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Patho > GI > Flashcards

GI Flashcards

1
Q

Causes of constipation

A
  • neurogenic disorders
  • functional or mechanical conditions
  • low-residue diet
  • sedentary lifestyle
  • opioids, especially codeine
  • excessive use of antacids
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2
Q

Major mechanisms of diarrhea

A
  • osmotic diarrhea =
  • secretory diarrhea = excessive secretion of fluid and electrolytes d/t endotoxins and exotoxins
  • motility diarrhea = increase in peristalsis, food not mixed properly

associated with malabsorption syndromes

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3
Q

Types of abdominal pain

A
  • parietal = local, usually more intense
  • visceral = poorly localized, radiating pain, general/diffuse
  • referred = visceral pain usually felt at some distance from affected organ
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4
Q

Upper GI bleeding

A

duodenum, stomach, esophagus

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5
Q

Lower GI bleeding

A

jejunum, ileum, colon, rectum

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6
Q

Types of acute bleeding

A
  • Hematemesis = vomiting blood
  • Hematochezia = bright red bleeding from rectum (also could have “coffee ground” appearance, which indicates older blood from farther up GI
  • Melena = black, tarry, sticky, foul smelling stool caused by digestion of blood in GI tract
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7
Q

Occult bleeding

A

slow, chronic blood loss that is not obvious and results in iron deficiency anemia

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8
Q

Achalasia

A
  • type of dysphagia

- is failure of sphincter to relax

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9
Q

Aspiration

A

vomit into lungs

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10
Q

Manifestations of Dysphagia

A
  • pain at level of obstruction
  • vomiting
  • aspiration
  • weight loss
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11
Q

Manifestations of GERD

A
  • heartburn
  • acid regurgitation
  • dysphagia
  • chronic cough
  • asthma attacks
  • mid-epigastric pain within 1 hr of eating
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12
Q

Hiatal hernias (HH)

A

Types:

  • sliding = portion of stomach slides or moves into the thoracic cavity through the esophageal hiatus
  • paraesophageal = the greater curvature of the stomach herniates through a secondary opening in the diaphragm, and lies alongside the esophagus
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13
Q

Causes of HH

A

congenitally short esophagus, trauma, weakening of the diaphragmatic muscles

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14
Q

Manifestations of HH

A 
·      Asymptomatic
·      GERD
·      Dysphagia
·      Heartburn
·      Vomiting
·      Epigastric pain
·      Regurgitation
·      Substrenal pain after eating 
**major complication will be cut off of blood supply and pain
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15
Q

Manifestations of pyloric obstruction

A

Both:
· Epigastric pain and fullness
· Nausea
· Succussion splash (splashing sound with stethoscope)
· Vomiting
· With prolonged obstruction will see malnutrition, dehydration, extreme debilitation

Congenital:
· Excessive vomiting

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16
Q

Gastritis

A

inflammatory disorder of the gastric mucosa; can be acute or chronic and affect the fundus or antrum, or both

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17
Q

Causes of acute and chronic gastritis

A

Acute:
overuse of alcohol, NSAIDs

Chronic:
H-pylori, alcohol, NSAIDs

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18
Q

Manifestations of gastritis

A 
anorexia
fullness
N/V
epigastric pain
bleeding
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19
Q

Peptic ulcer

A

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

Superficial ulcers - won’t see perforation or bleeding
Deep/true ulcers - will see bleeding and perforation

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20
Q

Duodenal ulcers

A
  • most common
  • caused by H Pylori; also smoking
  • patho: high levels of acid secretion (gastrin and pepsin)

-

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21
Q

Gastric ulcers-

A
  • occurs at antral region of stomach
  • patho: primary defect is an increased mucosal permeability to hydrogen ions; but gastric secretion tends to be normal or less than normal
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22
Q

Stress ulcers

A
  • related to severe illness
  • occurs in stomach and duodenum

-types:
ischemic (within hrs of trauma, burns, hemorrhage, sepsis)
cushing (develop as result of head/brain injury)

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23
Q

Manifestations of Peptic ulcers

A

Duodenal: chronic, intermittent pain in epigastric area (more pain when stomach is empty because of increased acid); relieved by food or antacids, hemorrhage or perforation

Gastric: pain frequently occurs after eating d/t normal or low acid level production; anorexia; N/V; weight loss

