Adult GI Flashcards

1
Q

How long is the adult GI tract?

A

~30 feet

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2
Q

What are the layers of the GI tract?

A

mucosa, submucosa, muscle, and serosa

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3
Q

What are the 4 functions of the GI system?

A

Ingestion, Digestion, Absorption, and Elimination

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4
Q

Where does digestion occur?

A

stomach, small intestine

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5
Q

Where does absorption occur?

A

stomach, small intestines (primary)

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6
Q

Where does elimination occur?

A

colon, anus

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7
Q

What are different types of endoscopies?

A

EGD, Colonoscopy, ERCP, Video capsule

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8
Q

What types of radiology diagnostic tests are done for GI issues?

A

CT, MRI, Nuclear medicine, ultrasound

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9
Q

What system stimulates the GI system?

A

parasympathetic

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10
Q

What are lab values that are related to GI function?

A

amylase, lipase, gastrin, AST, ALT, Alk Phos, Bilirubin, Albumin, Total protein

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11
Q

What are 3 reasons that malnutrition may occur?

A

Starvation, chronic-disease related, acute disease/injury related

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12
Q

What are s/s of malabsorption?

A

weight-loss, weakness, fatigue, anorexia, hypocalciemia, bone fx, muscle weakness/tenderness, ecchymosis, anemia (pernicious from lack of B12), steatorrhea, hypoalbuminemia, reduced muscle mass (including cardiac!)

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13
Q

What things should be assessed when looking into a GI assessment?

A

Anthropometric Measurements
Physical Examination
Health History
Dietary History
Laboratory Studies
Functional Status

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14
Q

What are some types of enteral nutrition?

A

G-tube, J-tube
NG, ND, NJ

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15
Q

What are three things that obesity may contribute to?

A

DM2, CAD, and cancers

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16
Q

Which systems does obesity effect?

A

all of them

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17
Q

Who is affected by obesity?

A

all cultures, ethinicities, races, genders, ages, socioeconomic classes (the worst among the poor)

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18
Q

What is the most common clinical manifestation of a GI disease?

A

nausea/vomiting

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19
Q

What are some pharmacological txs for nausea/vomiting?

A

Anticholinergics, Antihistamines, Cannabinoids, 5-HT3 Agonists, Phenothiazines

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20
Q

What is the most common upper GI problem?

A

GERD

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21
Q

Where does enteral nutrition go?

A

Into the stomach

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22
Q

What are factors that affect the esophageal sphincter?

A

ETOH, chocolate, medications, fatty food, nicotine, peppermint, tea/coffee

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23
Q

What is required when parenteral nutrition is used?

A

bowel rest

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24
Q

How is GERD diagnosed?

A

H&P exam, EGD, Barium Swallow, mobility studies

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25
Q

How is GERD managed?

A

Identify & eliminate cause, stop eating 2 hours before bedtime, avoid acidic foods and drinks, lifestyle management, Meds (PPIs, H2 receptor blockers, antacids, prokinetic therapy), Endoscopic therapy, surgical therapy

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26
Q

How many hours before bed should you stop eating if you have GERD?

A

2

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27
Q

How often should blood glucose be taken when parenteral nutrition is being used?

A

4-6 hours

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28
Q

What kind of medications can be used to treat GERD?

A

PPIs, H2 receptor blockers, antacids, prokinetic therapy

29
Q

When does TPN need to changed? And the tubing?

A

every 24 hours

30
Q

What is a hiatal hernia?

A

Herniation of part of the stomach above the diaphragm

31
Q

What is the most common upper GI problem found on X-ray?

A

hiatal hernia

32
Q

What is a sliding hiatal hernia?

A

top of stomach slides through when patient is supine and slides back down when patient is upright

33
Q

What is a paraesophageal or rolling hernia?

A

The fundus and greater curvature roll up through and form a pocket

34
Q

What type of hernia is a medical emergency?

A

acute paraesophageal

35
Q

What are the manifestations of a hiatal hernia?

A

similar to GERD

36
Q

Should a patient with GERD be lying down after a meal?

A

no

37
Q

How are hiatal hernias diagnosed?

A

barium swallow, EGD

38
Q

What is gastritis?

A

inflammation of gastric mucosa

39
Q

What kind of drugs are -prazoles?

A

PPIs

40
Q

What kind of drugs are -tadines?

A

h2 receptor blockers

41
Q

How is gastritis diagnosed?

A

H&P, drug and ETOH use, occ CBC and EGD

42
Q

What can cause hiatal hernias?

A

anything that is making the abdominal cavity larger

43
Q

When will someone with a gastric ulcer experience pain after eating?

A

1-2 hours after eating

44
Q

When will someone with duodenal peptic ulcers experience pain after eating?

A

2-5 hours after meals

45
Q

What kind of ulcers are common in women?

A

gastric peptic ulcers

46
Q

What causes 80% of gastric peptic ulcers?

A

h. pylori

47
Q

Are gastric peptic ulcers or duodenal peptic ulcers more common?

A

duodenal ulcers

48
Q

What is the second most common reason for a gastric peptic ulcer?

A

antacid use

49
Q

What is the management for gastric peptic ulcers?

A

Stop NSAIDS, ABX for H. pylori, ETOH & smoking cessation, eliminate coffee, Meds (H2 or PPI)

50
Q

Where can pain occur with duodenal ulcers that is not seen with gastric peptic ulcers?

A

back

51
Q

What is done to treat a hemorrhage/upper GI bleed?

A

EGD to cauterize bleed, meds/IVF to support pt, frequent vitals, blood products?

52
Q

What are the s/s of perforation?

A

sudden, severe upper abdominal pain, not relieved by rest or food, no bowel tones, septic shock

53
Q

Which chronic PUD complication is most lethal?

A

perforation

54
Q

If a patient presents with pain/discomfort in the upper abdomen that worsens as the day goes on, constipation, n/v, belching, anorexia, and dehydration, what may this patient have?

A

gastric outlet obstruction

55
Q

Why does a patient need to be NPO if there is a gastric outlet obstruction?

A

the bowels need to rest

56
Q

What is diarrhea defined as?

A

3 or more loose/liquid stools per day

57
Q

How can diarrhea be treated?

A

fluid/electrolyte support, nutrition support, antidiarrheal meds, fecal transplant for severe C-Diff

58
Q

what can constipation be a symptom of?

A

diverticulitis or bowel obstruction

59
Q

Why does constipation occur?

A

Too much water absorption

60
Q

How is constipation treated?

A

increase dietary fiber & water, limit low fiber foods, limit processed foods, increase exercise & activity, beware of laxatives (dependent)

61
Q

What are two types of IBD?

A

Crohn’s and Ulcerative Colitis

62
Q

When does IBD typically occur?

A

at ages 15-30

63
Q

What organ does ulcerative colitis involve?

A

colon only

64
Q

Which organs does Crohn’s disease involve?

A

colon or small intestine

65
Q

Who is at a higher risk for IBD?

A

white and ashkenazi jews, urban populations

66
Q

What kind of bowel movements does someone with Crohn’s disease have?

A

Diarrhea without blood

67
Q

When does Crohn’s and Ulcerative colitis typically have its onset?

A

teens-mid 30s and >60

68
Q

Where is Crohn’s disease commonly found?

A

in distal ileum and colon

69
Q

What layer is ulcerative colitis involved in?

A

mucosal layer