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PAS- PATHOPHYSIOLOGY > CHAPTER 42 > Flashcards

CHAPTER 42 Flashcards

Alterations of Digestive Function

1
Q

clinical manifestations of gastrointestinal dysfunction

  • _____
  • -forceful emptying of the stomach and _____ contents from the mouth
  • -vomiting center: _____
  • -several types of stimuli initiate the vomiting reflex
A

vomiting
intestinal
medulla onlongata

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2
Q

pathophysiology of vomiting

  • serotonin stimulates the vomiting center and appears to be released from enterochomaffin cells in the intestinal wall which activates vagal afferents leading to the chemoreceptors trigger zone
  • the activation of this zone, which lies in the medulla leads to vomiting by triggering receptors such as _____
A

dopamine

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3
Q

clinical manifestations of gastrointestinal dysfunction
vomiting
-_____: for nausea and vomiting
–(_____, _____, and _____ are _____ of _____

A 
antiemetic medications
metoclopramide
domperidone 
haloperidol
antagonists 
dopamine
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4
Q

clinical manifestations of GI dysfunction

-_____: directly caused by direct stimulation of the _____ by _____ such as _____, _____, or _____ involving the _____

A 
projectile vomiting
vomiting center
neurologic lesions
intracranial pressure
tumors
aneurysms 
brainstem
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5
Q

clinical manifestations of GI dysfunction

  • constipation
  • -infrequent or difficultly defecation
  • normal bowel habits range from _____ evacuations per day or _____ per week

-_____ per _____ are considered the _____ limits of normal

A 
two or three
one
three stools
day
upper
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6
Q

secretory and osmotic diarrhea
secretory diarrhea:
-primary causes of secretory diarrhea are _____, particularly those released by _____ or strains of Escherichia coli, and neoplasms, such as gastrinoma or thyroid carcinoma

osmotic diarrhea:
-_____ related to _____ deficiency, pancreatic enzyme or bile salt deficiency, small intestine bacterial overgrowth, and celiac disease cause osmotic diarrhea

A

bacterial enterotoxins
cholera
malabsorption
lactase

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7
Q

clinical manifestations of GI dysfunction
abdominal pain
-in _____ pain: _____, _____, poorly _____ and _____

A 
visceral 
diffused
vague
localized 
dull
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8
Q

cause of abdominal pain

  • chemical mediators such as _____, _____, and _____ produce abdominal pain
  • _____ and _____ produce abdominal pain by _____
  • _____, caused by distention of _____ or _____, produces abdominal pain
A 
histamine
bradykinin
serotonin 
edema
vascular congestion
stretching
ischemia
bowel obstruction
mesenteric vessel thrombosis
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9
Q

clinical manifestations of GI dysfunction
GI bleeding
-_____: bloody stools- with frank bright red or burgundy blood from the _____

A

hematochezia

rectum

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10
Q

disorders of motility

  • intestinal obstruction and ileus
  • clinical manifestations:
  • cardinal symptoms of small intestine obstruction: _____ caused by _____ followed by _____
A

colicky pain
distention
vomiting

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11
Q

disorders of motility

  • small intestinal obstruction
  • -most common: _____
  • large bowel obstruction
  • -most common: _____, _____ (twisting), and _____ related to _____
  • -_____ (_____): massive dilation of the large bowel; patients who are critically ill and older adults who are immobilized
A 
fibrous adhesions
colorectal cancer
volvulus 
strictures
diverticulitis 
acute chronic pseudo-obstruction
Ogilvie syndrome
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12
Q

intestinal obstruction at the pylorus or high in the small intestine causes metabolic alkalosis, why?
-if the obstruction is at the pylorus or _____ in the small intestine, then _____ initially develops as a result of excessive _____ of _____ that normally would be reabsorbed from the _____

A 
high 
metabolic alkalosis 
loss
hydrogen ions
gastric juices
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13
Q

the most immediate result of a small intestinal obstruction is _____

  • distention begins almost immediately, as _____ and _____ accumulate _____ to the obstruction.
  • within _____, up to _____ of fluid and _____ enters the _____ in the form of _____, _____, _____, _____, and _____.
  • _____ or _____ of fluids in the intestinal lumen prevents their _____ and produces severe _____ and _____
A 
distention 
gases 
fluids
proximal 
24 hours
8L 
electrolytes 
lumen
saliva
gastric juice
bile
pancreatic juice
intestinal secretions 
copious vomiting 
sequestration 
reabsorption 
fluid
electrolyte disturbances
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14
Q

mechanism of intussusception
-intussusception is the _____ of part of the _____ into another section of intestine, usually causing _____ of the _____ supply

