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Patho (Sem 2) > Patho - GI Disorders (W13) > Flashcards

Patho - GI Disorders (W13) Flashcards

1
Q

What can cause nausea

A

Stomach irritation/decreased BF to stomach during periods of anxiety

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2
Q

What can cause vomiting

A

GI mucosa irritation/inflammation/infection/ischemia, acid reflux, stimuli for chemosensitive zones [ie by toxins/chemo drugs], pain, stress, increased ICP, pregnancy

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3
Q

What is hematemesis

A

Coffee ground vomit

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4
Q

What is bilious vomit

A

Vomit with contents of the SI, such as bile

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5
Q

What does deep brown vomit indicate

A

That may contain matter from lower intestine or undigested food from previous meal

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6
Q

What would a large volume of diarrhea indicate

A

Excess secretions in the GI tract, often osmotic

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7
Q

What would a small volume of diarrhea indicate

A

Possibly CIBD

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8
Q

What is steatorrhea

A

Lipid-rich stool (bulky, bad smell, greasy)

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9
Q

What can cause constipation

A

Increasing age, less activity, low fibre intake, inadequate fluid intake, neurological disorder where they’re unable to respond to urgency, obstructions, medications (opioids, anticholinergic drugs)

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10
Q

What type of EL imbalances would vomiting cause

A

Loss of Na+ and Cl-

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11
Q

What type of EL imbalances would diarrhea cause

A

Loss of K+

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12
Q

Excessive vomiting causes ___ due to ___ which will result in an increased ___

A

Metabolic alkalosis // loss of HCl // ECF HCO3-

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13
Q

What would cause metabolic acidosis due to vomiting

A

A loss in HCO3-, where the body lacks the ability to absorb glucose and now relies on lipid metabolism

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14
Q

How can excessive diarrhea cause metabolic acidosis

A

Due to loss of HCO3- (normally found in bile and pancreatic juice which can be secreted by the LI)

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15
Q

What quadrant is the liver in

A

URQ

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16
Q

What quadrant is the stomach and pancreas in

A

ULQ

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17
Q

What quadrant is the appendix in

A

LLQ

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18
Q

What is found in the LLQ

A

Many things!

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19
Q

What are the various qualities of GI pain

A

Diffuse, colicky, somatic, referred

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20
Q

What may cause dysphagia neurologically

A

CVA, infection, damage to the neurons

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21
Q

What may cause dysphagia mechanically

A

Atresia, stenosis of esophagus, diverticula, tumor

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22
Q

What CN control deglutition

A

V, VII, IX, X, XI, XII

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23
Q

What I a hiatal hernia

A

When part of stomach passes through diaphragm into chest cavity

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24
Q

What can cause a hiatal hernia

A

Pregnancy, short esophagus, weak diaphragm

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25
Q

What is the pathophysiology behind a hiatal hernia

A

Sliding = esophagus and stomach move together, paraesophageal (rolling) fundus moves through diaphragm and can get strangled, therefore ischemic

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26
Q

What are the S/S of a hiatal hernia

A

Heartburn, reflex of stomach contents into esophagus, pain worse when supine/bending over

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27
Q

GERD

A

Gastroesophageal reflux disease

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28
Q

What can cause GERD

A

Hiatal hernia, incompétent LES, increase pressure in stomach, slow/reduced stomach emptying

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29
Q

What is the pathophysiology of GERD

A

Stomach contents causing irritation = nausea, what can cause scarring and stenosis

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30
Q

What is peptic ulcer disease

A

The ulceration of gastric or duodenal mucosa

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31
Q

What can cause peptic ulcer disease

A

An infection, mucosal damage, increased HCl secretion, stomach emptying too fast

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32
Q

If lesions penetrate deeper than the submucosal layer what will happpen

A

It can damage the muscular is and even serosa causing perforation and chemical peritonitis

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33
Q

How does peptic ulcer disease normally present

A

2-3hr after a meal/when lying down, heartburn, N/V, risk of iron deficiency anemia

