Exam 4

Question 1

What is the basic pathophysiology of ileus?

Answer 1

Obstruction of the intestines

Small intestine is more common due to a narrower lumen

Question 2

What are the manifestations of small intestine obstructions?

Answer 2

Colicky pains, nausea, vomiting

Question 3

What are the manifestations of large intestine obstruction?

Answer 3

Hypogastric pain, abdominal distention

Question 4

What are the manifestations of obstruction at the pylorus?

Answer 4

Early, profuse vomiting of clear gastric fluid

Question 5

What are the manifestations of obstruction in the lower small intestine?

Answer 5

Pronounced distention, vomiting may occur later with fecal material

Question 6

What is gastritis?

Answer 6

Inflammation of the gastric mucosa

Question 7

What are the manifestations of acute gastritis?

Answer 7

Abdominal discomfort, bleeding, epigastric tenderness

Question 8

What is PUD?

Answer 8

A break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum

Question 9

What are the manifestations of duodenal ulcers?

Answer 9

Epigastric pain, pain-food-relief pattern

Question 10

What are the manifestations of gastric ulcers?

Answer 10

Pain-food-relief, pain immediately after eating, more chronic, anorexia, vomiting, weight loss

Question 11

What is dumping syndrome?

Answer 11

Rapid emptying of chyme from a surgically created residual stomach into the small intestine

Question 12

What is maldigestion?

Answer 12

Failure of the chemical process of digestion

Question 13

What is malabsorption?

Answer 13

Failure of the intestinal mucosa to absorb digested nutrients

Question 14

What are the manifestations of vitamin deficiencies?

Answer 14

A: night blindness, D: decreased calcium absorption, K: prolonged prothrombin time, E: testicular atrophy

Question 15

What is ulcerative colitis?

Answer 15

Causes ulceration of the colonic mucosa, lesions are continuous, limited to mucosa, not transmural

Question 16

What is Crohn’s disease?

Answer 16

Idiopathic inflammatory disorder affecting anywhere from mouth to anus, inflammation in skipped lesions affecting entire intestinal wall

Question 17

What is diverticular disease?

Answer 17

Herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon

Question 18

Diverticula

Answer 18

herniations of mucosa through the muscle layers of the colon wall, especially the sigmoid colon

Example sentence: Diverticula can lead to diverticulitis if inflamed.

Question 19

Diverticulosis

Answer 19

a symptomatic diverticular disease

Question 20

Diverticulitis

Answer 20

inflammatory stage of diverticular

Example sentence: Diverticulitis can cause abscess formation.

Question 21

Appendicitis

Answer 21

Inflammation of the vermiform appendix

Example sentence: Appendicitis can present with RLQ pain.

Question 22

IBS

Answer 22

Functional GI disorder characterized by recurrent abd pain associated with altered bowel habits that present as diarrhea or constipation or both

Question 23

Portal hypertension

Answer 23

High blood pressure in the portal venous system is caused by resistance to portal blood flow. High pressure in the portal veins causes collateral vessels to open between the portal veins and systemic veins.

Example sentence: Portal hypertension can lead to varices.

Question 24

Ascites

Answer 24

Accumulation of fluid in the peritoneal cavity

Example sentence: Ascites can be caused by cirrhosis.

Question 25

Hepatic encephalopathy

Answer 25

Accumulation of toxins related to liver failure, causing a disruption of neurotransmission ## Footnote Example sentence: Hepatic encephalopathy can lead to confusion.

Question 26

Jaundice

Answer 26

Yellow pigmentation of the skin caused by hyperbilirubinemia ## Footnote Example sentence: Jaundice can be caused by gallstones.

Question 27

Hepatitis

Answer 27

types and stages, basics of each type ## Footnote Example sentence: Hepatitis B is transmitted through contact with infected blood.

Question 28

Cirrhosis

Answer 28

Irreversible inflammatory fibrotic disease that disrupts liver function and even liver structure. Decreased hepatic function from fibrosis, biliary channels become obstructed and cause portal hypertension, and then blood is shunted away from the liver and hypoxic necrosis develops. ## Footnote Example sentence: Cirrhosis can be caused by alcohol abuse.

Question 29

Cholelithiasis

Answer 29

gallstone formation ## Footnote Example sentence: Cholelithiasis can present with RUQ pain.

Question 30

Cholelithiasis

Answer 30

Gallstone formation ## Footnote Cholesterol stone: forms in bile that is supersaturated with cholesterol Pigmented stone: - Black: formed in sterile environment and are composed of calcium bilirubinate polymer from hyperbilirubinemia - Brown: associated with bacterial infection of the bile ducts with formation of stone that is composed to calcium soaps, unconjugated bilirubin, cholesterol, fatty acids, and mucin. Manifestations: RUQ pain, intolerance to fatty foods, + Murphy sign, biliary colic, jaundice, fever, common complication is pancreatitis.

Question 31

Cholecystitis

Answer 31

Inflammation of the gallbladder ## Footnote Manifestations: fever, leukocytosis, Murphy’s sign, increased pain with fatty meal, abd muscle guarding.

Question 32

Pancreatitis

Answer 32

Inflammation of the pancreas ## Footnote Patho: injury or damage to pancreatic cells and ducts, causing a leakage of pancreatic enzymes into the pancreatic tissue. These enzymes cause autodigestion of pancreatic tissue and leak into the bloodstream to cause injury to blood vessels Acute: resolves spontaneously, epigastric pain, N/V, fever, leukocytosis, elevated amylase and lipase Chronic: repeated exacerbations of acute can lead to chronic changes usually from alcoholism; destroys acinar cells and the islets or Langerhans, risk factor for pancreatic cancer. Manifestations: continuous or intermittent pain, associated with increased intra-ductal pressure, increased tissue pressure, ischemia, neuritis, changes in central pain perception, weight loss, steatorrhea.

Question 33

Splenomegaly

Answer 33

Enlargement of the spleen ## Footnote - Portal hypertension contributes to congestive splenomegaly by increasing intrasplenic blood pressure - Decreased platelet count is the most common manifestation.

Question 34

Cancers of GI tract basics

Answer 34

Esophageal cancer: alcohol and tobacco use concurrently, GERD --> Barrett’s esophagus can predispose Gastric: associated with H pylori, symptoms develop only after tumor has penetrated the wall of the stomach Colon cancer: - Tumors of right ascending colon: large and bulky - Tumors of left descending, sigmoid develop as small button-like masses and stool is pencil shaped. Manifestations: pain, bloody stools, and change in bowel habits Pancreatic: risk is heavy cigarette smoking, high mortality rate, s/s may not be evident until the tumor has spread to surrounding tissues.