Patho - GI Disorders (W13) Flashcards
1
Q
What can cause nausea
A
Stomach irritation/decreased BF to stomach during periods of anxiety
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
3
Q
What is hematemesis
A
Coffee ground vomit
4
Q
What is bilious vomit
A
Vomit with contents of the SI, such as bile
5
Q
What does deep brown vomit indicate
A
That may contain matter from lower intestine or undigested food from previous meal
6
Q
What would a large volume of diarrhea indicate
A
Excess secretions in the GI tract, often osmotic
7
Q
What would a small volume of diarrhea indicate
A
Possibly CIBD
8
Q
What is steatorrhea
A
Lipid-rich stool (bulky, bad smell, greasy)
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)
10
Q
What type of EL imbalances would vomiting cause
A
Loss of Na+ and Cl-
11
Q
What type of EL imbalances would diarrhea cause
A
Loss of K+
12
Q
Excessive vomiting causes ___ due to ___ which will result in an increased ___
A
Metabolic alkalosis // loss of HCl // ECF HCO3-
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
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)
15
Q
What quadrant is the liver in
A
URQ
16
Q
What quadrant is the stomach and pancreas in
A
ULQ
17
Q
What quadrant is the appendix in
A
LLQ
18
Q
What is found in the LLQ
A
Many things!
19
Q
What are the various qualities of GI pain
A
Diffuse, colicky, somatic, referred
20
Q
What may cause dysphagia neurologically
A
CVA, infection, damage to the neurons
21
Q
What may cause dysphagia mechanically
A
Atresia, stenosis of esophagus, diverticula, tumor
22
Q
What CN control deglutition
A
V, VII, IX, X, XI, XII
23
Q
What I a hiatal hernia
A
When part of stomach passes through diaphragm into chest cavity
24
Q
What can cause a hiatal hernia
A
Pregnancy, short esophagus, weak diaphragm
25
What is the pathophysiology behind a hiatal hernia
Sliding = esophagus and stomach move together, paraesophageal (rolling) fundus moves through diaphragm and can get strangled, therefore ischemic
26
What are the S/S of a hiatal hernia
Heartburn, reflex of stomach contents into esophagus, pain worse when supine/bending over
27
GERD
Gastroesophageal reflux disease
28
What can cause GERD
Hiatal hernia, incompétent LES, increase pressure in stomach, slow/reduced stomach emptying
29
What is the pathophysiology of GERD
Stomach contents causing irritation = nausea, what can cause scarring and stenosis
30
What is peptic ulcer disease
The ulceration of gastric or duodenal mucosa
31
What can cause peptic ulcer disease
An infection, mucosal damage, increased HCl secretion, stomach emptying too fast
32
If lesions penetrate deeper than the submucosal layer what will happpen
It can damage the muscular is and even serosa causing perforation and chemical peritonitis
33
How does peptic ulcer disease normally present
2-3hr after a meal/when lying down, heartburn, N/V, risk of iron deficiency anemia
34
What can cause acute gastritis
Infection, excessive EtOH, spicy foods, NSAIDS
35
What can cause chronic gastritis
EtOH abuse, age, chronic PUD, autoimmune disease
36
What is gastroenteritis
An infection of the stomach
37
What is the pathophysiology behind gastritis
Inflammatory process with the risk of mucosal cells undergoing metaplasia
38
What are common S/S of gastritis and gastroenteritis
Anorexia, N/V, pain, cramping, intolerance to some foods
39
What is cholelithiasis
Gall stones
40
what is likely the cause of cholelithiasis
Excess cholesterol [white], or bilirubin [black] in bile salt
41
Who are gall stones common in
Female, fat, forty+, high cholesterol intake, many kids, birth control users
42
What is the patho behind cholelithiasis
Higher concentration leads to stone production in gallbladder, cystic duct or common bile duct
43
What can large gall stones cause in the process of trying to be passed
Obstructions, inflammation, jaundice (pancreatitis if pancreatic duct is blocked)
44
Jaundice is what
A sign of liver dysfunction related to bilirubin
45
What causes jaundice
Excess oof conjugated or unconjugated bilirubin
46
What causes prehepatic jaundice
Excess destruction of heme in RBC, leading to increased unconjugated bilirubin in the blood
47
What causes intrahepatic jaundice
Liver disease (cirrhosis, hepatitis) that limits the ability to conjugate bilirubin (therefore can be either or)
48
What causes posthepatic jaundice
Obstruction of bile ducts which cause bile to ack up into the liver and into blood, therefore conjugated bilirubin in the blood
49
What is steatorrhea
Obstruction of bile ducts causing bile to be secreted into the SI
50
What type of jaundice is difficult to clear and why
Unconjugated, because it is bound to plasma proteins
51
What can clear this type of bile build up and why
