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Pathopharmacology I > Wk 5 Upper GI > Flashcards

Wk 5 Upper GI Flashcards

1
Q

What is included in the upper GI? (3)

A

Esophagus
Stomach
Beginning of small intestine

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2
Q

The esophagus, stomach, and beginning of small intestine makes up __ GI

A

upper

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3
Q

The small intestines, colon, rectum, and anus make up the __ GI

A

lower

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4
Q

What is included in the lower GI? (4)

A

Small intestines
Colon
Rectum
Anus

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5
Q

What are 2 esophageal problems?

A

GERD
Hiatal hernia

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6
Q

GERD and a hiatal hernia are problems of the…

A

esophagus

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7
Q

Gastritis, acute gastroenteritis, and PUD are what type of disorders?

A

inflammatory disorders of the stomach

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8
Q

What are 3 inflammatory disorders of the stomach?

A

Gastritis
Acute gastroenteritis
PUD

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9
Q

What is dysphagia?

A

Difficulty swallowing

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10
Q

What is the progression of dysphagia?

A

Begins with colds and then progresses to difficulty swallowing liquids

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11
Q

What are the 2 causes of dysphagia?

A

Mechanical and neuromuscular

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12
Q

What is mechanical dysphagia?

A

Problem with the structures that assist in swallowing

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13
Q

What are 3 examples of mechanical obstructive dysphagia

A

Stenosis or strictures
Diverticula
Tumors

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14
Q

What are neuromuscular dysfunctions that lead to dysphasia?

A

CVA (cerebrovascular accident)
Achalasia

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15
Q

What is achalasia?

A

Lower esophageal sphincter can’t open properly

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16
Q

What are diverticula?

A

Small bulging pouches that form in the GI tract

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17
Q

This is an example of..

A

Esophageal diverticuli

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18
Q

What are 2 other reasons someone may have dysphasia?

A

Tracheal intubation

Tracheostomy

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19
Q

What does GERD stand for?

A

Gastro Esophageal Reflux Disease

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20
Q

GERD is a disorder of the…

A

esophagus

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21
Q

The general population refers to GERD as __

A

Heartburn

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22
Q

What body part does GERD effect?

A

lower esaophageal sphincter (LES)

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23
Q

Where is the lower esophageal sphincter?

A

It’s what connects the stomach and the esophagus

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24
Q

What is GERD?

A

Backflow of gastric acid from the stomach into the esophagus

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25
Q

Why does GERD occur?

A

Anything that alters the closure strength of LES or increases abdominal pressure

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26
Q

What are causes/triggers of GERD? (11)

A

Fatty foods

Spicy foods

Tomato based foods

Citrus foods

Caffeine

Large amounts of alcohol

Cigarette smoking

Sleep position

Obesity

Pregnancy

Pharmacologic agents

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27
Q

What is the medical term for heartburn?

A

pyrosis

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28
Q

What is pyrosis?

A

Heartburn

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29
Q

What is dyspepsia?

A

Upper abdominal discomfort, described as burning sensation, bloating or gassiness, nausea, or feeling full too quickly after starting to eat

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30
Q

What is regurgitation?

A

Act of bringing back up already swallowed foods

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31
Q

What are 6 clinical manifestations of GERD?

A

Heartburn

Dyspepsia

Regurgitation

Chest pain

Dysphagia

Pulmonary symptoms

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32
Q

What clinical manifestations of GERD are associated with the mouth? (3)

A

Tooth decay

gingivitis

bad breath

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33
Q

What clinical manifestations of GERD are associated with the chest? (3)

A

Chronic cough

worsening asthma

recurrent pneumonias

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34
Q

What are 2 abdominal symptoms of GERD?

A

Abdominal bloating

Belching

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35
Q

Someone with GERD might also experience an __ache

A

earache

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36
Q

What throat symptoms might someone with GERD experience? (6)

A

Hoarseness

Chronic sore throat

Throat clearing

Laryngitis

Lump in throat

Post nasal drip

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37
Q

List 4 complications of GERD

A

Ulceration

Scarring

Strictures

Barrett’s esophagus

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38
Q

What are esophageal strictures?

