • 2nd leading cause of cancer death in NA
  • arise from adenomatous polyps (precancerous)
  • early detection = bleeding from colon
  • sigmoidoscopy and colonoscopy
25
Q

colorectal cancer tests

A

fecal occult blood test (FOBT)
fecal Hb > 2 mg/g stool

  • Guaiac FOBT: detect heme peroxidase activity
  • immunological FOBT; detect globin of human Hb (iFOBT = immunochemical FOBT); FIT test (fecal immunochemical test)
26
Q

xylose tolerance test

A
  • sugar absorption test; rarely done; for maldigestion and/or malabsorption
    > give 25 g xylose orally to fasting adult
    > collect blood at fasting and 2h
  • xylose fasting should be ‘0’
    > 2 h will be 0 if malabsorbed
27
Q

lactose tolerance test

A
  • lactase deficiency test; common; test for maldigestion/malabsorption
  • give 50g lactose orally to fasting adult
  • collect blood at fasting, 30, 60, 120 mins post-dose

[ glucose] = a rise > 1.7 mmol/L = lactose intolerance

  • a rise <1.1 mmol/L = lactose intolerant; lactase deficient
  • a rise 1.1-1.7 mmol/L = inconclusive
28
Q

causes of dyspepsia

A
  • NOT STRESS OR DIET
  • H. pylori
  • acid: stomach secretion, NSAIDs, acid reflux

MLSCI 263 (31 decks)

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