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Pathohysiology > GI disorders > Flashcards

GI disorders Flashcards

1
Q

what are functions of the GI tract?

A 
breaks down ingested food 
prepares food for uptake by cells 
provides body with water 
eliminates waste 
controlled by hormones and he autonomic nervous system
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2
Q

which is the most common manifestation of GI dysfunction?

A

diarrhea

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3
Q

diarrhea

A

increased frequency of bowel movements

increased volume, fluidity, weight of the feces

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4
Q

what are the major mechanisms of diarrhea?

A

osmotic diarrhea
secretory diarrhea
motility diarrhea

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5
Q

what is an example of osmotic diarrhea?

A

indigested lactose

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6
Q

what is an example of secretory diarrhea?

A

cholera which is common in less developed countries

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7
Q

what is an example of motility diarrhea?

A

post GI surgery

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8
Q

secretory diarrheas occur when

A

bexterial toxins enhance colonic secretion

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9
Q

what is a cholera cot?

A

a treatment for cholera

oral rehydration therapy

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10
Q

what are other clinical manifestations of GI dysfunction other than diarrhea?

A

gastrointestinal bleeding

abdominal pain

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11
Q

abdominal pain is a symptom of

A

a number of GI disorders

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12
Q

parietal pain, which is a type of abdominal pain results from

A

irritation of the peritoneum

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13
Q

parietal pain is more of a ___pain

A

localized

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14
Q

visceral pain, which is a type of abdominal pain, results from

A

internal organs

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15
Q

visceral pain is generally less ___ and more

A

well localized and more referred pain

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16
Q

referred pain

A

from deep within

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17
Q

upper gastrointestinal bleeding comes from organs like

A

esophagus
stomach
duodenum

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18
Q

lower gastrointestinal bleeding comes from organs like

A

jejunum
ileum
colon
rectum

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19
Q

hematamesis

A

bleeding from the upper portion of GI (mouth)

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20
Q

melena

A

bleeding from lower portion (proximal small intestine)

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21
Q

hematochezia

A

bleeding from the lower Gi (small intestine and anus)

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22
Q

the ___ of the blood gives an indication of how hight up

A

color

the darker the blood the higher up except for when it comes out of the mouth

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23
Q

dysphagia

A

difficulty swallowing

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24
Q

what are the different types of dysphagia?

A

mechanical obstruction

functional obstructions

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25
Q

mechanical obstruction dysphagia is when there is a

A

physical obstruction

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26
Q

functional obstruction dysphagia results from a

A

loss of function

achalasia

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27
Q

what is achalasia?

A

denervation of smooth muscle in the esophagus and lower esophageal sphincter relaxation which is likely the location of food blockage.

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28
Q

what are different ways of assessing disorders of motility

A

gastroscopy
colonoscopy
“pill camera”

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29
Q

gastroscopy looks at the :

A

esophagus
stomach
proximal SI

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30
Q

colonoscopy looks at:

A

the entire large intestine

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31
Q

GERD

A

gastroesophageal reflux disease

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32
Q

GERD is the reflux of chyme from the

A

stomach to the esophagus

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33
Q

when is GERD called reflux esophagitis?

A

if it causes inflammation of the esophagus

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34
Q

reflux esophagitis can cause

A

esophageal structure

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35
Q

How if GERD manifested?

A

heartburn
regurgitation of chyme
upper abdominal pain within 1 hr of eating

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36
Q

hiatal hernias cause

A

GERD

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37
Q

what is a hiatal hernia?

A

when part of the stomach comes up (herniates) above the diaphragm

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38
Q

pyloric obstruction

A

the blocking or narrowing of the opening between the stomach and the duodenum

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39
Q

pyloric obstructions can be acquired or

A

congenital

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40
Q

what are the manifestations of pyloric obstruction?

A

epigastric (higher up) pain and fullness
nausea
splashing
vomiting

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41
Q

what happens if the pyloric obstruction is unresolved?

