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Pathophysiology > Final: Ch 29 Disorders of GI Function > Flashcards

Final: Ch 29 Disorders of GI Function Flashcards

(94 cards)

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1
Q

dysphagia definition and causes

A

difficulty swallowing

narrowing of esophagus (scarring, cancer)

CNS lesions of swallowing nerves

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2
Q

Dx of dysphagia

A

Dx: endoscopy w/ barium

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3
Q

3 phases of dysphagia

A

1: neuromuscular disorder
2: pharyngeal phage/transport phase
3: esophageal phase/peristalsis

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4
Q

esophageal diverticula

A

weaknesses in the wall retain food

inflammation & ulceration result

requires surgery

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5
Q

esophageal laceraion

A

tear in mucosa

caused by severe vomiting

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6
Q

hiatal hernia

A

stomach protrudes through diaphragm

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7
Q

sliding HH

A

herniation at GE junction

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8
Q

para-esophageal HH

A

separate gastric pouch herniated

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9
Q

GERD

A

gastric contents enter esophagus through weak esophageal sphincter

esophageal mucosa injured

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10
Q

symptoms of GERD (heartburn)

A

heartburn 30-60min after eating (severe)

heartburn worse when bending/lying down

can produce chest pain or trigger asthma

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11
Q

other symptoms of GERD

A

mucosal injury can cause erosion or stricture

barrett’s esophagus (squamous epithelium replaced by columnar)

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12
Q

diagnosis of GERD

A

history

barium swallow

endoscopy

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13
Q

treatment of GERD

A

avoid large meals, fat, caffeine, and alcohol

antacids, proton pump inhibitors

histamine-2 receptor blockers

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14
Q

esophageal cancer

A

squamous cell or adenocarcinoma

squamous cell from alcohol/smoking

adenocarcinoma starts with barrett’s esophagus

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15
Q

treatment for esophageal cancer

A

surgery if early stage

radiation/chemo for late stage

poor prognosis

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16
Q

acute gastritis

A

acute inflammation caused by meds (NSAIDS), alcohol, or bacterial toxins

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17
Q

chronic gastritis

A

chronic inflammation –> atrophy of glandular epithelium

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18
Q

most common cause of chronic gastritis

A

H pylori gastritis

difficult to cure

treat with antibiotics and proton pump inhibitors

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19
Q

autoimmune gastritis

A

Ab vs. parietal cells and IF (intrinsic factor)

accompanies type 1 DM & hashimoto’s thyroiditis

lack of IF –> vit b12 deficiency

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20
Q

peptic ulcer disease can be ______ or _______

A

gastric or duodenal

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21
Q

peptic ulcer disease can penetrate ______ only or enter the ________ muscle

A

mucosa, smooth muscle

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22
Q

risk factors for peptic ulcer disease

A

H pylori

NSAIDS

aspirin

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23
Q

infection in duodenal disease

A

bacteria cause inflammation –> cytokines –> damage mucosa

acid production is increased

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24
Q

NSAIDS in peptic ulcer disease

A

inhibit prostaglandins –> mucosal injury

less gastric irritation if use selective COX-2 inhibitors (celebrex)