A

Abnormal tightening or narrowing of the esophagus

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39
Q

What is Barrett’s esophagus?

A

Development of abnormal metaplastic tissue

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40
Q

What is esophageal development of abnormal metaplastic tissue called?

A

Barrett’s esophagus

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41
Q

Barrett’s esophagus is pre__

A

premalignant

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42
Q

Patients with Barrett’s esophagus are three times more likely to develop what?

A

Adenocarcinoma of the esophagus

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43
Q

What is the overall survival rate of esophageal adenocarcinoma?

A

only 17%

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44
Q

A hiatal hernia is a defect in the __

A

diaphragm

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45
Q

When the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm)

A

Hiatal hernia

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46
Q

What is a hiatal hernia?

A

when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm)

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47
Q

What are the 2 types of a hiatal hernia?

A

Sliding

Paraesophageal

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48
Q

This is an example of a…

A

Paraesophageal hernia

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49
Q

This is an example of…

A

Barrett’s esophagus

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50
Q

A paraesophageal hernia is often called a…

A

Rolling hernia

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51
Q

A sliding hernia is often small and…

A

does not require treatment

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52
Q

With a sliding hernia the peritoneum stays __

A

intact

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53
Q

During a sliding hernia, because the peritoneum stays intact…

A

it restrains the size of the hernia

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54
Q

What type of hiatal hernia slides through the stomach and stays there?

A

paraesophageal hernia

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55
Q

This is an example of a…

A

Sliding hiatal hernia

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56
Q

What happens to the peritoneum that allows for a paraesophageal hernia?

A

the membrane becomes thinner or defective allowing for the stomach to sit above the diaphragm

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57
Q

During a paraesophageal hernia, the peritoneum becomes thin which allows for the sack to…

A

become even larger by entering into the intrathoracic pressure

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58
Q

What is unique about hiatal hernias considering the types?

A

You can have a mix, or have both types at the same time

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59
Q

What are the complex cases of hiatal hernias?

A

Type 3 and 4

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60
Q

What is the cause of hiatal hernias?

A

Exact cause if unknown

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61
Q

Hiatal hernias are thought to be __ related

62
Q

What 2 things may weaken the diaphragm muscle?

A

Injury

Repeatedly putting too much pressure on the muscles around the stomach

63
Q

What are 3 examples of actions that can cause injury to the diaphragm?

A

Severe coughing

Vomiting

Constipation and straining to have a bowel movement

64
Q

__ increases the risk of hiatal hernias.

65
Q

In general people who have hiatal hernias are __

A

asymptomatic

66
Q

What are 3 risk factors for hiatal hernias?

A

Age

Obesity

Smoking

67
Q

What are 3 manifestations of hiatal hernias?

A

Belching

Dysphagia

Chest or epigastric pain

68
Q

The clinical manifestations of hiatal hernias often present as…

69
Q

It’s common for hiatal hernias and GERD to __ in the same patient

70
Q

What is a teaching point for patients with hiatal hernias concerning eating? (2)

A

Small, frequent meals

Avoid lying down after eating

71
Q

What is a teaching point for hiatal hernias concerning obesity?

A

Weight control

72
Q

What is a teaching point for hiatal hernia and what the patient wears?

A

Avoid tight clothing and abdominal supports

73
Q

What is recommended pharmacologically for the GERD/hiatal hernia symptoms?

74
Q

If conservative treatments do not work for hiatal hernias, what is the next step?

75
Q

What are 3 inflammatory disorders of the stomach?

A

Gastritis

Acute gastroenteritis

PUD

76
Q

Inflammation of the stomach

77
Q

What is acute gastritis defined by?

A

Temporary inflammation of the stomach, intestines are NOT involved

78
Q

What is not involved in acute gastritis?

