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Pathophysiology > Test 4 > Flashcards

Test 4 Flashcards

1
Q

A technique for obtaining “live” X-ray images of a living patient

A

Fluoroscopy

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2
Q

A Metallic Powder that x-rays cannot penetrate is called ________.

A

Barium sulfate

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3
Q

Upper GI Involves oral ingestion of Barium which consist of what 3 organs?

A

Esophagus, Stomach, and Duodenum

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4
Q

Traces the passage of Barium through the Small Intestine

A

Small Bowel

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5
Q

Involves filling the Colon with Barium by means of a tube inserted into the Colon. This called?

A

Barium Enema

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6
Q

Barium Enema used both __________ and _________ to observe and obtain permanent pictures of Colon.

A

Fluoroscopy and Radiography

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7
Q

A flexible fiberoptic tube that is is placed through the Mouth or Anus is called _________.

A

Endoscopy

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8
Q

A Biopsy may be taken what procedure?

A

Endoscopy

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9
Q

A nasogastric tube is inserted through the Nose into the Stomach and upper region of the Small Intestine. This is called _________.

A

Gastric or Intestinal Analysis

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10
Q

Crohn’s Disease may affect any area of the

Digestive Tract, but where does it occur most frequently?

A

Small Intestine, particularly the terminal ilium (sometimes ascending colon)

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11
Q

What are “skip lesions”?

A

Inflammation occurred with affected segments separated by normal tissue.

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12
Q

As the Inflammation begins, what type of lesion typically develops in the mucosal layer?

A

Shallow ulcers

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13
Q

What is meant by a “cobblestone appearance”?

A

Thickened elevations or nodules

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14
Q

Describe the progressive inflammatory changes that occur in the intestinal wall.

A

Leading to thick, rigid (rubberhose wall) leaving a narrow lumen “String sign” which become obstructed.

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15
Q

what type of impairments would be seen with Crohn’s Disease?

A

Granulomas

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16
Q

What is the etiology of Crohn’s Disease

A

Idiopathic

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17
Q

Crohn’s Disease:

Age affected?

A

Ages 20-40

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18
Q

Crohn’s Disease:

What sex is most likely affected?

A

Equal in men and women

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19
Q

Crohn’s Disease:

What percentage of affected individuals have a positive family history?

A

10-20%

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20
Q

Crohn’s Disease:

Possible causes of Crohn’s include?

A

Infection
Allergies
Lymphatic obstruction

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21
Q

Circumscribed, Crater-Like lesion in the Mucous Membrane are called ________.

A

Ulcers

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22
Q

Ulcers of the Small Intestine are called __________.

A

Duodenal Ulcers

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23
Q

Ulcers of the Upper GI tract are more common in _______.

A

MEN

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24
Q

Where are peptic ulcers located:

A

Most commonly found in the proximal duodenum

Antrum of the Stomach (distal portion)

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25
Q

When the Erosion Invades a Blood Vessel, Bleeding May Occur and May Involve:

A

Blood loss
Massive Hemorrhage
Persistent loss of Small Amounts of blood and could present as Occult (Hidden) blood in the stool

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26
Q

Tissue that forms deep in the cavity and new Epithelial Tissue regenerates from the edges is called:

A

Granulation tissue

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27
Q

Granulation tissue often breaks down due to the presence of _________.

A

Chyme

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28
Q

Mucosal Barrier May be Damaged by what?

A 
A lack of adequate Blood Supply which interferes with rapid regeneration of the Epithelium and the production of sufficient mucus 
EXAMPLES:
Stress-induced vasoconstriction
Smoking
Shock
Circulatory impairment in the elderly
Severe anemia
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29
Q

Defenses May be Decreased by Substances that Break Down the Mucous Membrane. Which are?

A 
Refluxed Bile
Aspirin 
NSAIDs
Alcohol  
Prednisone with its catabolic effects
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30
Q

What is the name of the bacteria responsible for peptic ulcers?

A

Helicobacter pylori

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31
Q

Leukocytes and Macrophages induce

A

Gastritis

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32
Q

Some of the damage to the Mucosal Layer may be caused by ____________.

