Gastrointestinal Pathophysiology Flashcards

(55 cards)

1
Q

What is bowel obstruction?

A

Obstruction in the small or large intestine, causing difficulty in passing digested material normally through the bowel

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2
Q

What is the mechanical causes of bowel obstruction? (4)

A

Constriction or blockage in intestines

Abnormal narrowing (stenosis) or thickening of intestinal wall

Physical causes

Pressure on intestine from the outside

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3
Q

What is the neurological cause of bowel obstruction?

A
Paralytic Ileus (AKA pseudo obstruction) 
- paralysis of the intestine (disruption of normal propulsive ability meaning the malfunction of peristalsis)
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4
Q

What are some symptoms of of Ileus?

A
Loss of appetite
Abdominal discomfort 
Feeling of fullness
Constipation 
Inability to pass gas
Bloating
Excessive belching
Nausea
Vomiting
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5
Q

What is the vascular causes of bowel obstruction?

A

Thrombosis (clotting of blood)

Embolism (lodging of embolus, a blockage-causing material, inside a blood vessel)

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6
Q

What is a blood clot also known as?

A

Thrombus

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7
Q

What is a moving blood clot called?

A

Thromboembolus (thromboembolism)

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8
Q

What are the main signs and symptoms of bowel obstruction?

A
Abdo pain
Vomiting 
Constipation 
Loss of appetite 
Swelling of abdo 
Bloated 
Diarrhoea 

RED FLAGS
Absent bowel sounds
No passing of flatus

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9
Q

What is a hernia?

A

Occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall

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10
Q

What is D&V?

A

Diarrhoea and vomiting

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11
Q

What can D&V be a symptom of?

A

An infection or underlying condition

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12
Q

What is Maleana?

A

Blood in the faeces.

Usually black and tarry in appearance.

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13
Q

What does Maleana indicate?

A

Indicates bleeding in the upper gastrointestinal tract

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14
Q

What is haemetemisis?

A

Blood in vomit.

Usually brown and coffee ground in appearance.

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15
Q

What does haemetemesis indicate?

A

Bleeding in the upper gastrointestinal tract

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16
Q

What are common infections associated with D&V?

A

Typhoid and paratyphoid (enteric) fever

Salmonella

Escerichia Coli food poisoning

Staphylococcal food poisoning

Clostridium Perfringens

Clostridium Difficile

Campylobacter food poisoning

Cholera

Dysentery

Viral Gastroenteritis

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17
Q

What is typhoid fever? And how is it different to paratyphoid fever?

A

An infection caused by the bacterium Salmonella typhi.

Paratyphoid fever is an infection which is similar but with milder symptoms and caused by one of three types of Salmonella enterica.

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18
Q

What is Clostridium Perfringens?

A

It is a gram positive bacterium that is found in many environmental sources and in the intestines of humans and animals

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19
Q

What is Clostridium Difficile?

A

It is found in the gut of up to 3% in healthy adults and 66% of infants. It is a bacteria that can infect the bowel and cause diarrhoea. It most commonly affects people who have recently been treated with antibiotics. And it is contagious.

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20
Q

What is Campylobacter food poisoning?

A

It is a bacteria usually found on raw or uncooked meat, unpasteurised milk and untreated water. It usually develops over 2-5 days and can lead to gastroenteritis (infection of the gut/intestine) leading to diarrhoea and sometimes vomiting

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21
Q

What is dysentery?

A

It is a type of gastroenteritis that results in blood in diarrhoea. It is an infectious disease.

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22
Q

What is appendicitis?

A

It is an inflammation of the appendix

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23
Q

What is exudate?

A

A mass of elks and fluid that has seeped out of the blood vessels or an organ, especially in inflammation

24
Q

What is fibrin?

A

It is a fibrous, non-globular protein involved in blood clotting. It is formed by protease thrombin on fibrinogen which causes it is to polymerise. The polymerised fibrin together with platelets form a clot over wound site (hemostatic plug)

