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PC705 Pathophysiology > Module 7 Gastrointestinal, Liver, Gallbladder, and Pancreas Disorders > Flashcards

Module 7 Gastrointestinal, Liver, Gallbladder, and Pancreas Disorders Flashcards

0
Q

Causes of stomatitis.

A

Bacteria, viruses, mechanical trauma, irritant chemicals, medications (chemo), radiation, nutritional deficiencies.

Reiter syndrome or bechet syndrome.

Idiopathic

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1
Q

Define stomatitis.

A

An ulcerative inflammation of the oral mucosa that may extend to the buccal mucosa, lips, and palate.

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2
Q

What is the most common cause of stomatitis?

A

Herpes virus.

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3
Q

Define gastroesophageal reflux disease (GERD).

A

A backflow of gastric contents into the esophagus.

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4
Q

Causes of GERD.

A

Multifactorial. Any condition or agent that alters the closure strength and efficacy of the LES or increases intraabdominal pressure.

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5
Q

Clinical manifestations of GERD.

A

Heartburn, regurgitation, chest pain, and dysphasia.

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6
Q

What is a complication of GERD?

A

Barrett esophagus.

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7
Q

Define gastritis.

A

An inflammation of the stomach lining.

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8
Q

Causes if acute gastritis.

A

Ingestion of alcohol, aspirin, or irritating substances, As well as bacterial, viral and autoimmune illnesses.

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9
Q

Causes of chronic gastritis.

A

H. Pylori

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10
Q

Symptoms of gastritis.

A

Anorexia, nausea, vomiting, and postprandial discomfort. May be a symptomatic.

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11
Q

Define peptic ulcer disease.

A

Injury to the mucosal lining (break or ulcer) of the esophagus, stomach or duodenum

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12
Q

Causes of peptic ulcer disease.

A

Caused by action of hydrochloric acid and pepsin.

In the duodenum, inappropriate excess secretion of acid is a major factor. H. Pylori is also a factor.

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13
Q

Symptoms of peptic ulcer disease (PUD).

A

Epigastric burning pain, usually relieved by food.

Gastric ulcer: pain usually occurs on empty stomach.

Duodenal ulcer: pain usually occurs 2-3hours after eating (relieved by eating more).

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14
Q

What is the most common cause of emergency abdominal surgery?

A

Appendicitis

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15
Q

Define appendicitis

A

Inflammation of the vermiform appendix due to obstruction by fecalith.

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16
Q

Who does appendicitis most commonly affect?

A

Twice as likely under age 45 and affects men more than women. Peak age 10-19.

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17
Q

Clinical manifestations of appendicitis.

A

Earliest: generalized periumbilical pain, accompanied by nausea and, occasionally diarrhea.
Pain may “migrate” or localize to the lower right abdomen (McBurney’s point) because of distention of the serosa from inflammatory edema. Fever.

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18
Q

What are diverticula?

A

Acquired out-pouching herniations of the mucosa and submucosa through the muscular coat of the colon.

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19
Q

What causes diverticulosis?

A

Combination of structural and functional problems. Related to low fiber diet.

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20
Q

Clinical manifestations of diverticulosis.

A

j

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21
Q

Clinical manifestations of diverticulitis.

A

Acute lower abdominal pain (LLQ), fever, and leukocytosis. Constipation is common but 25% will experience diarrhea.
Long term: colonic strictures and fistulas

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22
Q

What is irritable bowel syndrome?

A

No clear definition, but characterized by the presence of alternating diarrhea and constipation accompanied by abdominal cramping pain in the absence of any identifiable pathologic process.

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23
Q

Define ulcerative colitis

A

Chronic inflammatory disease of the mucosa of the rectum and colon.

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24
Q

Characteristics of ulcerative colitis.

A

Most severe in rectum. Has exacerbations and remissions.

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25
Q

Pathophysiology of ulcerative colitis

A

Begins as an inflammation at the base of the crypts of Lieberkuhn. Damage to the crypt epithelium occurs with invasion of leukocytes and the formation of abscesses. Multiple absecesses coalesce forming large areas of ulceration in the epithelium. Attempts at repair cause a highly vascularized granulation tissue.

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26
Q

Clinical manifestations of ulcerative colitis

A

Abdominal pain, diarrhea, and rectral bleeding

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27
Q

Which disease is associated with increased risk of colon caner after 7-10 years?

A

Ulcerative colitis.

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28
Q

Define Crohn’s

A

An inflammation of the GI tract that extends through all layers of the intestinal wall.

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29
Q

What portion of the GI tract is most commonly affected with Crohns’

A

Proximal portion of the colon and less often the terminal ileum. Can affect multiple portions of the colon with intervening normal areas.

30
Q

Causes of ulcerative colitis.

A

Poorly understood. Genetic, environmental, and immunologic factors. Frequently accompanies other autoimmune disorders (thyroid disease and pernicious anemia)

31
Q

Define irritable bowel syndrome / defining characteristics.

A

No clear definition.
Defining characteristics: alternating diarrhea and constipation accompanied by abdominal cramping pain in the absence of any other identifiable pathologic process in the gi tract.

32
Q

IBS is a _________ bowel syndrome and primarily a disorder of bowel __________.

A

Functional / motility

33
Q

Is IBS more common in men or women?

A

Women

34
Q

Clinical manifestations of IBS.

