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pathophysiology > chapter 37 - disorders of gastrointestinal intestinal function > Flashcards

chapter 37 - disorders of gastrointestinal intestinal function Flashcards

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1
Q

anorexia, nausea, and vomiting are __

A

common manifestations of the digestive system

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2
Q

__ (vomiting/talking/singing) is a sign of digestive orders or systemic infections, kidney failure, or emotional response

A

vomiting

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3
Q

match the vomit type with its correct description:
1. partial digestion of blood by the stomach (hematemesis)
2. contents from lower intestine; seen in pts with intestinal bowel obstruction
3. bile from duodenum
4. visible blood; something in the esophagus
5. after a meal; problem w/gastric emptying (pyloric obstruction)

a. frank blood
b. deep brown
c. yellow
d. brown coffee grounds
e. frequent vomiting

A
  1. d
  2. b
  3. c
  4. a
  5. e
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4
Q

what kinds of blood can you see in stool?

A

frank blood, melena, and occult blood

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5
Q

frank blood in stool

A

red; not digested and results from lesions in the rectum or anal canal

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6
Q

melena in stool

A

dark stool; bleeding in higher intestinal tract; blood is digested

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7
Q

occult blood in stool

A

not visible (blood); can be detected though

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8
Q

general s/s of dysphagia include:

A
  • pain in swallowing
  • inability to swallow large pieces of solids
  • difficulty swallowing liquids
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9
Q

achalasia
congenital atresia
stenosis
diverticulum
tumor

are all types of __ (vomitus/stool/dysphagia)

A

dysphagia

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10
Q

achalasia is __ (failure of lower esophageal sphincter to relax due to loss of nerve innervation/compression or blockage/ undigested food becomes trapped in a blind pouch)

A

failure of the lower esophageal sphincter to relax due to a loss of nerve innervation

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11
Q

congenital atresia is __ (failure of lower esophageal sphincter to relax due to loss of nerve innervation/upper and lower esophagus were not developed properly therefore needing surgical correction/ undigested food becomes trapped in a blind pouch

A

upper and lower esophagus are not developed properly therefore needing surgical correction

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12
Q

stenosis is the __ (narrowing of the esophagus which can be developmental of acquired defects/compression or blockage/ undigested food)

A

narrowing of the esophagus (developmental or acquired defects)

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13
Q

a pt complains that food is stuck in a blind pouch, has accumulated, fermented, broke down, and has caused them to have extreme bad breath. they have __ (diverticulum/stenosis/achalasia)

A

diverticulum

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14
Q

a __ (stenosis/tumor/congenital atresia) is a compression or blockage of the esophagus

A

tumor

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15
Q

when the stomach protrudes through the esophageal hiatus (region of the diaphragm that the esophagus goes through), this is called a __ (axial/paraesophageal/hiatal) hernia

A

hiatal hernia

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16
Q

a __ (axial/paraesophageal) hernia goes around the whole surface (esophageal hiatus)

A

axial

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17
Q

a __ (axial/paraesophageal) hernia goes around one side of the esophageal hiatus

A

paraesophageal

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18
Q

reflux is __ (backward flow of stomach acid into the esophagus/weak lower esophageal sphincter)

A

backward flow of stomach acid into the esophagus

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19
Q

gerd is __ (backward flow of stomach acid into esophagus/chronic/weaker lower esophageal sphincter and food (chyme) can easily move back into esophagus)

A

chronic; weaker lower esophageal sphincter; food can easily move back into esophagus

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20
Q

a pt feels some burning in her esophagus for about 30-60 mins after eating. when she bends over or lays down, it gets worse. she also has hoarseness in her voice. this disorder can cause intestinal metaplasia. what is it?

A

gerd (gastroesophageal reflux disorder)

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21
Q

barrett’s esophagus is caused by __

A

gerd

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22
Q

why is barrett’s esophagus a concern for pts’ health?

A

it can lead to adenocarcinoma, and if it continues, can lead to esophagus cancer due to the constant movement of acid into the esophagus

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23
Q

how would you treat gerd?

