Unit 7: GI Paths

Question 1

Reflex esophagitis

Answer 1

AKA Gastroesophageal Reflux Disease (GERD)

Stomach acid and enzymes flow backwards from stomach into esophagus.

Most common Sx: heartburn

Question 2

Most common cause of GERD

Answer 2

Hiatal hernia

Question 3

Factors contributing to GERD

Answer 3

Weight gain
Fatty foods, chocolate, caffeine, tobacco, alcohol

Anticholinergic drugs (antihistamines, antidepressants).

Question 4

Hiatal Hernia

Answer 4

Most common cause of reflux esophagitis

Displacement of top of stomach into through diaphragmatic hiatus into stomach

Sliding (into esophagus)
Paraesophageal (beside esophagus)

Often asymptomatic, but can also result in strangulation, GERD

Question 5

General Sx of stomach and duodenal diseases

Answer 5

Pain (midline, upper abdomen)
Vomiting
Bleeding (hematemesis, melena)
Dyspepsia
Systemic consequences (B12 deficiency, anemia, etc)

Question 6

Pyloric stenosis

Answer 6

Congenital
Doesn’t allow stomach to empty

Projectile vomiting

Surgical tx

Question 7

Gastritis

Answer 7

Inflammation of the stomach

Acute or chronic

Question 8

Layers of alimentary wall

Answer 8

Mucosa
Submucosa
Muscular is
Serosa

Question 9

Acute Gastritis

Answer 9

AKA erosive gastritis

self-limiting, often spontaneously healing
Shallow mucosal defect limited to upper layers of epithelium

Can result from irritants (drugs, especially NSAIDs), Crohn’s disease, infection, etc.

Question 10

Acute Stress Gastritis

Answer 10

erosive gastritis that develops in response to a sudden illness or injury (ie burn, injuries involving major bleeding)

Question 11

Chronic Gastritis

Answer 11

Any of several pathologic processes causing chronic inflammation of the stomach.

Most often presents as atrophic gastritis, with or without metaplasia

Question 12

Atrophic gastritis

Answer 12

A form of chronic gastritis in which the stomach lining thins, and in which most of the acid- and enzyme-producing enzymes are lost.

Can result from h pylori infection (most common), partial stomach removal, and/or autoimmune attack (autoimmune metaplasic atrophic gastritis)

Question 13

Most common Sx of chronic gastritis:

Answer 13

dyspepsia

Question 14

Peptic Ulcer

Answer 14

round/oval sore which occurs where the lining of the stomach or duodenum have been eroded by stomach acid/digestive juices.

sharply demarcated; extend to deep layers

Most common: duodenal

Most common cause: H pylori. Also drugs.

Question 15

Peptic Ulcers: Complications

Answer 15

• Penetration into adjacent organ (liver, pancreas)
• Perforation into abdominal cavity (peritonitis)
• Bleeding (melena, anemia, coffee-ground hematemesis)
• Cicatrization (scarring, which may lead to stenosis, obstruction)
• Cancer

Question 16

Carcinoma of the stomach

Answer 16

95% adenocarcinomas
often develops from H pylori infection

Poor (15%) survival rate

Metastasizes easily/early to liver, ovaries, regional nodes

Question 17

Carcinoma of the stomach: Sx

Answer 17

Early: vague, easily ignored. May mimic peptic ulcer disease by Sx do not get better with Tx

Weight loss, anemia, B12 deficiency, hematemesis, melena