exam 3 - GI - week 5 content Flashcards by Garrett Anderson

Upper GI distress

what 2 drugs Increase protective factors

o Antacids
o Sucralfate

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upper GI or Lower GI=
- Esophagus
- Stomach
- Beginning of small intestines
- Small intestines
- Colon (large intestines)
- Rectum/anus

Upper GI
- Esophagus
- Stomach
- Beginning of small intestines

Lower GI
- Small intestines
- Colon (large intestines)
- Rectum/anus

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s/s of what UGI issue
- Pyrosis – heartburn
- Dyspepsia – indigestion
- Regurgitation
- Chest pain
- Dysphagia
- Pulmonary symptoms

GERD
Gastro esophageal reflux disease

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s/s
- abdominal distension
- fullness
- flatulence
- bloating
- intermittent abdominal pain exacerbated by stress and relieved by BM
- bowel urgency
- intolerance to certain food – sorbitol, lactose, gluten
- non-bloody stool that may contain mucus

Irritable bowel syndrome

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what develops when the GI tract is exposed to acid and H pylori (when the aggressive factors outweigh the defensive factors)?

ulcers
Peptic ulcer disease PUD

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s/s differences in duodenal ulcer vs gastric/peptic ulcer
- ________ ulcer timing = 2-4 hours after eating
- __________ulcer timing = 1-2 hours after eating

duodenal ulcer timing
= 2-4 hours after eating

gastric/peptic ulcer timing = 1-2 hours after eating

and that makes sense bc food passes through the stomach (gastric) area before it passes through the small intestine (duodenum)

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Complications from GERD
- Ulceration
- Scarring
- Strictures
- Barrett esophagus

ALL

Barrett esophagus – development of abnormal metaplastic tissue, increased risk of development into cancer

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Characterized by
- Chronic inflammation of the intestines
- Exacerbation and remissions

IBD or IBS?

Inflammatory bowel disease
A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

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Development or presence of diverticula – small pouches in lining of colon that bulge outward through weak spots
- Location – descending colon

Diverticulosis

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appendicitis
peritonitis
Irritable bowel disorder
Inflammatory bowel disorder
Crohns ulcerative colitis
Diverticulosis/Diverticulitis

lower GI or upper GI issues?

lower GI

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A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

Chronic condition
Characterized by alterations in bowel pattern due to changes in intestinal motility
- chronic and frequent constipation
OR
- chronic and frequent diarrhea

Inflammatory bowel disease or Irritable bowel syndrome?

Irritable bowel syndrome
Chronic condition
Characterized by alterations in bowel pattern due to changes in intestinal motility
- chronic and frequent constipation = IBSC
- chronic and frequent diarrhea = IBSD

Inflammatory bowel disease
A group of life changing, chronic illnesses
- Crohn’s disease
- Ulcerative colitis

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Complications
- Perforation
- Peritonitis
- Obstruction

Diverticulitis

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Patho/cause of ________
- Idiopathic
- Age related
- Injury/damage may weaken the diaphragm muscle
- Constantly too much pressure on the muscles around the stomach
o Severe coughing
o Vomiting
o Constipation and straining to have a BM

hiatal hernia

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s/s of ______
- asymptomatic
- n/v
- anorexia
- weight loss
- bleeding
- burning pain – in middle abdomen or back , worse when stomach is empty
- cramping
- gas like pain

PUD

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complications of acute or chronic gastritis?
- PUD
- Bleeding ulcers
- Anemia
- Gastric cancers

chronic gastritis
- lasts weeks to years

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s/s
- Abdominal pain
- Bloody diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- crypts of lieberkuhn affected

s/s
- LRQ pain
- LRQ mass – palpable
- Cramps
- Watery diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- Malabsorption of nutrients
- Mouth ulcers
- s/e fistula

Crohn’s or UC?