Stress: bleeding

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24
Q

Dumping syndrome

A

rapid emptying of hypertonic chyme from the surgically residual stomach into the small intestine 10 to 20 minutes after eating

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25
Q

Alkaline reflux gastritis

A

stomach inflammation caused by reflux of bile and alkaline pancreatic secretions containing proteolytic enzymes that disrupt the mucosal barrier in the remnant stomach

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26
Q

Afferent loop obstruction

A

intermittent severe pain and epigastric fullness after eating as result of volvulus, hernia, adhesion, or stenosis of duodenal stump on the proximal side of the gastrojejunostmy

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27
Q

Anemia

A

d/t absorption issues of B12, folate and iron

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28
Q

Bone and mineral disorders

A

d/t maladsorption of calcium

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29
Q

Maldigestion

A

failure of the chemical processes of digestion

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30
Q

Malabsorption

A

failure of the intestinal mucosa to absorb (transport) digested nutrients

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31
Q

Manifestations of pancreatic insufficiency

A
  • fat maldigestion = fatty stools
  • weight loss
  • deficiency of fat-soluable vitamins A, D, E, and K

A - nightblindness
D - osteoporosis, bone fractures
K - blood clot problems, bruising
E - neurologic problems

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32
Q

Patho of lactase deficiency

A

fermentation of lactose by bacteria causes gas and osmotic diarrhea

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33
Q

Bile salt

A

needed to emulsify and absorb fat

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34
Q

Manifestations of bile salt deficiency

A

poor intestinal absorption of lipids causes:

  • fatty stools
  • diarrhea
  • loss of fat soluble vitatmins
35
Q

Ulcerative colitis

A
  • chronic, relapsing inflammatory bowel disorder of unknown origin
  • continuous inflammation
  • only in colon
  • causes: infectious diseases, dietary or genetic
36
Q

Crohn disease

A
  • chronic, relapsing inflammatory bowel disorder of unknown origin
  • “skip lesions” or only portions of inflammations
  • can occur all over GI tract
37
Q

Manifestations of ulcerative colitis

A
  • diarrhea (10 to 20/day)
  • bloody stools
  • cramping
  • fever, elevated pulse rate
  • dehydration, weight loss
  • anemia
38
Q

Manifestations of Crohn disease

A
  • skip lesions **
  • diarrhea
  • rectal bleeding and blood stools
  • weight loss
  • abdominal pain
  • anemia
39
Q

Diverticula

A

herniation or saclike outpouchings of the mucosa and submucosa through the muscle layers

40
Q

Diverticulosis

A

asymptomatic diverticular disease

41
Q

Diverticulitis

A

inflammatory disease of diverticula

42
Q

Manifestations of diverticulitis

A 
cramping
diarrhea
abdominal distension
fever
lower abdominal pain
43
Q

Cause of appendicitis

A 
obstruction
ischemia
increased intraluminal pressure
infection
ulceration
44
Q

Manifestations of appendicitis

A

epigastric and RLQ pain
N/V
low grade fever
rebound tenderness

**may lead to peritonitis

45
Q

Peritonitis

A

Inflammation of the peritoneum

46
Q

peritoneum

A

The serous membrane that lines the walls of the abdominal cavity and folds inward to enclose the viscera.

47
Q

short-term starvation

A

1-14 days

will see glycogenolysis

48
Q

long-term starvation

A

14-60 days

see death from extreme electrolyte imbalance

49
Q

Portal Hypertension

A

Abnormally high blood pressure in the portal venous system

50
Q

Normal pressure =

A

3mm Hg

51
Q

Portal hypertension pressure =

A

at least 10 mm Hg

52
Q

Manifestations of portal hypertension

A
  • Slow, chronic bleeding of varices causes anemia

* Presence of digested blood in stools

53
Q

Varices

A

distended, tortuous, collateral veins – usually occur in esophagus

54
Q

Patho of varices

A

prolonged elevation of pressure in the portal vein causes collateral veins to open between the portal vein and systemic veins and their transformation into varices

55
Q

Manifestations of varices

A

Rupture of varices causes:
• Hemorrhage
• Voluminous vomiting of dark-colored blood

56
Q

Splenomegaly

A

Enlargement of spleen caused by increased pressure in the splenic vein, which branches from the portal vein

