Lesson 9 GI

Question 1

Digestive system include

Answer 1

Teeth
Tongue
Salivary glands
Liver
Gallbladder
Pancrease

Question 2

GI dysfunction manifestation

Answer 2

Anorexia
Vomiting嘔— forceful emptying of stomach
Nausea
Retching作嘔—non-productive vomitting
Diarrhea
Constipation-3days no output
Dysphagia-吞嚥困難
Hematemesis-vomitus present in blood

Question 3

GI manifestation-pain

Answer 3

Viseral pain
Related to nervous system

Burning sensation-inflammation or ulcer in upper digestive tract
Heartburn

Cramping

Colic 絞痛
Recurrent smooth muscle spasm

Question 4

GI dysfunction-bleeding related

Answer 4

Upper respiratory tract
—) Esophagus, stomach, duodenum

Lower respiratory tract
—) jejunum, ileum, colon, rectum

Hematichezia
—) blood poop

Melena
—) black stool

occult bleeding
—) hidden blood in stool

Question 5

GI dysfunction-jaundice
What happen?

Answer 5

Yellowish skin
High level of bilirubin
Bilirubin is a product of hemolysis 溶血
Grey stool

Question 6

GERD

Answer 6

Reflux of chyme from stomach to esophagus

Normal lower part of esophageal sphincter maintain high pressure to prevent chyme reflux

Manifestation:
Heartburn, upper abdominal pain
Appears for 30-60min after meal
Cause inflammation of esophagus

Question 7

Disorder of motility

Answer 7

Dysphagia
—difficulty in swallowing

Intestinal obstruction/ ileus腸阻塞
Lack of movement of intestinal content thru the intestine.
Ileus
—obstruction of intestine

Question 8

Gastritis
Is what?

Answer 8

Inflammatory disorder of gastric ulcer
—gastric mucosa is red and edematous
May be ulcerated
Bleeding

Question 9

Gastricenteritis
Is what?
Why
Manifestation

Answer 9

Inflammatory disorder to stomach and intestine

Infection by bacteria or virus
Allergic response to food

Clinical manifestation
Nausea
Vomit
Diarrhea
Abdominal cramp
Fever+ malaise

Question 10

Gastric ulcer

Answer 10

Increased mucosal permeability to hydrogen ions
—) appears at a small round cavity that penetrate the submucosa
—) eventually perforate the wall

Question 11

Duodenal ulcers
What bacteria?
Use what drug

Answer 11

H. Pylori infection

Hypersecretion of stomach acid and pepsin
Use NSAID

May cause by smoking

Question 12

Ulcerative colitis
Why…then cause
Causes
Manifestation
Treatment

Answer 12

Chronic inflammatory disease—) cause ulceration in colonic mucosa( sigmoid colon& rectum)

Infectious, dietary, genetic.

Manifestation: diarrhea 10-20/ day, bloody stool, cramping

Treatment
Antibiotic
Immunosuppressant agent

Question 13

Appendicitis
Possible cause

Answer 13

Obstrution, ischemia(缺血）infection, ulceration…
Rebound tenderness反覆痛
Peritonitis most bad

Question 14

Peritonitis
Is what?
How?
S/s

Answer 14

Is an inflammation on peritoneal membrane and other structures in abdominal cavity by chemical irritation

Bacteria invasion of sterile peritoneal cavity

Sudden generalized abdominal pain, vomit, fever

Treatment:
Antimicrobial drug

Question 15

Colonrectal cancer

Answer 15

1st most common cancer
M/F= 1.3/1
Screening is best prevention

Question 16

Hepatitis

Answer 16

Cause by fatty liver
Viral hepatitis
Chemical/ drug toxicity

Mild inflammation: obstruction
Severe inflammation: necrosis

Question 17

Hep A

Answer 17

Related to food ingestion
2-6weeks
Oral-fecal
Not carrier

Question 18

Hep B

Answer 18

Blood/ body fluid infection
1-6 months
Cause fibrosis/ cirrhosis
Have vaccine

Question 19

Hep C

Answer 19

Post transfusion (輸血）/ IV drug
50-80% turning into chronic hep/ carrier
Antiviral drug can heal 90%
No vaccine

Question 20

Manifestation in stages of hepatitis

Answer 20

Preiteric stage
Onset with fatigue, anorexia, nausea
Fever, headache

Iteric stage
Onset of jaundice as level of bilirubin rise
Tendered and enlarged liver

Posticteric stage
Reduction in signs
Acute stage of hep A last 8-10 week
Hep B prolonged to 16 weeks

Question 21

Treatment of hepatitis

Answer 21

High protein/ carb/ vitamins diet
Chronic —) eat interferon a to decrease viral replication

Question 22

Liver cirrhosis肝硬化

Answer 22

irreversible, inflammatory disease disrupt function& struture

Fatty cell/ necrosis

Fibrosis tissue synthesis and decrease hepatic function

Alcohol damage

Question 23

Gallbladder

Answer 23

Cholangitis—bile duct inflammation
Cholecystitis— inflammation of gallbladder
Cholelithiasis— gallstone

Question 24

Pancreas inflammation

Answer 24

Cause leakage of pancreatic enzyme into pancreatic tissue

Manifestation:
Back pain
Fever
Leukocytosis白血球增多
Chronic pancreatitis

Question 25

Drug in GI

Answer 25

Antacid
Neutrolize gastric acid—) raise pH

E.g. Mucaine

Antiemetic止嘔
Relieve vomitnig
e.g. Gravol

Laxatives
To treat constipation
Bulk forming— form gel like substance
E.g. metamucil MUST ADD 200ML WATER

Antidiarrhea/ relieve cramp
E.g. Lomotil

Antisoasmodic
Antispasm action to smooth muscle
E.e. Buscopan

H2 receptor inhibitor
Inhibit gastric acid secretion
E.g. Pepcidine