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Pathophysiology > Unit 4 - GI pt 1 > Flashcards

Unit 4 - GI pt 1 Flashcards

1
Q

s/s GI disease

A
  • outcome of underlying disorders

- constitutional symptoms: nausea and vom, diarrhea, malaise, fatigue, fever, dizziness, appetite loss

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2
Q

aging and GI system

A 
Constipation
Dehydration
Ileus
Incontinence
Diverticulosis
absorption loss
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3
Q

Atrophic Gastritis

A
  • Older age groups
  • Atrophy of gastric mucosa
  • dec in gastric acidity (HCI secreted by parietal cells)

is reversible

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4
Q

in atrophic gastritis, there is a reduced

A

intrinsic factor

  • Also known as Gastric Intrinsic Factor (GIF)
  • Secreted by Parietal Cells
  • necessary for the absorption of vitamin B12 (extrinsic factor)
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5
Q

lack of GIF can lead to hematologic disorders such as (4)

A
  1. pernicious anemia (macrocytic, normochromic)
  2. peripheral neuropathy (loss of sensation, weakness, and reduced DTRs)
  3. subacute combined degeneration (demyelination of lateral white columns causing UMN s/s and dorsal white columns causing loss of fine tactile senses)
  4. dementia or “megaloblastic madness”
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6
Q

s/s of esophageal disorders (4)

A
  • Dysphagia: difficulty swallowing
  • Pyrosis: heartburn
  • Odynophagia: pain with swallowing
  • Waterbrash: reflex saliva
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7
Q

Esophagitis

A

acute, non specific
spicy food
resolves in a few days

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8
Q

Gastro-esophageal Reflux (GERD)

A

Chronic Esophagitis
Acid from the Stomach “splashes” up to the Lower Esophagus
may develop barrett’s esophagus (metaplasia of lower esophagus)
can also be caused by hiatal hernia

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9
Q

scleroderma

A

(Systemic Sclerosis)
Esophageal Muscle Atrophy
Collagen replaces Muscle
Esophageal Dysmotility and Dysphagia

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10
Q

Esophageal tumor

common location

highest incidence pop

A 
Most (>50%) are in the lower 1/3 of the Esophagus
Obstruction
Dysphagia & Odynophagia
Bleeding
water brush, weight loss, cachexia

high incidence among AA on islands

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11
Q

risk factors and survival rate of esophageal cancer

A 
Smoking 
Alcohol excess
GE Reflux
Age
Being male

5 year relative survival rates is 47%; 25%; 5%

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12
Q

Achalasia (and plexi)

A

dilation of the lower esophagus due to loss of muscle tone

Loss of myenteric plexus (Auerbach’s)
Loss of submucosal plexus (Meissner’s)
Failure of the LES to relax when swallowing
Accumulation of food causes esophageal dilatation

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13
Q

Mallory-Weiss Syndrome (MWS)

A

Lower Esophageal Bleeding from Mucosal Tears

Bulimia, alcohol abuse, viruses

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14
Q

Tracheo-esophageal Fistula & 3 C’s

A

most common congenital disease of the esophagus (infants)

Communication between T&E
3 C’s (Cough, cyanosis, choke)
Aspiration Pneumonia

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15
Q

acute gastritis - stomach/duodenum

A 
Overindulgence in alcohol or eating
NSAIDs, ASA (aspirin)
GI Viral Infection
Some Antibiotics
Oral Corticosteroids
Diffuse inflammation
Epigastric pain
Pain - relief food pattern
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16
Q

peptic ulcer etiology

A 
Diet
Stress
Medications
Helicobacter Pylori (H. Pylori)
Barriers to Acid (pH=1.5-3.5)
-Mucus
-Mucosal Epithelium
Protective “Barriers” Fail

Back Diffusion of HCl with tissue erosion
-H2 (Histamine) Receptors are stimulated
-Histamine Release from Enterochromaffine-Like Cells (ECL)
Vasodilatation & Bleeding
More Gastric Acid Release-Parietal Cells

17
Q

incidence of peptic ulcers and locations

A
  • 1:1 Males: Females
  • 80% in the duodenal bulb
  • 20% pylorus of the stomach (or elsewhere in the stomach)
  • Occasionally occur in the esophagus
  • Helicobacter pylori (90 - 95%)
18
Q

clinical features of peptic ulcers

A
  • Nocturnal symptomatic pattern
  • Seasonal exacerbations
  • Pain - relief food pattern (as opposed to gall bladder disease)
19
Q

complications of peptic ulcers

A
  • Intractability
  • Hemorrhage
  • Perforation
  • Obstruction
20
Q

stress ulcers (where most common)

A 
Most form in the fundus of the stomach 
Generalized GI Ischemia
-Major trauma (TBI)
-SCI
-Serious Illness
21
Q

risk factors for stress ulcers

A
  • respiratory failure w/ ventilation
  • coagulopathy
  • shock
  • sepsis
  • head trauma
  • neurosurgery
  • severe burns
22
Q

stomach cancer

A
  • most are adenocarcinomas
  • more males and low SES, japan and south korea
  • decreasing in frequency
  • H. pylori usually present
  • 5 yr survival rate
23
Q

linitis plastica

A

gastric cancer with poor prognosis

leather bottle stomach

24
Q

gastric carcinoma - other types

A

Squamous Cell Carcinoma
Gastric Lymphoma (Mucosa Associated Lymphoid Tumor)
Gastrointestinal Stromal Tumor (GIST)
Gastric Neuroendocrine Tumor (Carcinoid)
Gastric Infiltrative Carcinoma (GIC)

25
Q

Gastric Squamous Cell carcinoma-Excavated

A

May form a polyp

Invades the stomach wall

26
Q

Gastric Lymphoma-Mucosa Associated Lymphoid Tissue (MALT) Lymphoma

A

Indolent tumor
Usually occurs in the stomach
Originates in B lymphocytes
Associated with chronic gastric inflammation (H. Pylori)

27
Q

s/s of gastric neoplasia

A 
epigastric pain
weight loss
bloating
dysphagia
nausea
vom blood
black tarry stools

Pathophysiology (27 decks)

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