Exam 5 part 1 Flashcards
(31 cards)
Achalasia
failure of the lower esophageal sphincter to relax due to loss of nerve innervation
congenital atresia
developmental disorder in which the upper and lower esophagus are not connected surgical correction
stenosis
narrowing of the esophagus may be developmental or acquired defects (fibrosis associated with chronic inflammation or ulceration)
Diverticulum
undigested food becomes trapped in a blind pouch - causes bad breath
Tumor
compression or blockage
s/s of dysphagia
pain in swallowing
inability to swallow large pieces of solids
difficulty swallowing liquids
common causes of acute gastritis
Aspirin (breaks lining)
NSAID (breaks lining)
Alcohol (increases release of gastric juice)
Chemotherapy (breakdown mucus barrier)
Gastric radiation (breakdown mucus barrier)
Acute gastritis
gastric mucosa is inflamed, red and edematous; may be ulcerative / bleeding -> is transient and self limiting in nature. Few days to recover
Chronic Gastritis
- Chronic inflammatory changes to the mucosa
- atrophy of the gastric mucosa with loss of secretory glands
- can cause permanent damage to stomach wall
3 types of chronic gastritis
Helicobacter pylori gastritis (most common)
Autoimmune gastritis
Chemical gastropathy
Helicobacter pylori gastritis
Produce substances that neutralizes the acid pH of the stomach
Treatment: Antibiotics and proton pump inhibitor
Autoimmune gastritis
auto antibodies against parietal cells and intrinsic factor
- Defect in acid secretion and Vit B12 deficiency
- pernicious anemia
Chemical gastropathy
due to reflux of alkaline duodenal content
main cause of gastric ulcers
h. pylori and aspirin/NSAID
gastric ulcers treatments
Getting rid of H.Pylori, proton pump inhibitors, avoiding NSAID
2 types of IBD
crohn’s disease and ulcerative colitis
crohn’s
- Affects any region of the gastrointestinal tract from mouth to anus (usually distal small intestine and proximal colon)
- transmural inflammation (effects all layers) -> lumen narrows and can cause complete occlusion
- scarring of intestine resulting in blockage
- affects submucosa most
- colorectal cancer
- exacerbations/remission
- fistulas
- inability to digest and absorb food
ulcerative colitis
- confined to colon and rectum
- inflammation is only in mucosa (innermost layer)
- Tissue becomes edematous and ulcers develop.
- Tissue bleeds easily
- Tissue destruction interferes with absorption of fluid and electrolytes
- Long term complication: colorectal carcinoma
Treatment for IBD
- Anti-inflammatory medications
- Anticholinergic medications (decreases gastric motility: diarrhea)
- Nutritional supplements during acute episodes; deal with malnutrition
- Antimicrobials
- Surgery: ileostomy or colostomy
clostridium difficile colitis
- Occurs when normal flora balance in LI is disrupted
- Acquisition and germination of the spores and overgrowth of the bacillus and toxin production
- Oral-fecal route
- Bind to and damages the mucosa layer -> inflammation and hemorrhage
- Antibiotic therapy makes the LI susceptible of infection, colonization by C. Diff
- C. Diff usually acquired in hospitals
Clostridium Difficile Colitis; S/S
- Diarrhea, fever, loss of appitite
- Abdominal cramping
- s/s starts 1-2 weeks after antibiotic treatment
Treatment for Clostridium Difficile Colitis;
- Stop antibiotic treatment
- Metronidazole and vancomycin
- Fecal transplant aka Fecal bacteriotherapy
- Had it once 20% chance of getting it again, had it twice 50% chance of getting it again
Enterocolitis
Caused by a number of microbes including viruses, bacteria and protozoa. -> contaminated food/water
Enterocolitis s/s
- Diarrhea
- Abdominal pain
- Ulcerations
- hemorrhage
