quiz #4 - GI, liver, gallbladder

Question 1

causes of acute gastritis

Answer 1

-food poisoning, viruses, bacteria (helicobacter pylori or parasites)
-chemical toxins
-allergies to food
-irritation from chemotherapy/ radiation

Question 2

causes of Crohn’s disease

Answer 2

-unknown, possibly an autoimmune disease
-genetic predisposition

Question 3

causes of IBD/IBS

Answer 3

-unknown, sensitive colon reacts to stress or foods
-women may have more symptoms during menses (hormonal contribution)
-nervous system irregularities, infection & gut microbe changes

Question 4

2 most important risk factors for stomach cancer

Answer 4

presence of helicobacter pylori bacteria & diet

Question 5

risk factors for liver cancer

Answer 5

infections of Hep B or Hep C with cirrhosis

other predisposing factors: heavy smoking & drinking

Question 6

risk factor for IBS

Answer 6

increased risk of colorectal cancer

Question 7

risk factors for colorectal polyps

Answer 7

-age (over 50)
-smoking
-obesity
-low dietary fiber & family history of colon polyps/ colon cancer

Question 8

etiology of peptic ulcers

Answer 8

bacteria helicobacter pylori

Question 9

narrowing of opening (pylorus) from stomach to small intestine (duodenum) – causes severe projectile nonbilious (not containing bile) vomiting in first few months of life

Answer 9

pyloric stenosis

Question 10

inflammation of the peritoneal lining

Answer 10

peritonitis

Question 11

acute inflammation of lining of stomach or gastric intestinal mucosa caused by viruses (rotavirus & norovirus), bacteria, parasites or fungi – often from eating contaminated food or water

Answer 11

gastroenteritis

Question 12

upper part of stomach protrudes through a hole or hiatus in diaphragm & into thorax

Answer 12

hiatus hernia

Question 13

most common type of hiatus hernia

Answer 13

(90%) = sliding hiatal hernia: stomach slides into thoracic cavity through esophageal hiatus

other type (10%) = rolling/ paraesophageal hiatal hernia: greater curvature of stomach protrudes through secondary opening in diaphragm

Question 14

periodic regurgitation of gastric contents or stomach acids upwards into esophagus – acids irritate lining of esophagus & causes burning sensation – often seen in conjunction with a hiatal hernia

Answer 14

gastroesophageal reflux disease (GERD)

Question 15

causes inflammation & ulcers in bowel, affecting innermost lining of large intestine & rectum – may be mild or life threatening

Answer 15

ulcerative colitis

Question 16

abnormal muscular contractions in large intestine that does not cause inflammation or permanent damage or an increased risk of colorectal cancer

Answer 16

irritable bowel syndrome (IBS)

Question 17

diverticula or herniations become infected or inflamed – diverticula develop in weak areas of walls of GI tract & form pouches called herniations

Answer 17

diverticulitis

Question 18

presence of diverticula in colon wall

Answer 18

diverticulosis

Question 19

sites of metastasis of colorectal cancer

Answer 19

liver

also spreads to ovaries

Question 20

-reduced appetite, intermittent diarrhea, weight loss, fatigue, flatulence, bloating, dermatitis herpetiformis (itchy blistery skin rash) most often seen on elbows, knees, buttocks
-large, pale, greasy, foul-smelling stools that float is a cardinal sign
-osteoporosis may develop later in life as a result of reduced calcium absorption

Answer 20

celiac disease

Question 21

-may be mild or severe
-diarrhea = most common sign
-chronic diarrhea may lead to dehydration, fatigue, weight loss, hemorrhoids
-tenderness in lower R quadrant, feeling of fullness
-30% have low-grade fever
-periods of exacerbations & remission

Answer 21

Crohn’s disease

Question 22

-often mild to moderate symptoms with long periods of remission
-diarrhea (with blood or pus), abdominal pain or cramping, rectal pain or bleeding, defecation urgency, weight loss, fatigue, fever

Answer 22

ulcerative colitis

Question 23

-diarrhea, watery, frequent stools = clinical hallmark
-due to impaired water, carbohydrate & electrolyte absorption or irritation from unabsorbed fatty acids
-cramping P, weight loss, growth retardation, delayed puberty
-anemias from lack of vitamin B12, iron deficiency (fatigue & weakness)
-mm cramps from decreased vitamin D & calcium absorption

Answer 23

malabsorption syndrome

Question 24

-sudden, severe abdominal pain with localized tenderness
-P intensifies with movement
-abdominal bloating & rebound tenderness
-nausea, vomiting, chills, fatigue, thirst, confusion, diarrhea, fever, inability to urinate & pass stools or gas

