Gastrointestinal system pt 2

Question 1

(Inflammatory disorders) Which term refers to herniations or saclike outpouchings of the mucosa and submucosa through the muscle layers, usually in the wall of the sigmoid colon?

The cause is idiopathic (most of the time), & can be however, related to increased intracolonic pressure (such as constipation), abnormal neuromuscular function, & alterations in intestinal motility

Answer 1

Diverticula

Question 2

(Inflammatory disorders)
Which term refers to an asymptomatic diverticular disease?

Answer 2

Diverticulosis

Question 3

(Inflammatory disorders)
Which term represents the inflammation stage in diverticulosis?

Answer 3

Diverticulitis

Question 4

Older age, genetic predisposition, obesity (Can increase pressure within digestive system, especially visceral obesity), changes in digestive motility as well, smoking, low fiber diet, sedentary lifestyle, & meds such as aspirin and NSAIDS are predisposing factors of..?

Answer 4

Diverticular disease

Question 5

(Inflammatory disorders)
Symptoms of diverticular disease may be __ or ___ (___) , ___ ___ in lower abdomen, __, ___, ___ or flatulence may occur

Answer 5

• Vague; Absent; Asymptomatic; Cramping pain; diarrhea; constipation; distention

Question 6

(Inflammatory disorders)
fever, leukocytosis (increased white blood cell count), and tenderness of the lower-left quadrant, are all symptoms of…?

Answer 6

Diverticulitis, the inflamed stage of diverticular disease

Question 7

(Inflammatory disorders)
Which term refers to an inflammation of the vermiform appendix, which is a projection from the apex of the cecum?

It is the most common surgical emergency of the abdomen, usually occurs between 10 and 19 years of age

Answer 7

Appendicitis

Question 8

(Inflammatory disorders)
Obstruction of the lumen with stool, tumours, or foreign bodies with consequent bacterial infection is the most common theory of the causes of ___?

Answer 8

Appendicitis

Question 9

(Inflammatory disorders)
Gastric or periumbilical pain is the typical symptom of..?

initially – __ ___ ___, cramping sensation
Over 24 hours – pain becomes more localized in __
Will also see anorexia, nausea or ____, ___ ___, ___ tenderness on ___

Answer 9

• An inflamed appendicitis
• vague epigastric pain; right lower quadrant (RLQ);
• Vomiting; low-grade fever; rebound; palpation

Question 10

(Disorders of nutrition)
Which term refers to an increase in body fat mass and a metabolic disorder, defined as a BMI>30?

It is also associated with higher all-cause mortality, increasing the risk for all diseases

How is BMI calculated?

Answer 10

Obesity
- (BMI = kg/m2)

Question 11

(Disorders of nutrition)–> Causes of obesity

The causes of obesity are complex and involve the interaction of ___ which is a substance produced by ___ ___ and other body weight control signals at the level of the ____.

Metabolic dysregulation includes ___ resistance, __ resistance, and a ___ ___ that contribute to the complications of obesity

Answer 11

• Adipokines; fat cells; hypothalamus
• Leptin; Insulin; Proinflammatory state

Question 12

(Disorders of nutrition)
What are the two different forms of adipose tissue distribution called in obesity?

Answer 12

• Viceral & peripheral

Question 13

(Disorders of nutrition)
Which term refers to when the distribution of body fat is localized around the abdomen and upper body, resulting in an “apple shape” or “Android type”?

Answer 13

Visceral obesity (also known as intra-abdominal, central, or masculine obesity)

Question 14

(Disorders of nutrition)
Which term refers to when the distribution of body fat is extraperitoneal and distributed around the thighs and buttocks and through the muscle, resulting in a “pear shape”, and is more common in women.

Answer 14

Peripheral obesity (also known as gluteal-femoral, feminine, or subcutaneous obesity)

Question 15

(Disorders of nutrition)
Which term refers to individuals with normal body weight and BMI with percentage of body fat greater than 30%.?

Answer 15

Normal weight obesity (NWO)

Question 16

(Disorders of nutrition)
Which term refers to individuals who are obese but have no metabolic-obesity–associated complications and decreased risk for morbidity and mortality?

Where it delays…?