25
What causes inflammation of the appendix?
Inflammatory exudate, fibrin and phagocytes. They cause swelling and ulceration of the mucous membrane of the appendix
26
What are some signs and symptoms of appendicitis?
Central abdo pain initially After a few hours, would present in localised pain in right iliac fossa Pain that worsens if you cough, walk or make jarring movements Nausea Vomiting Loss of appetite High temp Abdo swelling
27
What is the iliac fossa?
It is a large, smooth, concave surface on the internal surface of the ilium which is part of the 3 fused bones making the hip bone). The fossa is bounded above the iliac crest, below the actuate line.
28
If the appendix ruptured what can it lead to?
Peritonitis - an inflammation of the peritoneum where the membrane that lines the inner abdominal wall and encloses organs within the abdomen
29
What can scar tissue from a healed appendix lead to?
Bowel obstruction
30
What is cholecystitis?
An acute inflammation of the gall bladder
31
What would cause cholecystitis (inflammation of the gallbladder)?
Gall stones becomes impacted in the cystic duct. Strong peristaltic contractions occur to try to move the stone outwards. The build of bile behind the stone leads to an inflammatory reaction within the gall bladder
32
What are signs and symptoms of cholecystitis?
Biliary Colic (pain under right side of rib cage) Projectile Vomiting - green bile Fever Jaundice Pain radiating to right shoulder or back Tenderness of abdo Nausea Vomiting Temperature
33
What is biliary colic?
A steady or intermittent (random) ache in the upper abdomen, usually under the right side of the rib cage. It happens when something blocks the normal flow of bile form the gallbladder
34
What is Diverticulitis?
It is an inflammation of the diverticula as a result of impaction of faeces. Small pouches of mucosa (faeces) that herniate into the peritoneal cavity through the muscular fibres of the colon. It occurs at the weakest points of the intestinal wall.
35
What is the main cause of diverticulitis?
Lack of fibre in the diet
36
Where is the most common location for the development of diverticulitis?
Sigmoid colon
37
What are some signs and symptoms of diverticulitis?
Feeling bloated Constipation Diarrhoea Abdo pain that follows eating and is often eased on emptying bowels or passing wind
38
What are the signs and symptoms considered red flags for diverticulitis?
Constant severe abdo pain Fever Nausea Vomiting Rectal bleeding Lethargy
39
What is pancreatitis?
Proteolytic enzymes produce by the pancreas becomes activated in the pancreas other then in the intenstine, causing the pancreas to digest itself causing pancreatitis. Severity is dependent upon how much pancreatic tissue is involved and over how long
40
What are some common causes of pancreatitis?
Gallstones Excessive use of alcohol Pancreatic cancer Viral infections - eg.mumps Kidney and liver transplantation Hypercalcaemia Severe hypothermia Drugs such as corticosteroids and cytotoxic agents
41
What are some signs and symptoms of pancreatitis?
Severe upper abdo pain Fever Signs of hypovolaemic shock - loss of more than 20% of blood or fluid supply to the body which could result to organ failure.
42
Signs and symptoms of hypovolaemic shock?
``` Cold Clammy Pale Rapid breathing Rapid heart rate Weakness Decreased or absent urine output Sweating Anxiety Confusion Unconsciousness ```
43
What is Inflammatory Bowel Syndrome (IBS)?
Inflammation in the mucosa and submucosa in the rectum and colon. This leads to swelling, oedema (swelling due to build up of excessive fluid), bleeding and ulceration. in later stages of the disease, walls thicken and become fibrous.
44
What causes IBS?
``` Poor nutrition Stress Bowel infection Genetic factors Autoimmune dysfunction ```
45
What is coeliac disease?
A genetically determined autoimmune reaction to gluten. There is often villous atrophy (finger-like projection surround small intestines that help absorb nutrients is flattened caused by damage done by immune system) in the jejunum leading to malabsorption. Sometimes other autoimmune conditions are present as well.
46
What are some signs and symptoms of IBS?
Abdo pain Lethargy Severe diarrhoea Blood, pus or mucus in diarrhoea Steatorrhea (secretion of abnormal quantities of fat with faeces owing to reduced absorption of fat by the intestine). Weight loss Poor appetite Nausea Vomiting
47
What is ectopic pregnancy?
Where the faeces develops outside of the womb, usually in the Fallopian tubes
48
What are some signs and symptoms of ectopic pregnancy?
Pain in abdomen and/or pelvic areas Tenderness 1 or more missed menstruation Vaginal bleeding Tachycardia Dizziness Syncope (fainting)
49
What are the four different types of Urinary Tract Infections (UTI)?
Urethritis Cystitis Ureteritis Pyelonephritis
50
What is urethritis?
Inflammation of the urethra: the opening of the tube that carries urine from the bladder to the outside of the body
51
What is ureteritis?
Inflammation of the ureter - the duct by which urine passes from the kidney to the gallbladder
52
What is cystitis?
An inflammation of the urinary bladder or any part of the urinary system
53
What is pyelonephritis?
A sudden and severe inflammation of kidney due to bacterial infection
54
What is renal calculi?
Stones that form due to build up of urinary constituents deposited in layers. Most originate in collecting tubules or renal papillae. ``` These include: Oxalates Phosphates Urates Uric acid ```
55
What are predisposing factors of UTIs?
Dehydration pH of urine Infection Tumours