A

Ammonia Halo

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33
Q

Bacteria also secrete toxins which are _______________.

A

protease, phospholipase

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34
Q

Peptic Ulcers may also be related to lack of sanitation by what?

A

Contaminated drinking water from an unclean source

Could also be transmitted from food that has not been washed or cooked properly

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35
Q

Epigastric burning or aching pain is relieved by:

A

Ingestion of Food or Antacids (Pain Food Relieve)

Heartburn

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36
Q

Some individuals with Duodenal Ulcers may be:

A

Asymptomatic

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37
Q

First clinical manifestation with Duodenal Ulcers may be:

A

Hemorrhage or Perforation

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38
Q

Diagnostic Tests for ulcers include:

A

UGI
Endoscopy
Tissue Biopsy
Culture of H. Pylori

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39
Q

Blood Tests are the Most Common to Reveal what?

A

Antibodies against H. pylori

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40
Q

Non-invasive test may be used either for diagnosis or to determine the effectiveness of treatment is called _________.

A

Urea Breath Test (PYtest)

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41
Q

If H. pylori is Present

A

The Urease produced by the bacteria breaks down the labeled Urea into 14C- carbon dioxide and ammonia

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42
Q

Test that May be used to detect H. pylori in the Feces

A

Stool Test

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43
Q

May result from stricture formation caused by scar tissue around the Pylorus or Duodenum

A

Bowel Obstruction

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44
Q

The most proven effective treatment for Ulcers is a 2 week course of treatment called?

A

Triple Therapy

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45
Q

After completing the Treatment Regimen, further testing is usually ordered which is:

A

Urea Breath Test (PY test)

Stool Tests

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46
Q

More than 75% of the Gallstones that develop in patients in the U.S. are ____________

A

Cholesterol stones

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47
Q

Composed of calcium bilirubin
Either Black or Brown
Often associated with Cirrhosis of the Liver

A

Pigmentary

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48
Q

Four F’s: Risk factors for gallstones are:

A

Female
Forty (Over 40)
Fertile
Fat

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49
Q

Contributing Factors to gallstones are:

A

Diet high in Cholesterol
Estrogen therapy and pregnancy promote Cholesterol excretion in the Bile
Multiparity (having several children)
Drugs that are used for the treatment of hypercholesterolemia

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50
Q

Most Gallstones are:

A

Asymtomatic

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51
Q

cardinal manifestations of Cholelithiasis are:

A

Abdominal Pain and Jaundice

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52
Q

Caused by the lodging of one or more gallstones in the Cystic or Common Bile Duct. ______________

A

Biliary Colic (Pain can be Intermittent or Steady)

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53
Q

Location for a Biliary Colic would be where?

A

Right Upper Quadrant (RUQ) and radiates to the mid-upper back or right Shoulder

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54
Q

Abdominal Tenderness (Rebound) and Fever Indicate _________.

A

Cholecystitis

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55
Q

Cholecystitis would cause what?

A

Inflammation of the Gallbladder
Obstruction causes the Gallbladder to become distended and inflamed
Caused by lodging of a gallstone in the Cystic Duct
Leukocytosis may be present

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56
Q

The most prevalent Liver disease in the world is called:

A

Viral Hepatitis

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57
Q

Chronic Inflammation occurs with Hepatitis __ and __.

A

B AND C

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58
Q

Persistent low-grade inflammation & necrosis of liver for greater than 6 months is called?

A

Chronic Hepatitis

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59
Q

Hepatitis A causative agent is?

A

Caused by a small RNA Virus

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60
Q

Hepatitis A is transmitted by:

A

Passed from the body into the feces (Most frequently spread by Fecal-Oral Route)

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61
Q

How long is the incubation period for Hep A?

A

Abrupt onset after 2-6 weeks incubation

62
Q

Prevention for Hep A is done by:

A

Immune Serum Globulin (ISG)

63
Q

Hepatitis B causative agent is:

A

DNA Virus

64
Q

Hep B is transmitted by:

A

Occurs by Percutaneous (IV, IM, SC or Intradermal) and/or Permucosal exposure to infected body fluids

65
Q

How long is the incubation period for Hep B?