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34
Q

What can cause acute gastritis

A

Infection, excessive EtOH, spicy foods, NSAIDS

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35
Q

What can cause chronic gastritis

A

EtOH abuse, age, chronic PUD, autoimmune disease

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36
Q

What is gastroenteritis

A

An infection of the stomach

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37
Q

What is the pathophysiology behind gastritis

A

Inflammatory process with the risk of mucosal cells undergoing metaplasia

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38
Q

What are common S/S of gastritis and gastroenteritis

A

Anorexia, N/V, pain, cramping, intolerance to some foods

39
Q

What is cholelithiasis

A

Gall stones

40
Q

what is likely the cause of cholelithiasis

A

Excess cholesterol [white], or bilirubin [black] in bile salt

41
Q

Who are gall stones common in

A

Female, fat, forty+, high cholesterol intake, many kids, birth control users

42
Q

What is the patho behind cholelithiasis

A

Higher concentration leads to stone production in gallbladder, cystic duct or common bile duct

43
Q

What can large gall stones cause in the process of trying to be passed

A

Obstructions, inflammation, jaundice (pancreatitis if pancreatic duct is blocked)

44
Q

Jaundice is what

A

A sign of liver dysfunction related to bilirubin

45
Q

What causes jaundice

A

Excess oof conjugated or unconjugated bilirubin

46
Q

What causes prehepatic jaundice

A

Excess destruction of heme in RBC, leading to increased unconjugated bilirubin in the blood

47
Q

What causes intrahepatic jaundice

A

Liver disease (cirrhosis, hepatitis) that limits the ability to conjugate bilirubin (therefore can be either or)

48
Q

What causes posthepatic jaundice

A

Obstruction of bile ducts which cause bile to ack up into the liver and into blood, therefore conjugated bilirubin in the blood

49
Q

What is steatorrhea

A

Obstruction of bile ducts causing bile to be secreted into the SI

50
Q

What type of jaundice is difficult to clear and why

A

Unconjugated, because it is bound to plasma proteins

51
Q

What can clear this type of bile build up and why

A

Blue light because it oxidizes bilirubin

52
Q

What can cause hepatitis

A

Viral sources, or toxic: hepatotoxic drugs/chemicals

53
Q

What is the patho behind hepatitis

A

-direct damage to hepatocytes (or indirect through immune response = inflammation
-cells enlarge = liver enlarges
-sometimes mild // sometimes necrosis // fibrosis = scarring of liver tissue
-cells may regenerate but may lose organization and lose correct function

54
Q

Pre-icteric hepatitis is AKA

A

Pre-jaundice

55
Q

How does pre-icteric jaundice present

A

Insidious, fatigue, malaise, muscle aches, anorexia, nausea, headache, URQ pain

56
Q

How does icteric hepatitis present

A

Jaundice, bilirubin may be conjugated = dark urine, liver is enlarged and possibly tender, trouble producing bile may result in light coloured stool

57
Q

What is post icteric hepatitis

A

The recovery period (can take up to 4 months)

58
Q

What is cirrhosis

A

Diffuse fibrosis of liver with loss of organization

59
Q

Alcohol abuse can cause cirrhosis in 3 stages, what are they

A

Stage 1: fatty liver
Stage 2: alcoholic hepatitis
Stage 3: end-stage

60
Q

What occurs during stage 1/fatty liver (of cirrhosis)

A

EtOH metabolite is toxic causing cellular dysfunction = fat accumulation causing enlarged liver

61
Q

What occurs during stage 2/alcoholic hepatitis (of cirrhosis)

A

Chronic inflammation leading to necrosis of hepatocytes which can cause lack of organization, liver may be tender

62
Q

What occurs during stag 3/end-sage (or cirrhosis)

A

Liver is fibrotic = failure

63
Q

Loss of hepatocytes function can cause

A

-impaired metabolism of macromolecules (drugs)
-impaired digestion/lipid absorption
-prolonged clotting times

64
Q

Why do you have impaired metabolism of macromolecules when hepatocytes lose their functions

A

..

65
Q

Why do you have impaired digestion/less lipid absorption when hepatocytes lose their functions

A

…

66
Q

Why do you have prolonged clotting times when hepatocytes lose their functions

A

..

