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1
Q

What is the gastrointestinal (GI) tract?

A

The GI tract extends from the mouth to the anus and is composed of several organs with distinct functions.

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2
Q

What role do sphincters play in the GI tract?

A

Sphincters assist in gut compartmentalization.

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3
Q

What are the main layers of the gut wall?

A

The gut wall is organized into well-defined layers that contribute to functional activities.

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4
Q

What is the primary function of the mucosa in the GI tract?

A

The mucosa acts as a barrier to luminal contents or a site for transfer of fluids or nutrients.

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5
Q

How does propulsion occur in the GI tract?

A

Gut smooth muscle, in association with the enteric nervous system, mediates propulsion from one region to the next.

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6
Q

What are pancreaticobiliary conduits?

A

Pancreaticobiliary conduits deliver bile and enzymes into the duodenum.

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7
Q

What is the primary function of the GI tract?

A

The GI tract serves two main functions: assimilating nutrients and eliminating waste.

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8
Q

What happens to food in the mouth?

A

Food is processed, mixed with salivary amylase, and delivered to the gut lumen.

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9
Q

What is the role of the lower esophageal sphincter?

A

The lower esophageal sphincter prevents oral reflux of gastric contents.

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10
Q

What is the main function of the stomach?

A

The stomach triturates and mixes the bolus with pepsin and acid.

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11
Q

What is intrinsic factor, and why is it important?

A

Intrinsic factor is secreted by the stomach for vitamin B12 absorption.

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12
Q

What is the primary function of the small intestine?

A

The small intestine serves most of the nutrient absorptive function of the gut.

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13
Q

What is the role of bile in digestion?

A

Bile is essential for intestinal lipid digestion.

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14
Q

Fill in the blank: The proximal intestine is optimized for rapid absorption of _______.

A

nutrient breakdown products and most minerals.

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15
Q

What is the function of the colon?

A

The colon prepares the waste material for controlled evacuation.

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16
Q

What is the typical volume of stool expelled from the rectum?

A

100–200 mL.

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17
Q

What role do lymphatic channels play in the GI tract?

A

Lymphatic channels assist in gut immune activities.

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18
Q

True or False: The gut is in continuity with the outside environment.

A

True.

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19
Q

What are common causes of impaired digestion and absorption?

A
  • Lactase deficiency
  • Celiac disease
  • Bacterial overgrowth
  • Crohn’s ileitis
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20
Q

What disorders are associated with altered secretion in the GI tract?

A
  • Zollinger-Ellison syndrome
  • Atrophic gastritis
  • Inflammatory bowel disease
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21
Q

What is achalasia?

A

Achalasia is characterized by impaired esophageal body peristalsis and incomplete lower esophageal sphincter relaxation.

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22
Q

What is the most common cause of abdominal pain?

A

Irritable bowel syndrome and functional dyspepsia.

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23
Q

What is heartburn?

A

Heartburn is a burning substernal sensation, often resulting from gastroesophageal reflux of acid.

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24
Q

What are the symptoms of altered bowel habits?

