Test 4 Flashcards
A technique for obtaining “live” X-ray images of a living patient
Fluoroscopy
A Metallic Powder that x-rays cannot penetrate is called ________.
Barium sulfate
Upper GI Involves oral ingestion of Barium which consist of what 3 organs?
Esophagus, Stomach, and Duodenum
Traces the passage of Barium through the Small Intestine
Small Bowel
Involves filling the Colon with Barium by means of a tube inserted into the Colon. This called?
Barium Enema
Barium Enema used both __________ and _________ to observe and obtain permanent pictures of Colon.
Fluoroscopy and Radiography
A flexible fiberoptic tube that is is placed through the Mouth or Anus is called _________.
Endoscopy
A Biopsy may be taken what procedure?
Endoscopy
A nasogastric tube is inserted through the Nose into the Stomach and upper region of the Small Intestine. This is called _________.
Gastric or Intestinal Analysis
Crohn’s Disease may affect any area of the
Digestive Tract, but where does it occur most frequently?
Small Intestine, particularly the terminal ilium (sometimes ascending colon)
What are “skip lesions”?
Inflammation occurred with affected segments separated by normal tissue.
As the Inflammation begins, what type of lesion typically develops in the mucosal layer?
Shallow ulcers
What is meant by a “cobblestone appearance”?
Thickened elevations or nodules
Describe the progressive inflammatory changes that occur in the intestinal wall.
Leading to thick, rigid (rubberhose wall) leaving a narrow lumen “String sign” which become obstructed.
what type of impairments would be seen with Crohn’s Disease?
Granulomas
What is the etiology of Crohn’s Disease
Idiopathic
Crohn’s Disease:
Age affected?
Ages 20-40
Crohn’s Disease:
What sex is most likely affected?
Equal in men and women
Crohn’s Disease:
What percentage of affected individuals have a positive family history?
10-20%
Crohn’s Disease:
Possible causes of Crohn’s include?
Infection
Allergies
Lymphatic obstruction
Circumscribed, Crater-Like lesion in the Mucous Membrane are called ________.
Ulcers
Ulcers of the Small Intestine are called __________.
Duodenal Ulcers
Ulcers of the Upper GI tract are more common in _______.
MEN
Where are peptic ulcers located:
Most commonly found in the proximal duodenum
Antrum of the Stomach (distal portion)
When the Erosion Invades a Blood Vessel, Bleeding May Occur and May Involve:
Blood loss
Massive Hemorrhage
Persistent loss of Small Amounts of blood and could present as Occult (Hidden) blood in the stool
Tissue that forms deep in the cavity and new Epithelial Tissue regenerates from the edges is called:
Granulation tissue
Granulation tissue often breaks down due to the presence of _________.
Chyme
Mucosal Barrier May be Damaged by what?
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
Defenses May be Decreased by Substances that Break Down the Mucous Membrane. Which are?
Refluxed Bile Aspirin NSAIDs Alcohol Prednisone with its catabolic effects
What is the name of the bacteria responsible for peptic ulcers?
Helicobacter pylori
Leukocytes and Macrophages induce
Gastritis
Some of the damage to the Mucosal Layer may be caused by ____________.
Ammonia Halo
Bacteria also secrete toxins which are _______________.
protease, phospholipase
Peptic Ulcers may also be related to lack of sanitation by what?
Contaminated drinking water from an unclean source
Could also be transmitted from food that has not been washed or cooked properly
Epigastric burning or aching pain is relieved by:
Ingestion of Food or Antacids (Pain Food Relieve)
Heartburn
Some individuals with Duodenal Ulcers may be:
Asymptomatic
First clinical manifestation with Duodenal Ulcers may be:
Hemorrhage or Perforation
Diagnostic Tests for ulcers include:
UGI
Endoscopy
Tissue Biopsy
Culture of H. Pylori
Blood Tests are the Most Common to Reveal what?