UC s/s
- Abdominal pain
- Bloody diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- crypts of lieberkuhn affected

Crohn’s
s/s
- LRQ pain
- LRQ mass – palpable
- Cramps
- Watery diarrhea
- Weight loss
- Fatigue
- Anorexia
- Fever
- Malabsorption of nutrients
- Mouth ulcers
- s/e fistula

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acute ___________
temporary inflammation of the stomach lining only (intestines are not affected)
- lasts 2-10 days

chronic ___________
progressive disorder with chronic inflammation in the stomach
- lasts weeks to years

acute _____________
inflammation of stomach and small intestine
- lasts 1-3, or 10 days

acute gastritis
temporary inflammation of the stomach lining only (intestines are not affected)
- lasts 2-10 days

chronic gastritis
progressive disorder with chronic inflammation in the stomach
- lasts weeks to years

acute gastroenteritis
inflammation of stomach and small intestine
- lasts 1-3, or 10 days

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Risk factors for what UGI issue?
- Age
- Smoking
- Obese

hiatal hernia

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Ulcerative disorder of the upper GI tract

Peptic ulcer disease PUD

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Treatment for GERD
SATA
- Avoid triggers
- Prevent complications
- Some meds
- surgery

Avoid triggers
Prevent complications
Some meds
X- surgery

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Difficulty swallowing
- Begins with solids and progresses to liquids

Dysphagia

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Etiology of _______
- H pylori
- Injury causing substances – daily use of NSAIDS, ASA, alcohol
- Excess secretion of acid
o Stress – increased gastric acid is secreted with body’s stress response
- Smoking
- Family hx

PUD

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_________________
o H pylori
o NSAIDS
o Acid
o Pepsin
o Smoking
______________
o Mucus
o Bicarbonate
o Blood flow
o Prostaglandins

which factors cause ulcers and which factors protect against ulcers?

Aggressive factors
o H pylori
o NSAIDS
o Acid
o Pepsin
o Smoking
Defensive factors
o Mucus
o Bicarbonate
o Blood flow
o Prostaglandins

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s/s
- LLQ pain
- Fever
- Increase WBC
- Constipation or diarrhea
- Acute – passage of large quantity of frank blood

Diverticulitis

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- Elastic reservoir for food, mixing, and initial digestion of proteins - Lined with epithelium/gastric glands, which secrete HCl, IF – intrinsic factor, and gastrin

Stomach

- Perforated ulcer - Pancreatitis - Ruptured gallbladder, spleen, bladder, appendix cause ________

Peritonitis

- Esophageal disorders like o GERD o Hiatal hernia - Inflammatory disorders of the stomach like o Gastritis o Acute gastroenteritis o PUD upper or lower GI problems?

Upper GI problems

Membrane wall = plicae circulares Fingers on membrane wall = intestinal villi Fingers on the fingers = microvilli These all give larger surface area for digestion small or large intestine?

small

Backflow of gastric acid from the stomach into esophagus - Occurs via the lower or upper esophagus sphincter? - Highly acidic material

GERD Gastro esophageal reflux disease “heart burn” Backflow of gastric acid from the stomach into esophagus - Occurs via the LES - Highly acidic material

PUD Classification _____________ o Most common o Age any, early adulthood _____________ o Age 50-70 peak o b/c increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses Gastric/peptic ulcer or Duodenal ulcer ?

Classification - Duodenal ulcer o Most common o Age any, early adulthood - Gastric/peptic ulcer o Age 50-70 peak o b/c increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses

s/s of acute gastroenteritis - watery diarrhea – bloody if bacterial - abdominal pain - n/v - fever - malaise complications =

FVD

__________ intestine Includes appendix, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum - No villi and no digestive enzymes - Cells absorb water and electrolytes - Goblet cells produce mucus - Endocrine cells produce hormones

Large

- Fatty foods - Spicy foods - Tomato based foods - Citrus foods - Caffeine - Alcohol - Smoking - Sleep position - Obesity - Pregnancy - Pharmacologic agents cause what upper GI issue?

