week 7- gastro

Question 1

right upper quadrant

Answer 1

gall bladder, bile duct, kidney, transverse colon, ascending colon

Question 2

right lower quadrant

Answer 2

cecum, vermiform, appendix, uterus, ovaries

Question 3

left upper quadrant

Answer 3

diaphragm, spleen, kidney, duodenum, pancreas, pancreatic duct, descending colon.

Question 4

left lower quadrant

Answer 4

small intestine, umbilicus, rectum, bladder, anus

Question 5

GERD Gastroesophageal Reflux Disease

Answer 5

relaxation of weak oesophageal sphincter causing back-flow of gastric contents into oesophagus
Causes heart burn or pyrosis
- Oesophageal mucosal injury may occur

Question 6

Reflux Oesophagitis

Answer 6

Barett oesophagus: results from persistent reflux, producing mucosal damage causing:
Hyperemia (excess blood in vessels supplying organ/part of body)
Oedema
Erosion of luminal surface

Question 7

hiatus hernia

Answer 7

Protrusion of stomach through diaphragm-whole stomach can end up going into thorax

Question 8

Oesophageal Varicies

Answer 8

Occur with portal hypertension & gradual obstruction of venous blood flow in liver
-pressure in portal vein increases causing thin walled varicies to form in submucosa layer

Question 9

Gastritis

Answer 9

Inflammation of gastric mucosa

Many causes, grouped as acute or chronic

Question 10

peptic ulcers

Answer 10

-Ulcerative disorder of upper GI tract
Occurs with exposure to acid-pepsin secretions
Variety of causes (bacteria, NSAIDs, congenital)
-Duodenal & gastric ulcers most common
-Affect one or all layers of stomach or duodenum

Question 11

gastro-enteritis

Answer 11

• An acute illness with primary manifestation of diarrhoea

- Associated with fluid shifts leading to dehydration, shock & death

Question 12

Irritable Bowel Syndrome (IBS)

Answer 12

• chronic & recurrent intestinal symptoms; pain, constapation, bloating
• Thought to result from dysregulation of intestinal motor activity & central neural functions modulated in CNS

Question 13

Inflammatory bowel disease- Crohn’s Disease

Answer 13

Slow, progressive & recurrent inflammation of any section of GI tract
Extends through all layers of intestinal wall
-causes Fistula formation, Abdominal abscess, Intestinal obstruction

Question 14

Inflammatory bowel disease-Ulcerative Colitis

Answer 14

Isolated to rectum & colon
Lesions form in base of mucosal layer
Inflammation causes pinpoint mucosal haemorrhages, which develop into abscesses

Question 15

diverticulum

Answer 15

each weakened pouch

Question 16

Diverticula:

Answer 16

multiple pouches (often present with many)
-Most common in lower portion of large intestine, called the sigmoid colon

Question 17

Diverticulitis:

Answer 17

type 2 of 2 types of dirverticulitis- when pouches become inflamed or perforate (microscopically)

Question 18

diverticular disease

Answer 18

-Condition commonly occurring in distal descending sigmoid colon, where mucosal layer herniates through surrounding muscle
-however can occur anywhere from pharynx to anus
-In diverticulitis, undigested food & bacteria accumulate & harden in diverticular sac
Prevents blood supply to sac walls
-may cause fatal obstruction, haemorrhage or infection

Question 19

Diverticulosis:

Answer 19

1 of 2 types of peritonitisdiverticular present but asymptomatic

Question 20

appendicitis

Answer 20

Inflammation & obstruction of appendix
Becomes swollen & gangrenous, & perforates if untreated
Related to intraluminal obstruction with faecal matter, gallstones, tumours, parasites, or lymphatic tissue

Question 21

Bowel/Intestinal Obstruction

Answer 21

• bowl blockage
• intersitual fluid not absorbed- vommiting starts
• stop eating-intravascular volume and electrolyes decreas- can lead to shock
• intestinal pressure increases
• pressure stops cappilary on bowl flow
• bowl ischaemic- may perforate

Question 22

peritonitis

Answer 22

-Inflammatory response of serous membrane (lining abdominal cavity & visceral organs)
Caused by bacterial invasion or chemical irritation
-Translocation of extracellular fluid into peritoneal cavity into bowel
Nausea & vomiting cause further fluid loss
May result in hypovolaemia & shock

Question 23

what cinditions lead to peritonitis

Answer 23

diverticulitis, bowel obstruction, appenicitis- they all result in the release of constituents into the free abdominal space. This consequents in an inflammatory response, resulting in peritonitis.

