Altered GI Fx Flashcards
(22 cards)
Gastrointestinal dysfunction: Clinical
manifestations
- Nausea
- Retching, ie Nonproductive vomiting
- Anorexia
- Vomiting
- Projectile vomiting, ie spontaneous
- Constipation
- Diarrhoea (Osmotic, Secretory, Motility)
Colorectal cancer: non-modifiable risks
- Family history
- Extensive inflammatory bowel disease such as ulcerative colitis
- Ageing - occurs in older people over 55
- Race(Caucasian)
Colorectal cancer: modifiable risks
Diet: • animal fats • red meat • alcohol Sedentary Life
Colorectal cancer: Clinical manifestations
- Rectal bleeding
- Change in bowel habits
- Fatigue
- weight loss (5 kg 2-3 months)
- Abdominal pain (2 -3 weeks)
- Iron-deficiency anaemia
- Intestinal obstruction or perforation
Colorectal cancer: Pathophysiology
• Benign polyps of mucosal epithelium
- metastases to liver and lungs
Define Peptic ulcer
A break or ulceration in the protective mucosal lining of the lower oesophagus, stomach or duodenum
Name the Developmental Factors of Peptic Ulcer
Helicobacter pylori (Gramnegative Stress, caffeine, cigarette smoking and alcohol bacterium)
Peptic ulcer: Pathophysiology
- H. pylori bacterial infection leads to death of the mucosal epithelial cells of the stomach and duodenum
- An inflammatory response, further destruction of mucosal lining and ulceration
- Too little mucus coupled with too much acid production will leave the digestive tract vulnerable to acid erosion and ulceration -> gastric contents leaking out into peritoneum
Peptic ulcer: Clinical manifestations
● dyspepsia ● epigastric pain ● heart burn ● nausea and vomiting (maybe blood) ● loss of weight ● eructation
Peptic ulcer: Diagnoses
● Gastroscopy and biopsy
● Barium swallow -> X-ray
● Full blood analysis - test of H. Pylori
Gastric ulcer: Pathophysiology
Antral region of the stomach
- increased mucosal permeability to H+
Define Stress ulcer
and 2 types
peptic ulcer that is related to severe illness, neural injury or systemic trauma
- Ischaemic ulcers
- Cushing ulcers
Causes of Appendicitis
and complication
• Obstruction, ischaemia, increased intraluminal pressure,
infection, ulceration.
• Reduced blood flow and oxygen supply, causing ulceration and infection/inflammation
Complication: peritonitis
What is Dysphagia?
Types?
difficulty swallowing
Types
- Mechanical obstructions
- Functional obstructions
Define Gastro-oesophageal reflux (GORD)
chyme from the stomach to the oesophagus
• Inflammation of the oesophagus: reflux oesophagitis
GORD: Clinical manifestations
Heartburn
regurgitation of acidic chyme
upper abdominal pain
Define Bile salt deficiency
Note: Conjugated bile salts are synthesised from cholesterol in the liver
Liver disease and bile obstructions
Poor intestinal absorption of lipids
Name Fat-soluble vitamin deficiencies
Vitamin A - Night blindness Vitamin D - Decreased calcium absorption, bone pain, osteoporosis, fractures Vitamin K - Prolonged prothrombin time, purpura and petechiae Vitamin E - Uncertain
Define Coeliac disease
Coeliac disease is an immune-mediated, permanent intolerance to gluten
Inability to break down lactose into monosaccharides; prevents lactose digestion and monosaccharide absorption
Functions of the liver
- Detoxification (filters harmful substances from the blood, alcohol)
- Stores vitamins A, D, K and B12
- Protein synthesis
- Production of biochemicals needed for digestion - bile
- Maintains proper levels of glucose in the blood
- Produces 80% of your body’s cholesterol
- Glycogen storage (also converts glucose to glycogen)
- Decomposing red blood cells
- Synthesizing plasma protein
- Production of hormones
- Urea production
Liver Function Test
• ALP - alkaline phosphatase
• Bilirubin- product of red cell breakdown
• Albumin - produced entirely by liver.
• INR
• ALT - alanine amintransferase - enzyme involved in the
recycling of the amino acid alanine into glucose
• AST - asparatate aminotransferase
• GGT - gamma glutamic transferase
Acute liver failure: Clinical manifestations
Prolongation of PT and INR Raised Liver enzyme Altered mental status -encephalopathy Elevated ammonia levels Jaundice due to hyperbilirubinemia