A

Vary. Some experience only diarrhea or constipation while others experience both. Cramping abdominal pain and may have nausea, and mucus in the stool.

35
Q

What characterizes celiac disease?

A

Intolerance of gluten, a protein in wheat and wheat products.

36
Q

What triggers celiac disease?

A

Exposure to gliadin, a specific wheat gluten, in genetically predisposed people.

37
Q

Pathologic findings in celiac disease.

A

Villus atrophy with a decrease in the activity and amount of surface epithelial enzymes.

38
Q

Effects of celiac disease.

A

Malabsorption of ingested nutrients resulting in malnutrition and severe debilitation.

39
Q

Does celiac affect men or women more often?

A

Women

40
Q

Celiac disease has a __________ inheritance pattern.

A

Familial.

41
Q

When does dumping syndrome occur?

A

When there is a loss of normal, gradual pyloric emptying of the stomach into the small bowel after surgical removal of all or part of stomach.

42
Q

Clinical manifestations of dumping syndrome.

A

Diarrhea, abdominal pain, rebound hypoglycemia.

43
Q

What causes diarrhea in dumping syndrome?

A

Large volume of hyperosmolar food dumped into small intestine draws water into the lumen and stimulates motility.

44
Q

What causes rebound hypoglycemia in dumping syndrome?

A

Rapid absorption of large amount of glucose stimulates excessive rise in plasma insulin which results in a rapid fall in blood glucose 1-3 hours after meal.

45
Q

Define short bowel syndrome?

A

Severe diarrhea and malabsorption due to surgical removal of large portions of the small intestine.

46
Q

What is a colon polyp?

A

Any protrusion into the colon lumen.

47
Q

Differentiate between a sessile polyp and pedunculated polyp.

A

Sessile: raised protuberance with a broad base

Pedunculated: attached to a bowel wall by a stalk that is narrower than the body of the polyp

48
Q

Clinical manifestations of colon polyps.

A

May cause occult or gross bleeding and abdominal pain related to obstruction.

49
Q

Risk factors for colon cancer.

A
  • advancing age
  • high fat, low fiber diet
  • ulcerative colitis or crohn’s disease
  • hereditary predisposition
50
Q

What are the he dietary conditions associated with colon cancer?

A
  1. Familial adenomatous polyposis (FAP) - Gardner syndrome

2. Hereditary non polyposis

51
Q

Colon cancer is the _________ leading cause of cancer related death when both sexes are considered together.

A

Second

52
Q

Clinical manifestations of colon cancer on right side (ascending colon)

A

Black, tarry stools which signify bleeding into the intestinal lumen.

53
Q

Clinical manifestations of colon cancer on left side (descending colon, sigmoid colon)

A

Manifestations of obstruction - intermittent abdominal cramping and fullness. Ribbon or pencil shaped stools. Passage of stool or flatus relieves abdominal pain. As disease progresses, blood or mucus may be present in stool.

54
Q

Clinical manifestations of colon cancer in rectum.

A

Change in bowel habits, urgent need to defecate upon awakening or alternating constipation and diarrhea. Later- rectal fullness and dull ache in rectum or sacral region.

55
Q

Where do gall stones lodge that cause pancreatitis?

A

Ampule of vater

56
Q

Name two types of gall stones. Which occurs more frequently?

A

Pigmented stones and cholesterol stones. Cholesterol stones are more frequent.

57
Q

Three phases of cholesterol stone formation.

A

1) supersturation of bile with cholesterol
2) nucleation of crystals
3) hypomotility allowing stone growth

58
Q

What is a sign of chronic cholecystitis?

A

Thickened gallbladder wall (calcified or porcelain) increased cancer risk

59
Q

Risk factors for cholelithiasis

A

Prolonged fasting or rapid weight loss, pregnancy, oral contraceptives, obesity, DM, “female, forty, fat, fertile, fair”, native americans (PIMA indians)

60
Q

Acute cholecystitis definition.

A

Acute inflammation of gallbladder wall

61
Q

In what % of acute cholecystitis is a gall stone present?

A

90%

62
Q

Where is the pain in acute cholecystitis. Is fever present?

A

R upper quadrant may radiate to back. Often, for fever.

63
Q

Lab results for acute cholecystitis

A

Leukocytosis, mild elevations in bilirubin and serum transaminases (liver functions)

64
Q

Define acute pancreatitis

A

inflammatory process involving the pancreas ranging from mild to severe

65
Q

_______________ occurs when the digestive enzymes are trapped within the pancreas

A

autodigestion

66
Q

Risk factors for pancreatitis.

A

Biliary tract disease, hypertriglyceridemia, alcohol use

67
Q

Clinical manifestations of acute pancreatitis

A

steady boring pain in the epigatric region or left upper quadrant, gradully increasing. reduced bowel sounds

68
Q

Labs for pancreatitis

A

Serum **lipase and amylase, aminotransferases, alk phos, bilirubin

69
Q

Three pathways causing acute pancreatitis

A

1) duct obstruction 2) acinar cell injury 3) defective intracellular transport

70
Q

Which aminotransferase is associated with alcoholism

A

AST

71
Q

Which liver function test is associated with intrahepatic cholestasis

A

alkaline phosphatase

72
Q

What labs are elevated with extrahepatic cholestatsis

A

GGT, ALT, conjugated bilirubin

PC705 Pathophysiology (8 decks)

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