Week 11: Digestive

Question 1

retching

Answer 1

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

Question 2

constipation patho

Answer 2

neurogenic disorders
functional/mech disorders, affected by weakness/pain
low residue diet can ^ chance
sedentary lifestyle ^ chance
depression and anticholinergics contribute

Question 3

systemic effects of diarrhea

Answer 3

dehydration
electrolyte imbalance
weight loss
metabolic acidosis

Question 4

steatorrhea

Answer 4

fat in the feces, more common in malabsorption syndromes

Question 5

types of abdominal pain

Answer 5

parietal, visceral, referred

Question 6

hematochezia

Answer 6

blood in stool

Question 7

occult bleeding

Answer 7

Blood in the feces or vomit that is not visible upon gross inspection but is detected in tests used to screen for colon cancer.

Question 8

duodenal ulcers

Answer 8

Blood in the feces or vomit that is not visible upon gross inspection but is detected in tests used to screen for colon cancer.

Question 9

gastric ulcers

Answer 9

ulcers of the stomach
dt ^ in mucosal permeability to HCl
normal/v acid prod
tend to be chronic, more vomiting, anorexia

Question 10

pyloric obstruction

Answer 10

the blocking or narrowing of the opening between the stomach and the duodenum
cause distress, anorexia, copious vomiting

Question 11

intestinal obstruction

Answer 11

partial or complete blockage of the small or large intestine caused by a physical obstruction

Question 12

simple obstruction

Answer 12

mechanical blockage of the lumen

functional blockage dt lack of motility

Question 13

gi obstruction patho

Answer 13

consequences are variable
gas can cause distension
distension v ability to absorb H2O and electrolytes
if distension severe, may cause necrosis, ischemia, perforation, peritonitis

Question 14

ulcerative colitis

Answer 14

chronic condition of colonic mucosa, usually in rectum and sigmoid
oft 20-40, may be familial
causes incl: dietary, infections, immunologic

Question 15

uc patho

Answer 15

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)

Question 16

uc cm

Answer 16

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)

Question 17

appendicitis

Answer 17

inflammation of the appendix
most common abd sx emerg
may arise from obstruction/bacterial infection

Question 18

appendicitis cm

Answer 18

epigastric/periumbilical pain, getting worse
RLQ pain associated w inflammation
rebound tenderness
^ WBC and C-reactive proteins

Question 19

appendicitis complications

Answer 19

perforation, peritonitis, abscess

Question 20

obesity

Answer 20

BMI> 120% ideal body wt
associated w CV disease, CA, DM
imbalance between energy intake and expense

Question 21

anorexia nervosa

Answer 21

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

Question 22

anorexia nrevosa cm

Answer 22

ED denial
skeletal look
postural hypoTN
hypoK, hypoT
sleep disturbances

Question 23

bulimia nervosa

Answer 23

an eating disorder characterized by binge eating followed by purging
teeth damaged dt acid, tracheoesophageal fistulas
rectal bleeding dt laxatives

Question 24

hav

Answer 24

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

Question 25

hbv

Answer 25

Spread through fluids, bld, needles

incubation 4-6 wks IgG are elevated for yrs

Question 26

hcv

Answer 26

Most cases of post-transfusion hep (screened in bld)
incurable RNA virus
Risk fx in chronic liver disease, cirrhosis, carcinoma

Question 27

hep patho

Answer 27

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

Question 28

hep cm

Answer 28

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

Question 29

chronic hep

Answer 29

Persistence of CM and liver inflammation after hep (most common in HBV)

Question 30

hep dx

Answer 30

Use HBsAg: marker for HBV, or anti HAV for HAV/HCV

Liver function tests

Question 31

hep tx

Answer 31

Less fat, ^ carb diet if bile flow is obstructed
precautions
Prophylactic Ig can prevent HBV

Question 32

cholithiasis patho

Answer 32

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

Question 33

acute pancreatitis

Answer 33

Usually dt damage to biliary duct by ETOH, drugs, infection, trauma
Characterized by severe epigastric pain radiating to back, fever, anorexia, N+V, jaundice

Question 34

chronic pancreatitis tx

Answer 34

oral lipase, insulin
corticosteroids if autoimmune
cessation of ETOH/smoking
sx