Answer 16

Metabolically healthy obesity (MHO)
- Obesity-related complications until an older age

Question 17

(Disorders of nutrition)
__ __ and __ __ __ increase the risk of developing systemic inflammation, dyslipidemia, & insulin resistance with predisposition to atherosclerosis, hypertension, cardiovascular disease, cancer, & type 2 diabetes mellitus.

Answer 17

Visceral obesity; Normal weight obesity

Question 18

(Disorders of nutrition)
Which term refers to the lack of nourishment from inadequate amounts of calories, protein, vitamins, or minerals and is caused by improper diet, alterations in digestion or absorption, chronic disease, or a combination of these factors?

Answer 18

Malnutrition

Question 19

(Disorders of nutrition)
Which term refers to the reduction in energy intake leading to weight loss (an extreme state of malnutrition)?

This term also has 2 phases which are called..?

Answer 19

Starvation
- Short-term & long-term starvation

Question 20

(Disorders of nutrition)
Which term refers to the total dietary abstinence or deprivation for 3 or 4 days?

Once all available energy has been absorbed from the intestine, glycogen in the liver is converted to glucose through ____, the metabolism of glycogen into glucose. This process peaks within 4 to 8 hours, and ____ begins. ___ is the formation of glucose from noncarbohydrate molecules: depletion of stored nutrients (proteins & lipids)

Answer 20

Short-term starvation, or extended fasting

• Glycogenolysis; gluconeogenesis; gluconeogenesis

Question 21

(Disorders of nutrition)
Which term refers to what follows several days of dietary abstinence, which involves the breakdown of ketone bodies and fatty acids to make energy which will create acidosis; & eventually, proteolysis (protein breakdown) begins, and death ensues if nutrition is not restored?

Answer 21

Long-term starvation

Question 22

(Disorders of nutrition)
Which term refers to what can be defined as thepotentially fatal shifts in fluids & electrolytes(hypophosphatemia, hypomagnesemia, & hypokalemia) that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally), where these shifts result from hormonal (insulin release) & metabolic changes & may cause serious clinical complications?

Answer 22

Refeeding syndrome

Question 23

(Disorders of nutrition)
Which term refers to the physical wasting associated with chronic disease such as cancer, TB?

Answer 23

Cachexia (also known as cytokine-induced malnutrition)

Question 24

The accessory organs of the digestive system are..?

Answer 24

The liver & portal veins, gall bladder, & pancreas

Question 25

Which term refers to the system which drains the blood from the gastrointestinal tract, gallbladder, pancreas, and spleen to the liver?

Answer 25

Portal venous system (PVS)

Question 26

(Liver diseases)
Which term refers to an irreversible inflammatory and fibrotic liver disease, causing widespread destruction of hepatic cells or hepatocytes?

An inflammatory disease of the liver that causes fibrosis, and nodular regeneration.

Answer 26

Cirrhosis

Question 27

(Liver diseases)
Cirrhosis can result from __ or exposure to __, such as ___ (a product of ___ ___). These 2 being the main causes

The disease causes progressive irreversible liver damage, usually over a period of years, where the severity and rate of progression depend on the cause

Answer 27

Hepatitis; toxins; acetaldehyde; alcohol metabolism

Question 28

(Liver diseases)
Which term is related to the toxic effects of alcohol & coexisting liver disease, & is more prevalent in middle aged men compared to women, but women develop more severe injury than men?

However, not all alcoholics will develop cirrhosis, only ___ will

Answer 28

Alcoholic liver disease
- 25%

Question 29

(Liver diseases)
The spectrum (3 stages) of alcoholic liver disease includes..?

Answer 29

Alcoholic fatty liver, alcoholic steatohepatitis, & alcoholic cirrhosis

Question 30

(Liver diseases)
Which term is characterized by an excessive accumulation of fat inside the liver cells, making It it hard for the liver to function properly, but is reversible if patient stops drinking? (mildest form of alcoholic liver disease, & is asymptomatic)

Answer 30

Alcoholic fatty liver (steatosis)

Question 31

(Liver diseases)
Which term is characterized by the inflammation of the liver leading to the degeneration of liver cells (haptic cells), where this stage might last for some years and is reversible but will eventually progress to an irreversible fibrous if the patient continues to drink?