A
  • Constipation
  • Diarrhea
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25
What is melena?
Melena is the passage of black, tarry stools indicating upper GI bleeding.
26
What factors can lead to impaired gut blood flow?
* Arterial embolus * Arterial thrombosis * Venous thrombosis
27
What type of cancer is most common in the United States?
Colorectal cancer.
28
What are some disorders without obvious organic abnormalities?
* Irritable bowel syndrome * Functional dyspepsia * Functional chest pain
29
What is a genetic influence in GI diseases?
Family members of inflammatory bowel disease patients show a genetic predisposition.
30
What are the most common GI symptoms?
* Abdominal pain * Heartburn * Nausea and vomiting * Altered bowel habits
31
What is melena?
Dark, tarry stools indicating upper GI bleeding ## Footnote Melena is often associated with ulcer disease or other upper GI conditions.
32
What are the common causes of upper GI bleeding?
* Ulcer disease * Gastroduodenitis * Esophagitis * Portal hypertensive causes * Malignancy * Tears across the gastroesophageal junction * Vascular lesions ## Footnote Upper GI bleeding may also present with hematemesis.
33
What are typical symptoms of lower GI bleeding?
Passage of bright red or maroon stools ## Footnote Lower GI bleeding can also present as voluminous red rectal bleeding in cases of brisk bleeding.
34
What is jaundice?
A yellowing of the skin and eyes due to excess bilirubin in the blood ## Footnote Jaundice can result from prehepatic, intrahepatic, or posthepatic disease.
35
Name one posthepatic cause of jaundice.
* Biliary diseases (e.g., choledocholithiasis) * Pancreatic disorders (e.g., acute pancreatitis) ## Footnote Other causes include strictures and neoplasm.
36
What symptoms suggest esophageal disease?
* Dysphagia * Odynophagia * Unexplained chest pain ## Footnote A globus sensation is also reported with esophagopharyngeal conditions.
37
What does weight loss, anorexia, and fatigue indicate?
Nonspecific symptoms of various GI conditions ## Footnote These symptoms may relate to neoplastic, inflammatory, gut motility, pancreatic, small-bowel mucosal, and psychiatric conditions.
38
What are the components of a patient's history for suspected GI disease?
* Symptom timing * Duration of symptoms * Relation of symptoms to meals * Previous surgeries * Recent travel history * Medication history * Sexual history ## Footnote Each component can help narrow down the potential causes of GI symptoms.
39
What do the Rome criteria pertain to?
Symptom-based criteria for diagnosing functional bowel disorders ## Footnote The Rome criteria have a diagnostic specificity exceeding 90% for many functional bowel disorders.
40
What is the significance of abnormal vital signs during physical examination?
They provide diagnostic clues and indicate the need for acute intervention ## Footnote For example, fever may suggest inflammation or neoplasm.
41
What is the role of laboratory tests in evaluating GI disease?
They facilitate the diagnosis of various GI conditions ## Footnote Tests can indicate anemia, electrolyte disturbances, and inflammatory conditions.
42
What is endoscopy used for in GI evaluation?
To directly visualize and biopsy abnormalities in the GI tract ## Footnote Endoscopy can diagnose causes of bleeding, pain, nausea, and other symptoms.
43
What is the purpose of stool sample analysis?
To identify bacterial pathogens, leukocytes, parasites, or measure fecal fat ## Footnote Stool samples can provide diagnostic clues for various GI diseases.
44
What does upper endoscopy assess?
The esophagus, stomach, and duodenum ## Footnote It is the initial structural test for suspected ulcer disease and other upper GI conditions.
45
What is the indication for colonoscopy?
Colon cancer screening and surveillance, as well as diagnosis of colitis ## Footnote Colonoscopy assesses the colon and distal ileum.
46
What are some treatments for GI disease?
* Dietary modifications * Medications * Interventional endoscopy * Surgery * Therapies for external influences ## Footnote Treatment options depend on the underlying cause of the symptoms.
47
Fill in the blank: Dietary modifications for GI disease may include _______ for lactose intolerance.
lactose restriction
48
What medications are commonly used for GI conditions?
* Antacids * Histamine H2 antagonists * Proton pump inhibitors * Laxatives * Fiber supplements ## Footnote Over-the-counter agents are typically used for mild symptoms.
49
True or False: Over-the-counter medications are used for severe GI symptoms.
False ## Footnote They are generally reserved for mild symptoms.
50
What are over-the-counter agents used for?
Mild GI symptoms
51
Name two types of over-the-counter agents that decrease symptoms in gastroesophageal reflux.
* Antacids * Histamine H2 antagonists
52
What type of over-the-counter agents reduce gaseous symptoms?
* Antiflatulents * Adsorbents
53
Which over-the-counter medication is now available for chronic gastroesophageal reflux disease (GERD)?
Proton pump inhibitors
54
What are the categories of laxatives?
* Stimulants * Osmotic agents * Poorly absorbed sugars
55
What are some nonprescription antidiarrheal agents?
* Bismuth subsalicylate * Kaolin-pectin combinations * Loperamide
56
What do lactase pills treat?
Lactose intolerance
57
What type of drugs are prescribed for constipation refractory to other agents?
Prosecretory drugs
58
True or False: Cytoprotective agents are commonly used for upper gut ulcers.
False
59
What is the role of prokinetic drugs?
Stimulate GI propulsion in gastroparesis and pseudoobstruction
60
Name two types of prescription antidiarrheals.
* Opiate drugs * Anticholinergic antispasmodics
61
What class of drugs is used to treat nausea and vomiting?
Antiemetics
62
What is the use of antibiotics in GI diseases?
Treat ulcer disease secondary to Helicobacter pylori, infectious diarrhea, diverticulitis, intestinal bacterial overgrowth, and Crohn’s disease
63
What are probiotics used for?
Adjuncts in some cases of infectious diarrhea and irritable bowel syndrome
64
Fill in the blank: Enemas relieve __________ or assist in gas evacuation.
fecal impaction
65
What is the purpose of nasogastric tube suction?
Decompress the upper gut in ileus or mechanical obstruction
66
What can endoscopy be used for besides diagnosis?
Therapeutic capabilities
67
What technique is used to stop hemorrhage from ulcers during endoscopy?
Cautery techniques
68
What intervention can relieve symptoms of choledocholithiasis?
Endoscopic sphincterotomy of the ampulla of Vater
69
True or False: Surgery is only performed to cure diseases.
False
70
What types of conditions can be cured with surgery?
* Medication-unresponsive ulcerative colitis * Diverticulitis * Cholecystitis * Appendicitis * Intraabdominal abscess
71
What is fundoplication used to treat?
Severe ulcerative esophagitis and drug-refractory symptomatic acid reflux
72
What psychological therapies have shown efficacy in functional bowel disorders?
* Psychotherapy * Behavior modification * Hypnosis * Biofeedback

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