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GI Week 2 > Vascular Disorders and Obstruction > Flashcards

Vascular Disorders and Obstruction Flashcards

1
Q

what locations are considered an Upper GI bleed?

A

esoph
stomach
duodenum

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2
Q

what locations are considered a lower GI bleed?

A

SI
LI
rectum
anus

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3
Q

when you have hematochezia with hemodynamic instability, what test do you do? why?

A

upper endo…bc may be severe upper GI bleed

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4
Q

when you have hematochezia with hemodynamic stability, what test do you do? why?

A

colonoscopy bc likely lower GI bleed

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5
Q

name the four things that can cause esophageal bleeding

A

varics
laceration
esophagitis
cancer

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6
Q

what cause esophageal varices?

A

portal hypertension

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7
Q

what is the usual cause of an esophageal lacerations

A

severe vomiting or retching

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8
Q

what is retching?

A

pretty much dry heaving

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9
Q

when you have esophageal mucosal laceration from vomiting what is this called?

A

Mallory Weiss tear

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10
Q

when you have esophageal rupture from severe vomiting what is it called?

A

Boerhaave syndrome

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11
Q

outside of vomiting, what is another way to get esophageal laceration?

A

trauma

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12
Q

name the three ways to have gastric bleeds

A

cancer
peptic ulcer disease
acute hemorrhagic gastritis

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13
Q

name the four ways to get SI bleeds

A

volvulus
intussusception
meckel diverticulum
mesenteric ischemia

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14
Q

name the six ways to get LI bleeds

A 
angiodysplasia
hemorrhoids
ischemic colitis
colorectal carcinoma
IBD
diverticular disease
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15
Q

what is angiodysplasia?

A

small vascular malformations in the GI tract

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16
Q

explain the pathophys behind angiodysplasia

A

arteries dont branch into caps and just lead straight into veins so increased venous pressure leads to bleeding in GI tract

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17
Q

who gets angiodysplasia? where is it most common in GI?

A

elderly

most common in cecum and right colon

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18
Q

what are hemorrhoids? what are two common causes of them?

A

increased venous pressure in rectal veins…

constipation and pregnancy

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19
Q

superior plexus of rectal veins leads to what type of hemorrhoid? inferior plexus?

A

internal hemorrhoids for superior

external hemorrhoids for inferior

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20
Q

what are the two ways to get ischemic bowel disease?

A

occlusion from thrombus or atherosclerosis
and
non-occlusion from hypotension or hypovolemia

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21
Q

ischemic bowel disease is SI is called what?

A

mesenteric ischemia

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22
Q

ischemic bowel disease in LI is called what?

A

ischemic colitis

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23
Q

for occlusive ischemic bowel disease what artery is most common?

A

superior mesenteric

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24
Q

for occlusive ischemic bowel disease what artery is least common?

A

celiac pretty much never happens

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25
Q

what area is most quickly ischemic in ischemic bowel disease?

A

the tips of villi because they are farthest from blood supply

26
Q

what are the two types of injury you can have from ischemic bowel disease?

A

hypoxia and reperfusion injury

27
Q

what color do bowels change to when ischemic?

A

a dark purplish color

28
Q

what type of necrosis is ischemic bowel disease?

A

coagulative necrosis

29
Q

what causes the purple appearance of ischemic bowel disease?

A

distended submucosal veins

30
Q

which is worse to have, ischemic colitis or acute mesenteric ischemia?

A

acute mesenteric ischemia is worse

31
Q

is ischemic colitis usually occlusive or low flow cause?

A

low flow usually causes..so think CHF, cardiac issues, sepsis etc

32
Q

how does ischemic colitis present?

A

LLQ pain
hematochezia
abdominal tenderness

33
Q

in what quadrant do you have pain with ischemic colitis?

A

LLQ

34
Q

what is the sign on Xray that you can see with ischemic colitis? what causes this?

A

thumbprinting sign…caused by inflammation in colon leading to edema

35
Q

what is treatment for ischemic colitis?

A

supportive care

36
Q

how does acute mesenteric ischemia present?

A

acute abdominal pain
abdominal distension
SMA embolus

37
Q

what test do you use for acute mesenteric ischemia?

A

angiography

38
Q

non occlusive mesenteric ischemia is caused by what?

A

splanchnic vasoconstriction secondary to CV event

39
Q

how does chronic mesenteric ischemia present?

A

intestinal angina
sitophobia
weight loss

40
Q

what is sitophobia?

A

fear of eating

41
Q

how does chronic mesenteric ischemia usually occur?

A

stomach steals blood from intestines for digestion

42
Q

how many arterial systems are compromised in chronic mesenteric ischemia?

A

two of three (celiac superior/inferior mesenteric)`

43
Q

Kaposi sarcoma is from what bug?

A

HHV 8

44
Q

what cell does kaposi sarcoma infect? what layer of tissue does it cause issues with>

A

endothelial cells

causes issue in mucosal surfaces of the body

45
Q

how does intestinal obstruction present?

A

vomiting bloating and cramping

46
Q

how does esophageal obstruction present?

A

dysphagia

47
Q

how does stomach obstruction present?

A

vomiting

48
Q

what are the four intrinsic causes of bowel obstruction?

A

neoplasms
ulcers
stenosis
foreign body

49
Q

what are the four extrinsic causes of bowel obstruction?

A

neoplasms
pancreatitis
adhesion
endometriosis

50
Q

what are the HIV causes of bowel obstruction?

A

hernia (internal)
intussusception
volvulus

51
Q

what causes most intussusceptions in kids?

A

idiopathic or rotavirus

52
Q

what causes most intussusceptions in adults?

A

might be neoplasms

53
Q

what is a volvulus?

A

twisting of bowel on itself

54
Q

what tells you where are volvulus originated?

A

wherever the axis is pointing

55
Q

how does an intussusception appear on CT?

A

like a bulls eye

56
Q

what organs does scleroderma affect the most

A

skin and GI tract

57
Q

name three things that can happen to fingers with scleroderms

A

calcinosis
raynauds
sclerodactyly

58
Q

what is calcinosis?

A

calcium deposits on fingers in scleroderma

59
Q

what is sclerodactyly?

A

skin tightens on digits in scleroderma

60
Q

where does scleroderma cause issues in GI tract?

A

all over it

GI Week 2 (12 decks)

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