Answer 31

Alcoholic steatohepatitis (alcoholic hepatitis)

Question 32

(Liver diseases)
Which term is characterized by cell damage that initiates an inflammatory response that results in excessive collagen formation creating permanent Fibrosis & scarring alter the structure of the liver and obstruct biliary duct and vascular channels?

Answer 32

Alcoholic cirrhosis

Question 33

(Liver diseases)
Alcoholic cirrhosis impairs the hepatocytes’ ability to __ fatty acids, synthesize __ & __, degrade __, & clear portal blood of __ & __.

The inflammatory response includes excessive __ formation, __, & scarring, which obstruct bile canaliculi & sinusoids.

Bile obstruction causes __. Vascular obstruction causes __ __, __, and __.

Answer 33

• Oxidize; enzymes; proteins; hormones; ammonia; toxins.
• Collagen; Fibrosis
• Jaundice; portal hypertension; shunting; varices

Question 34

(liver diseases)
Which term refers to a systemic viral disease that primarily affects the liver, caused by a strain of the hepatitis virus (i.e., hepatitis A virus, hepatitis B virus [HBV], hepatitis C virus, and hepatitis E virus), where they differ with respect to modes of transmission & severity of acute illness; which all can cause hepatic cell necrosis, Kupffer cell (liver macrophages) hyperplasia, & infiltration of liver tissue by mononuclear phagocytes, also these changes obstruct bile flow and impair hepatocyte function?

Which one is a reportable disease? & which are the most severe

Answer 34

Viral hepatitis
- Hepatitis B
- Hepatitis B & C

Question 35

(Liver diseases)
Manifestations of viral hepatitis depend on the..?

Which are..?

Answer 35

Stage of infection
-Stage1: Prodromal (preicteric) phase
- Stage 2: Icteric phase
- Stage 3: Recovery phase

Question 36

(Liver diseases)
Which stage of viral hepatitis is includes these following manifestations: Fever, malaise, & anorexia

Answer 36

Stage1: Prodromal (preicteric) phase

Question 37

(Liver diseases)
Which stage of viral hepatitis is includes these following manifestations: Jaundice, hyperbilirubinemia, & liver enlargement and tenderness

Answer 37

Stage 2: Icteric phase

Question 38

(Liver diseases)
Which stage of viral hepatitis is includes these following manifestations: Symptoms resolve which takes several weeks (return of normal liver function 2-12 week after jaundice)

Answer 38

Stage 3: Recovery phase

Question 39

(Liver diseases)
Chronic hepatitis can occur with..?

Answer 39

Hepatitis B,C, & D

Question 40

(Complications of liver disease)
Which term refers to high blood pressure in the portal venous system, caused by disease that obstructs or impedes blood flow in any part of the portal venous system including the vena cava such as cirrhosis of the liver or viral hepatitis that cause inflammation or fibrosis, or cardiac disorders that impair pumping ability of the right side of the heart?

List the long-term pathological complication of said term

Answer 40

Portal hypertension
- Varices, splenomegaly, ascites, & hepatic encephalopathy

Question 41

(Complications of liver disease)
Which term refers to distended, tortuous collateral veins, caused by prolonged elevation of pressure in the portal vein causing collateral veins to open between the portal vein & systemic veins, particularly in the lower esophagus and stomach, where it is life threatening if ruptured?

Answer 41

Varices

Question 42

(Complications of liver disease)
Which term refers to an enlargement of the spleen caused by increased pressure in the splenic vein, which branches from the portal vein, where thrombocytopenia is the most common symptom of this complication?

Answer 42

Splenomegaly

Question 43

(Complications of liver disease)
What is the most common clinical manifestation of portal hypertension?

Answer 43

• Vomiting of blood (hematemesis) from bleeding esophageal varices

Question 44

(Complications of liver disease)
Which term refers to the accumulation of fluid in the peritoneal cavity, where body fluid is trapped in the peritoneal space, from which it cannot escape and reduces amount of fluid available for normal physiological functions?

Biggest cause is __, but can also be caused by heart failure, constrictive pericarditis (thickened, fibroticpericardium), abdominal malignancies, nephrotic syndrome (pass too much protein in urine),
decreased synthesis of albumin in liver & portal hypertension => capillary hydrostatic pressure to ___ capillary osmotic pressure pushing water into the __ ___

Answer 44

Ascites
- Cirrhosis; exceed; peritoneal cavity

Question 45

(Complications of liver disease)
Which term refers to the complex neurological syndrome characterized by impaired behavioural, cognitive, and motor function that occurs as a result of severe liver disease, where the liver can’t adequately remove toxins from your blood causing a buildup of toxins in your bloodstream?

