Gastric System Flashcards

Aoife

1
Q

Describe ingestion

A

food is taken in through the mouth

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2
Q

Describe the process of mechanical digestion

A

large pieces of food broken into smaller pieces by chewing. also in stomach when food churned and mixed

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3
Q

Describe process of chemical digestion

A

the breakdown/hydrolysis of food molecules by water and digestive enzymes

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4
Q

Describe movements

A

Peristalsis propels food through digestive tract

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5
Q

Describe absorption

A

Food molecules pass through lining of small intestine into blood/lymph capillaries

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6
Q

Describe elimination

A

Food molecules that cant be digested/absorbed are eliminated from the body in the form of faeces

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7
Q

What are proteins broken into

A

Amino acids

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8
Q

What are fats broken into

A

Fatty acids and glycerol

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9
Q

What are carbohydrates broken into

A

Glucose

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10
Q

Function of Mouth

A

Saliva moistens food and begins to breakdown starch

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11
Q

Function of Oesophagus

A

Peristalsis moves food to stomach

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12
Q

Function of Stomach

A

Produces acid and enzymes

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13
Q

Function of Pancreas

A

Produces enzymes that metabolise food (small intestine)

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14
Q

Function of Liver

A

Produces bile that digests fats and vitamins

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15
Q

Function of Gallbladder

A

Stores bile

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16
Q

Function of Small Intestine

A

Produces digestive juices which mix with bile and pancreatic enzymes to breakdown proteins, carbs and fats. Absorption of water

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17
Q

Function of Large Intestine

A

Water absorption, Vitamin K production and where excess waste becomes stool

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18
Q

MUMPS
description

A

an acute viral disease

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19
Q

MUMPS
characterised by?

A

Swelling of the parotid salivary glands

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20
Q

MUMPS
age group most common in?

A

childhood/adolescence
(5-15 years)

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21
Q

MUMPS
when is mumps more severe?

A

In adults if onset is delayed

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22
Q

MUMPS
what has made mumps less common?

A

MMR vaccine

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23
Q

MUMPS
signs & symptoms (5)

A
  • painful swelling in side of face, under ears
  • headaches
  • joint pain
  • fever
  • dysphagia (difficulty swallowing)
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24
Q

MUMPS
diagnosis

A
  • visual in GP
  • clinical examination of saliva for IgM
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25
Q

How is mumps spread?

A

Spread via droplets

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26
Q

When are mumps contagious?

A

Contagious before and after symptoms

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27
Q

MUMPS
complications

A
  • may affect other tissues (joints, pancreas, myocardium, kidneys)
  • meningitis
  • orchitis infertility in males
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28
Q

MUMPS
treatment

A

Symptom relief

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29
Q

How long until mumps infection passes?

A

1-2 weeks

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30
Q

MUMPS
prognosis- immunity?

A

Immunity usually lifelong

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31
Q

When does GORD develop?

A

When backflow of stomach contents causes troublesome symptoms

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32
Q

What is the development of GORD due to?

A

Dysfunction of the lower oesophageal sphincter

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33
Q

GORD
symptoms (2)

A
  1. heartburn
  2. acid regurgitation
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34
Q

GORD
causes & risk factors (4)

A
  1. obesity
  2. preganancy
  3. gastroparesis (delayed emptying of stomach contents)
  4. diseases of connective tissue (RA, scleroderma, lupus)
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35
Q

What is GORD exacerbated by? (4)

A
  1. Smoking
  2. High fat foods, chocolate, coffee, alcohol
  3. eating shortly before bed
  4. medications (aspirin)
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36
Q

GORD
treatments (5)

A
  1. Antacids: neutralise acid in stomach and oesophagus
  2. H2 Blockers: reduces acid in stomch by blocking acid secretion in stomach
  3. Proton Pump Inhibitors: reduce stomach acid by blocking protein that makes stomach acid
  4. Surgery: severe cases
  5. Lifestyle Changes: stop smoking, change diet, no aspirin etc
37
Q

GORD
complications (4)

A
  1. Oesophageal Ulcer: caused by acid
  2. Oesophageal Stricture
  3. Barrett’s Oesophagus
  4. Lung Problems: due to inadvertent aspiration of stomach contents
38
Q

Barrett’s Oesophagus

What is Barrett’s Oesophagus sometimes a complication of?