A
  • antacids
  • h2 receptor antagonists (histamine is a stimulant of parietal cells in the stomach)
  • proton pump inhibitors
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24
Q

__ (acute/chronic) gastritis has inflamed, red, and edematous gastric mucosa that may be ulcerative/bleeding –> transient and self limiting

A

acute

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25
causes of acute gastritis include:
aspirin, nsaids, alcohol, chemotherapy, gastric radiation
26
these two things decrease the formation of mucin
aspirin and nsaids
27
this cause of acute gastritis is responsible for the increased release of gastric juices
alcohol
28
both __ and __ have activated cells that are decreased in acute gastritis
chemotherapy; gastric radiation
29
chronic inflammatory changes to mucosa and atrophy of the gastric mucosa with loss of secretory glands is considered __ (acute/chronic) gastritis
chronic
30
helicobacter pylori and autoimmune gastritis are the __ of chronic gastritis
types
31
__ is the main cause of chronic gastritis
helicobacter pylori
32
h pylori __ (produces substances - neutralizes stomach pH/auto antibodies against parietal cells and intrinsic factor)
produces substances - neutralize stomach pH
33
how do you treat h pylori?
with antibiotics and proton pump inhibitors, histamine (h2) receptor antagonist
34
autoimmune gastritis is __ (the most common gastritis/defect in acid secretion and vit b12 deficiency)
defect in acid secretion and vit b 12 deficiency
35
why do you see pernicious anemia in chronic gastritis?
autoimmune gastritis causes antibodies against intrinsic factor (absorption of vit b 12)
36
main causes of gastric ulcers are __
h pylori aspirin nsaids
37
complications of gastric ulcers include:
bleeding perforation obstruction
38
the treatment for gastric ulcers include:
getting rid of h pylori, avoiding nsaids, proton pump inhibitors
39
to test for gastric ulcers, you can look for __ (frank/occult/yellow) blood in stool and hypochromic anemia (iron deficient anemia) as well as an __ and test for __
occult; endoscopy; h pylori
40
__ disease affects mouth to anus, distal small intestine and proximal colon
crohn's
41
crohn's disease affects the __ the most, but is transmural (all 4 layers affected)
submucosa
42
arthritis, inflammation of eyes/mouth, kidney stones, fistulas, gall stones, nutritional problems (lack of protein) --> inability to digest and absorb food, pain in lower right abdomen are all s/s of __
crohn's disease
43
crohn's disease has no known cause because it is an __ disease
autoimmune
44
both crohn's disease and ulcerative colitis predisposes you to __
colorectal carcinoma
45
__ can affect the large intestine or colon, descending and sigmoid colon
ulcerative colitis
46
this inflammatory bowel disease can be seen in pt whose inflammation is confined to the mucosa and tissues bleed easily
ulcerative colitis
47
this ibd also has no known cause because it is autoimmune and predisposes you to colorectal carcinoma
ulcerative colitis
48
anti-inflammatory meds anticholinergic meds (decrease intestinal motility) nutritional supplements during acute episodes antimicrobials surgery: ileostomy or colostomy are all treatments for __
ibd
49
__ (ulcerative/clostridium difficile) colitis occurs when c-diff increases and binds to and damages mucosa layer --> inflammation and hemorrhage
c diff
50
a pt can get c diff after antibiotic therapy because __
it makes the large intestine susceptible to c diff colonization
51
c diff colitis occurs when __
normal flora balance in LI is disrupted
52
c diff is usually acquired in __ (the hospital/at home/outside)
the hospital
53
a pt has 1) diarrhea, 2) fever, 3) loss of appetite, 4) abdominal cramping 1-2 weeks after antibiotic therapy. what does the pt have?
c diff colitis
54
the pt wants to know the treatment options for c diff colitis. what do you tell them?
