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NUR 326 > Upper GI > Flashcards

Upper GI Flashcards

1
Q

upper GI

A

esophagus, stomach, beginning of SI

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2
Q

esophageal disorders

A

GERD
hiatal hernia

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3
Q

inflammatory disorders of the stomach

A

gastritis
acute gastroenteritis
PUD

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4
Q

dysphagia

A

difficulty swallowing
- begins with solids and progresses to liquid

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5
Q

common causes of dysphagia

A

mechanical obstruction
neuromuscular

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6
Q

what is mechanical obstruction of dysphagia

A

problem with structures that assist in swallowing
- stenosis or stricture
- diverticula
- tumors

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7
Q

what is neuromuscular dysphagia

A

related to
- CVA (stroke): esophagus is no longer innervated appropriately
- achalasia: LES cant open properly
- people that have been intubated or tracheostomies

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8
Q

GERD stands for

A

gastro esophageal reflux disease

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9
Q

GERD occurs because

A

the LES doesnt close properly allowing stomach contents to pass back into the esophagus
- backflow of gastric contents (highly acidic–> causes heart burn feeling)

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10
Q

2 reasons that GERD occurs

A
  • anything that alters the closure strength or LES
  • inc in abdominal pressure
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11
Q

examples of things that cause GERD

A
  • fatty, spicy, citrus, tomato foods
  • caffeine
  • large amount of alc
  • cigs
  • sleep position
  • obesity
  • pregnancy
  • drugs
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12
Q

clinical manifestations of GERD

A
  • heartburn (pyrosis)
  • dyspepsia
  • regurgitation
  • chest pain
  • dysphagia
  • pulmonary symptoms
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13
Q

more complex manifestations of GERD

A
  • tooth decay, gingivitis, bad breath
  • earache
  • chronic cough, worse asthma, recurrent pneumonias
  • hoarseness, chronic sore throat, laryngitis, post nasal drip
  • bloating, belching
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14
Q

complications of GERD

A

ulcers
scarring
strictures
Barrett esophagus

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15
Q

what is barrett esophagus

A

development of abnormal metaplastic tissue
- pre malignant
- inc risk of adrenocarcinoma of esophagus

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16
Q

hiatal hernia

A

defect in the diaphragm that allows part of the stomach to pass into the thorax cavity

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17
Q

types of hiatal hernias

A

sliding: usually small and doesn’t need treatment
paraesophageal: part of stomach pushed through diaphragm and stays there (peritoneum membrane becomes thin/defect and allows the stomach to sit up there)

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18
Q

cause of hiatal hernia

A

unknown

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19
Q

risks of hiatal hernia

A
  • age related
  • injury or other damgage that weakens the diaphragm muscles
  • repeated pressure on muscles around stomach like coughing, vomiting, constipation/straining
  • obesity
  • smoking
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20
Q

clinical manifestations of hiatal hernia

A

asymptomatic
belching
dysphagia
chest or epigastric pain
similar to gerd

21
Q

treatment for hiatal hernia

A
  • teach small frequent meals, dont lie down after meals
  • avoid tight clothing and abdominal supports
  • wt control
  • antacids
  • sometimes surgery
22
Q

what is gastritis

A

non specific inflammatory condition of the stomach

23
Q

what are the types of gastritis

A

acute and chronic

24
Q

what is acute gastritis

A

temporary inflammation of the stomach lining (no intestines)
- last 2-10 days

25
Q

causes of acute gastritis

A

irritating substances (alc)
drugs (NSAIDS-> cause dec of protected coating)
infectious agents (h pylori)

26
Q

what is chronic gastritis

A

progressive disorder with chronic infalmmation of stomach lining
- weeks to years

27
Q

complications of chronic gastritis

A

PUD (peptic ulcer disease)
bleeding
ulcers
anemia
gastric cancers

28
Q

causes of chronic gastritis

A
  • autoimmune where the parietal cells are attacked
  • chronic H pylori infection
29
Q

what is h pylori

A

helicobacter pylori, gram - spiral that lives in acidic environments

30
Q

why is h pylori problematic

A

it can become over grown causing a destructive pattern of persistant inflammation
- can lead to chronic gastritis, PUD, stomach cancer

31
Q

how is h pylori transmitted

A

person to person via saliva, fecal matter, vomit
contaminated food or water

32
Q

clinical manifestations of both gastritis

A

none
anorexia
NV
postprandial discomfort (occurs soon after you eat)
intestinal gas
hemetemesis
tarry stools
anemia

33
Q

what is acute gastroenteritis

A

inflammation of the stomach wall and SI

34
Q

causes of acute gastroenteritis

A

viral infections: novovirus, rotavirus
bacterial infections: e coli, salmonella, campylobacter
parasitic infections

35
Q

how long does acute gastroenteritis occur

A

1-3 typically, sometimes up o 10 days
- typically let them play out, not treated w drugs unless lasts a while

36
Q

what are the clinical manifestations of acute gastroenteritis

A

watery D –> can be bloody if bacterial
ab pain
NV
fever
malaise

37
Q

complication of acute gastroenteritis

A

fluid volume deficits

38
Q

what is PUD

A

peptic ulcer disease
- ulcerative disorder of the upper GI (esophagus, stomach –> gastric ulcer, duodenum–> peptic ulcer)

39
Q

why does a PUD occur

A

GI tract exposed to acid and h pylori infection

40
Q

GI health balancing act: aggressive factors

A

h pylori
NSAIDS
acid
smoking
pepsin

41
Q

GI health balancing act: defensive factors

A

mucus
bicarbonate
blood flow
prostaglandins

42
Q

causes of PUD

A

h pylori
injury causing substances (alc, NSAIDS, ASA)
excessive secretions of acids
smoking
fam hx
stress –> inc gastric secretion so adds to the problem but not cause

43
Q

risk factors of PUD

A

NSAIDS–> inhibit prostaglandins synthesis which dec mucus protective coating
age
hx of PUD
chronic corticosteriod and anti coag
serious systemic disordes (auto immune)
h pylori

44
Q

PUD pathogenesis

A

mucosa is damaged
histamines are secreted which results in
- inc acid and pepsin secretion –> inc damage
- vasodilation–> causing edema
if bv are around ulcer and get destroyed then bleeding ulcers result

45
Q

PUD classifications

A

duodenal ulcers: most common, any age/early adulthood
gastric/peptic: peak 50-70 bc inc use of NSAIDS, corticosteroids, anticoags, more likely to have systemic illnesses

46
Q

PUD clinical manifestations

A

none
NV
anorexia
wt loss
bleeding
burning pain–> middle of ab, usually worse when stomach is empty

47
Q

what is the difference in clinical manifestations of gastric and peptic ulcers that distingusihes the two

A

gastric ulcer pain will occur around 1-2 hours after eating which duodenal pain will occur 2-4 hours after eating

48
Q

PUD complications

A

HOP
H: hemorrhage
O: obstruction
P: perforation and peritonitis

NUR 326 (20 decks)

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