Which can develop quickly in __ or slowly in ___

Answer 45

Hepatic encephalopathy (portal-systemic encephalopathy)
- Hepatitis; cirrhosis

Question 46

(Complications of liver disease)
Which term refers to a yellow or greenish pigmentation of the skin or sclera of the eyes caused by increases in plasma bilirubin concentration (hyperbilirubinemia)?

Answer 46

Jaundice, or icterus

Question 47

(Complications of liver disease)
Which term is caused by obstructed bile canaliculi (intrahepatic __ ___) or obstructed bile ducts outside the liver (extrahepatic ___ ___), where bilirubin accumulates proximal to the sites of obstruction, enters the bloodstream, and is carried to the skin and deposited, due to liver inflammation, gallstones, or tumours?

Answer 47

Obstructive jaundice

Question 48

(Complications of liver disease)
Which term refers to when the rate of destruction of red blood cells exceeds the liver’s ability to metabolize unconjugated bilirubin?

Answer 48

Hemolytic jaundice (prehepatic or nonobstructive jaundice)

Question 49

(Complications of liver disease)
Which term refers to functional kidney failure in the absence of kidney disease that develops as a complication of advanced liver disease, where decreased blood flow to the kidneys causes oliguria, sodium & water retention, peripheral edema, & hypotension?

Answer 49

Hepatorenal syndrome

Question 50

(Disorders of the Gallbladder)
___ form in the bile as a result of the aggregation of cholesterol crystals (cholesterol stones) or precipitates of unconjugated bilirubin (pigmented stones). ___ that fill the gallbladder or obstruct the cystic or common bile duct cause abdominal pain and jaundice.

Answer 50

Gallstones

Question 51

(Disorders of the Gallbladder)
Gallstone formation is termed __. Inflammation of the gallbladder or cystic duct is known as __.

Answer 51

Cholelithiasis; cholecystitis

Question 52

(Disorders of the Gallbladder)
Obesity, middle age, female gender, use of oral contraceptives, rapid weight loss, First Nations ancestry, genetic predisposition, and gallbladder, pancreatic, or ileal disease are risk factors for …?

Answer 52

Cholelithiasis

Question 53

(Disorders of the Gallbladder) Gallstones are of three types, depending on chemical composition:

Answer 53

Cholesterol (70-80% cholesterol and the most common), pigmented (black [hard] & brown [soft]; and mixed

Question 54

(Disorders of the gallbladder)
Gallstones or cholelithiasis can be __ or can have epigastric & right upper quadrant pain and an intolerance for __ __, __, __, __ __, & food intolerances, particularly to fats & __

Answer 54

Asymptomatic; fatty food; heartburn; flatulence, epigastric discomfort; cabbage

Question 55

(Disorders of the gallbladder)
Which term can be acute or chronic, but both forms are almost always caused by a gallstone lodged in the cystic duct, where this obstruction causes the gallbladder to become distended & inflamed, in which the pressure against the distended wall of the gallbladder decreases blood flow and may result in ischemia, necrosis, & perforation?

Signs & symptoms include:
Fever, __, __ __, & ___ ___ __

Answer 55

Cholecystitis
- Leukocytosis; rebound tenderness; abdominal muscle guarding

Question 56

Which term refers to inflammation of the pancreas, is a relatively rare and potentially serious disorder, where the incidence is about equal in men and women, is more common between 50 and 60 years of age, and is more likely to occur in Blacks.?

Risk factors include: Cholelithiasis, alcoholism, obesity, peptic ulcers, trauma, dyslipidemia, hypercalcemia, smoking, certain medications, & genetic factors (hereditary ___, cystic fibrosis)

It can either be..?

Answer 56

Pancreatitis
-Acute or chronic

Question 57

Which term refers to a usually a mild disease that resolves spontaneously, due to an obstruction to the outflow of pancreatic digestive enzymes caused by bile & pancreatic duct obstruction (e.g., gallstones)?