- stop antibiotic treatment - metronidazole and vancomycin - fecal transplant (fecal bacteriotherapy)
55
diverticulitis is most commonly found in the __ (ascending/transverse/sigmoid) colon
sigmoid
56
true or false. most people don't have symptoms for diverticulitis.
true
57
diverticulitis is __ in the pouches (diverticulum)
infection
58
diarrhea and cramping abdominal pain are symptoms of __
diverticulitis
59
inflammation of the appendix is called __
appendicitis
60
appendicitis is caused by: __, __, __, or __
fecalith; gall stones; twisting; spasms
61
__ can lead to ischemia and necrosis --> gangrene
appendicitis
62
a pt has 1) increased water in stool, 2) noninflammatory and inflammatory, and 3) osmotic and secretory. this is called __
diarrhea
63
__ (acute/chronic) diarrhea is caused by infectious agent, self limiting (2 weeks)
acute
64
__ (inflammatory/noninflammatory) diarrhea is caused by a toxin that leads to large water volume, non-bloody, diarrhea
non-inflammatory
65
a pt has a small volume of bloody diarrhea and a fever. do they inflammatory or non-inflammatory diarrhea?
inflammatory
66
true or false. bacteria invade the intestinal wall and cause damage in inflammatory diarrhea
true
67
the symptoms of chronic diarrhea can last __ (1-2 weeks/2-3 weeks/3-4 weeks) in children/adults and __ (2 weeks/3 weeks/4 weeks) in infants
2-3 weeks; 4 weeks
68
this diarrhea is caused by hyperosmotic chyme: lactose intolerant and secretory diarrhea: increased intestinal secretions or w/excessive bile salts (present in SI)
chronic
69
the __ is when chyme from the stomach is dumped into the SI too quickly bc of pyloric sphincter damage
dumping syndrome
70
hyperosmolar chyme __ fluid out of vascular component
draws
71
hypovolemia results due to __ (fluid shift from blood to SI to dilute hypertonic chyme/digest and absorb food)
fluid shift form blood to SI to dilute hypertonic chyme
72
hypovolemia can be detected by:
- decreased bp - feeling faint, weak, or dizzy - tachycardia - pallor, diaphoresis
73
distended intestine results from __
fluid shift
74
s/s of distended intestine are
- pain - cramps - nausea - vomiting
75
__ (hypoglycemia/hyperglycemia) is followed by __ (hypoglycemia/hyperglycemia)
hyperglycemia; hypoglycemia
76
why does hyperglycemia result from the dumping syndrome?
chyme is rapidly dumped into the SI, digested , and absorbed
77
why does hypoglycemia result from hyperglycemia in the dumping syndrome?
insulin is released; glucose goes into cells; 2-3 hrs following a meal; no food or chyme to supply additional glucose
78
intestinal obstruction can be __ or __
mechanical; paralytic
79
a pt has a hernia, post operative adhesions, tumor, and had intestinal twisting. what obstruction is this?
mechanical intestinal obstruction
80
a pt has both neurological and muscular impairment. what kind of obstruction is this?
paralytic
81
high pitched peristalsis is heard in which obstruction?
mechanical
82
s/s of mechanical obstruction include:
- intestinal hernias - tumors - ibd - twisting (volvulus) - telescoping of intestine (intussusception)
83
__ has inaudible bowel sounds
paralytic obstruction
84
s/s of paralytic obstruction include:
- malfunction of nerves and muscle - electrolyte imbalance - gastroenteritis - appendicitis - pancreatitis - surgical complications - certain drugs and medication
85
inflammation of the peritoneal membrane sis
peritonitis
86
__ peritonitis includes a ruptured gall bladder/spleen
chemical
87
__ peritonitis is caused by perforation in intestines
bacterial
88
a 1) board-like abdomen (abdominal wall muscles tighten), 2) reflex paralysis or paralytic ileus (pain and sympathetic nervous stimulation cause bowel to freeze), and 3) shallow breathing (diaphragm & accessory muscle breathing decrease) are __ of peritonitis
s/s

pathophysiology (11 decks)

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