Antibodies against H. pylori
Non-invasive test may be used either for diagnosis or to determine the effectiveness of treatment is called _________.
Urea Breath Test (PYtest)
If H. pylori is Present
The Urease produced by the bacteria breaks down the labeled Urea into 14C- carbon dioxide and ammonia
Test that May be used to detect H. pylori in the Feces
Stool Test
May result from stricture formation caused by scar tissue around the Pylorus or Duodenum
Bowel Obstruction
The most proven effective treatment for Ulcers is a 2 week course of treatment called?
Triple Therapy
After completing the Treatment Regimen, further testing is usually ordered which is:
Urea Breath Test (PY test)
Stool Tests
More than 75% of the Gallstones that develop in patients in the U.S. are ____________
Cholesterol stones
Composed of calcium bilirubin
Either Black or Brown
Often associated with Cirrhosis of the Liver
Pigmentary
Four F’s: Risk factors for gallstones are:
Female
Forty (Over 40)
Fertile
Fat
Contributing Factors to gallstones are:
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
Most Gallstones are:
Asymtomatic
cardinal manifestations of Cholelithiasis are:
Abdominal Pain and Jaundice
Caused by the lodging of one or more gallstones in the Cystic or Common Bile Duct. ______________
Biliary Colic (Pain can be Intermittent or Steady)
Location for a Biliary Colic would be where?
Right Upper Quadrant (RUQ) and radiates to the mid-upper back or right Shoulder
Abdominal Tenderness (Rebound) and Fever Indicate _________.
Cholecystitis
Cholecystitis would cause what?
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
The most prevalent Liver disease in the world is called:
Viral Hepatitis
Chronic Inflammation occurs with Hepatitis __ and __.
B AND C
Persistent low-grade inflammation & necrosis of liver for greater than 6 months is called?
Chronic Hepatitis
Hepatitis A causative agent is?
Caused by a small RNA Virus
Hepatitis A is transmitted by:
Passed from the body into the feces (Most frequently spread by Fecal-Oral Route)
How long is the incubation period for Hep A?
Abrupt onset after 2-6 weeks incubation
Prevention for Hep A is done by:
Immune Serum Globulin (ISG)
Hepatitis B causative agent is:
DNA Virus
Hep B is transmitted by:
Occurs by Percutaneous (IV, IM, SC or Intradermal) and/or Permucosal exposure to infected body fluids
How long is the incubation period for Hep B?
Slow onset after an incubation of approximately 2 - 6 Months
Prevention for Hep B is done by:
Hepatitis Immune Globulin (HBIG)
Causative Agent for Hepatitis C is?
RNA Virus
How is Hepatitis C transmitted?
Blood and body fluids
How long is the incubation period for Hep C?
Insidious onset after 2 weeks – 6 months incubation (Average: 6 – 9 weeks)
How is Hepatitis C prevented?
NO CURE!
Highly contagious and is responsible for epidemic outbreaks of the disease. __________
Hep A
Those at Risk of Contacting Hepatitis B are:
IV drug users
Male homosexuals
Infants of infected mothers
Dialysis patients
Hepatitis - Signs and Symptoms in the Preicteric Stage are:
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
Hepatitis - Signs and Symptoms in the Icteric Stage are:
Jaundice as serum Bilirubin levels rise
As biliary obstruction increases, Stools become clay colored and the Urine becomes darker due to Bilirubin excretion
Hepatomegaly
Diagnostic Tests for Hepatitis would be:
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
Serum Markers for Hepatitis A:
Anti-HAV IgM
Anti-HAV IgG
Serum Markers for Hepatitis B:
Australia antigen (HBsAg)
Serum Markers for Hepatitis C:
Anti-HCV (Antibody to HCV)
Can be detected 4-10 weeks after infection
HCV RNA PCR (Polymerase Chain Reaction)
Third leading cause of death worldwide
Liver Cell (Hepatocellular) Carcinoma - HCC
Treatment for Liver Cell (Hepatocellular) Carcinoma would be:
Bedrest Adequate diet (High in protein, carbohydrate and vitamins) and Fluid Intake
May be prescribed for the treatment of BOTH Chronic Hepatitis B and C. _____________
Alpha Interferon
Saclike Outpouchings of the Mucosa through the Muscle Layers of the Colon wall is called ___________.