A

Slow onset after an incubation of approximately 2 - 6 Months

66
Q

Prevention for Hep B is done by:

A

Hepatitis Immune Globulin (HBIG)

67
Q

Causative Agent for Hepatitis C is?

A

RNA Virus

68
Q

How is Hepatitis C transmitted?

A

Blood and body fluids

69
Q

How long is the incubation period for Hep C?

A

Insidious onset after 2 weeks – 6 months incubation (Average: 6 – 9 weeks)

70
Q

How is Hepatitis C prevented?

A

NO CURE!

71
Q

Highly contagious and is responsible for epidemic outbreaks of the disease. __________

A

Hep A

72
Q

Those at Risk of Contacting Hepatitis B are:

A

IV drug users
Male homosexuals
Infants of infected mothers
Dialysis patients

73
Q

Hepatitis - Signs and Symptoms in the Preicteric Stage are:

A 
Fatigue and malaise
Anorexia, nausea and vomiting
Changes in the senses of taste & smell
Distaste for cigarettes
Mild discomfort in the RUQ
Headache
Mild fever
Elevated Liver Enzymes
74
Q

Hepatitis - Signs and Symptoms in the Icteric Stage are:

A

Jaundice as serum Bilirubin levels rise
As biliary obstruction increases, Stools become clay colored and the Urine becomes darker due to Bilirubin excretion
Hepatomegaly

75
Q

Diagnostic Tests for Hepatitis would be:

A

Serum Levels of Liver Enzymes: AST or ALT
Bilirubin (serum)
Elevated serum levels
Liver Biopsy
Could be performed to denote the extent of liver damage as seen with Chronic Hepatitis

76
Q

Serum Markers for Hepatitis A:

A

Anti-HAV IgM

Anti-HAV IgG

77
Q

Serum Markers for Hepatitis B:

A

Australia antigen (HBsAg)

78
Q

Serum Markers for Hepatitis C:

A

Anti-HCV (Antibody to HCV)
Can be detected 4-10 weeks after infection
HCV RNA PCR (Polymerase Chain Reaction)

79
Q

Third leading cause of death worldwide

A

Liver Cell (Hepatocellular) Carcinoma - HCC

80
Q

Treatment for Liver Cell (Hepatocellular) Carcinoma would be:

A 
Bedrest
Adequate diet (High in protein, carbohydrate and vitamins) and Fluid Intake
81
Q

May be prescribed for the treatment of BOTH Chronic Hepatitis B and C. _____________

A

Alpha Interferon

82
Q

Saclike Outpouchings of the Mucosa through the Muscle Layers of the Colon wall is called ___________.

A

Diverticular Disease

83
Q

Etiology for Diverticular Disease:

A

Western World affecting:
5-10% of the population over 45 years of age
85% of those individuals older than 85 years of age

84
Q

Most frequent or significant site for Diverticular Disease is where?

A

Sigmoid Colon

85
Q

Diverticula can become impacted with __________ and ________ Resulting in acute Inflammation.

A

Feces and bacteria

86
Q

Signs and Symptoms: Diverticula

A 
Mild Discomfort, Diarrhea, Constipation or Flatulence
Fever
Leukocytosis:  Elevated WBC Count
Tenderness of the LLQ with 
Nausea and Vomiting
87
Q

Diagnostic Test for Diverticular Disease are:

A

Sigmoidoscopy: Permits direct Observation of the lesions
Barium Enema, CT Scan
Ultrasound may confirm the diagnosis
(CT scans are the safest and most cost-effective)

88
Q

Complications for Diverticular Disease include:

A

Intestinal Obstruction
Perforation with Peritonitis
Abscess Formation

89
Q

How can Diverticular Disease be prevented?

A

Increase fiber/bulk in diet and encourage regular Bowel movements

90
Q

Occurs when there is a defect in the Diaphragm & it permits a portion of the Stomach to protrude through the Esophageal Hiatus into the Thoracic Cavity

A

Hiatal Hernia

91
Q

Digestive System Disorder that is more common in WOMEN than men?