GERD Gastro esophageal reflux disease anything that alters closure/strength of LES or increases abdominal pressure

complications of _______ Fluids Shifting 1. Third spacing: fluids leave blood vessel and accumulate in the abdomen or pleural cavity. 2. This can lead to hypovolemia and Hypovolemic shock: If fluid loss is significant 3. Sepsis: infection Decreased Peristalsis 1. Paralytic ileus: intestines stop moving 2. Intestinal obstruction: intestines become completely blocked associated with which lower GI issue

Peritonitis

obstruction that causes Appendix inflammation

Appendicitis

complications of PUD H – O – P –

complications of PUD H – hemorrhage – if blood vessels are damaged O – obstruction – scar tissues P – perforation and peritonitis

Crypts of lieberkuhn – secrete fluid Goblet cells and brunner glands – make mucus for protection against acid small or large intestine?

small

1. _________ esophageal sphincter – prevents food and fluids from aspirating into lungs (top of esophagus) 2. _______ esophageal sphincter or “cardiac sphincter" – separates the esophagus from the stomach, prevents acidic content of the stomach from entering back into the esophagus (bottom of esophagus)

– upper – lower (LES)

_____________ is a chronic inflammatory bowel disease (IBD) that can affect any part of the digestive tract, from the mouth to the anus. ________ is a chronic inflammatory bowel disease (IBD) that causes inflammation of the mucosa of the rectum and colon

Crohn's disease ulcerative colitis

which layer of the stomach contains: - G-cells – produce gastrin which facilitates production of HCl - Parietal cells – produce HCl to help break down food, and produce IF to protect mucosa - Chief cells – secrete pepsin - epithelial cells – secrete bicarbonate-rich solution to protect mucosa - blood vessels

Mucosa layer - Inner layer

Cause - Autoimmune activated by an infection causes IBS or IBD?

Inflammatory bowel disease A group of life changing, chronic illnesses - Crohn’s disease - Ulcerative colitis

s/s of ________ - Asymptomatic - Belching - Dysphagia - Chest or epigastric pain

hiatal hernia

Complications of what lower GI issue - Gangrene - Abscess formation - Peritonitis

Appendicitis

Inflammation of one or more of the pouches (diverticula) - May resolve spontaneously

Diverticulitis

s/s - Sudden and severe - Abdominal pain - Tenderness - Rigid board like abdomen - n/v - fever - elevated WBC - increased HR – r/t pain and fluid shifts - decreased BP – r/t pain and fluid shifts

Peritonitis

Patho for crohn's disease 1. Lymph structures in the GI tract are _______ 2. Tissue becomes engaged and ________ 3. Skip lesions - Deep linear fissures and ulcers develop in a patchy pattern in the bowel wall, _________ appearance

Patho 1. Lymph structures in the GI tract are blocked 2. Tissue becomes engaged and inflamed 3. Skip lesions - Deep linear fissures and ulcers develop in a patchy pattern in the bowel wall, cobblestone appearance

A group of life changing, chronic illnesses - Crohn’s disease - Ulcerative colitis

Inflammatory bowel disease

Patho of PUD 1. ______ is damaged 2. _________ secreted 3. ___crease in acid and pepsin secretion = causes further tissue damage 4. Vaso____tion = causes edema 5. Destroyed blood vessels = bleeding ulcers

Patho 1. Mucosa (lining of the stomach) is damaged 2. Histamine secreted 3. Increase in acid and pepsin secretion = causes further tissue damage 4. Vasodilation = causes edema 5. Destroyed blood vessels = bleeding ulcers

s/s - Asymptomatic - Accidentally discovered or with presentation of acute diverticulitis

Diverticulosis

is it Common for GERD and hiatal hernia to coexist ? Treatment for HH 1. Teaching o meals = o don’t _____ after eating o _____- tight clothes and abdominal supports o ________ if obese o _______ meds for GERD symptoms 2. surgery if other treatment doesn’t work

Treatment 1.Teaching o Small frequent meals o don’t lie down after eating o avoid tight clothes and abdominal supports o weight control if obese o antacids for GERD symptoms 2. surgery if other treatment doesn’t work

s/s - RLQ pain - Rebound pain – severe pain after release of palpating hand over RLQ - Sudden pain relief = rupture (peritonitis)

Appendicitis

o CVA-stroke o Achalasia – LES cant open properly o Common in intubated people resulting in dysphagia cause is.... Mechanical obstruction (structure issue) or Neuromuscular dysfunction (brain issue)?