Diverticular Disease
Etiology for Diverticular Disease:
Western World affecting:
5-10% of the population over 45 years of age
85% of those individuals older than 85 years of age
Most frequent or significant site for Diverticular Disease is where?
Sigmoid Colon
Diverticula can become impacted with __________ and ________ Resulting in acute Inflammation.
Feces and bacteria
Signs and Symptoms: Diverticula
Mild Discomfort, Diarrhea, Constipation or Flatulence Fever Leukocytosis: Elevated WBC Count Tenderness of the LLQ with Nausea and Vomiting
Diagnostic Test for Diverticular Disease are:
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)
Complications for Diverticular Disease include:
Intestinal Obstruction
Perforation with Peritonitis
Abscess Formation
How can Diverticular Disease be prevented?
Increase fiber/bulk in diet and encourage regular Bowel movements
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
Hiatal Hernia
Digestive System Disorder that is more common in WOMEN than men?
Hiatal Hernia
Type of Hiatal Hernia that is part of the Fundus of the Stomach and moves up through the Esophageal Hiatus
Rolling or Paraesophageal Hernia
Involves the periodic flow of gastric contents into the Esophagus
Often seen associated with a Hiatal Hernia
GERD
A mass that Protrudes into the lumen is called a _____
POLYP
Approximately 50% of the Intestinal Cancers develop in the ______________.
Recto-sigmoid Areas
As a Polyp increases in size there is an increased risk for:
Dysplasia
Cells vary in size and shape, nuclei
Genetic Factors for Colorectal Cancer are:
Familiar Multiple Polyposis
Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
Chronic Ulcerative Colitis
Crohn’s Disease
Later Signs and Symptoms of Colorectal Cancer include:
Indigestion Pain with tenderness in lower abdomen Pallor Ascites Cachexia Lymphadenopathy
Diagnostic Tests for Colorectal Cancer are:
Digital Rectal Exam
Briefly describe the patient’s stools with Crohn’s Disease.
Typically soft or semi-formed
Crohn’s Disease:
What type of signs and symptoms are observed as a result of malabsorption and malnutrition?
Anorexia, weight loss, anemia, and fatigue
Crohn’s Disease:
How might a young child be affected by this disorder?
Experience delayed growth and sexual maturation resulting from lack of proteins and vitamin A and D.
Crohn’s Disease Diagnostic Tests include:
H& P
Small Bowel Series & Barium Enema
Colonoscopy and Sigmoidoscopy
Biopsy of the mucosa
Where would fistulas develop; what organs would be involved?
Intestinal Wall of intestine (Large or small) and Bladder
According to our authors, what type of medication would be administered to treat Crohn’s Disease:
Anti-inflammatory medications
Antibiotics
Immunomodulators
Surgical Treatment
Mucosal Barrier May be Damaged by what 5 things?
Stress-induced vasoconstriction Smoking Shock Circulatory impairment in the elderly Severe anemia
What is is responsible for the majority of Peptic Ulcers?
Helicobacter pylori
What cells induce gastritis?
Leukocytes and Macrophages
How is peptic ulcers transmitted?
Possible routes include:
- Fecal-Oral
- Oral-Oral
- (Contaminated food)
- Lack of sanitation
Signs and Symptoms of Peptic ulcers:
- Epigastric burning or aching pain
- Pain-food-relief (Pain is relieved by the ingestion of Food or Antacids)
- Intake of spicy foods may Initiate the pain at mealtime
- Nausea and Vomiting (especially with alcohol consumption or an irritating food)
- Heartburn
Anorexia and Weight Loss are a common sign with what disease?
