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Advanced Pathology > Gastrointestinal Disorders- Notes from Slideshow (Quiz 4) PART 2 > Flashcards

Gastrointestinal Disorders- Notes from Slideshow (Quiz 4) PART 2 Flashcards

1
Q

Impermeable epithelial cell surface

A

Gastric Mucosal Barrier

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2
Q

Function of the Gastric Mucosal Barrier

A

Mechanisms for selective transport of hydrogen & bicarbonate ions

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3
Q

What protects the gastric mucosa?

A

Mucus

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4
Q

What types of mucus are there?

A
  • water insoluble

- water soluble

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5
Q

Thin, stable gel that adheres to gastric mucosal surface

A

water insoluble mucus

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6
Q

What is the function of water insoluble mucus?

A

protection from proteolytic (protein-digesting) pepsin

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7
Q

How does insoluble mucus protect from pepsin?

A
  • Forms unstirred layer
  • traps bicarbonate
  • forms an alkaline interface b/w luminal contents of stomach & its mucosal surface
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8
Q

Where does water soluble mucous come from

A

washed from mucosal surface

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9
Q

What makes up water soluble mucous?

A

luminal contents

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10
Q

What is the function of water soluble mucous?

A

prevents mechanical damage to mucosal surface

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11
Q

How does water soluble mucous prevent damage?

A
  • viscid nature

- lubricant

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12
Q

Major causes of Gastric Irritation & Ulcer Formation

A
  • NSAIDS/asparin

- H. Pilori

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13
Q

How do NSAIDS/asparin cause gastric iratation and ulcers?

A
  • Irritate gastric mucosa

- inhibit prostaglandin synthesis

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14
Q

What do prostaglandins produce?

A

Hcl

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15
Q

How does H. Pylori cause gastric irritation and ulcers?

A
  • Thrives in acidic environment of stomach

- Disrupts mucosal barrier that protects stomach from harmful effects of its digestive enzymes

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16
Q

Pathophysiology of H. Pylori in stomach

A
  • Low Hcl lowers pH
  • Mucin forms gel
  • Mucin transitions from gal to solid
  • H. Pylori can then swim freely through mucus
  • Attaches to epithelia cells
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17
Q

Types of Gastritis

A
  • Acute

- Chronic

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18
Q

Transient inflammation of gastric mucosa

A

Acute gastritis

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19
Q

What causes Acute gastritis?

A

Local irritants such as

  • bacterial endotoxins
  • alcohol
  • aspirin
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20
Q

Absence of grossly visible erosions & presence of chronic inflammatory changes

A

Chronic Gastritis

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21
Q

Complication of Chronic Gastritis

A

atrophy of glandular epithelium of stomach

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22
Q

Types of Chronic Gastritis

A
  • H. pylori
  • Autoimmune
  • Multifocal atrophic
  • Chemical gastropathy
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23
Q

Symptoms of Chronic Gastritis

A
  • abdominal pain with gnawing sensation
  • pain often made worse w empty stomach
  • night time pain
  • poor apatite
  • weight loss
  • heart burn
  • dyspepsia
  • belching
  • N&V
  • blood in stool
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24
Q