Answer 24

peritonitis

Question 25

3 stages of disease progression in hepatitis

Answer 25

1. Preicteric stage: flu-like symptoms (nausea, fatigue, loss of appetite, mm aches) last 1 week, upper R quadrant pain, low-grade fever, occasional headache 2. Icteric stage: 1-4 weeks, jaundice & liver enlargement (hepatomegaly); prolonged in Hepatitis B infections 3. Posticteric stage: recovery phase, 4-6 weeks, gradual reduction of symptoms; can extend longer

Question 26

severe hepatitis symptoms

Answer 26

massive necrosis & liver failure

Question 27

-ascites, hepatic encephalopathy, splenomegaly (enlargement of spleen) portacaval anastomosis & hemorrhage -high BP in portal vein system causes veins to distend irregularly & dilate, possible rupture

Answer 27

portal hypertension

Question 28

-40% asymptomatic until obstruction occurs -at first, symptoms mimic indigestion -gallstone becomes lodged, symptoms of nausea, vomiting & pain -pain may be intermittent or steady, usually located in R upper quadrant, often radiating to mid-upper back & right SH

Answer 28

cholelithiasis

Question 29

appendicitis: epigastric or umbilical pain to start may be vague pain and then shifts to lower R quadrant of abdomen at a point called _____

Answer 29

McBurney's point

Question 30

changes in systemic circulation as in low BP or atherosclerosis, local constriction of blood vessels or a blood clot (often not identified)

Answer 30

causes of: bowel ischemia

Question 31

anatomic defects in diaphragm & in suspensory ligaments of stomach

Answer 31

causes of: gastric volvulus

Question 32

-food & water contamination by bacteria (E. coli, salmonella) -viruses (rotavirus, norovirus), parasites, common with traveler's diarrhea -allergic reactions, irritating foods, drugs

Answer 32

gastroenteritis

Question 33

cirrhosis of liver: 3 main causes

Answer 33

1. Chronic alcohol abuse 2. Viral Hepatitis B or C infection (65% of cases) 3. Autoimmune (Primary Biliary Cirrhosis)

Question 34

mutation in gene that controls “hepcidin” a hormone in liver that controls iron absorption from GI tract causing increased absorption of iron from intestine, more than what is needed

Answer 34

causes of: Haemochromatosis

Question 35

gene mutation inherited from both parents (recessive), responsible for copper transportation (ATPase) & excretion from liver in & out of body in urine

Answer 35

cause of: Wilson’s disease

Question 36

mutated genes promote uncontrollable cell growth forming a mass or tumor

Answer 36

cause of: liver cancer

Question 37

cells in lining of colon develop changes in DNA (stem cell mutations) causing cells to become cancerous & grow uncontrollably accumulating into a mass or tumor

Answer 37

cause of: colorectal cancer

Question 38

progressive scarring of bile ducts caused by infection & producing obstruction and inflammation – scars make ducts hard & narrowed

Answer 38

primary sclerosing cholangitis

Question 39

-metabolic disorder that damages mm tissue & nerve cells caused by accumulation of glycogen -lysosomal storage disorder where enzyme to break down lysosome containing glycogen is deficient due to genetic mutation

Answer 39

Glycogen storage disease type 2 causes buildup of glycogen inside lysosomes that impairs function of nearby tissues

Question 40

masses of solid material or stones called calculi or gallstones

Answer 40

cholelithiasis (gallstones)

Question 41

2 types of gallstones based on composition

Answer 41

1. cholesterol: most common - 80%, made of undissolved cholesterol, round & small (1-5 mm), yellowish white, common with obesity & diabetes 2. pigment: composed of bile pigment & calcium salts, faceted & larger (5-10mm), black or dark brown, common in sickle cell anemia & cirrhosis

Question 42

four F’s for tendencies to form gallstones

Answer 42

Female older than Forty Fertile Fat

Question 43

-typically develops in male babies in first 2–6 weeks of life & leads to vomiting, dehydration, weight loss -first weeks-months of life with progressively worsening projectile vomiting, non bilious -some infants present with poor feeding & weight loss -dehydration causing baby to cry without having tears, & having less wet diapers

Answer 43

pyloric stenosis

Question 44

most cases of ____ cancer (95%) develop from small, benign clumps of cells, called adenomatous polyps

Answer 44

colorectal

Question 45

causes diarrhea, bloating, fatigue, anemia, weight loss & ultimately leads to malabsorption syndrome with vitamin & nutrient deficiencies

Answer 45

celiac disease