T. Upper Gastrointestinal Problems

Question 1

Nausea

Answer 1

• A feeling of discomfort in the epigastrium with a conscious desire to vomit
• Usually occurs before vomiting
• Related to slowing of gastric motility and emptying

Question 2

Vomiting

Answer 2

• The forceful ejection of partially digested food and secretions (emesis) from the upper gastrointestinal (GI) tract
• closure of pyloris, closure of glottis, deep inspiration, relaxation of stomach ad contraction of abs

Question 3

Chemoreceptor trigger zone (CTZ)

Answer 3

area of the medulla oblongata that receives inputs from blood-borne drugs or hormones, and communicates with other structures in the vomiting center to initiate vomiting.

Question 4

Regurgitation

Answer 4

partially digested food that’s brought up from stomach

Question 5

Projectile vomiting

Answer 5

real propulsive expulsion of stomach contents, no nausea associated with it. Very quickly comes out

Question 6

Antiemetics

Answer 6

Drug that act on CNS in CTZ to block chemicals that trigger nausea and vomiting.

Question 7

Foodborne Illness

Answer 7

• Nonspecific term that describes acute GI symptoms such as nausea, vomiting, diarrhea, and colicky abdominal pain caused by the intake of contaminated food.

Two main types
Acute gastro-enteritis from bacteria
Neurological symptoms from botulism

Question 8

Escherichia coli O157:H7 Poisoning

Answer 8

• Causes hemorrhagic colitis and kidney failure
• Found primarily in undercooked meats, particularly poultry and hamburger
• Treatment involves supportive care to maintain blood volume.

Hemorrhagic colitis is an illness characterized by crampy abdominal pain, initial watery diarrhea, and subsequent development of grossly bloody diarrhea with little or no feve

Question 9

Oral Cancer

Answer 9

• may occur on the lips or anywhere within the mouth (e.g., tongue, floor of the mouth, buccal mucosa, hard palate, soft palate, pharyngeal walls, tonsils).
• Get rid of pre-exsisting factors: tabacco (chew/pipe), smoking, oral hygine
• symptoms: ulcers, hardness, thickening, pain

Question 10

Gastro-esophageal Reflux Disease (GERD)

Answer 10

caused by reflux of gastric contents up into the lower esophagus causing irritation, inflammation, even erosion of esophagus

Avoid factors that cause reflux:
• Smoking cessation
• Elevating head of bed 30 degrees
• Avoid lying down 2–3 hours after eating.
• Avoid late-night eating.

Question 11

Antacids

Answer 11

neutralize stomach acid

Question 12

H2 receptor blockers

Answer 12

• Reduce amount of acid made in stomach

* Histamine H2-receptor antagonists

Question 13

Proton Pump Inhibitors

Answer 13

Block acid production and heal the esophagus

Question 14

Hiatal Hernia

Answer 14

Herniation of a portion of the stomach into the esophagus through an opening, or hiatus, in the diaphragm

Hiatus = opening in diaphragm
hernia = gap in this muscular wall that allows the contents inside the abdomen to protrude outward.

Question 15

Sliding hiatal hernia

Answer 15

stomach sludes into thoracic cavity when supine then goes back into abdomen when upright

Question 16

Para-esophageal (rolling) hiatal hernia

Answer 16

esophageal junction is in place but the fundus and greater curvature of stomach roll up through diaphragm. Acute episode=medical emergency cause it’s getting pinched

Question 17

Esophageal Cancer

Answer 17

• Majority of tumours are located in middle and lower portions of esophagus.
• usually appears as ulcerated lesion.
• may penetrate muscular layer and outside wall of esophagus.

Question 18

Esophageal Diverticuli

Answer 18

• Sac-like outpouchings of one or more layers of esophagus
• 3 kinds

Diverticula are small, bulging pouches that can form in the lining of your digestive system

Question 19

Zenker’s diverticulum

Answer 19

• a condition characterized by a pouch that develops in the upper esophagus in the neck.
• Most common location

Question 20

Traction diverticulum

Answer 20

Near esophageal midpoint

Question 21

Epiphrenic diverticulum

Answer 21

Above the LES (lower esophageal sphincter)

Question 22

Esophageal Strictures

Answer 22

• a narrowing or tightening of the esophagus that causes swallowing difficulties.
• Causes include: GERD, Ingestion of strong acids or alkalis, Trauma

Question 23

Achlasia

Answer 23

• Peristalsis of lower two-thirds of esophagus absent
• Impairment of neurons that innervate esophagus
• Unopposed contraction of LES
• Incomplete relaxation of LES
• Obstruction occurs at/near diaphragm
• Food and fluid accumulate in lower esophagus
• Result: dilation of lower esophagus

Question 24

Halitosis

Answer 24

Foul odor emanating from the mouth.

• symptom of Achlasia

Question 25

Esophageal Varices

Answer 25

• Dilated tortuous veins in lower portion of esophagus
• Result of portal hypertension
• Common complication of liver cirrhosis