Alterations of Digestive Function 1 Flashcards
(102 cards)
1
Q
what is anorexia associated with?
A
a) nausea
b) abdominal pain and indigestion
c) diarrhea
2
Q
what is vomiting a result of?
A
reverse peristalsis in duodenum/stomach
3
Q
what is vomiting?
A
forceful contraction of abdominal mm.
4
Q
what is vomiting usually preceded by?
A
by N/V
5
Q
how is vomiting initiated?
A
a) various drugs
b) trauma or torsion to ovaries, testes, uterus, bladder, kidney, GI or brain
c) activation of medullary centre
6
Q
what is constipation d/t?
A
a) personal habits
b) various disorders
c) drugs
d) inadequate fluid intake
e) mm. weakness
7
Q
what may constipation lead to?
A
hard stools and difficult evacuations
8
Q
what is fecal impaction?
A
retention of hardened stool in rectum or colon causing bowel obstruction
9
Q
in which populations is fecal impaction more common in?
A
a) elderly
b) immobilized
c) prolonged bed rest
10
Q
if a patient is experiencing fecal impaction, what is there usually a hx of?
A
watery diarrhea/fecal incontinence
11
Q
a sigmoidoscope is used for what?
A
treating fecal impaction
12
Q
what is large volume diarrhea d/t?
A
excessive water and/or secretions in intestines
13
Q
what is small volume diarrhea d/t?
A
increase intestinal motility
14
Q
what is parietal abdominal pain?
A
localized and intense
15
Q
what is visceral abdominal pain?
A
diffuse and vague
16
Q
what is visceral abdominal pain closely connected to?
A
ANS. will see pallor, sweating, N/V
17
Q
what is referred abdominal pain?
A
well localized (more than parietal abdominal pain), felt in skin/deeper tissues
18
Q
what is hematemesis?
A
bloody vomit.
can either be frank or coffee-ground in colour
19
Q
what is melena?
A
tarry, foul-smelling stool d/t digested blood
20
Q
what is hematochezia?
A
frank blood from rectum
21
Q
what is occult blood?
A
trace amounts of blood in stool or gastric secretions (detected in lab)
22
Q
what does acute severe GI bleeding cause?
A
HR/BP changes
23
Q
what can happen if there is blood accumulation in the GI tract?
A
vomiting & diarrhea
24
Q
what is dysphagia d/t?
A
a) lack of salivary glands
b) esophageal obstruction
c) neural or muscular disorders (impaired esophageal motility)
25
the term used to describe when the lower esophageal sphincter fails to relax is _______.
achalasia
26
what is a hiatal hernia?
protrusion of upper part of stomach INTO thoracic cavity through esophageal hiatus
27
which type of hiatal hernia is common and considered okay in asymptomatic patients?
sliding hiatal hernia
28
which type of hiatal hernia progressively enlarges and may lead to the entire stomach herniating into the thorax?
paraesophageal hernia
29
what can hiatal hernias lead to although often symptomatic?
a) GER
b) esophagitis
c) dysphagia
d) regurgitation
30
what is gastroesophageal reflux?
backwards movement of gastric contents into esophagus
31
what can GER lead to?
a) esophagitis
b) cancer
c) asthma attack
d) strictures
e) esophageal spasm
f) decreased esophageal motility
32
when does GER turn into GERD (gastroesophageal reflux disease)?
when regurgitation of chyme into esophagus becomes persistent
33
what can GERD lead to?
a) upper abdominal pain w/in 1 hour of eating
| b) heartburn
34
how can symptoms of GERD worsen?
lying down or increased intra-abdominal pressure
35
what is GERD associated with?
a weak gastroesophageal sphincter
36
what is inflamed in gastritis?
gastric mucosa (usually superficial erosions)
37
what is acute gastritis d/t?
mucosal injury d/t drugs, chemicals or bacterial toxins
38
what erodes in acute gastritis?
surface epithelium in diffuse or localized patterns
39
list the manifestations of acute gastritis (3)
1. vague abdominal discomfort
2. epigastric tenderness
3. bleeding (ocasional hematemesis)
40
in acute gastritis, inflammation is usually ____ and heals ______ w/in a few days.
in acute gastritis, inflammation is usually transient and heals spontaneously w/in a few days.
41
what is chronic gastritis?
a) thinning and degeneration of stomach lining
b) absence of visible erosions
c) presence of chronic inflammatory changes leading to atrophy of glandular epithelium
42
which population does chronic gastritis usually affect?
the elderly
43
list 3 signs of chronic gastritis
1. anorexia
2. nausea
3. pain
44
list causes of chronic gastritis (3)
1. H. Pylori (most common)
2. autoimmune
3. chemicals (NSAIDs or secretions/bile)
45
why does auto-digestion occur in peptic ulcer disease?
breaks/ulcerations (from pepsin and acid) exposes submucosal tissue to gastric secretions
46
what type of ulcerations erode the mucosa but do not penetrate it?
superficial ulcerations/erosions
47
what are true ulcers?
ulcers that extend through muscularis and damages blood vessesls
48
why would an ulcer lead to the complication of bleeding?
because the ulcer has penetrated to the submucosa or deeper
49
what can happen if slow bleeding occurs in PUD?
iron deficiency anemia
50
why would an ulcer lead to the complication of perforation?
because the ulcer has extended through the entire stomach wall
51
what else can happen if an ulcer perforates?
peritonitis
| gastric juices enters the peritoneal cavity
52
where do gastric ulcers usually occur?
antrum
53
what age range do gastric ulcers usually occur?