A

malnutrition
dehydration
extreme debilitation

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42
Q

intestinal obstruction

A

any condition that prevents the flow of chyme through the intestinal lumen

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43
Q

what are the two types of intestinal obstruction?

A

simple obstruction

functional obstruction

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44
Q

simple intestinal obstruction

A

mechanical blockage

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45
Q

functional intestinal obstruction

A

failure of motility (ileus)

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46
Q

what are the symptoms for small intestinal obstruction

A

pain
distenstion
vomiting

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47
Q

what are the symptoms of large bowel intestinal obstruction?

A

lower GI pain
distension
constipation
no vomiting

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48
Q

gastritis

A

inflammatory disorder of the gastric mucosa

there is chronic and acute

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49
Q

acute gastritis

A

superficial erosion of mucosa due to bacteria (H.pylori) or NSAIDs

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50
Q

What are the two different types of chronic gastritis

A

fundal gastritis

antral gastritis

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51
Q

fundal gastritis

A

autoimmune
more rare
higher up in the stomach

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52
Q

antral gastritis

A

more common

further down in the stomach

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53
Q

what are the different types of inflammatory Bowel diseases?

A

ulcerative colitis

crohn disease

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54
Q

ulcerative colitis

A

chronic inflammation disease that causes ulceration of the colonic mucosa

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55
Q

what are some suggested causes of ulcerative colitis?

A

infectious
immunologic (anticolon antibodies)
genetic
dietary

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56
Q

what are the symptoms of ulcerative colitis?

A

Diarrhea for up to 10-20 days
bloody stool (bright red)
cramping

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57
Q

what is the treatment for ulcerative colitis

A

antibiotics and steroids
immunosuppressive agents
surgery

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58
Q

Crohn Disease

A

idiopathic inflammatory disorder

affect any part of the digestive tract from mouth to anus

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59
Q

which organs does Crohn disease more most commonly affect

A

distal small intestine

proximal large colon

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60
Q

crohn disease causes__ lesions

A

skip

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61
Q

what is a skip lesion

A

when one portion is affected followed by a patch that is not affects (healthy) they’re like patchy

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62
Q

in crohn disease, ____ may result due to ____ of vit B12 and folic acid

A

pernicious anemia
malabsorption of B12 and folic acid
cells can’t divide so you dont have enough RBC

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63
Q

treatment for crohn disease is similar to treatment for:

A

ulcerative colitis

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64
Q

irritable bowel syndrome (IBS) affects ___ of people

A

7-20%

65
Q

irritable bowl is more common in

A

women

66
Q

what are the subtypes that IBS is classified into?

A

diarrhea
constipation
pain

67
Q

IBS may arise from

A

abnormal motility
allergies/sensitivities
gut bacteria

68
Q

what is the treatment for IBS?

A

it varies
counseling
dietary intervention
probiotics

69
Q

what are the two classes of malabsorption syndromes?

A

maldigestion

malabsorption

70
Q

maldigetsion

A

failure of the chemical processed of digestion

71
Q

malabsorption

A

failure of the intestinal mucosa to absorb digested nutrients

72
Q

maldigestion is malabsorption frequently___

A

occur together

maldigestion can lead to malabsorption but not the other way around

73
Q

what are different types of malabsorption syndromes?

A

pancreatic insufficiency
lactase deficiency
bile salt deficiency
fal-sol vits deficiencies

74
Q

in pancreatic insufficiency…

A

the pancreas isn’t doing it’s job

there are insufficient pancreatic enzyme production

75
Q

which enzyme are low in pancreatic insufficiency?

A

lipase
amylase
trypsin
chymotrypsin

76
Q

what causes pancreatic insufficiency?

A

pancreatitis
pancreatic carcinoma
pancreatic resection
cystic fibrosis

77
Q

fat maldigestion is the main problem of pancreatic insufficiency so the patient will have ___ stool and ___

A

fatty stool
(steatorrhea)
and weight loss

78
Q

what is the treatment for pancreatic insufficiency?