A

the intestines

79
Q

How long does gastritis usually last?

80
Q

What are 3 causes of acute gastritis?

A

Irritating substances such as alcohol

NSAIDs

Infectious agents

81
Q

Why do NSAIDs cause acute gastritis?

A

They block prostaglandin synthesis?

82
Q

What do prostaglandins do concerning the stomach?

A

Stimulate secretion of mucus in the stomach

83
Q

How do prostaglandins contribute to the development of acute gastritis? (2)

A

They stimulate mucus production that gives the stomach it’s protective coating

They also inhibit gastric acid secretion

84
Q

What is the most common infectious agent that causes acute gastritis?

85
Q

What other types of infectious agents are typically associated with acute gastritis? (besides H. pylori)

86
Q

Chronic gastritis is a __ disorder

A

progressive

87
Q

How long does chronic gastritis last?

A

Weeks to years

88
Q

Chronic gastritis is defined by:

A

Progressive disorder with chronic inflammation of the stomach

89
Q

What is chronic gastritis classified by?

A

Immune related or non-immune related

90
Q

What GI disorder is PUD?

A

Peptic ulcer disease

91
Q

What are 4 complications of chronic gastritis?

A

PUD

Bleeding ulcers

Anemia

Gastric cancers

92
Q

What is the autoimmune type of chronic gastritis?

A

Attacks parietal cells

93
Q

What is the non-immune type of chronic gastritis?

A

H. pylori infection

94
Q

What does H. pylori stand for?

A

Helicobacter pylori

95
Q

What type of bacteria is H. pylori?

A

Gram-negative, spiral bacteria

96
Q

What type of environment does H. pylori proliferate in?

A

Acidic environment

97
Q

Persistent infection with H. pylori can cause what 3 conditions?

A

Chronic gastritis

Peptic ulcer disease

Stomach cancer

98
Q

Patients who develop a gastric infection with H. pylori are often __

A

asymptomatic

99
Q

What is the MOT of H. pylori? (2)

A

Person to person via saliva, fecal matter, or vomit

Contaminated food or water

100
Q

The symptoms for actue and chronic gastritis are…

A

Often the same

101
Q

Vomiting blood and black stool are symptoms that are more common in which type of gastritis?

A

Chronic gastritis

102
Q

What are the symptoms of chronic and acute gastritis? (6)

A

Vomiting

Stomach burn (postprandial)

Upset stomach

Loss of appetite

Vomiting blood

Black stool

103
Q

What is postprandial discomfort?

A

Discomfort after eating a meal

104
Q

What is the definition of acute gastroenteritis?

A

Inflammation of the stomach AND the small intestine

105
Q

Acute gastroenteritis is typically related to…

A

Stomach viruses such as norovirus or rotavirus

106
Q

What are 3 bacterial infections common for acute gastroenteritis?

A

E. coli

Salmonella

Campylobacter

107
Q

What else might cause acute gastroenteritis?

A

Parasitic infections

108
Q

How long does acute gastroenteritis typically last?

109
Q

How long CAN acute gastroenteritis last?

110
Q

What typically causes acute gastroenteritis?

A

Food poisoning

111
Q

What are the clinical manifestations of acute gastroenteritis? (7)

A

Watery Diarrhea

Hemorrhagic diarrhea if infection if bacterial

Abdominal pain

Nausea

Vomiting

Fever

Malaise

112
Q

Acute gastroenteritis can cause hemorrhagic diarrhea is the infection is __

113
Q

What does malaise mean?

A

A general feeling of discomfort, illness, or uneasiness whose exact cause is difficult to identify

114
Q

What is a concerning problem for the nurse in a patient who has acute gastroenteritis?

A

Fluid volume deficit

115
Q

What doesn’t work for acute gastroenteritis?

A

Antivirals

116
Q

You may need antibiotics for gastroenteritis if it is…

117
Q

What is peptic ulcer disease?