55-65 years
54
list the major causes of gastric ulcers (4)
1. H. Pylori
2. NSAIDs (decrease PGs)
3. hyper/hyposecretion of acid/bicarbonate
4. stress/chemicals
55
describe the manifestation of gastric ulcers and how can one relieve this?
chronic intermittent pain (burning, gnawing, cramping) that occurs SHORTLY after meals
can be relieved by antacids
56
how do gastric ulcers heal?
fibrosis w/in 6-8 weeks
57
gastric ulcerations is an _______ condition
gastric ulcerations is an episodic condition
58
do duodenal ulcers have more anorexia, vomiting, and weight loss than gastric ulcers?
no. gastric ulcers have more anorexia, vomiting, and weight loss.
59
how is irritable bowel syndrome (IBS) characterized?
by persistent and recurrent intestinal manifestations in the absence of structural abnormalities
60
list the manifestations of IBS (7)
1. abdominal pain
2. diarrhea/constipatino
3. urgency
4. bloating
5. nausea
6. anorexia
7. anxiety
61
what is the IBS hallmark?
abdominal pain that is relieved by defecation
62
list the treatments for IBS (3)
1. anti-diarrheals
2. increase fibre
3. probiotics
63
name the 2 diseases classified under inflammatory bowel diseases
1. ulcerative colitis
| 2. chron's disease
64
what is ulcerative colitis?
chronic inflammation of colon mucosa
65
where do you typically see ulcerative colitis?
rectum and sigmoid colon
66
describe ulcerative erosions
they are small erosions that form in the mucosal layer. they can merge to form ulcers that bleed and become necrotic.
67
what are pseudopolyps?
ulcerated tissue separated by islands of raise, inflamed mucosa
68
what likes between pseudopolyps?
the only remaining muscularis
69
in ulcerative colitis, what happens to the lumen?
edema and thickening of muscularis narrows it
70
what will a patient w/ ulcerative colitis experience?
frequent diarrhea (large volume) w/ passage of small amounts of blood, purulent mucous and cramping
71
what happens if the entire colon is suffering from ulcerative colitis?
a) fever
b) increased pulse rate
c) urgency
d) frequent, bloody diarrhea
e) continuous crampy pain
72
name the treatments used for ulcerative colitis?
1. avoid caffeine, lactose, spicy or gas-forming food
2. increase fibre intake
3. anti-inflammatories
4. immunosuppressive drugs
5. surgical resection/colostomy (if other therapies fail)
73
does UC increase risk of colon cancer?
yes
74
what is chron's disease and what does it affect?
it is recurrent granulomatous inflammation that beings in submucosa w/ hyperemia.
it affects the distal 10-20 cm of ileum, rarely affects colon
75
in chron's disease, what do you call portions of the bowel that are unaffected?
skip lesions
76
name the IBD that has a greater familial predisposition
chron's disease
77
what can happen to the ileum?
WBC infiltration -> fibrosis -> rigidity like a lead pipe
78
manifestations of chron's disease
1. weight loss
2. lower abdominal pain
3. malaise
4. low grade fever
79
what can happen if the ileum is involved in chron's disease?
anemia d/t malabsorption of vitamin B12
80
what is infectious enterocolitis?
infection to the small or large intestine that leads to inflammation
81
how does infectious enterocolitis commonly manifest?
rapidly w/ low grade fever, vomiting, abdominal pain, and watery diarrhea
82
name the virus that can cause infectious enterocolitis
norwalk virus
83
name the bacteria that can cause infectious enterocolitis
1. staph
2. salmonella
3. c. diff
3. e. coli
84
how does c diff proliferate?
when broad-sprectrum antibiotics wipe out mucosal bacteria
85
what does e. coli do?
produces toxins that lead to local inflammation (diarrhea), damage the kidneys and other structures if systemic
86
what is diverticular disease?
multiple herniations of mucosa through muscularis externa
87
where do you see diverticular disease usually?
sigmoid colon
88
describe the surface of the colon suffering from diverticular disease
hyperemic
89
what can happen to the erosion from the stool in the diverticula?
it can become inflamed and hemorrhage
90
in which population is diverticular disease most common?
in the elderly and young people w/ low dietary fibre
91
what is inflammation of diverticula usually d/t?
infection from an accumulation of fecal matter
92
when not asymptomatic, what symptoms will you see with diverticular disease?
1. cramping
2. distension
3. constipation
4. flatulence
93
how can you relieve diverticular disease?
from increasing dietary fibre
94
what will you observe if inflammation occurs in diverticular disease?
1. LLQ pain
| 2. rectal bleeding
95
how do you treat diverticular disease?
1. antibiotics
| 2. bowel rest
96
fecalith, tumour and foreign bodies all can cause _____ by?
appendicitis by obstructing lumen of appendix resulting in bacterial infection or torsion
97
manifestations of acute appendicitis
1. gastric/periumbilical pain of incresing intensity over 2-12 hrs --> pain will focus in the RLQ once serosa is involved
98
name the complications of appendicitis
1. abcess formation
| 2. gangrene -> performation -> peritonitis
99
how can an intestinal obstruction occur?
by any condition that prevent normal flow of chyme through intestinal lumen
100
types of intestinal obstructions
1. simple (mechanical blockage by lesion or motility issue)
2. acute or chronic
3. intrinsic
4. extrinsic
101
list 4 major causes of intestinal obstruction
1. herniation
2. adhesion
3. intussusception
4. volvulus
102
clinical manifestations of intestinal obstruction
1. intermittent pain with peristalsis
2. constipation w/ peristaltic noises
3. sweating
4. N/V
5. abdominal distention