Question 24

Alcohol-Induced Liver Disease

Answer 24

-Includes fatty liver disease, alcoholic hepatitis, & cirrhosis
-Metabolic end-products responsible liver injury
-acetaldehyde, free radicals impede mitochondrial electron transport; hydrogen ions undergo lipid synthesis & ketogenesis
Abnormal accumulation of these in hepatocytes & blood

Question 25

cirrhosis

Answer 25

End stage of chronic liver disease Much of functional liver tissue replaced by fibrous scar tissue partially blocking blood flow through liver -signs Hepatomegaly (enlarged liver) & jaundice

Question 26

portal hypertension

Answer 26

- Increased resistance to flow in portal venous system, & sustained portal vein pressure - this causes Collateral channels open, connecting portal circulation with systemic

Question 27

Gall Stones (Cholelithiasis)

Answer 27

-Abnormalities in composition of bile, stasis of bile & inflammation of gall bladder may result in stone formation -associated with obesity & women with multiple pregnancies or taking oral contraceptives -Asymptomatic until stone obstructs bile flow or causes inflammation -Small stones (<8mm) pass into common duct with symptoms of indigestion and biliary colic Larger stones more likely to obstruct flow & cause jaundice

Question 28

Cholecystitis

Answer 28

``` -Acute cholecystitis: diffuse inflammation of gallbladder, usually secondary to obstruction of gallbladder outlet Most cases (85% - 90%) associated with gallstones -Chronic cholecystitis: occurs with repeat acute cholecystitis ```

Question 29

Pancreatitis

Answer 29

-Inflammation of the pancreas -Acute pancreatitis: two forms – Oedematous: fluid accumulation & swelling Necrotising: cell death & tissue damage -Several causes; typically gallstones or alcohol abuse

Question 30

chronic Pancreatitis

Answer 30

Chronic pancreatitis: persistent inflammation causes irreversible change to pancreatic structure & function May follow acute pancreatitis episode Protein precipitates harden/calcify & block pancreatic duct Pancreatic glands enlarge  further inflammation May damage islets of Langerhans  diabetes mellitus Insulin secretion affected Sudden, severe pancreatitis can cause massive haemorrhage & total destruction of pancreas

Question 31

Urinary Tract Infection (UTI)

Answer 31

One of the most common reasons for abdominal pain in all ages, & frequent cause of sepsis steps=colonisation-uropithilium penetration-ascention-pyelonephritis-acute kidney injury

Question 32

Kidney Stones (Renal Calculi)

Answer 32

typically forms in kidneys. Polycrystalline aggregates composed of materials typically excreted in urine. -2 types of pain associated renal colicky and non-colickly

Question 33

renal colicky

Answer 33

describes colicky-like pain of kidney stones that is caused by stretching of collecting system or ureter Caused by stones 1 – 5mm in diameter, that can move into ureter & obstruct flow-excruciating pain on upper outer quadrant of effected side.

Question 34

Non-colicky renal pain:

Answer 34

caused by stones producing distension of renal calyces or renal pelvis Dull, deep ache in flank/back that varies in intensity (mild – severe)

Question 35

what can cause abdominal haemorrage

Answer 35

Trauma Perforation secondary to ulceration or bowel obstruction Ectopic pregnancy

Question 36

Diarrhoea

Answer 36

: may be associated with bleed, some frank blood may be present indicating lower abdominal bleed

Question 37

Malena:

Answer 37

dark, tar-like bowel motion indicated high abdominal bleed

Question 38

Haematemesis:

Answer 38

vomiting of bright red blood indicating bleed proximal to stomach

Question 39

Coffee ground vomitus:

Answer 39

(exactly as sounds) indicate lower GI bleed

Question 40

etopic pregnacy

Answer 40

-Implantation of an embryo outside of uterus Most common site is within fallopian tubes -prone to people with endometriosis and scarring of tubes -The fallopian tube may rupture, triggering massive haemorrhage. -Patients with ectopic pregnancy often have severe unilateral abdominal pain, may radiate to the shoulder on affected side

Question 41

acute abdomen

Answer 41

Term used to describe sudden, severe abdominal pain that likely necessitates surgery -occurs with many of the discussed conditions