A

oral enzyme replacement which may damage and scar intestines

79
Q

lactase deficiency

A

the inability to break down lactose into monosaccharides

80
Q

the fermentation of lactose by bacteria causes

A

gas
cramping pain
flatulence
osmotic diarrhea

81
Q

why are bile salts necessary?

A

conjugated bile salts are needed to emulsify and absorb fats

82
Q

where are conjugated bile salts synthesized?

A

they are synthesized from the cholesterol in the liver

83
Q

what causes bile salt deficiency?

A

liver disease and bile obstructions

84
Q

if you inhibit ___ you also inhibit bile production

A

cholesterol

85
Q

what are the manifestations of bile salt deficiency?

A

poor intestinal absorption of lipid causes:
fatty stools
diarrhea
loss of fat soluble vitamins

86
Q

what is the consequence of vit A deficiency?

A

night blindness

87
Q

what are the consequence of vitamin D deficiency?

A

decreased Ca absorption
bone pain
osteoporosis
fractures

88
Q

what are the consequences of vitamin K deficiency?

A

prolonged prothrombin time
pupura (easily bruised)
petachiae (spots)

89
Q

what are the consequences of vit E deficiency?

A

slow growth

muscle weakness

90
Q

what are the different liver disorders?

A

hepatitis
cirrhosis
varices

91
Q

hepatitis

A

inflammation of hepatocytes which causes infiltration of WBC

92
Q

what are the different types of hepatitis?

A

acute

chronic

93
Q

Acute hepatitis

A

hepatocytes vary from impaired to necrosis

94
Q

acute hepatitis is open caused by

A

acetaminophen overdose

95
Q

chronic hepatisis

A

chronic liver infection/inflammation

96
Q

what is a common form of chronic hepatitis?

A

viral hepatitis

97
Q

hepatitis

A

viral disease that primarily affects the liver

98
Q

Which type of hepatitis is known as infectious hepatitis?

A

hep A

99
Q

which form of hepatitis if known a serum hepatitis?

A

Heo B

100
Q

what is the sequence of events for viral hepatitis?

A

incubation phase
prodromal (preicteric) phase
icertic phase
recovery phase

101
Q

what are manifestations of the prodromal phase of hepatitis?

A

fatigue
fever
hyperalgesia
vomiting

102
Q

in the icteric phase the liver is damaged enough

A

where you see manifestations like jaundice

103
Q

cirrhosis

A

irreversible inflammatory disease that disrupts liver function and structure

104
Q

what are general manifestation of cirrhosis?

A

decreased hepatic function
biliary channels become obstructed and cause portal hypertension
hypoxic necrosis develops

105
Q

what are two types of cirrhosis?

A

alcoholic

biliary

106
Q

Alcoholic cirrhosis

A

the oxidation of alcohol damages hepatocytes which causes massive lipid accumulation

107
Q

biliary cirrhosis begins in

A

the bile canaliculi and ductules

108
Q

what is primarily biliary cirrhosis?

A

autoimmune

109
Q

what is secondary biliary cirrhosis?

A

obstruction

gall stones, tumors

110
Q

portal hypertension

A

abnormally high blood pressure in the portal venous system

111
Q

what is considered high blood pressure?

A

greater than 10mmHg

112
Q

what causes the high blood pressure in portal hypertension?

A

resistance to portal blood flow

113
Q

prehepatic portal hypertesion

A

narrowing of vessels preceding liver

114
Q

intrahepatic portal hypertension

A

cirrhosis

115
Q

posthepatic portal hypertension

A

cardiac disorders

harder time getting back to the heart and through the liver so clearing the blood from the liver

116
Q

which form of portal hypertension is most common?

A

intrahepatic due to cirrhosis

117
Q

where can problems originate in prehepatic portal hyper tension?

A

blood flow from the heart to the spleen, stomach, and intestines or blood from those organs to the liver

118
Q

where can problems originate in intrahepatic portal hypertension?

A

the liver

119
Q

where can problems originate in posthepatic portal hypertension?

A

in the veins on the way back to the heart

120
Q

what are the consequences of portal hypertension?