A

Hiatal Hernia

92
Q

Type of Hiatal Hernia that is part of the Fundus of the Stomach and moves up through the Esophageal Hiatus

A

Rolling or Paraesophageal Hernia

93
Q

Involves the periodic flow of gastric contents into the Esophagus
Often seen associated with a Hiatal Hernia

A

GERD

94
Q

A mass that Protrudes into the lumen is called a _____

A

POLYP

95
Q

Approximately 50% of the Intestinal Cancers develop in the ______________.

A

Recto-sigmoid Areas

96
Q

As a Polyp increases in size there is an increased risk for:

A

Dysplasia

Cells vary in size and shape, nuclei

97
Q

Genetic Factors for Colorectal Cancer are:

A

Familiar Multiple Polyposis
Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
Chronic Ulcerative Colitis
Crohn’s Disease

98
Q

Later Signs and Symptoms of Colorectal Cancer include:

A 
Indigestion
Pain with tenderness in lower abdomen
Pallor
Ascites
Cachexia
Lymphadenopathy
99
Q

Diagnostic Tests for Colorectal Cancer are:

A

Digital Rectal Exam

100
Q

Briefly describe the patient’s stools with Crohn’s Disease.

A

Typically soft or semi-formed

101
Q

Crohn’s Disease:

What type of signs and symptoms are observed as a result of malabsorption and malnutrition?

A

Anorexia, weight loss, anemia, and fatigue

102
Q

Crohn’s Disease:

How might a young child be affected by this disorder?

A

Experience delayed growth and sexual maturation resulting from lack of proteins and vitamin A and D.

103
Q

Crohn’s Disease Diagnostic Tests include:

A

H& P
Small Bowel Series & Barium Enema
Colonoscopy and Sigmoidoscopy
Biopsy of the mucosa

104
Q

Where would fistulas develop; what organs would be involved?

A

Intestinal Wall of intestine (Large or small) and Bladder

105
Q

According to our authors, what type of medication would be administered to treat Crohn’s Disease:

A

Anti-inflammatory medications
Antibiotics
Immunomodulators
Surgical Treatment

106
Q

Mucosal Barrier May be Damaged by what 5 things?

A 
Stress-induced vasoconstriction
Smoking
Shock
Circulatory impairment in the elderly
Severe anemia
107
Q

What is is responsible for the majority of Peptic Ulcers?

A

Helicobacter pylori

108
Q

What cells induce gastritis?

A

Leukocytes and Macrophages

109
Q

How is peptic ulcers transmitted?

A

Possible routes include:

  1. Fecal-Oral
  2. Oral-Oral
  3. (Contaminated food)
  4. Lack of sanitation
110
Q

Signs and Symptoms of Peptic ulcers:

A
  1. Epigastric burning or aching pain
  2. Pain-food-relief (Pain is relieved by the ingestion of Food or Antacids)
  3. Intake of spicy foods may Initiate the pain at mealtime
  4. Nausea and Vomiting (especially with alcohol consumption or an irritating food)
  5. Heartburn
111
Q

Anorexia and Weight Loss are a common sign with what disease?

A

Peptic Ulcers

112
Q

Diagnostic Test for Peptic Ulcers:

A
  1. UGI
  2. Endoscopy
  3. Tissue Biopsy
  4. Culture for H.Pylori
  5. BLOOD TEST (MOST COMMON)
113
Q

May result from stricture formation caused by scar tissue around the Pylorus or Duodenum

A

Bowel Obstruction

114
Q

75% of gallstones are what type?

A

Cholesterol

115
Q

Gallstones that associated with cirrhosis of the liver are?

A

Pigmentary

116
Q

What are the risk factors for gallstones?

A 
Four F's
Female
Forty
Fertile
Fat
117
Q

What are some contributing factors to developing gallstones?

A
  1. High Caloric Diet
  2. Diet high in Cholesterol
  3. Oral Contraceptives
  4. Estrogen therapy and pregnancy promote Cholesterol excretion in the Bile
  5. Multiparity (having several children)
  6. Drugs that are used for the treatment of hypercholesterolemia
  7. Older in Age
118
Q

Most Gallstones are ____________

A

Asymptomatic

119
Q

Abdominal Pain and Jaundice are the cardinal manifestations of _______________.