It can also results from direct cellular injury from __, __, or __ __

Answer 57

Acute pancreatitis
- Alcohol; medication; viral infection (hepatitis)

Question 58

Manifestations of acute pancreatitis include:

constant mild to severe epigastric pain which may radiate to the back, fever, increased WBC count (leukocytosis), __ & __, & ___

Answer 58

Nausea; vomitting; jaundice

Question 59

Which term refers to the process of progressive fibrotic destruction of the pancreas, with alcohol abuse being the most common cause, & obstruction from gallstones, smoking, and genetic factors increase also the risk for said condition?

The pancreatic parenchyma is destroyed and replaced by __ tissues, __, ductal __, & pancreatic ___.

Answer 59

Chronic pancreatitis
- Fibrous; calcification; obstruction; cysts

Question 60

Manifestations of chronic pancreatitis include …?

Answer 60

Intermittent or continuous abdominal pain & weight loss

Question 61

(Cancer of the Gastro-Intestinal Tract)

In terms of cancers in GI tract, which gender has a higher prevelance?

Liver cancer is uncommon in ..? Where the pancreatic cancer is the only one higher in..?

Answer 61

• Men
• Women
• Women

Question 62

(Cancer of the Gastro-Intestinal Tract)

Which type of cancer is rare, and is characterized by squamous cell carcinoma & adenocarcinoma, associated with cigarette smoking, obesity, & chronic gastric reflex? More prevalent in __

Risk factors include..?

Answer 62

Cancer of the esophagus or esophageal cancer
- Men
- Malnutrition, alcohol, & tobacco

Question 63

(Cancer of the Gastro-Intestinal Tract)

Which type of cancer has been on a steady decline, due to improvement of diets, decreasing smoking & alcohol use, & recognition & treatment of the H.Pylori bacteria?

Fatality rate is 75%, being more prevalent in __. Its asymptomatic until ____ which produces symptoms

Answer 63

Cancer of the stomach or gastric cancer
- Asia; metastasized

Question 64

(Cancer of the Gastro-Intestinal Tract)

Which type of cancer is characterized with a strong genetic connection, such as family history of said cancer puts you at greater risk, but can also be caused by eating red meat, fatty foods, processed meat, inflammatory bowel disease, & diverticulitis?

Which term refers to a projection arising from the mucosal epithelium or abnormal tissue growth?

Answer 64

Cancer of the colon & rectum or colorectal cancer
- Polyp, or papilloma

Question 65

(Cancer of the GI tract) –> Colorectal cancer

The most common types of polyps are ..?

Which term refers to premalignant lesions?

The larger the ___, the greater the risk for ___ ___

Answer 65

• Hyperplastic (a non-neoplastic, or benign, polyp)
• Neoplastic polyps
• Polyp; Colorectal cancer

Question 66

(Cancer of the GI tract)

Symptoms of __ __ depend on the location, size, and shape of the lesion and are silent in the early stages

Answer 66

Colorectal cancer

Question 67

(Cancer of the GI tract)

Most common location for colorectal cancer is..?

Tumours on the ascending colon produce ___ coloured stool, while tumours on the descending, sigmoid & rectum colon produce __ coloured stool

Answer 67

• The ascending colon
• Dark red or mahogany-coloured blood; Bright red blood

Question 68

(Cancer of the GI tract)–> Colon cancer staging

Stage 0 (carcinoma in situ):
The cancer cells are only in the __ __ of the colon or __ ___. The cancer cells have not grown past the __ layer of the mucosa.

Stage 1:
The tumour has grown into the layer of __ __ that surrounds the mucosa (__) or into the thick outer __ layer of the colon or rectum (__ __).

Stage 2:
Involves __ – or into tissues beyond the __ layer into other organs

Stage 3:
There are cancer cells in __ __ near the colon or rectum. Stage 3 can be divided into stages 3A, 3B and 3C depending on __ the tumour has grown and how many __ __ have cancer.

Stage 4:
The cancer has spread to __ __ of the body (called __ __), such as to the __ or __. This is also called __ colorectal cancer.

Answer 68

• Inner lining; rectum (mucosa); muscle
• Connective tissue; submucosa; muscle; muscularis propria
• Serosa; muscle
• Lymph nodes; where; lymph nodes
• Other parts; distant metastasis; liver; lungs; metastatic

Question 69

(Cancer of the GI tract)
Which type of cancer is characterized with risk factors such as hepatitis B,C,D or cirrhosis?