A

telescoping
intestine
strangulation
blood

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15
Q

acute and chronic gastritis

  • acute gastritis
  • -_____, _____, _____, _____
  • -infections (_____ transient)
  • chronic gastritis
  • -autoimmune: pernicious anemia (autoantibody)
  • -chem: NSAIDs, bile reflux, alcohol
  • -bacterial: _____
A 
drugs
toxins
alcohol
ischemia
h. pylori
helicobacter pylori
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16
Q

chronic gastritis
type A: _____
type B: _____

A

autoimmune gastritis

antral gastritis

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17
Q

chronic antral gastritis

-associated with _____ and NSAIDs

A

H. pylori

18
Q

chronic antral gastritis

  • generally involves only the antrum and is more common than fundal gastritis
  • it is caused by _____ bacteria or the chronic use of alcohol, tobacco, and nonsteroidal anti-inflammatory drugs
A

H. pylori

19
Q

facts about chronic gastritis

  • chronic gastritis tends to occur in _____
  • chronic gastritis results in _____ and _____
  • _____ is a common outcome of chronic gastritis
  • _____ is often observed with chronic gastritis
A 
older adults
chronic inflammation
mucosal atrophy
mucosal atrophy 
epithelial metaplasia
20
Q

peptic ulcer disease

  • peptic ulcer is a _____ or _____ in the protective mucosal lining of the lower _____, _____, or _____
  • acute versus chronic ulcers
  • superficial (erosions) versus deep
  • risk factors:
  • -_____ predisposition
  • -_____ infection
  • -habitual use of _____
  • -excessive use of alcohol, smoking, acute pancreatitis, COPD, obesity, cirrhosis, and over 65 years of age
A 
break
ulceration
esophagus
stomach
duodenum
genetic
H. pylori
NSAIDs
21
Q

primary cause of peptic ulcers

_____

A

H. pylori

22
Q

clinical manifestations duodenal ulcers

  • _____ from duodenal ulcers causes _____ or _____
  • the characteristic pain begins _____ to _____ after eating when the stomach is _____
  • duodenal ulcers occur with _____ frequency than other types of peptic ulcers
  • _____ is relieved by _____
A 
bleeding
hematemesis
melena 
30 mins
2 hours
empty
greater
pain
food
23
Q

ulcerative colitis
-inflammation begins at the _____ of the _____ of _____ in the _____, primarily the _____, with infiltration and release of _____ from _____, _____, _____, _____, _____, and _____

A 
base
crypts
lieberkuhn
large intestine
left colon
inflammatory cytokines
neutrophils
lymphocytes
plasma cells
macrophages 
eosinophils 
mast cells
24
Q

ulcerative colitis

-increased risk for _____ is demonstrated

A

colon cancer

25
Q

chrons disease

  • alterations in _____ production have been found in individuals with this disorder
  • causes “skip” lesions
  • ulcerations: longitudinal and transverse Inflammatory fissures extend into lymphoid tissue
  • -_____ having _____ projections
A

immunoglobulin
granuloma
cobblestone

26
Q 
cancer of the colon and rectum
clinical manifestations
LEFT
shape: \_\_\_\_\_, \_\_\_\_\_, \_\_\_\_\_ masses
characteristics: 
stools become narrow and \_\_\_\_\_; progressive abdominal distention, pain, vomiting, constipation, need for laxatives, cramps, and bright blood on the surface of the stool
A

small
elevated
buttonlike
pencil shaped

27
Q

left sided colon cancers

  • narrow and _____ stools
  • tumors of the _____ or _____ are _____, _____, _____-like masses
  • obstruction is common but occurs _____ and stools become narrow and _____
A 
pencil shaped
left
descending 
small
elevated
button
slowly
pencil shaped
28
Q