Blue light because it oxidizes bilirubin
52
What can cause hepatitis
Viral sources, or toxic: hepatotoxic drugs/chemicals
53
What is the patho behind hepatitis
-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
Pre-icteric hepatitis is AKA
Pre-jaundice
55
How does pre-icteric jaundice present
Insidious, fatigue, malaise, muscle aches, anorexia, nausea, headache, URQ pain
56
How does icteric hepatitis present
Jaundice, bilirubin may be conjugated = dark urine, liver is enlarged and possibly tender, trouble producing bile may result in light coloured stool
57
What is post icteric hepatitis
The recovery period (can take up to 4 months)
58
What is cirrhosis
Diffuse fibrosis of liver with loss of organization
59
Alcohol abuse can cause cirrhosis in 3 stages, what are they
Stage 1: fatty liver
Stage 2: alcoholic hepatitis
Stage 3: end-stage
60
What occurs during stage 1/fatty liver (of cirrhosis)
EtOH metabolite is toxic causing cellular dysfunction = fat accumulation causing enlarged liver
61
What occurs during stage 2/alcoholic hepatitis (of cirrhosis)
Chronic inflammation leading to necrosis of hepatocytes which can cause lack of organization, liver may be tender
62
What occurs during stag 3/end-sage (or cirrhosis)
Liver is fibrotic = failure
63
Loss of hepatocytes function can cause
-impaired metabolism of macromolecules (drugs)
-impaired digestion/lipid absorption
-prolonged clotting times
64
Why do you have impaired metabolism of macromolecules when hepatocytes lose their functions
..
65
Why do you have impaired digestion/less lipid absorption when hepatocytes lose their functions
…
66
Why do you have prolonged clotting times when hepatocytes lose their functions
..
67
What can portal HTN cause
-splenomegaly
-esophageal varices (increased pressure in left gastric vein)
-increased pressure in mesenteric and other GI-related vessels
-ascites
68
What can cause acute pancreatitis
Obstruction of pancreatic duct, or alcohol abuse
69
What is the pathophysiology behind acute pancreatitis
-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
What are the S/S of acute pancreatitis
Severe epigastric pain often worse after a meal, low grade fever, distended abd, hypocalcemia
71
What is chronic pancreatitis
Low level chronic inflammation leading to necrosis and fibrosis of the pancreas
72
What can chronic pancreatitis cause
Disorders relating to absorption and digestion, can alter pancreatic hormone secretion, pain in epigastric region
73
CIBD.. AKA
Chronic inflammatory bowel disease, Crohn’s disease
74
What is Crohn’s disease
Inflammatory disease w excessive release of cytokines
75
What is a skip lesion
Areas along SI that have lesions on mucosa, and healthy areas as well
76
What is the process of Crohn’s disease
Inflammation = necrosis = fibrosis process
77
What does Crohn’s disease cause in the body
Poor absorption of nutrients
78
How can Crohn’s disease present
Cramping in RLQ, diarrhea (steatorrhea, melena), malnutrition, hypoproteinemia, lack of vit ADEK
79
CIBD… AKA pt 2
Ulcerative colitis
80
What is the patho behind ulcerative colitis
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
How does ulcerative colitis present
Poor H2O and EL absorption in LI, bloody and mucus diarrhea, rectal bleeding, cramping pain
82
What is appendicitis
The obstruction of appendix or twisting leading to trapping bacteria
83
What is the patho behind appendicitis
Trapped bacteria causes inflammation, swelling and compression of blood vessels = ischemia = necrosis of wall = peritonitis
84
How does appendicitis present
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
How can an intestinal obstruction occur
Mechanically or chemically
86
What is the pathophysiology behind a mechanical intestinal obstruction
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
What is the patho behind a functional intestinal obstruction
Same as mechanical, just without the reflex contraction of smooth muscles
88
What are the S/S of an intestinal obstruction in the SI
Colicky pain consistent with bowel sounds, vomiting of materials proximal to the obstruction, diaphoresis, tachycardia, hypovolemia = shock, EL imbalances, weakness, confusion
89
What are the S/S of an intestinal obstruction at the LI
Insidious onset w milder pain, if ad distension pain may worsen
90
What can cause chemical peritonitis
Pancreatitis, perforated ulcer, ruptured bladder, perforated gall bladder, blood
91
What can cause bacteria peritonitis
Burns appendix, penetrating abd injury, obstruction
92
What is the patho behind peritonitis
-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
How can peritonitis present
Sudden, severe abd pain worse on movement, N/V, SOB, hypovolemia (low BP and increased SNS response), rigid abd distension
