Exam 2 - Gastrointestinal system

Question 1

digestion

Answer 1

Mechanical = teeth, churning, etc

chemical = enzymes

*most digestion occurs in small intestines

Question 2

absorption

Answer 2

-almost all and 80% of water absorption occur in small intestine (specific jejunum)

Question 3

Regulation of digestive tract

Answer 3

• autonomic nervous system
• endocrine (gastrin, secretin, cck)
• paracrine (histamine and prostaglandins)

Question 4

common problems with GI issues

Answer 4

• malnourishment
• vitamin and mineral deficiencies
• anorexia
• cachexia (wasting syndrome)
• dehydration
• osteoporosis
• anemia
• clotting disorders
• weakness, fatigue, de-conditioning

Question 5

GI signs and symptoms

Answer 5

• nausea
• vomiting
• diarrhea
• constipation
• dysphagia
• heartburn
• abdominal pain
• GI bleeding (poop stuff)
• fecal incontinence

Question 6

Causes of nausea/vomiting

Answer 6

general stuffffff

-neurological
= inc intracranial pressure, concussion, homorrhage, vestibular, migraines)

Question 7

Achalasia (what is it)

Answer 7

-inc tone of lower esophageal sphincter (LES) - failure to relax normally when swallowing

causes chest pain, fullness, dysphagia.

can lead to dilatation of the esophagus and lack of peristalsis

Question 8

Achalasia (why)

Answer 8

• loss of myenteric ganglion cells and inhibitory neurons, reduced NO production likely play a role
• may occur cuz of other disorders

treat: pneumatic balloon dilation, myotomy, nitrates, botox

Question 9

Gastroesophageal reflux disease GERD

Answer 9

-inflammation of esophagus resulting from reflux of stomach acid into esophagus

Question 10

GERD causes

Answer 10

• reduced pressure in LES
• inc gastric or intra-ab pressure
• position

it is common
-fat people, age, what you eat and drink, etc

Question 11

GERD signs and symptoms

Answer 11

• chest pain
• burning (heartburn)
• dysphagia and/or painful swallowing
• belching
• indigestion
• regurgitation
• chronic cough
• laryngitis

-long term can inc risk of cancer and pulmonary complications (barrett esophagus)

Question 12

Treating GERD

Answer 12

• lifestyle
• meds (antacids, H2 receptor blocks, proton pump inhibitors)
• surgery

Question 13

Hiatal hernia

Answer 13

• hernia of stomach through diaphragm
• due to weak diaphragm or inc intra-ab pressure (aging, trauma, etc)

signs: like GERD
med treatment: like GERD. surgery if severe

Question 14

Esophageal cancers (types, signs, treatment, prog)

Answer 14

• squamous cell carcinoma
• adenocarcinoma

signs: pain with swallowing, wt loss, hematemesis, chest pain, hoarseness, fistula thingy
treat: prevent. or do surgery, radiation, chemo
prog: most detected late. survival bad

Question 15

Squamous cell carcinoma

Answer 15

• most common worldwide
• more common in blacks in US
• risk factors: alcohol, tobacco, achalasia, nutritional deficiencies

Question 16

Adenocarcinoma

Answer 16

Esophageal cancer

• rising incidence in the US
• more common in middle aged caucasian men
• barrett esophagus most common cause

Question 17

What is Gastritis?

Answer 17

inflammation of the lining of the stomach (gastric mucosa)

Acute hemorrhagic and chronic

Question 18

Acute hemorrhagic gastritis

Answer 18

• characterized by erosion of mucosal epithelium

- associated with ASA/NSAIDs, EtOH, and stress

Question 19

Chronic gastritis

Answer 19

Type A: rare, links to autoimmune disorders

Type B: more common, liked to H. pylori infection

Question 20

Gastritis (symptoms and treatment)

Answer 20

symptoms

• epigastric pain, ab distension, loss of appetite, nausea, GI bleeding
• may develop anemia

Treat:

• avoid irritation
• PPIs, antacids, H2 blocks, antimicrobials for H. pylori

Question 21

what is Peptic ulcer disease (PUD)

Answer 21

• deeper ulceration in stomach or duodenum
• 90% caused by H. pylori
• can involve mucosa, submucosa, and muscular layers
• chronic inflam is bad

Question 22

PUD signs and treatment

Answer 22

signs
-ab pain, loss of appetite, nausea/vomiting

treatment
-antibiotics, antacids, pump inhibitors, H2 blockers, stop using ASA/NSAIDs, surgery

Question 23

Pyloric stenosis

Answer 23

• obstruction of pyloric sphincter (stomach -> duodenum)
• congenital or acquired

symptoms: projectile vomit, node in RUQ (infants)

Diag: ultrasound
Treat: surgery

Question 24

Gastric cancer

Answer 24

-adenocarcinoma = most common

treatment: surgery, chemo
Prog: depends on severity

Question 25

Malabsorption syndrome

Answer 25

- reduced intestinal absorption of food and lose nutrients in poo - either maldigestion or malabsorption - many causes: celiac, CF, crohns, etc - common nutrients: fat, iron, mg, K, vit K/B12/D

Question 26

Crohn's vs ulcerative colitis

Answer 26

Crohn's - any segment. usually small or large intestines - entire intestinal wall involved Ulcerative colitis - Large intestine. Rectum - more superficial layers

Question 27

Inflammatory bowel disease

Answer 27

- inappropriate immune response as a result of a lot of factors. - Crohn's and ulcerative colitis Treat: drugs, diet, surgery *increases risk of cancer

Question 28

Irritable bowel syndrome (IBD)

Answer 28

- functional disorder of GI motility - absence of inflammation, no identifiable abnormality of the bowel signs: diarrhea and constipation, bloating diag: depends Treat: diet, meds, stress management etcccccc

Question 29

Diverticular disease

Answer 29

- herniation of large intestinal mucosa and submucosa through muscle layers of intestinal wall - sigmoid colon most common

Question 30

What is diverticulitis?

Answer 30

When poo is trapped in diverticula and gets infected

Question 31

Bowel obstruction

Answer 31

``` Mechanical = physically blocked Functional = lack of parastalsis ``` treat: restricted oral intake, NG tube, surgery

Question 32

what is a Hernia?

Answer 32

Protrusion of the intestine through fascial defect in the ab wall

Question 33

What are hemorrhoids?

Answer 33

varicose veins of the anus and lower rectum Treatment is typically to reduce pain and itching. may need surgery chronically

Question 34

What is appendicitis

Answer 34

- inflammation of appendix - McBurney's point Treat: remove it and antibiotics

Question 35

Colon cancer

Answer 35

- Adenocarcinoma of colon is more common malignancy of the GI tract - 2nd leading cause of cancer death in US - often slow growing. starts with a polyp - cellular hyperplasia and transformation Prevent: screening. 50 yrs old. every 5-10 yrs symptoms: bloody poo. ETC