cancer of the cecum and ascending colon clinical manifestations

  • _____- colored _____ mixed with stool
  • _____
  • _____
  • _____ in the _____
A 
mahogany 
blood
anemia
pain
palpable mass
lower right quadrant
29
Q

common complications of liver disorders

  • _____
  • _____
  • _____
A

ascites
hepatic encephalopathy
jaundice

30
Q

ascites most common cause is _____

A

cirrhosis

31
Q

true statements concerning the accumulation of fluid in the peritoneal cavity

  • impaired _____ of _____ by the kidneys promotes _____
  • _____ and _____ cause the movement of fluid into the peritoneal cavity
A 
excretion
sodium
water retention
decreased oncotic pressure
increased hepatic sinusoidal hydrostatic pressure
32
Q

what is hepatic encephalopathy?
-the underlying mechanism is believed to involve the _____ of _____ in the _____, a substance that is normally removed by the _____

A

build up
ammonia
blood
liver

33
Q

true facts regarding the sources of increased ammonia that contribute to hepatic encephalopathy

  • _____ of _____ are sources of increased ammonia
  • _____ leaking from _____ is a source of increased ammonia
  • _____ in the _____ are sources of increased ammonia
A 
end products 
intestinal protein digestion 
digested blood
ruptured varices
ammonia-forming bacteria 
colon
34
Q

all forms of acute hepatitis present with

  • _____
  • _____, _____ and _____
  • _____
  • _____
  • _____, _____, _____
A 
jaundice
fever, weight loss, fatigue
dark urine
hepatosplenomegaly 
nausea, vomiting, abdomen pain
35
Q

acute hepatitis

  • hepatitis is an infections or inflammation of the _____
  • most cases of acute hepatitis are from _____ hepatitis _____ or _____. _____ for unknown reasons rarely presents with an _____ and is found as a silent infection on blood test, unfortunately, when pt presents with _____
  • _____ exits exclusively in those who have active viral replications of _____
A 
liver
viral
A
B
Hepatitis C
acute infection
cirrhosis 
hepatitis D
hep B
36
Q 
cirrhosis
alcoholic liver disease 
-oxidation of alcohol, causing damage to hepatocytes 
-\_\_\_\_\_ (alcoholic fatty liver)
--is the mildest form
--is \_\_\_\_\_ if drinking is stopped
  • _____ (steatohepatitis)
  • -is characterized by _____
  • -_____ and _____ of the hepatocytes occur
  • _____ (fibrosis)
  • -toxic effects of _____ on the liver, _____ alterations, oxidative stress from _____, and _____ occur
A 
steatosis
reversible
alcoholic hepatitis
inflammation
degeneration
necrosis
alcoholic cirrhosis 
alcohol metabolism
lipid peroxidation
malnutrition
37
Q

alcoholic liver disease

  • the sequence for the development of alcoholic liver disease is
  • -_____
  • -_____
  • -_____
A

steatosis
steatohepatitis
fibrosis

38
Q

alcoholic cirrhosis

-hepatic _____ accumulation happens in _____

A

fat

alcoholic cirrhosis

39
Q

the pathophysiologic process of alcoholic cirrhosis
-impairs the hepatocytes ability to oxidize _____, synthesize enzymes and proteins, degrade _____, and clear _____ of _____ and _____

  • the pathophysiologic process of alcohol cirrhosis
  • -alcohol is transformed to _____, which promotes _____
  • -_____ function is impaired, decreasing _____ of _____
  • -_____ inhibits export of _____ from the _____
A 
fatty acids
hormones
portal blood
ammonia
toxins 
acetaldehyde 
liver fibrosis 
mitochondrial 
oxidation
fatty acids
acetaldehyde 
proteins
liver
40
Q

disorders of the pancreas

  • pancreatitis
  • -associated with several _____ (_____ intake and _____)
A

clinical disorders
alcohol
cholelithiasis

41
Q

acute pancreatitis

  • _____ or _____ obstruction blocks the outflow of _____
  • acute pancreatitis can also result from direct _____ from _____ or _____
  • acute pancreatitis is usually _____ and spontaneously resolves
A 
bile duct
pancreatic duct 
pancreatic digestive enzymes 
cellular injury
drugs
viral infection
mild

PAS- PATHOPHYSIOLOGY (17 decks)

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