Week 11: Digestive Flashcards
retching
glottis closes and intrathoracic P v
esophagus becomes distended
abd muscles contract, ^ P
duodenum and antrum spasm
reverse peristalsis and P gradient force chyme up
chyme does not enter mouth and falls back down
constipation patho
neurogenic disorders
functional/mech disorders, affected by weakness/pain
low residue diet can ^ chance
sedentary lifestyle ^ chance
depression and anticholinergics contribute
systemic effects of diarrhea
dehydration
electrolyte imbalance
weight loss
metabolic acidosis
steatorrhea
fat in the feces, more common in malabsorption syndromes
types of abdominal pain
parietal, visceral, referred
hematochezia
blood in stool
occult bleeding
Blood in the feces or vomit that is not visible upon gross inspection but is detected in tests used to screen for colon cancer.
duodenal ulcers
Blood in the feces or vomit that is not visible upon gross inspection but is detected in tests used to screen for colon cancer.
gastric ulcers
ulcers of the stomach
dt ^ in mucosal permeability to HCl
normal/v acid prod
tend to be chronic, more vomiting, anorexia
pyloric obstruction
the blocking or narrowing of the opening between the stomach and the duodenum
cause distress, anorexia, copious vomiting
intestinal obstruction
partial or complete blockage of the small or large intestine caused by a physical obstruction
simple obstruction
mechanical blockage of the lumen
functional blockage dt lack of motility
gi obstruction patho
consequences are variable
gas can cause distension
distension v ability to absorb H2O and electrolytes
if distension severe, may cause necrosis, ischemia, perforation, peritonitis
ulcerative colitis
chronic condition of colonic mucosa, usually in rectum and sigmoid
oft 20-40, may be familial
causes incl: dietary, infections, immunologic
uc patho
begins w inflammation in colon w neutrophil infiltration
inflammatory cytokines cause tissue damage
abscesses form in crypts, causing blding, pain, cramps
urge to defecate (diarrhea w bld and purulent mucus)
uc cm
begins w inflammation in colon w neutrophil infiltration
inflammatory cytokines cause tissue damage
abscesses form in crypts, causing blding, pain, cramps
urge to defecate (diarrhea w bld and purulent mucus)
appendicitis
inflammation of the appendix
most common abd sx emerg
may arise from obstruction/bacterial infection
appendicitis cm
epigastric/periumbilical pain, getting worse
RLQ pain associated w inflammation
rebound tenderness
^ WBC and C-reactive proteins
appendicitis complications
perforation, peritonitis, abscess
obesity
BMI> 120% ideal body wt
associated w CV disease, CA, DM
imbalance between energy intake and expense
anorexia nervosa
an eating disorder in which an irrational fear of weight gain leads people to starve themselves
oft associated w nausea, abd pain, diarrhea, CA
less WBC = ^ infection
loss of 25-30% of body wt leads to starvation induced CF
anorexia nrevosa cm
ED denial skeletal look postural hypoTN hypoK, hypoT sleep disturbances
bulimia nervosa
an eating disorder characterized by binge eating followed by purging
teeth damaged dt acid, tracheoesophageal fistulas
rectal bleeding dt laxatives
hav
spread by fecal-oral, bld route (rapidly in unsanitary)
Incubation 4-6 wks, most contagious 4 days pre symp to 3 mo post, IgG elevated for yrs
hbv
Spread through fluids, bld, needles
incubation 4-6 wks IgG are elevated for yrs
hcv
Most cases of post-transfusion hep (screened in bld)
incurable RNA virus
Risk fx in chronic liver disease, cirrhosis, carcinoma
hep patho
similar lesions to other viruses
Hepatic necrosis, scarring, Kupffer cell hyperplasia and phagocyte infiltration occur, regen w/in 48 hrs
damage worst in HBV/HCV
hep cm
prodromal: Begins 2 wks post-exposure, ends w jaundice
icteric: 1-2 wks after prodromal, lasts 2-6 wks
posticteric: Begins w resolution of jaundice, liver function normal after 2-12 wks
chronic hep
Persistence of CM and liver inflammation after hep (most common in HBV)
hep dx
Use HBsAg: marker for HBV, or anti HAV for HAV/HCV
Liver function tests
hep tx
Less fat, ^ carb diet if bile flow is obstructed
precautions
Prophylactic Ig can prevent HBV
cholithiasis patho
Enzyme defect: ^ cholesterol synth
Less secretion of bile acids to emulsify fats
Less resorption of bile salts from ileum
Gallbladder hypomobility/stasis
^ secretion of gallbladder mucin and biliary Ca
genetics
acute pancreatitis
Usually dt damage to biliary duct by ETOH, drugs, infection, trauma
Characterized by severe epigastric pain radiating to back, fever, anorexia, N+V, jaundice
chronic pancreatitis tx
oral lipase, insulin
corticosteroids if autoimmune
cessation of ETOH/smoking
sx