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25
clinical presentation of peptic ulcer disease
pain when the stomach is empty hemorrhage b/c of erosion of arteries or veins --> tarry stool or coffee grounds emesis perforation -- peritonitis
26
Dx of peptic ulcer disease
H&P X-ray w/ contrast endoscopy
27
treatment of peptic ulcer disease
antacids proton pump inhibitors H2 receptor antagonists surgery for bleeding
28
Zollinger-Ellison syndrome
ulcers from gastrin-secreting tumor most tumors in the pancreas
29
stress ulcers
seen with burns, sepsis, ARDS
30
stomach cancer is the __ most common worldwide
2nd
31
what increases risk for stomach cancer
eating smoked meat H pylori infection
32
most stomach cancer is in which regions
pyloric antrum irregularly shaped
33
symptoms of stomach cancer
pain weight loss N/V asymptomatic until late stage
34
Dx/Rx of stomach cancer
Dx: x-ray w/ contrast, endoscopy w/ biopsy Rx: subtotal gastrectomy
35
irritable bowel syndrome symptoms
recurrent abdominal pain n/v bloating farting, altered bowel movements
36
causes of IBS
poor nervous regulation abnormal contractions due to stress
37
Dx of IBS
based on S&S continuous or recurrent symptoms for > 12 wks in a year 2/3 of: relief w/ pooping, onset associated w/ change in frequency, onset w/ change in stool appearance
38
Rx of IBS
reduce stress avoid fatty foods, alcohol, antispasmotic meds
39
inflammatory bowel disease includes
Crohn's disease ulcerative colitis
40
common features of inflammatory bowel disease
inflammation of large bowel w/ no cause or family pattern remissions & exacerbations
41
areas of Crohn's disease
distal SI proximal colon
42
areas of ulcerative colitis
descending colon rectum
43
pathogenesis of inflammatory bowel disease
genetics environment immune response microbes
44
Crohn's disease
small/large bowel inflammation demarcated lesions surrounded by normal mucosa (skip lesions) submucosa affected mucosa has cobblestone appearance (fissures surrounded by edema)
45
symptoms of Crohn's disease
pain, diarrhea, weight loss, electrolyte imbalances fistula, abscess, obstruction
46
Dx of Crohn's disease
sigmoidoscopy w/ biopsy CT H&P
47
Rx of Crohn's disease
anti-inflammatory meds immunosuppressant meds surgical resection
48
ulcerative colitis
inflammation of colon only - begins in rectum and spreads proximally mostly impacts mucosa - pinpoint hemorrhages
49
symptoms of ulcerative colitits
relapsing attacks of severe diarrhea - bloody stool/mucus incontinence anorexia weakness
50
Dx of ulcerative colitis
sigmoidoscopy H&P
51
Rx of ulcerative colitis
avoid caffeine, lactose, spicy foods anti-inflammatory meds colectomy
52
complications of ulcerative colitis
colon cancer
53
infectious enetocolitis
viral, bacterial, protozoal spread person to person in food
54
viral infectious enterocolitis
rotavirus protection from nursing diarrhea causes dehydration in infants use supportive management vaccinate
55
bacterial infectious enterocolitis
clostridium, E. coli, salmonella, C. difficile some invasive, some non-invasive 2ndary to Antibiotic therapy severe and life-threatening dehydration
56
diverticular disease
colon mucosa herniates through submucosa in multiple places lack of fiber and inactivity
57
longitudinal muscle of colon is not continuous... (diverticular disease)
3 bands called teniae coli places where blood vessels penetrate circular muscle are weak spots for herniations
58
symptoms of diverticular disease
pain, diarrhea, constipation, bloating, farting
59
complications of diverticular disease
perforation bleeding obstruction fistula
60
Dx of diverticular disease
H&P CT barium enema
61
Rx of diverticular disease
stop solid food during acute attack increase bulk in diet
62
appendicitis
inflamed appendix -- possibly gangrenous abrupt onset of localized pain, signs of infection, rebound tenderness
63
Dx/Rx of appendicitis
H&P, ultrasound, CT removal
64
complications of appendicitis
peritonitis abscess systemic sepsis
65
acute diarrhea
less than 2 wks duration inflammatory or non-inflammatory
66
non-inflammatory acute diarrhea
large volume of watery stool b/c bacterial toxins E. coli, S. aureus, vibro cholerae
67
inflammatory acute diarrhea
small volume of bloody stool & fever b/c bacterial infection salmonella
68
chronic diarrhea
more than 4 wks duration osmotic - lactose intolerance/excess magnesium salts secretory - bile salts not reabsorbed in SI inflammatory - inflammatory bowel disease treat w/ oral rehydration
69
causes of constipation
neurologic (MS parkinson's) endocrine (hypothyroidism) drugs (narcotics, anticholinergics, Ca channel blockers, diuretics)
70
treatment of constipation
treat cause hydrate exercise dont use laxatives/enemas
71
fecal impaction
hard stool in rectum that interferes with pooping multiple causes that progress from constipation digital or sigmoidoscopy dis-impaction
72
intussusception
telescoping of bowel usually terminal ileum enters colon common in kids > adults
73
volvulus
bowel twists on axis usually cecum or sigmoid colon
74
inguinal hernia
SI enters defect may strangulate
75
paralytic ileus
neurological disease or post surgical
76
mass
bowel cancer
77
symptoms of intestinal obstruction
abdominal distention fluid loss n/v severe pain
78
complications of intestinal obstruction
perforation peritonitis sepsis
79
treatment of intestinal obstruction
NG suction w/ IV fluids surgery
80
peritonitis
inflammation of the peritoneum due to bacteria or chemicals gut perforation
81
peritonits causes
massive fluid loss --> hypovolemic shock
82
treatment of peitonitis
NPO NG suction fluid resuscitation fix perforation
83
malabsorption syndrome
poor fat absorption --> fat in stool pancreatic or hepatic insufficiency mucosal lesions lymphatic obstruction
84
celiac disease
autoimmune disorder triggered by gluten inflammation damages villi --> less absorption surface
85
celiac is more common in people with
type 1 DM other autoimmune disorders increases risk for cancer
86
symptoms of celiac
infancy w/ diarrhea and FTT malnutrition
87
diagnosis/treatment of celiac
Dx: biopsy, measure Ab Rx: don't eat gluten
88
adenomatous polyps
benign growths from intestinal mucosal epithelium crypt cells proliferate --> abnormal --> adenoma 1/2 in rectum or sigmoid
89
tubular adenoma
some dysplasia only --> unlikely to progress to cancer
90
villous adenoma
broader more diffuse lesion more likely to progress to cancer
91
colorectal cancer
3rd most common cancer, 2nd leading cause of death familial risk and high risk for those with inflammatory bowel disease high fat diet and bacterial infection increases risk
92
familial adenomatous polyposis increases risk for what
colorectal cancer
93
what protects vs. colorectal cancer
aspirin
94
Dx/Rx of colorectal cancer
Dx: screening - DRE, fecal occult blood test, colonoscopy Rx: surgical removal

Pathophysiology (24 decks)

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