Neuromuscular dysfunction (brain issue)

Risk factors for _______ induced PUD - older Age - Higher doses of NSAIDS – inhibit prostaglandin, lose protective mucus coating - Hx of PUD - Use of corticosteroids long term and anticoagulants - Serious systemic disorders – autoimmune - H pylori infection

NSAID

2 types of hernia - - Paraesophageal hernia and Sliding hernia ________ o Usually small o Doesn’t need treatment o Less severe __________ o Part of the stomach pushes through the diaphragm and stays there o More severe

2 types - Sliding hernia o Usually small o Doesn’t need treatment o Less severe - Paraesophageal hernia o Part of the stomach pushes through the diaphragm and stays there o More severe There are types 3 and 4 and they are a mixture and worse

psychosocial stress and IBS T/F - emotional stress doesn’t cause IBS - emotional stress doesn't make IBS worse - IBS doesn't cause emotional stress T/F Causes of IBS - Idiopathic - Triggered by stress - Triggered by food - Triggered by hormone changes - Triggered by GI infections - Triggered by menses - autoimmune activated by an infection

- emotional stress doesn’t cause IBS X - emotional stress can make IBS worse X - IBS can cause emotional stress - Idiopathic - Triggered by stress - Triggered by food - Triggered by hormone changes - Triggered by GI infections - Triggered by menses X- autoimmune activated by an infection = IBD

___________ __________ - Normally closed at rest - Prevent the movement of food backwards

Esophageal sphincters

Complications of ______ - Malnutrition and anemia - Scar tissue and obstructions - Fistulas – inappropriate connections - Cancer Complications of ________ - Hemorrhage - Perforation - Cancer - Malnutrition - Anemia - Strictures - Colon, rectal and/or Anal Fissures - Colon, rectal and/or Anal abscesses - Toxic megacolon – rapid dilation of the large intestine that can be life threatening - Colorectal carcinoma - Liver disease – from inflammation and scarring of the bile ducts - F&E and pH imbalances Crohn's or UC?

crohn's Complications - Malnutrition and anemia - Scar tissue and obstructions - Fistulas – inappropriate connections - Cancer UC Complications - Hemorrhage - Perforation - Cancer - Malnutrition - Anemia - Strictures - Colon, rectal and/or Anal Fissures - Colon, rectal and/or Anal abscesses - Toxic megacolon – rapid dilation of the large intestine that can be life threatening - Colorectal carcinoma - Liver disease – from inflammation and scarring of the bile ducts - F&E and pH imbalances

etiology of _______: - irritating substances – like alcohol - drugs – like NSAIDS - infectious agents – like H pylori 2 main etiology of ______: - Autoimmune – attacks parietal cells (produce HCl to help break down food, and produce IF to protect mucosa) - H pylori infection etiology of ________: - viral – noro and rota - bacterial – E.coli, salmonella, campylobacter - parasitic infection acute gastroenteritis, acute gastritis, or chronic gastritis?

etiology acute gastritis - irritating substances – like alcohol - drugs – like NSAIDS - infectious agents – like H pylori 2 main etiology chronic gastritis - Autoimmune – attacks parietal cells (produce HCl to help break down food, and produce IF to protect mucosa) - H pylori infection etiology acute gastroenteritis - viral – noro and rota - bacterial – E.coli, salmonella, campylobacter - parasitic infection

