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Human disease and therapeutics 2020 > Test #3 GI and Liver path > Flashcards

Test #3 GI and Liver path Flashcards

1
Q

What causes chemical esophagitis?

A

-Irritants to squamous mucosa (like medications)

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2
Q

What causes infectious esophagitis?

A
  • Usually immunosuppressed
  • Herpes
  • Candida
  • Cytomegalovirus
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3
Q

What virus affects the entire GI tract?

A

-Cytomegalovirus

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4
Q

What virus may be associated with irritable bowel disease?

A

-Cytomegalovirus

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5
Q

What do you see with herpes simplex esophagitis?

A

-Small ulcers

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6
Q

Where is CMV most likely found in?

A
  • Glandular epithelium

- Endothelial cells

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7
Q

What are the symptoms of Reflux Esophagitis?

A
  • Burning
  • Excessive salivation
  • Choking
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8
Q

What is reflux esophagitis?

A

-Relaxation (or malfunction) of gastroesophageal sphincter combined with reflux of gastric acid - can reflux into sinuses or mouth

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9
Q

What are aggravating factors of reflux esophagitis?

A
  • Obesity
  • Pregnancy
  • Alcohol/Tobacco use
  • Caffeine
  • Nicotine
  • Many prescription drugs
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10
Q

What is the medical treatment of reflux esophagitis?

A
  • Antacids
  • H2 blockers
  • Proton Pump inhibitors
  • Lose weight
  • Stop smoking/drinking
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11
Q

What are the complications of reflux esophagitis?

A
  • Ulceration
  • Stricture
  • Barrett esophagus (frequently becomes adenocarcinoma)
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12
Q

What is barrett’s esophagus?

A
  • Continual irritation and long tongues of extended columns of epithelium cells into esophagus
  • Lining takes on a small intestine appearance due to chronic irritation
  • Metaplasia goes to dysplasia and becomes adenocarcinoma
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13
Q

What does the esophageal lining take the appearance of in barrett’s esophagus?

A

-Small intestine

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14
Q

What is reactive (erosive) Gastropathy induced by?

A
  • Alcohol
  • NSAIDs
  • Iron
  • Stress
  • Bile reflux
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15
Q

What is acute gastritis

A

-Asymptomatic to erosion and ulceration with possible significant blood loss

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16
Q

What can cause acute peptic ulcerations?

A
  • Nausea
  • Vomiting
  • NSAIDs
  • Stress
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17
Q

What do you see with H pylori gastritis?

A
  • Dueodenal and pyloric ulcers

- May lead to cancer

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18
Q

What are types of chronic gastritis?

A
  • H pylori gastritis
  • Autoimmune gastritis
  • Peptic ulcer disease
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19
Q

What is causative of Peptic Ulcer Disease?

A
  • H pylori

- NSAIDs

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20
Q

What happens to acid in peptic ulcer disease?

A

-Increases

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21
Q

What do the ulcers look like in peptic ulcer disease?

A

-Punched out ulcers giving potential for perforation and hemorrhage

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22
Q

What can peptic ulcer disease lead to?

A
  • Gastric ulcer
  • Dysplasia
  • Eventuall adenocarcinoma
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23
Q

What can you treat H pylori with?

A

-Antibiotics

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24
Q

Gastric polyps that are hyperplastic are a response to what?

A

-Gastric injury around ulcers

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25
Q

T/F Gastric polyps that are hyperplastic may contain some dysplasia

A

True

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26
Q

The intestinal type of gastric adenocarcinoma forms what?

A

-Glands

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27
Q

The diffuse type of gastric adenocarcinoma have what type of cell morphology?

A

-Signet

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28
Q

What usually causes intestinal obstruction?

A

-Mechanical such as hernia or postsurgical adhesions

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29
Q

What percent of intestinal obstructions are mechanical

A

80%

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30
Q

What percent of intestinal obstructions are neoplasms and infarctions?

A

-20%

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31
Q

What is Hirschprung disease?

A
  • Congenital defect
  • Lack ganglia cells to stimulate smooth muscle
  • Can’t pass meconium at birth (need to remove section of colon that can’t contract)
32
Q

Where do 80% of peptic ulcers frequently occur in?

A

-Duodenum

33
Q

What are four diarrheal diseases?

A
  • Celiac sprue
  • Irritable bowel syndrome
  • Infectious self limiting colitis
  • Pseudomembranous colitis
34
Q

What are the oral effects of celiac sprue?

A
  • Enamel defects
  • Delayed eruptions
  • Recurrent aphthous ulcers
35
Q

What is celiac sprue triggered by?

A
  • Gluten

- Metabolite causes tissue damage (especially in small bowel)

36
Q

What happens to the villi in celiac sprue?