What is dyspepsia

A

indigestion

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25
Disorders of the small and large intestine
- Irritable Bowel Syndrome - Inflammatory Bowel Disease - Crohn’s & UC - Appendicitis - Infectious Enterocolitis - Viral, Bacterial, Protozoan - Diverticular Disease - Intestinal Motility - Malabsorption Syndrome - Celiac Disease (Celiac Sprue) - Adenomatous Polyps
26
Normal anatomy of the large intestine- be able to identify location
- Appendix - cecum - where small intestine attaches - taenia - hepatic flexure - diverticula - splenic flexure - haustra - ascending colon - transverse colon - descending colon - sigmoid colon
27
Intestinal disorder causing functional issues but no structure abnormality defined by symptoms.
IBS
28
Cause of IBS
- isn't well understood | - can be caused by abnormal contractions in muscular layer of bowel
29
How is diagnosis of IBS made?
based on symptoms
30
Symptoms of IBS
- Abdominal pain (persistent, intermittent, cramps) - Altered bowel function - Flatulence - Bloating - Nausea - Anorexia - Constipation - Diarrhea - Mucus in stool - Anxiety/Depression
31
How common is IBS?
1 in 5
32
Are male or females more likely to get IBS? How much more likely?
- women | - 2-3 times more likely
33
Treatment for IBS
- Medications - Diet - Exercise - Psychotherapy - Stress release
34
What medications are used to treat IBS?
- laxatives - antispasmodics - tricyclic antidepressants - serotonin antagonists - serotonin agonists
35
What can be used in the diet to improve IBS?
prune juice
36
Are irritable bowel syndrome and inflammatory bowel disease the same thing?
No
37
Major types of inflammatory bowel disease
- Ulcerative Colitis (UC) | - Crohn disease (CD)
38
What is the major difference between UC and CD?
UC- colonic mucosa only | CD- any segment of the GI (mouth to the anus)
39
Defining characteristics of CD
- skip lesions | - transmural
40
UC vs CD: location
UC: begins in rectum and continues continuously toward cecum CD: most common in terminal ileum w/ patches through all layers of bowel
41
UC vs CD: etiology
UC: unknown CD: unknown
42
UC vs CD: peak age
UC: 15-25 and 55-65 CD: 15-40
43
UC vs CD: number of stools
UC: 10-20 CD: 5-6
44
UC vs CD: consistency of stool
UC: liquid CD: loose
45
UC vs CD: blood in stool
UC: yes CD: no
46
UC vs CD: complications
UC: hemorrhage CD: fistula
47
UC vs CD: nutritional deficiency
UC: yes CD: yes
48
UC vs CD: surgery
UC: infrequent CD: frequent
49
An inflammation of the digestive tract, involving enteritis of the small intestine and colitis of the colon.
Infectious Enterocolitis
50
How is Infectious Enterocolitis classified?
By type of organism causing the infection
51
What are the different types of Infectious Enterocolitis?
- Viral - Bacterial - Protozoan
52
Which virus often causes Infectious Enterocolitis?
Rotavirus
53
Which bacteria often causes Infectious Enterocolitis?
- C-diff | - E. Coli
54
Characteristics of C-diff colitis
- infectious diarrhea | - pseudomembranous colitis
55
Pathophysiology of C-diff colitis
- toxin-induced cytokines | - cause inflammatory response
56
Symptoms of C-diff
- fever - increase WBCs - bandemia - abdominal pain - can have diarrhea but not always
57
How high are WBCs in C-diff colitis?
often as high as 50,000 or more
58
Too many white blood cells being released by bone marrow into the bloodstream
bandemia
59
What causes C-diff colitis?
- The elimination of normal flora | - Allowing C-diff to grow
60
What often causes the elimination of normal flora that causes C-diff colitis?
Antibiotics
61
How long after antibiotic therapy does it take for C-diff colitis to occur?
Up to 8 weeks after therapy
62
Number one risk factor for C-diff colitis
ANTIBIOTICS
63
Which antibiotics most commonly cause C-diff colitis?
- penicillin - clindamycin - cephalosporins
64
Other risk factors for C-diff colitis
- prolonged hospital stay - infected roommate - repeated enemas - prolonged NG tube - GI tract surgery
65
Why is the C-diff colitis WBC count significant?
Most infectious/inflammatory conditions do not typically elevate WBCs over 25,000
66
Symptoms of Rotavirus
- severe watery diarrhea - vomiting - fever - abdominal pain
67
Transmission of Rotavirus
- fecal-oral route | - enters mouth by feces contaminated hands, surfaces or objects
68
Complications of Rotavirus
can become severely dehydrated and die
69
Who gets rotavirus?