67
Q

What can portal HTN cause

A

-splenomegaly
-esophageal varices (increased pressure in left gastric vein)
-increased pressure in mesenteric and other GI-related vessels
-ascites

68
Q

What can cause acute pancreatitis

A

Obstruction of pancreatic duct, or alcohol abuse

69
Q

What is the pathophysiology behind acute pancreatitis

A

-pancreatic enzymes digest pancreas unless enzymes contained within abscess
-excessive tissue damage = bleeding = inflammation/necrosis = chemical peritonitis = bacterial pancreatitis
-inflammation causes vasoD and decreased BP

70
Q

What are the S/S of acute pancreatitis

A

Severe epigastric pain often worse after a meal, low grade fever, distended abd, hypocalcemia

71
Q

What is chronic pancreatitis

A

Low level chronic inflammation leading to necrosis and fibrosis of the pancreas

72
Q

What can chronic pancreatitis cause

A

Disorders relating to absorption and digestion, can alter pancreatic hormone secretion, pain in epigastric region

73
Q

CIBD.. AKA

A

Chronic inflammatory bowel disease, Crohn’s disease

74
Q

What is Crohn’s disease

A

Inflammatory disease w excessive release of cytokines

75
Q

What is a skip lesion

A

Areas along SI that have lesions on mucosa, and healthy areas as well

76
Q

What is the process of Crohn’s disease

A

Inflammation = necrosis = fibrosis process

77
Q

What does Crohn’s disease cause in the body

A

Poor absorption of nutrients

78
Q

How can Crohn’s disease present

A

Cramping in RLQ, diarrhea (steatorrhea, melena), malnutrition, hypoproteinemia, lack of vit ADEK

79
Q

CIBD… AKA pt 2

A

Ulcerative colitis

80
Q

What is the patho behind ulcerative colitis

A

Inflammation begins in rectum and moves proximally, lesions extend to submucosa and cause the formation of granulation tissue (mucosa may grow over lesion sites)

81
Q

How does ulcerative colitis present

A

Poor H2O and EL absorption in LI, bloody and mucus diarrhea, rectal bleeding, cramping pain

82
Q

What is appendicitis

A

The obstruction of appendix or twisting leading to trapping bacteria

83
Q

What is the patho behind appendicitis

A

Trapped bacteria causes inflammation, swelling and compression of blood vessels = ischemia = necrosis of wall = peritonitis

84
Q

How does appendicitis present

A

Periumbilical pain = severe LRQ pain w nausea and vomiting, often tender until it bursts will then diffuse and come back severely and steadily, pt my be tachycardic and hypotensive

85
Q

How can an intestinal obstruction occur

A

Mechanically or chemically

86
Q

What is the pathophysiology behind a mechanical intestinal obstruction

A

Stretched smooth muscle just before the obstruction which contracts and increases the pressure in veins causing edema, excessive fluid loss leads to vomiting therefore EL imbalances
When arterioles compress ischemia and necrosis occurs
Inflammation due to bacterial overgrowth = peritonitis

87
Q

What is the patho behind a functional intestinal obstruction

A

Same as mechanical, just without the reflex contraction of smooth muscles

88
Q

What are the S/S of an intestinal obstruction in the SI

A

Colicky pain consistent with bowel sounds, vomiting of materials proximal to the obstruction, diaphoresis, tachycardia, hypovolemia = shock, EL imbalances, weakness, confusion

89
Q

What are the S/S of an intestinal obstruction at the LI

A

Insidious onset w milder pain, if ad distension pain may worsen

90
Q

What can cause chemical peritonitis

A

Pancreatitis, perforated ulcer, ruptured bladder, perforated gall bladder, blood

91
Q

What can cause bacteria peritonitis

A

Burns appendix, penetrating abd injury, obstruction

92
Q

What is the patho behind peritonitis

A

-inflammation of bowel = increased permeability = bacteria leaving GI tract and infect peritoneum
-exudate secreted by peritoneum to seal the leak may lead to the formation of abscess
-infection spreads along vascular peritoneum
-abd distension = muscle contraction of abd muscles
-type of third spacing where fluid goes into peritoneal space = hypovolemia and EL imbalances = purulent fluid = ascites

93
Q

How can peritonitis present

A

Sudden, severe abd pain worse on movement, N/V, SOB, hypovolemia (low BP and increased SNS response), rigid abd distension

Patho (Sem 2) (2 decks)

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