The primary carcinomas of said cancer are..?

Answer 69

Liver cancer
- Hepatocellular or cholangiocellular

Question 70

(Cancer of the GI tract)
Which term refers to cancer developing in the hepatocytes, & can either be and can be ___ (consisting of multiple, discrete nodules), ___ (consisting of a large tumour mass having satellite nodules), or __ (consisting of small nodules distributed throughout most of the liver)

Because carcinoma of the liver invades the hepatic & portal veins, it often spreads to the ___ & __.

Answer 70

Hepatocellular carcinoma (HCC)
- Nodular; massive; diffuse
- Heart; Lungs

Question 71

(Cancer of the GI tract)
Which type of cancer develops in the bile ducts & represents less than 1% of liver cancers?

Answer 71

Cholangiocellular carcinoma

Question 72

(Cancer of the GI tract)

___ ___ is asymptomatic at the beginning can develop symptoms slowly or abruptly, such as nausea & vomiting, fullness, pressure, dull ache in RUQ, sudden worsening of portal hypertension, & ascites if there is an obstruction

Answer 72

Hepatocellular carcinoma (HCC)

Question 73

(Cancers of the GI tract)–> Liver cancer

Stages:

1 - ___ section involved; __ adjoining sections are tumor free.
2 - __ or __ sections involved; __ adjoining sections are tumor free.
3 - __ or __ sections involved; __ adjoining section is tumor free
4 - ___ sections involved.

Answer 73

• One; three
• One; Two; Two
• Two; Three; one
• Four

Question 74

(Cancers of the GI tract)

Which type of cancer is has the lowest survival rate of all major cancers, where incidence rate rises with age, with mortality nearly 100% at 5 years?

Risk factors include: smoking, high-fat foods, processed meat, obesity, diabetes mellites, chronic pancreatitis, & family history

Answer 74

Pancreatic cancer

Question 75

(Cancers of the GI tract)

Manifestations of pancreatic cancer in the early stages are __. When symptoms occur there usually has been a __ __.
Typically, vague upper abdominal pain that radiates to the back. ___ arises in most cases, usually caused by obstruction of the bile duct. Because obstruction impairs __ __ and flow to the duodenum, pancreatic cancer causes __ & __ malabsorption, resulting in weight loss. Distant metastases are found in the cervical lymph nodes, the __, and the __. Most individuals die of __ __, __, or ___ diseases.

Answer 75

• Asymptomatic
• Malignant transformation; Jaundice; enzyme secretion; fat; protein; lungs; brain; hepatic failure; malnutrition; systemic.

Question 76

(Cancers of the GI tract)–> Pancreatic cancer

Stages:

Stage 0 (cancer in situ): Top layers of pancreatic duct cells

Stage 1: Confined to pancreas __cm or __ cm

Stage 2: Confined to pancreas __ cm

Stage 3: Spread to __ _ __ lymph nodes OR grown outside of the pancreas with __ lymph nodes involved

Stage 4: Spread to __ __ – any size, may or may not have __ ___ ___

Answer 76

• <2 cm or < 4 cm
• > 4 cm
• 4 or more; no
• Distant sites; lymph node involvement

Question 77

(Congenital Impairment of Motility in children)

Which terms refer to a congenital anomaly that features a defect of the lip, alveolus, and/or palate and could be unilateral or bilateral? (incomplete fusion during the second month of development)

Epigenetic influences include: Maternal alcohol and tobacco use, maternal diabetes mellitus, & folate deficiency

Answer 77

Cleft lip (CL) or cleft palate (CP), or both (CLP).

Question 78

(Congenital Impairment of Motility in children)

Which term refers to the congenital malformations of the esophagus occur in 1 of 3 000 to 4 500 live births?

___ ___ is usually accompanied by a fistula between the esophagus and the trachea called the ___ __

Causes include: Environmental exposure to __ (medication to treat hyperthyroidism), ½ have one or more other birth defects, infectious disease, alcohol or smoking, maternal diabetes, maternal age

Manifestations include:
Drooling at birth, inability to swallow secretions, choking with feeding, respiratory distress – depending on type, abdomen may fill with air becoming distended and interferes with respiration – may show intermittent cyanosis

Answer 78

Esophageal atresia
- Esophageal atresia; tracheoesophageal fistula
- Tapazole

Question 79

(Congenital Impairment of Motility in children) –>5 Types of Esophageal Atresia and Tracheoesophageal Fistulae.