A

varices
splenomegaly
ascites
hepatic encephalopathy

121
Q

varices

A

distended veins usually in the lower esophagus, stomach, and rectum

122
Q

what is the most common manifestation of varices?

A

esophageal bleeding

123
Q

spenomegaly is especially common with which type of portal hypertension

A

intrahepatic

124
Q

splenomegaly can result in

A

platelet accrual

125
Q

hepatic encephalopathy

A

CNS disturbances

126
Q

ascites almost always accompanies

A

cirrhosis

127
Q

altered pressue that takes place during ascites leads to

A

overflow into peritoneal cavity

128
Q

hepatic encephalopayhy

A

a neurologic syndrome of impaired cognitive function, flapping tremor, and EEG changes

129
Q

what is the cause of hepatic encephalopathy?

A

cells in the bervous system are vulnerable to neurotoxins absorbed from the GI tract that , due to liver dysfunction, circulate to the brain

130
Q

what is the progression of dysfunction of nonalcoholic fatty liver disease

A 
steatosis (fatty liver) 
nonalcoholic steatohepatitis (NASH fatty and inflamed)
NASH=fibrosis (scarred) 
cirrhosis (scarred and inflamed)
cancer
131
Q

what are treatment options for NAFLD?

A

increase insulin sensitivity
diet
weight loss
metformin

132
Q

what is the best treatment for NAFLD

A

improved insulin sensitivity

133
Q

most common assessment of liver function involves:

A

analysis of plasma proteins

134
Q

what are normal levels of albumin?

A

4-5 g/dl

135
Q

what are normal levels of alanine transaminase(ALT)?

A

10-50 IU/L

136
Q

what are normal levels of aspartate transaminase(AST)?

A

5-45 IU/L

137
Q

which has more AST? muscle or liver?

A

muscle

138
Q

some liver enzyme are expressed in

A

skeletal muscle

139
Q

why does weight loss, which improves insulin sensitivity, increase risk of gallstones?

A

because people generally eat less to loss weight and if they are eating less they are not using all heir bile so its sitting in their gallbladder and when its just in there it can cause stones.

140
Q

what does consuming fat decrease your chance of gallstones?

A

it increases the movement of bile in the system

141
Q

peptic ulcer disease

A

a break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

142
Q

superficial peptic ulcers

A

erosions

erodes mucosa but not muscularis mucosae

143
Q

deep peptic ulcer

A

deep

true ulcer

144
Q

the timing of pain can tell of what about an ulcer?

A

where it is.gastric or duodenal

145
Q

gastric ulcers

A

tend to develop in the antral region of the stomach, adjacent to the acid-secreting mucosa of the body

146
Q

what are the developmental factors of duodenal ulcers

A

H. pylori infection
use of NSAIDs
high gastrin levels
acid production by cigarette smoking

147
Q

what do NSAIDs do?

A

they inhibit bicarbonate and mucin production

148
Q

stress ulcer

A

an acute ulcer that is related to severe illness, neural injury, or systemic trauma
not caused by bacteria

149
Q

ischemic ulcer

A

a type of stress ulcer that develops within hours of hemorrhage, trauma, heart failure or sepsis

150
Q

cushing ulcers

A

stress ulcers that develop as a result of a burn injury

151
Q

what kind of ulcer would you expect to see with H. pylori infection?

A

any kind of peptic ulcer

152
Q

Lipopolysaccharide ____ fat oxidation and ___ fat storage

A

reduces fat ox and increases storage

153
Q

which type of meals increase blood toxins?

A

high fat, high carb

154
Q

obesogens

A

a compound that can increase weight gain

155
Q

exposure to which compounds can increase risk of infant and future obesity?

A

estrogen like compounds

ex: bisphenol A and diethylstilbestrol which is found in plastics and detergents

156
Q

what are some obesogens?

A

BPA
DES
MSG

157
Q

fructose increases ___ more than glucose

A

hepatic lipogenesis

158
Q

populating gut with ____ may prevent fat gain and maintains insulin sensitivity

A

“good” bacteria

Pathohysiology (16 decks)

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