Patho Quiz 7 (GI, Gall Bladder, Pancreas, Liver) Flashcards
In addition to stimulating gastric juice, Gastrin stimulates chief cells to release what? What drug inhibits Gastrin?
HCl. PPI drugs inhibit release of HCl.
What is another word for pyrosis and what occurs during this process?
Heartburn; reflux of gastric contents into esophagus.
What is visceral pain caused by? Somatic pain? Symptoms for each?
- Visceral: stretching or distending of an abdominal organ inflammation–burning/cramping
- Somatic: injury to abdominal wall, peritoneum, or diaphragm–sharp, intense
What might signal the nature or reason for nausea with vomiting?
Characteristics of vomitus (color, odor, texture, etc.)
What are reasons for constipation?
Dietary (lack of fiber), lack of exercise, pathologic conditions (diverticulitis, obstruction).
What are the four major mechanisms of diarrhea?
- Osmotic: Na and water influx
- Secretory: bacterial toxins
- Exudative: inflammatory processes (mucus, blood, protein)
- Motility disturbances: decreased contact in small intestine (dumping syndrome)
Define stomatitis
Inflammation of oral mucosa, buccal mucosa, lips, and palate
Define herpetic stomatitis (Type I) and who commonly gets it?
Prodromal tingling/itching; ages 1-3
What are risk factors for GERD?
Intake of fatty foods, caffeine, and ethanol, cigarette smoking, sleep position, obesity
What is a complication of GERD?
Aspirational pneumonia
What is a hiatal hernia?
Defect in diaphragm when a portion of the stomach passes through the diaphragmatic opening into the thorax
Which two GI diseases share similar symptoms and are treated the same?
GERD and Hiatal hernia.
What is the treatment for GERD and Hiatal hernia?
PPI, H2 blockers, or surgery (if severe).
What is Mallory-Weiss syndrome?
Bleeding caused by tears in the mucosa or submucosa; forced prolonged vomiting.
What is the layman’s term for gastroenteritis?
The flu.
Which bacteria thrives in the GI environment and causes gastritis?
H. Pylori.
What is chronic gastroenteritis caused by? Acute?
Chronic: another GI disorder
Acute: direct infection of tract by virus or bacteria.
What occurs during Peptic Ulcer Disease?
It is an increase in factors that tend to injure the mucosa relative to those that protect it.
What should you avoid to prevent recurrence of gastric acidity?
Smoking, ASA, NSAIDs, alcohol
What is ulcerative colitis and what are the hallmark symptoms?
Large ulcers form in the mucosal layer of colon and rectum; bloody diarrhea and lower abdominal pain.
What is the difference between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS)?
IBD is an umbrella term that includes ulcerative colitis and Crohn’s Disease.
IBS is the presence of alternating diarrhea/constipation accompanied by abdominal cramping (no inflammation present upon inspection, no pathological process).
What is Crohn’s Disease? And what are suggestive findings?
Inflammation of all layers of the intestinal wall resulting from blockage and inflammation of lymphatic vessels.
-Granulomas, ulcerations, structures, and fistulas
What bacteria causes enterocolitis?
Clostridium difficile.
What is the difference between diverticulosis and diverticulitis?
- Diverticulosis is the presence of diverticula (pouches in the GI tract)
- Diverticulitis is the inflammatory response when food gets caught in them
What factors can affect intestinal motility and what are examples of them?
Mechanical: blockage of intestines (hernia, tumor, impaction, etc.)
Functional: conditions that inhibit peristalsis (narcotics, surgery, spinal cord injuries)
What bowel sounds might you expect in mechanical v. functional intestinal obstructions?
Mechanical: active or hyperactive (trying to push obstruction out)
Functional: absent
What is intussusception? And what age group does it usually affect?
Telescoping/invagination of a portion of bowel into adjacent (usually distal) bowel causing intestinal obstruction; pediatrics.
What is volvulus?
Twisting of bowel on itself causing intestinal obstruction and blood vessel compression.
Patients with colon polyps are put at risk for developing what?
Colon cancer.
What is a clinical manifestation of IBS?
Constipation diarrhea. (and stupid Rachel says alternating)
What is bile composed of?
Water, electrolytes, cholesterol, solutes
What are the three phases of gallstone formation (cholelithiasis)?
- Supersaturation of bile with cholesterol
- Nucleation of crystals
- Hypomotility allowing stone growth
What is the most common cause of cholecystitis?
Gallstones.
What precipitates biliary colic?
Meals or at night time.
What are predisposing factors for acute pancreatitis?
- Biliary tract disease
- Hypertriglyceridemia
- Ethanol (66%)
What lab value will indicated acute pancreatitis?
↑Amylase and lipase
↑Alkaline phosphatase and Bilirubin
↑Aminotransferases
Where is bile created and stored?
Liver creates bile
Gallbladder stores bile
What are clinical manifestations of liver failure?
Jaundice, muscle wasting, ascites, osteomalacia (bone softening), hyper or hypoglycemia
Where is the easiest place to see jaundice on the body?
Conjunctiva of the eye
What is the classic sign of liver failure?
Clay colored stools
What is the most common cause of cholestatic jaundice?
Mechanical obstruction
What transaminase values might you expect in viral hepatitis v. alcoholic/toxic hepatides?
- Viral hepatitis ALT>AST
- Alcoholic/toxic hepatides AST>ALT
Define cirrhosis
The end result of some kind of liver disease–the liver becomes scarred, hardened, and enlarged.
Gastroesophageal varices is a direct complication of? (6)
Portal hypertension, alcoholic or post-hepatic cirrhosis, vasoactive hormones, increased splanchnic blood flow, and increased vascular resistance in the liver.
What are the treatments for Gastroesophageal varices? (3)
Vitamin K, FFP, Recombinant factor Vlla
How is Hepatic Encephalopathy related to liver disease?
The liver is unable to metabolize ammonia to urea, and it builds in the blood stream
High liver ammonia levels cause the classic sign of _____ ____.
Liver flap (in hands)
What can occur as a result of untreated Hepatic Encephalopathy (stage 3 or 4 -late sign)?
Cerebral edema
Define Hepatorenal syndrome
Kidney failure as a result of liver failure (prerenal cause of AKI)
What are the routes of transmission in Hepatitis A-E?
- A: oral/fecal
- B,C,D: parenteral contact with blood/blood products, needles, sexual contact
- E: oral/fecal
What strain of Hepatitis accentuates Hep D when both are acquired?
Hep B
What are two toxic metal liver disorders and what metals are associated with them?
- Hereditary hemochromatosis–Iron
- Wilson Disease (Hepatolenticular Degeneration)–Copper
What causes Reye’s Syndrome? And what is the prognosis?
As a result of a viral illness such as influenza or chickenpox–40% mortality.
What is the most common cause of mechanical bowel obstructions?
Adhesions.
This disease may be a result of chronic pancreatitis
DM II
What is one of the hormones of the duodenum and what does it do?
Secretin–regulates water homeostasis throughout the body
How is acute pancreatitis treated?
NPO, and continuous gastric suctioning
What electrolyte is found at high levels in pancreatic secretions?
Bicarb