___________ - Tube for food and fluids - Connects throat to stomach - Mucus and muscles help move food

Esophagus

gastroenteritis vs gastritis? s/s - asymptomatic - anorexia - n/v - postprandial pain – after eating - intestinal gas - hematemesis - tarry stool - anemia s/s - watery diarrhea – bloody if bacterial - abdominal pain - n/v - fever - malaise

gastritis s/s - asymptomatic - anorexia - n/v - postprandial pain – after eating - intestinal gas - hematemesis - tarry stool - anemia gastroenteritis s/s - watery diarrhea – bloody if bacterial - abdominal pain - n/v - fever - malaise

o Stenosis or stricture o Diverticula o Tumor resulting in dysphagia cause is.... Mechanical obstruction (structure issue) or Neuromuscular dysfunction (brain issue)?

- Mechanical obstruction – structure issue

Cause _______ - Congenital or acquired - Low fiber diet = chronic constipation

Diverticulosis

Small intestine 1st 2nd 3rd jejunum ileum duodenum

Small intestine 1st duodenum 2nd jejunum 3rd ileum

Peritoneum inflammation – serous membrane that lines the abdominal cavity and covers visceral organs

Peritonitis

Chronic condition Characterized by alterations in bowel pattern due to changes in intestinal motility - chronic and frequent constipation OR - chronic and frequent diarrhea

Irritable bowel syndrome - chronic and frequent constipation = IBSC - chronic and frequent diarrhea = IBSD

complications of _______ H – hemorrhage – if blood vessels are damaged O – obstruction – scar tissues P – perforation and peritonitis

complications of PUD H – hemorrhage – if blood vessels are damaged O – obstruction – scar tissues P – perforation and peritonitis

G – granulomas A – all L – layers S – skip lesions Crohn’s disease of ulcerative colitis?

Crohn’s disease

H pylori causes ________ and ________ and ___________ SATA - Bacteria or virus? - Acidic environment - Persistent inflammation - Transmission o person to person via saliva, feces, or vomit o contaminated food/water

chronic gastritis PUD stomach cancer - Bacteria - Acidic environment - Persistent inflammation - Can cause chronic gastritis, PUD, and stomach cancer - Transmission o person to person via saliva, feces, or vomit o contaminated food/water

Defect in the diaphragm that allows part of the stomach to pass into the thorax

Hiatal hernia

bacteria or virus causes acute gastroenteritis? bacteria or virus causes chronic gastritis?

acute gastroenteritis - viral – noro and rota - bacterial – E.coli, salmonella, campylobacter - parasitic infection chronic gastritis Bacteria = H pylori also autoimmune

IBD or IBS More common in - Women - White - Jewish - Smokers

Inflammatory bowel disease A group of life changing, chronic illnesses - Crohn’s disease - Ulcerative colitis

Small intestine sphincter is called __________ sphincter where food passes from small intestines to large intestines - Distention allows passage and prevents reflux back onto ileum

Ileocecal sphincter

Peptic ulcer disease PUD - Esophageal – ulcer in the _________ - Gastric ulcer – ulcer in the __________ - Duodenum ulcer – ulcer in the ___________

esophagus stomach first part of the small intestine

Patho of UC 1. Begins in_______and extends in a continuous segment that may involve the entire colon 2. Inflammation = large ulcerations 3. _____ abscesses - Necrosis of the epithelia tissue can cause abscesses 4. Colon and rectum try to repair the damage with new _________ tissue – which is problematic b/c it is fragile and bleeds easy

Patho 1. Begins in rectum and extends in a continuous segment that may involves the entire colon 2. Inflammation = large ulcerations 3. Crypt abscesses - Necrosis of the epithelia tissue can cause abscesses 4. Colon and rectum try to repair the damage with new granulation tissue – which is problematic b/c it is fragile and bleeds easy

which quadrant diverticulitis = appendicitis = crohns =

Left LQ (descending colon) Right LQ Right LQ (mouth to anus)

exam 3 - GI - week 5 content Flashcards

(76 cards)