A

GORD/GERD

39
Q

Barrett’s Oesophagus

Risk factors (7)

A

overlap with GORD:
1. obesity
2. pregnancy
3. gastroparesis
4. diseases of connective tissue
different:
5. family history
6. being male
7. being Caucasian

40
Q

Barrett’s Oesophagus

What is the tissue change in the lining of the oesophagus?

A

Squamous cells to columnar cells

41
Q

Barrett’s Oesophagus

Metaplasia definition

A

The conversion of one cell type to another

42
Q

Barrett’s Oesophagus

Dysplasia defintion

A

The transformation of a cell into an abnormal version of itself

43
Q

Barrett’s Oesophagus

What does dysplasia increase the risk of?

A

Adenocarcinoma (type of cancer that starts in mucous producing/glandular cells)

44
Q

Barrett’s Oesophagus

What do 3-13% of patients develop?

A

Oesophageal cancer

45
Q

Barrett’s Oesophagus

Symptoms? (4)

A
  1. heartburn
  2. regurgitation of stomach contents
  3. dysphagia
  4. chest pain (less common)
46
Q

Barrett’s Oesophagus

Treatment (2)

A
  1. daily Proton Pump Inhibitors
  2. therapy to destroy dysplasia
47
Q

Barrett’s Oesophagus

Diagnosis (2)

A
  1. OGD: OesophoGealDuodenoscopy
  2. Biopsy
48
Q

Achalasia

Description?

A

People with achalasia have dysfunction of the oesophageal muscles and their lower oesophageal sphincter fails to open

49
Q

Achalasia

Symptoms (5)

A
  1. Progressive dysphagia
  2. Regurgitation
  3. Heartburn
  4. Chest pain
  5. Weight loss (due to difficulty consuming foods)
50
Q

Achalasia

Causes (5)

A
  1. Nerve damage
  2. Viral infection
  3. Toxin exposure
  4. Autoimmune disease
  5. Genetic
51
Q

Achalasia

Diagnosis (4)

A
  1. Manometry: tube inserted into oesophagus to measure pressure applied along oesophagus
  2. Barium swallow and x-ray
  3. Endoscopy eg: OGD
  4. Biopsy
52
Q

Achalasia

Treatment (4)

A

No cure, only supportive treatments:
1. Medicines: relaxants (eg: nitrates) for oesophageal muscles, short lived symptom relief
2. Stretching muscle through dilation with a balloon, multiple treatments needed for long lived symptom relief
3. Surgery: Heller’s Myotomy: muscle fibres of lower oesophageal sphincter cut, disadvantage: acid reflux
4. Botox injection into muscle

53
Q

Stomach Disorder Terminology

Gastritis

A

Inflammation of the stomach

54
Q

Stomach Disorder Terminology

Anorexia

A

Chronic loss of appetite

55
Q

Stomach Disorder Terminology

Nausea

A

Unpleasant feeling that may lead to vomiting

56
Q

Stomach Disorder Terminology

Emesis

A

Vomiting

57
Q

Gastritis

Gastritis is the general term to describe what?

A

inflammation of the lining of the stomch

58
Q

Gastritis

Causes (4)

A
  1. Infection
  2. Use of pain relievers aspirin, ibuprofen
  3. Alcohol abuse: irrates and erodes stomach lining
  4. Autoimmune gastritis: seen in Hashimoto’s Disease, T1DM
59
Q

Gastritis

The onset can be both??

A

Acute or chronic
eg. acute: food poisoning

60
Q

Gastritis

Symptoms (4)

A
  1. Indigestion
  2. Nausea
  3. Emisis: vomiting
  4. Feeling of fullness in upper abdomen after eating
61
Q

Gastroparesis

What is gastroporesis?

A

Delayed gastric emptying

62
Q

Gastroparesis

Most common cause?

A

Diabetes

63
Q

Gastroparesis

What does the delayed gastric emptying do to the flow of food?

A

Slows/stops flow of food to small intestine through pyloric sphincter

64
Q

Gastroparesis

Symptoms (4) (same as gastritis)

A
  1. Indigestion
  2. Nausea
  3. Emesis
  4. Feeling of fullness in upper abdomen after eating
65
Q

Gastric Ulcers

What are gastric ulcers?