Most common in infants and children
70
When are infants and children most likely to get Rotavirus?
6-24 mo
71
Is Rotavirus still relevant today?
Yes, it is still a significant cause of death
72
How many are hospitalized by Rotavirus worldwide?
2 million
73
How can Rotavirus be prevented?
Rotavirus vaccine by mouth
74
A condition in which small, bulging pouches develop in the digestive tract.
Diverticular Disease
75
Types of Diverticular Disease
- Diverticul(OSIS) | - Diverticul(ITIS)
76
What is the difference between diverticulosis and diverticulitis?
diverticulosis-small, bulging pouches (diverticula) develop in the digestive tract diverticulitis-when one or more of these pouches become inflamed or infected
77
Symptoms of Diverticular Disease
- Pain LLQ - N&V - tenderness in LLQ - Slight fever - Elevated WBCs
78
When appendix becomes inflamed, swollen, & gangrenous, and can eventually perforate if not treated
Appendicitis
79
What causes Appendicitis
- intraluminal obstruction with a fecalith - gallstones - tumors - parasites - lymphatic tissue
80
hard piece of stool
fecalith
81
Symptoms of Appendicitis
- loss of appetite - flatulence - fever - pain in rectum - RLQ pain - diarrhea - constipation - bloating - N&V
82
Types of Intestinal Obstruction
1. Mechanical | 2. Paralytic/adynamic
83
absence of force
adynamic
84
Difference between mechanical and paralytic/adynamic intestinal obstruction
- Mechanical: result from post-op cause (ex: external hernia, postop adhesions) - Paralytic/adynamic: results from neurogenic or muscular impairment of peristalsis
85
Symptoms of Intestinal Obstruction
- fecal smelling/malodorous vomit - abdominal distention - constipation w/ failure to pass flatus
86
Complications of intestinal obstruction r/t vomiting
- hypovolemia | - loss of of electrolytes
87
Bowel sounds with intestinal obstruction
increased to silent: -high pitched at fist then they go silent
88
Inflammation of the membrane lining the abdominal wall and covering the abdominal organs.
peritonitis
89
Severity of peritonitis
Severe and often life threatening
90
Cause of peritonitis
Usually caused by bacterial infection via - blood - after rupture of an abdominal organ
91
In what situation would an abdominal organ rupture causing peritonitis
- perforated peptic ulcer - ruptured appendix - perforated diverticulum - gangrenous bowel - pelvic inflammatory disease - abdominal trauma/wounds
92
What surface is inflamed in peritonitis
serosal surfaces
93
Characteristics of peritonitis
Throughout abdomen - fecal matter - purulent material
94
Pathophysiology of peritonitis
- rapid absorption of bacterial toxins - causes spreading of contaminants - causes inflammatory response
95
Autoimmune disorder that can occur in genetically predisposed people where ingestion of gluten leads to damage in small intestine
Celiac Disease
96
What is another name for Celiac Disease
Celiac Sprue
97
How common is Celiac Disease worldwide?
1 in 100
98
How many Americans go undiagnosed with Celiac Disease?
2.5 mil
99
Why is it bad to go undiagnosed for Celiac Disease?
risk for long-term health complications
100
Pathophysiology of Celiac Disease
- ingestion of gluten | - immune response that attacks small intestines'
101
gluten
protein found in - wheat - rye - barley
102
Complications of autoimmune response in Celiac Disease
- damage/atrophy of the villi | - nutrients cannot be absorbed properly
103
Who gets Celiac Disease?
-hereditary
104
Risk factor for Celiac Disease if in family
-Pts with first degree relative have a 1 in 10 risk
105
first degree relative
family member who shares about 50 percent of their genes with a particular individual in a family
106
Who do we share about 50 percent of out genes with?
- parents - offspring - siblings
107
Symptoms of Colon Cancer
Change in BM habits: - diarrhea - constipation - stool consistency change Bleeding: - rectal bleeding - blood in the stool Persistent abdominal discomfort: - cramps - gas - pain - Feeling of bowel not emptying completely - Weakness/fatigue - Weight loss
108
How long does diarrhea or constipation or a change in the consistency of the stool last to be considered for colon cancer?
>4 weeks
109
Characteristics of Symptoms of colon cancer
- many have no symptoms with early stages | - when symptoms appear, they vary (depending on the cancer size & location)

Advanced Pathology (27 decks)

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