A

Painful ulcers develop in the lining of the stomach or the first part of the small intestine (the duodenum)

118
Q

If ulcers are in the esophagus what are they called?

A

Esophageal ulcers

119
Q

An ulcer that is in the stomach is called a __ __

A

gastric ulcer

120
Q

An ulcer that is in the duodenum is called a __ __

A

peptic ulcer

121
Q

How do peptic, esophageal, or gastric ulcers develop?

A

Most commonly when the GI tract is exposed to acid and H. pylori

122
Q

What 5 factors increase your risk for developing an ulceration?

A

H. pylori

NSAIDs

Acid

Pepsin

Smoking

123
Q

Is bicarbonate acidic or alkaline?

124
Q

What 4 factors are protective against the development of an ulcer?

A

Mucus

Bicarbonate

Blood flow

Prostaglandins

125
Q

3 common substances that can be responsible for causing ulcers

A

Alcohol

NSAIDs

Aspirin

126
Q

Stress can increase production of __ __

A

gastric acid

127
Q

What are 3 miscellaneous risk factors of developing uclers

A

Excess secretion of gastric acid

Family history

Smoking

128
Q

Stress does not __ gastric ulcer development

129
Q

What are 6 risk factors for the development of NSAID-induced PUD?

A

Age

Higher/frequent doses of NSAIDs

History of PUD

Corticosteroids/Antigoagulants

Systemic disorders (autoimmune)

H. pylori infection

130
Q

What is the pathogenesis of peptic ulcer disease (PUD)? (3)

A
  1. Mucosa damage
  2. Histamine release
  3. Blood vessels destroyed which causes bleeding
131
Q

PUD Pathogenesis:

Histamine release results in an increase in… (2)

A

Acid and pepsin secretion which causes further damage

132
Q

PUD Pathogenesis:

Release of histamine causes what inflammatory response that can cause further damage to the area?

A

Vasodilation by increasing edema

133
Q

What causes the bleeding in the pathogenesis of peptic ulcers?

A

If blood vessels are close in proximity to the ulcer and are destroyed, this will cause a bleeding ulcer

134
Q

Where is the most common area for a peptic ulcer to develop?

A

In the duodenum

135
Q

A duodenal ulcer can happen at…

136
Q

When do peptic ulcers typically develop?

A

Young adulthood

137
Q

What age range do gastric/peptic ulcers peak?

138
Q

Why are patients in the age range of 50-70 more likely to get peptic/gastric ulcers? (4)

A

Increased use of NSAIDs

Corticosteroids

Anticoagulants

More likely to have a systemic illness

139
Q

If the peptic ulcers are bleeding a patient may have no…

A

clinical manifestations

140
Q

If a patient with PUD does have symptoms, what are they? (6)

A

Nausea

Vomiting

Anorexia

Weight loss

Bleeding

Burning pain

141
Q

The abdominal burning pain that is associated with PUD is usually worse when…

A

the stomach is empty

142
Q

What are symptoms associated with GASTRIC ulcers?

A

Burning, cramping, gas-like pain

143
Q

Where on the body does gastric ulcer pain occur?

A

Epigastrum, back

144
Q

When does GASTRIC ulcer pain usually occur?

A

1-2 hours after eating

145
Q

Where does DUODENAL ulcer pain occur?

A

Epigastrum, back

146
Q

What does DUODENAL ulcer pain feel like?

A

Burning, cramping, gas-like pain

147
Q

When does DUODENAL ulcer pain occur?

A

2-4 hours after eating

148
Q

What differentiates between a gastric ulcer and a duodenal ulcer?

A

The timing of the pain symptoms (1-2hrs versus 2-4 hrs after eating)

149
Q

What are the H.O.P. complications associated with PUD?

A

Hemorrhage

Obstruction

Perforation and peritonitis

150
Q

H.O.P. complications are associated with what disease?

A

PUD - peptic ulcer disease

Pathopharmacology I (33 decks)

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