A

Cholelithiasis

120
Q

Jaundice indicates that the stone is located in the _____________.

A

Common Bile Duct

121
Q

Caused by the lodging of one or more gallstones in the Cystic or Common Bile Duct

A

Biliary Colic (RUQ)

122
Q

Treatment for gallstones include

A

Cholecystectomy

123
Q

What is the most prevalent disease in the world?

A

Viral hepatitis

124
Q

Chronic hepatitis occurs with what two types?

A

Hep B and Hep C

125
Q

How is Hep A transmitted?

A

Fecal-Oral (contaminated water,food, shellfish, sewage)

126
Q

What is the incubation period for Hep A?

A

2-6 weeks (Most contagious during the 10-14 days during symptoms)

127
Q

Process or formation of stone-like masses called gallstones is called?

A

Cholelithiasis

128
Q

Highly contagious and is responsible for epidemic outbreaks of the disease is?

A

HEP A

129
Q

What are the 2 core antigens of HEP B?

Surface Antigen?

A

HBcAg and HBeAg

HBsAg

130
Q

With Hep B all people with what antigen are infectious?

A

HBsAg THE SURFACE ANTIGEN

131
Q

Another name for Hep A would be?

A

Infectious Hepatitis or HAV

132
Q

Another name for Hep B would be?

A

Serum Hepatitis or HBV

133
Q

Another name for Hep C (formerly called)

A

HCV

(Formerly called non-A-non-B or NANB

134
Q

These signs and symptoms are from what stage:

Fatigue and malaise
Anorexia, nausea and vomiting
Changes in the senses of taste & smell
Distaste for cigarettes
Mild discomfort in the RUQ
Headache
Mild fever
Elevated Liver Enzymes
A

Preicteric Stage (Prodromal stage)

135
Q

What happens during the icteric stage of Hepatitis

A

Jaundice as serum Bilirubin levels rise

As biliary obstruction increases, Stools become clay colored and the Urine becomes darker due to Bilirubin excretion

136
Q

What stage lasts longer with Hep B patients?

A

Icteric Stage

137
Q

Serum makers for Hep A would be?

A

Anti-HAV IgM

Anti-HAV IgG

138
Q

Serum makers for Hep B would be?

A

Australia antigen (HBsAg)

139
Q

Third leading cause of death worldwide is ____________

A

Liver Cell Carcinoma

140
Q

What is used to treat Hep C?

A

A combination of a slow acting Interferon and the antiviral drug Ribavirin

141
Q

Saclike Outpouchings of the Mucosa through the Muscle Layers of the Colon wall

A

Diverticula

142
Q

Most frequent or significant site of Diverticula is?

A

Sigmoid colon

143
Q

Signs and Symptoms of Diverticulitis would be?

A

Fever
Leukocytosis
Tenderness of the LLQ with Nausea and Vomiting

144
Q

Occurs when there is a defect in the Diaphragm & it permits a portion of the Stomach to protrude through the Esophageal Hiatus into the Thoracic Cavity

A

Hiatal Hernia

145
Q

Type of Hiatal Hernia where part of the Fundus of the Stomach moves up through the Esophageal Hiatus?

A

Rolling or Paraesophageal Hernia

146
Q

More common type of Hiatal Hernia

Portion of Stomach & the Gastroesophageal Junction move above the Diaphragm, especially in a supine position

A

Sliding Hernia

147
Q

A mass that Protrudes into the lumen is called a _________.

A

Polyp

148
Q

Old Tarry Blood, black stools is called?

A

Melana

149
Q

Involves the periodic flow of gastric contents into the Esophagus

A

GERD

150
Q

Signs and Symptoms for Diverticula are:

A

May be vague or Asymptomatic

Mild Discomfort, Diarrhea, Constipation or Flatulence

151
Q

What is Diverticulitis?

A

Inflammation of the Diverticula

152
Q

What is Diverticulosis?

A

Asymptomatic Diverticular Disease

Condition of many of these outpouchings

Pathophysiology (7 decks)

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