A

-It gets blunted

37
Q

T/F Celiac sprue is unique because it is not immune mediated

A

False

-It is immune mediated

38
Q

What symptoms do you have with Irritable bowel syndrome?

A
  • Relapsing pain
  • Bloating
  • Constipation
  • Diarrhea
39
Q

What can cause irritable bowel syndrome?

A
  • Diet
  • Abnormal motility
  • Stress
40
Q

What diarrheal disease has no gross microscopic abnormalities associated with it?

A

-Irritable bowel syndrome

41
Q

What causes infectious self limiting colitis?

A
  • E. coli

- Salmonella

42
Q

What is the most common nosocomial infection in older adults?

A

-Pseudomembranous colitis

43
Q

What usually causes pseudomembranous colitis?

A

-Clostridium difficile (heat resistant and hard to destroy)

44
Q

Can pseudomembranous colitis spread and how?

A

-Yes via person to person from C diff

45
Q

T/F Pseudomembranous colitis often follow antibiotic therapy

A

True

46
Q

What do the toxins from C diff cause?

A
  • Pseudomembranous formation
  • Fluid secretions
  • Ulcerations
  • May cause perforation of intestinal wall
47
Q

What percent of neonates are carries of C diff?

A

-50%

48
Q

What other disease is Crohns disease similar to?

A

-Ulcerative colitis

49
Q

Where does Crohns disease affect?

A

-Mainly the lower GI tract (rectum) but can also affect the upper

50
Q

T/F Crohns disease can lead to cancer

A

True

51
Q

T/F Crohns disease doesn’t have transmural lesions

A

False

-It does have transmural lesions

52
Q

What type of inflammatory bowel disease has fistulas and peranal disease as well as granulomas?

A

-Crohn disease

53
Q

What inflammatory bowel disease has skipped areas that are non-lesioned and has intermediate strictures?

A

-Crohn disease

54
Q

What inflammatory bowel disease is more continuous especially in colon and has no strictures and is also found more superficial?

A

-Ulcerative colitis

55
Q

Do hyperplastic colon polyps have malignant potential?

A

-No

56
Q

What are the types of inflammatory bowel disease?

A
  • Crohns disease

- Ulcerative colitis

57
Q

Can a colon polyp adenoma become malignant?

A

-yes

58
Q

What percent of cancer death in the US is a result of invasive colonic adenocarcinoma?

A

15%

59
Q

Do you find ulcerative colitis in the upper GI tract?

A

No

60
Q

What are some dietary factors that can lead to invasive colonic adenocarcinoma?

A
  • Low vegetable soluble fiber

- High fat/carbohydrate diet

61
Q

Malabsorption is typically due to nutrients not being absorbed by what segment of the GI tract?

A

-Small intestine

62
Q

What can malabsorption be associated with?

A

-Steatorrhea (high fat content in stools)

63
Q

How do you detect pernicious anemia?

A

-Shilling test

64
Q

What does Zollinger-Ellison syndrome cause?

A

-Causes tumors in duodenum and ulcers

65
Q

what patients does cytomegalovirus typically affect?

A

elderly or immunocompromised

66
Q

cytomegalovirus affects the entire GI tract. how does it typically present?

A

multiple discrete, well-circumscribed superficial ulcers

67
Q

what is reactive (erosive) gastropathy?

A

damage to protective epithelial layer

68
Q

which type of chronic gastritis is usually genetic, does not have ulcers, and is characterized by generalized metaplasia?

A

autoimmune atrophic gastritis

69
Q

what gets destroyed in autoimmune atrophic gastritis?

A
  • parietal and chief cells

- destroyed by antibodies

70
Q

what vitamin deficiency is commonly associated with autoimmune atrophic gastritis, and what can it lead to?

A

vit B12, which can lead to adenocarcinoma

71
Q

what part of the GI does peptic ulcer disease affect?

A

lower stomach and proximal duodenum

72
Q

A variety of colitis-related disorders are ___-based and cause ___

A
  • inflammatory

- diarrhea

73
Q

what are characteristics of the bowels in irritable bowel syndrome?

A

they are functional, without the typical structural correlates

74
Q

is inflammatory bowel disease chronic or acute? is it contageous?

A
  • chronic

- not contageous

75
Q

do patients with inflammatory bowel disease have oral lesions?

A

some may

76
Q

what are the oral manifestations of crohn’s disease are typically associated with?

A

typically associated with rectal changes to mucosal layers

77
Q

what are some prognostic features of invasive colonic adenocarcinoma?

A
  • depth of invasion and lymph node involvement

- the deeper the involvement, the more likely to metastasize

Human disease and therapeutics 2020 (60 decks)

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