A, __ ___ ___. Proximal esophagus and distal esophagus end in blind pouches, and there is no __ communication. Nothing enters the stomach; regurgitated food and fluid may enter the lungs.

B, Proximal and distal ___ segments end in blind pouches, and a fistula connects the proximal ___ to the ___. Nothing enters the stomach; food and fluid enter the ___ from the mouth.

C, Proximal ___ ends in a blind pouch, and a fistula connects the __ to the distal __. Air enters the __; regurgitated gastric secretions enter the __ through the fistula.

E, _ ___ _ between otherwise normal esophagus and trachea. Air, food, and fluid enter the __ and the ___ from the mouth through the fistula; and regurgitated gastric secretions enter the ___ through the fistula.

Answer 79

• Simple esophageal atresia; tracheal
• Esophageal; esophagus; trachea; lungs
• Esophagus; trachea; esophagus; stomach; lungs
• Simple tracheoesophageal fistula; stomach; lungs; lungs

Question 80

(Congenital Impairment of Motility in children)

Which term refers to an acquired narrowing & distal obstruction of the pylorus and a common cause of postprandial vomiting, where the etiology is unclear but probably multifactorial, involving genetic & environmental factors?

Individual muscle fibres thicken, so the entire __ __ becomes enlarged and inflexible. Because of the extra peristaltic effort necessary to force the gastric contents through the narrow ___, the muscle layers of the stomach may become ___ as well.

Answer 80

Infantile hypertrophic pyloric stenosis (IHPS)
- Pyloric sphincter; Pylorus; hypertrophied

Question 81

(Congenital impairment of motility in children)

Manifestations of infantile hypertrophic pyloric stenosis include:

___weeks after birth the infant has forceful, nonbilious ___ immediately after feeding; __ due to no fluid reaching intestines

If left untreated, it can lead to sever ___ & __ imbalances, malnutrition, & __ __ that can be fatal in 4-6 weeks

Answer 81

• 2-8 weeks; vomiting; constipation
• Fluid; electrolyte; weight loss

Question 82

(Congenital impairment of motility in children)
Which term refers to the functional obstruction of the colon, and is also the most common cause of colon obstruction, accounting for about one-third of all GI obstructions in infants, and is a multifactorial malformation?

It is characterized by the absence of ___ cells in part of colon which causes decreased __, resulting in the distention to the proximal colon, creating ‘___’

The infant typically becomes symptomatic during the first 24 to 72 hours after birth with delayed passage of __.

Manifestations include:
Mild to moderate __; poor feeding, poor __ __, increasing __, watery __ as water may pass obstruction

Answer 82

Hirschsprung’s disease, or aganglionic megacolon

• Nerve; peristalsis; megacolon
• Meconium
• Constipation; weight gain; distention; diarrhea

Question 83

(Congenital impairment of motility in children)

Which term refers to when the bowel protrudes through weakening in abdominal wall ligament, which can occur at any age but are most common in newborns but may not be noticeable for several weeks or months after birth? Caused by weakness in abdominal muscles

Answer 83

Mechanical Obstruction Hernias

Question 84

(Congenital impairment of motility in children)

Which term refers to an autosomal recessive disease that involves multiple organ systems & leads to death at an earlier age, where the GI presentation of this disorder is caused by a dysfunction of the cystic fibrosis transmembrane regulator (CFTR) protein, which is located on epithelial membranes and regulates chloride and sodium ion channels?

The hallmark pathophysiological triad of ___ ___ includes obstruction, infection, & inflammation that are evident throughout the GI tract and within the airways.

Manifestations of include: Feeding problems, delayed growth, dry skin, sparse hair, poorly developed musculature, & decreased subcutaneous fat

Which term refers to present in cystic fibrosis which is a physical sign that a child is receiving inadequate nutrition for optimal growth and development, with deceleration in weight gain, usually presenting before 18 months?

Answer 84

Cystic fibrosis
- Failure to thrive