57
Q

Ascites

A

Accumulation of fluid in the peritoneal cavity

58
Q

Patho of Ascites

A

ascites traps body fluid in a “third space” form which it cannot escape

59
Q

Causes of ascites

A

portal hypertension; decreased synthesis of albumin

60
Q

Manifestations of ascites

A
  • Decrease in serum albumin levels
  • Increase in capillary hydrostatic pressure causes visible veins;
  • At risk for infection in peritoneal cavity d/t extra fluid
  • Pulmonary issue
61
Q

Hepatic encephalopathy (portal-systemic encephalopathy)

A

Neurologic syndrome that causes impaired cerebral function

Patho: ammonia isn’t broken down into urea by liver but instead circulates in blood

62
Q

Manifestations of hepatic encephalopathy

A
  • Will see changes in EEG
  • Personality changes
  • Memory loss
  • Irritability
  • Sleep disturbances
63
Q

Jaundice

A

A yellow or greenish pigmentation of the skin caused by hyperbilirubinemia

Can be hemolytic or obstructive

64
Q

Manifestations of jaundice

A
  • Dark urine
  • Clay-colored stools
  • Fever
  • Pain
  • Pruritus (itching)
65
Q

Hepatorenal syndrome

A

Functional renal failure that develops as a complication of advanced liver disease

66
Q

Manifestations of hepatorenal syndrome

A
  • Oliguria
  • Fatigue
  • Weakness
  • Anorexia
  • Increase in blood urea levels and then increase in creatinine concentration
  • At terminal stages, will see dangerous increase in serum potassium levels
67
Q

Viral Hepatitis

A

systemic viral disease that primarily affects the liver

there are different strains - A, B, C, D, E, G

68
Q

Hep A

A
  • usually transmitted by the fecal-oral route

- will see in bigger cities in developing countries

69
Q

Hep B

A
  • transmitted through contact with infected blood, body fluids, or contaminated needles
  • maternal transmission can occur if mother is infected during 3rd trimester
70
Q

Hep C

A
  • responsible for most cases of post-transfusion hepatitis
  • also implicated in infections related to IV drug use
  • can result in chronic liver disease
71
Q

Sequence of acute hepatitis

A
  1. Incubation phase:
    From exposure to time with symptoms show; usually a few weeks
  2. Prodromal phase:
    Begins about two weeks after exposure and ends with appearance of jaundice; marked by fatigue, anorexia, malaise, N/V, HA, hyperalgia, cough, low-grade fever
  3. Icteric phase:
    Begins 1 to 2 weeks after prodromal phase and lasts 2 to 6 weeks; marked by jaundice, dark urine, clay-colored stools, liver is enlarged, smooth and tender, palpitation of liver causes pain
  4. Recovery phase:
    Begins with resolution of jaundice; about six weeks after exposure; symptoms diminish but liver remains enlarged and tender; liver function returns to normal 2 to 12 weeks after exposure
72
Q

Chronic active hepatitis

A

persistence of clinical manifestations and liver inflammation after acute stages

73
Q

Fulminant viral hepatitis

A

is wide-spread necrosis throughout liver which means pts will need transplant within weeks

74
Q

Cirrhosis

A

irreversible inflammatory, fibrotic liver disease where structural changes result from injury and fibrosis

develops slowly over years

severity and rate depend on cause

formation of fibrous bands give liver a cobblestone appearance

75
Q

Causes of cirrhosis

A
  • Hep B and C
  • idiopathic
  • excessive alcohol
76
Q

Patho of cirrhosis

A

biliary channels become obstructed > portal hypertension > blood shunted away from liver > hypoxic necrosis

77
Q

Manifestations of cirrhosis

A

anorexia, nausea, jaundice, and edema develop with advanced fatty infiltration

78
Q

Manifestations of cirrhosis

A

anorexia, nausea, jaundice, and edema develop with advanced fatty infiltration

79
Q

Cholecystitis

A

inflammation of the gallbladder

80
Q

Cholelithiasis

A

gallstones

81
Q

Types of gallstones

A
  • pigmented: seen in patients with cirrhosis

- cholesterol: more common

82
Q

Risks for cholelithiasis

A
  • native american
  • obesity
  • middle age
  • female
  • oral contraceptives
83
Q

Manifestations for cholecystitis and cholelithiasis

A
  • abdominal pain
  • heartburn
  • food intolerance to fats
  • epigastral pain

w/ stones may be asymptomatic or with stones will see jaundice which indicates stones in bile duct

Patho (8 decks)

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