Gastroenterology

Question 1

difficulty/ discomfort with swallowing

Answer 1

Dysphagia

Question 2

pain upon swallowing

Answer 2

Odynophagia

Question 3

various description of “burning” chest pain

Answer 3

Heartburn

Question 4

regurgitation of sour or tasteless fluid

Answer 4

Waterbrush

Question 5

“burping” or gas regurgitation

Answer 5

Eructation

Question 6

rapid abdominal fullness or a hunger satisfaction in the beginning of a meal consumption.

Answer 6

Early Satiety

Question 7

fear of eating (bc it hurts use caution - may be a peptic ulcer, esp in ST)

Answer 7

Sitophobia

Question 8

vomiting blood (Portal HPT when LV is in trouble)

Answer 8

Hematemesis

Question 9

vomitus looks like a coffee grind due to digested blood. (suspect intestinal bleeding that has been oxidized)

Answer 9

Coffee ground emesis

Question 10

bright- bloody stool (indicates either profuse upper GI bleeding or lower GI bleeding (ulcerative cholitis, peptic ulcers in duodenum, etc)

Answer 10

Hematochezia

Question 11

black tarry stool (suggestive of upper GI bleeding)

Answer 11

Melena

Question 12

yellow discoloration of the sclera and skin due to bilirubin (bile pigment) deposition (bc of bilirubin conjugation)

Answer 12

Jaundice/ Icterus (pancreatic cancer or gallstones red flag for jaundice)

Question 13

Itching

Answer 13

Pruritus

Question 14

collection of intra-peritoneal fluid

Answer 14

Ascites

Question 15

transaminases are ____ enzymes

Answer 15

LV (ALT most specific) –(also secretes bile)

Question 16

Bleeding times and clotting factors are specific to the _____

Answer 16

LV

Question 17

Amylase/lipase are ______ enzymes

Answer 17

Pancreatic

Question 18

Gastric Acid/gastrin & Pepsin are ____ digestive enzymes.

Answer 18

ST (

Question 19

several-centimeters-long, circular thickening of smooth muscle that lies inside the anus is known as the _____ ________

Answer 19

Internal sphincter

Question 20

composed of striated voluntary muscle, surrounds the internal sphincter and is controlled by nerve fibers in the pudendal nerve, which is part of the somatic nervous system and therefore under voluntary control

Answer 20

External sphincter

Question 21

_______ innervation occurs through the vagus nerve and nerve fibers from sacral segments of the spinal cord; it increases GI motility.

Answer 21

Parasympathetic innervation

Question 22

_________ innervation/activity occurs through thoracolumbar output from the spinal cord, its paravertebral ganglia, & celiac, superior mesenteric, & inferior mesenteric ganglia. Sympathetic stimulation enhances sphincter fx. & reduces motility by inhibiting the activity of intramural plexus neurons.

Answer 22

Sympathetic

Question 23

GI hormones and their actions chart

Question 24

GI Fx. & D/O’s

Question 25

The Enteric System is composed of the outer myenteric ____________ plexus that is located between the longitudinal and circular layers of smooth muscle cells

Answer 25

(Auerbach) - controls mainly intestinal movements along the length of the gut

Question 26

The Enteric Plexus is composed of two layers: an inner submucosal\_\_\_\_\_\_\_\_\_\_ plexus that lies between the mucosal and circular muscle layers

Answer 26

(Meissner) concerned mainly with controlling the function within each segment of the intestine

Question 27

\_\_\_\_\_\_\_\_\_ is the narrowing of LES and inability to relax the sphincter. S&S - chest pain when eating, weight loss or regurgirtation of food with LES distention

Answer 27

Achalasia - "Rat's tail"

Question 28

Esophageal cancer - no screening test but ________ is a red flag. Barrett's esophagus is a major cause of esophageal cancer (50-80% of cases). Typical patients are male, btwn 40-60 yrs old.

Answer 28

Dysphagia

Question 29

Right Heart Atrium receives blood from ______ (Upper body) &\_\_\_\_\_\_ vena cava (Collects blood from LV & Lower body)

Answer 29

Superior & Inferior Vena Cava (LV)

Question 30

Chronic Hep B, Chronic Hep C, chronic alcoholism, Cirrhosis of the LV, will all eventually develop into ______ \_\_\_\_\_\_

Answer 30

Portal Hypertension

Question 31

\_\_\_\_\_\_ \_\_\_\_\_\_will include vericose veins in esophagus, hemorrhoids, jaundice, ascites, and caput medusa(distended veins surrounding ABD/umbilicus).

Answer 31

Portal Hypertension (Stagnation phenomenon)

Question 32

Ulcers (crater like injury of layers of GI tube - or on skin), can be superficial or deep, ______ \_\_\_\_\_ is so called because of pepsin juice, most common are in the _______ and second most common are in \_\_\_\_\_. 80% are caused by Helicobactor Pylori - (S-shaped bacteria - two C's together) - micro-aerophylic partial pressure of Oxygen - only type to survive in gastric juices.

Answer 32

Peptic ulcers; most common in Duodenum and 2nd most common in Stomach.

Question 33

Gastric juice is a type of \_\_\_\_-\_\_\_\_\_ immune system that just kills due to non-specific PH and amount of hydrogens dissolved. Secretes Urease to create large amount of ammonia poison and injures barrier of GI tract mucosal barrier.

Answer 33

non-specifc immune

Question 34

Abuse of Non-steroidal anti-inflammatory drugs, steroids inflammatory drugs, and some also beleive stress caused Hypoxia can be other 20% cause of _____ \_\_\_\_\_

Answer 34

peptic ulcers

Question 35

Pain upon eating = ______ ulcers - Sytophobia aka fear of eating because painful

Answer 35

Gastric ulcers - food rubs against wounds in stomach causing pain upon eating - want to eat but can't because pain

Question 36

Alleviated by eating = ________ ulcers, bolus of food is being mismatched with HCL acid and being absorbed. Pain goes away.

Answer 36

Duodenal

Question 37

Most common gastric cancer type is \_\_\_\_\_\_\_\_\_\_\_

Answer 37

Adenocarcinoma

Question 38

anorexia, weight loss, abdominal pain, vomiting, anemia, hemorrhage, altered bowel habits - RED FLAG FOR MEDICAL REFERRAL for what type of cancer? . _Common metastasis_: left supra-clavicular lymph node (**_Virchow’s node_**), ovaries - grading needed to determine type Krukenberg’s tumor will show path from Stomach to 2nd stage in Ovaries.

Answer 38

Gastric Cancer - associated with Virchow’s node over ST 12 area. Mostly developed by males in 30-40's.

Question 39

is twisting of the gut upon itself or upon a narrow mesenteric pedicle. It may be acute and complete or chronic and intermittent. Midgut ______ is the most common form.

Answer 39

volvulus

Question 40

\_\_\_\_\_\_\_\_ is a condition in which one part of the intestine tunnels (is “telescoping” into an adjoining section.

Answer 40

Intussusception - newborns, seniors or very ill will suffer this. Red Jelly in poop is a sign.

Question 41

Most common surgical emergency is \_\_\_\_\_\_

Answer 41

Appendicitis