Peptic Ulcers
Diagnostic Test for Peptic Ulcers:
- UGI
- Endoscopy
- Tissue Biopsy
- Culture for H.Pylori
- BLOOD TEST (MOST COMMON)
May result from stricture formation caused by scar tissue around the Pylorus or Duodenum
Bowel Obstruction
75% of gallstones are what type?
Cholesterol
Gallstones that associated with cirrhosis of the liver are?
Pigmentary
What are the risk factors for gallstones?
Four F's Female Forty Fertile Fat
What are some contributing factors to developing gallstones?
- High Caloric Diet
- Diet high in Cholesterol
- Oral Contraceptives
- Estrogen therapy and pregnancy promote Cholesterol excretion in the Bile
- Multiparity (having several children)
- Drugs that are used for the treatment of hypercholesterolemia
- Older in Age
Most Gallstones are ____________
Asymptomatic
Abdominal Pain and Jaundice are the cardinal manifestations of _______________.
Cholelithiasis
Jaundice indicates that the stone is located in the _____________.
Common Bile Duct
Caused by the lodging of one or more gallstones in the Cystic or Common Bile Duct
Biliary Colic (RUQ)
Treatment for gallstones include
Cholecystectomy
What is the most prevalent disease in the world?
Viral hepatitis
Chronic hepatitis occurs with what two types?
Hep B and Hep C
How is Hep A transmitted?
Fecal-Oral (contaminated water,food, shellfish, sewage)
What is the incubation period for Hep A?
2-6 weeks (Most contagious during the 10-14 days during symptoms)
Process or formation of stone-like masses called gallstones is called?
Cholelithiasis
Highly contagious and is responsible for epidemic outbreaks of the disease is?
HEP A
What are the 2 core antigens of HEP B?
Surface Antigen?
HBcAg and HBeAg
HBsAg
With Hep B all people with what antigen are infectious?
HBsAg THE SURFACE ANTIGEN
Another name for Hep A would be?
Infectious Hepatitis or HAV
Another name for Hep B would be?
Serum Hepatitis or HBV
Another name for Hep C (formerly called)
HCV
(Formerly called non-A-non-B or NANB
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
Preicteric Stage (Prodromal stage)
What happens during the icteric stage of Hepatitis
Jaundice as serum Bilirubin levels rise
As biliary obstruction increases, Stools become clay colored and the Urine becomes darker due to Bilirubin excretion
What stage lasts longer with Hep B patients?
Icteric Stage
Serum makers for Hep A would be?
Anti-HAV IgM
Anti-HAV IgG
Serum makers for Hep B would be?
Australia antigen (HBsAg)
Third leading cause of death worldwide is ____________
Liver Cell Carcinoma
What is used to treat Hep C?
A combination of a slow acting Interferon and the antiviral drug Ribavirin
Saclike Outpouchings of the Mucosa through the Muscle Layers of the Colon wall
Diverticula
Most frequent or significant site of Diverticula is?
Sigmoid colon
Signs and Symptoms of Diverticulitis would be?
Fever
Leukocytosis
Tenderness of the LLQ with Nausea and Vomiting
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
Hiatal Hernia
Type of Hiatal Hernia where part of the Fundus of the Stomach moves up through the Esophageal Hiatus?
Rolling or Paraesophageal Hernia
More common type of Hiatal Hernia
Portion of Stomach & the Gastroesophageal Junction move above the Diaphragm, especially in a supine position
Sliding Hernia
A mass that Protrudes into the lumen is called a _________.
Polyp
Old Tarry Blood, black stools is called?
Melana
Involves the periodic flow of gastric contents into the Esophagus
GERD
Signs and Symptoms for Diverticula are:
May be vague or Asymptomatic
Mild Discomfort, Diarrhea, Constipation or Flatulence
What is Diverticulitis?
Inflammation of the Diverticula
What is Diverticulosis?
Asymptomatic Diverticular Disease
Condition of many of these outpouchings