A

Open sores that develop on lining of stomach

66
Q

Gastric Ulcers

Symptoms (4)

A
  1. Indigestion
  2. Heartburn
  3. Nausea
  4. Asymptomatic - open sore = blood in stool
67
Q

Gastric Ulcers

Causes (2)

A
  1. Helicobacter pylori
  2. NSAID use: aspirin, ibuprofen
68
Q

Gastric Ulcers

Risk factors for H. pylori infections (5)

A
  1. low socio economic background
  2. geography: high rates in developing world
  3. hygiene
  4. non filtered water
  5. high meat/fish content diet
  6. smoking
69
Q

Gastric Ulcers

Risk factors for development of H.pylori ulcers (5)

A
  1. Diet: too much sugar/fat/acidic foods/spicy foods
  2. Alcohol
  3. Smoking
  4. Family history
  5. Age
70
Q

Gastric Ulcers

Diagnosis- to visually detect

A

OGD

71
Q

Gastric Ulcers

Diagnosis- Micro Methods (5)

A
  1. Antigen tests: presence/absence of antigens specific to bacterium in stool sample
  2. Urea breath test: breathe into 2 tubes, H.pylori breaks up substance (urea C13) if present
  3. Culture/ sensitivity: biopsy placed in special culture medium & grown in special conditions
  4. PCR: stool sample, detection of genes specific to bacterium, ability to detect resistance to antibiotics
  5. Serology: detection of IgM antibodies specific to bacterium
72
Q

Gastric Ulcers

Diagnosis- Histo Method

A

Staining of biopsy

73
Q

Gastric Ulcers

Treatment (2)

A
  1. Antibiotics -> Clarithromycin and Amoxicillan
  2. PPIs
74
Q

Gastric Ulcers

Why is antibiotic resistance a concern in the diagnosis??

A

Treatment failures after receiving Clarithromycin, limited choices then, have to do susceptibility testing = biopsy

75
Q

Gastric Ulcers

Complications (5)

A
  1. Bleeding: most common
  2. Perforation: hole forms through stomach
  3. Penetration: ulcer/perforation continues to adjacent organs/ tissues
  4. Obstruction: cycles of inflammation= scarring = pyloric stenosis
  5. Cancer: most commonly adenocarcinoma
76
Q

Coeliac Disease

Description

A

A digestive problem where the SI can’t absorb nutrients due to it becoming inflamed

77
Q

Coeliac Disease

Symptoms (8)

A
  1. Diarrhoea
  2. Abdominal pain & cramps
  3. Bloating
  4. Indigestion & Constipation
    Systemic symptoms:
  5. Tiredness -> malnutrition
  6. Weight loss
  7. Rash
  8. Nerve damage
78
Q

Coeliac Disease

Causes (2)

A
  1. Autoimmune: immune system mistakes substances found in gluten as threat & attacks them
  2. Damage to intestines: affects ability to absorb nutrients from food
79
Q

Coeliac Disease

What is the genetic component of the autoimmunity demostrated by??

A

The dependence of certain halotypes

80
Q

Coeliac Disease

What are halotypes?

A

A set of DNA variations that tend to be inherited together

81
Q

Coeliac Disease

What do the halotypes affect?

A

Genes of white blood cells that distinguish between self and non self cells

82
Q

Coeliac Disease

Diagnosis- Histo

A

Biopsy examined using different stains forpresence/absence of villi destruction commonly seen in Coeliacs Disease

83
Q

Coeliac Disease

Diagnosis- Biochem/Immunology

A

Blood serum analysed for antibodies specific to Coeliac Disease
eg. anti-TGA

84
Q

Coeliac Disease

What do worldwide rates mirror?

A

Spread of wheat consumption

85
Q

Coeliac Disease

Complications (6)

A
  1. Malnutrition: insufficient absorption of nutrients
  2. Bone weakening: insufficient absorption of calcium & Vit.D
  3. Infertility & miscarraige
  4. Lactose intolerance: damage to SI
  5. Cancer: intestinal lymphoma and cancer of SI
  6. Spleen disorders: reduced immunity
86
Q

Coeliac Disease

Treatment

A

Exclude foods w/ gluten

87
Q

Coeliac Disease

What may be the problem if a gluten free diet does not work?

A

Patient has Refractory Coeliac Disease

88
Q

Coeliac Disease

Treatment of refractory coeliac disease

A

Medicines to reduce inflammatory response -> steriods

89
Q

Coeliac Disease

Cause of Refractory coeliac disease (5)

A
  1. Inadvertant gluten contaminations
  2. Microscopic colitis
  3. Bacterial overgrowth of small bowel
  4. Lactose intolerance
  5. Bowel disorders