Gestrointestinal Flashcards

Question

Signs/symptoms of obstruction in ileum

Answer 1

more pronounced distension Vomiting is late sign Constipation (rarely diarrhea) **Increased bowel sounds**

Answer 2

Hypogastric pain Abdominal distension Pain varies depending on ischemia Vomiting is late sign

Answer 3

Inflammation of gastric mucosa Acute: vague abd discomfort, epigastric tenderness. Spontaneous recovery. H2 receptor agonists for healing Chronic: seen in older adults. mucosal atrophy, epithelia metaplasia

Answer 4

Example: Fundal gastritis. Leads to gastric atrophy, which diminishes acid and intrinsic factor, causing pernicious anemia (Poor vit B12 absorption)

Answer 5

Involves antrum only - follows acute gastritis

Answer 6

**Gastric** Ulceration of stomach linine **Duodenal** Ulceration of upper part of small intestine S&S: Nausea, vomiting, bloating, 75% have no symptoms Causes: H.pylori, medication Risk factors: >70, alcohol, smoking, injury/trauma

Answer 7

**Gastric** Normal secretion of acid Pain 1-2 hr after meal Food aggravates pain Vomiting common More likely to hemorrhage **Duodenal** Hyper-secretion of acid Pain 2-4 hr after meal Food relieves pain Vomiting not common Less likely to hemorrhage (Malena if it does bleed)

Answer 8

Acute peptic ulcer that forms due to physiological stress of severe illness or trauma **ischemic ulcer** due to trauma such as hemorrhage, multisystem trauma, heart failure, sepsis **Curling ulcer:** Burn injury **Cushing ulcer:** Brain injury Primary sign of stress ulcer is bleeding

Answer 9

Rapid emptying of residual stomach - cramping, nausea, vomiting, diarrhea, weakness, pallor, hypotension

Answer 10

Duodenal removal Decreased acid secretion Supplements

Answer 11

inflammation caused by reflux of bile and pancreatic secretions Nausea, vomiting bile, epigastric pain,

Answer 12

•Form of IBD •Affects large intestine only •Ulcerations in mucosa of the colon •Chronic condition -Peak occurrence age 20-40 then 50-70. More men. -possible due to abnormal immune response of GI tract -Not caused by stress, but stress can make worse -Smoking seems to be a protective factor (unknown why) -Remission and exacerbation -Severe=entire colon, abd pain, fever, tachycardia, diarrhea, bloody stool Malabsorption Chronic Anemia

Answer 13

Idiopathic (unknown cause) Affects ANY part of digestive tract from mouth to anus. “Skip lesions” - skips from place to place Ulcers can cause **fistulas** that extend into lymphatics. Can form in perianal area, between loops of bowels, extend into vagina or bladder. **Anemia** from malabsorption of vit B12 and folic acid. Signs/Symptoms: Can be asymptomatic for years. S&S similar to ulcerative colitis. Diarrhea major symptom. Also weight loss and abdominal pain. If crohns in ileum, can have malabsorption of folic acid and vitamin D

Answer 14

**Ulcerative Colitis** Pain lower left abdomen Bleeding common Inflammation in colon only Continuous inflammation Colon wall thinning No granulomas Ulcers in mucus lining (colon) Fewer complications Non-smokers mucosal and submucosal wall **Crohn’s** Pain lower right abdomen Bleeding uncommon Inflammation *anywhere* Inflammation in patches Cobblestone appearance Thickened GI wall Granulomas present Ulcers in colon are deeper Complications more common Smoking worsens it •”transmural” - affects full thickness of wall

Answer 15

Asymptomatic herniations or saclike outpouching of mucosa and submucosa **Diverticulitis:** Inflammation of the outpouching Idiopathic - related to increased intracolonic pressure, abnormal neuromuscular function, alterations in intestinal motility Anywhere in GI tract - weak points in colon wall Complications: obstruction, fistula, abscess, bleed, perforation Predisposing factors: Older age, genetic predisposition, obesity, smoking, diet, sedentary lifestyle, meds such as aspirin and NSAIDS S&S: cramping lower abd, diarrhea, constipation, distended, flatulence Diverticulitis S&S: fever, increased WBC, tenderness lower left abd

Answer 16

Peritonitis Due to perforation causing contents to spill into abdominal cavity

Answer 17

pancreas liver portal vein gall blader

Answer 18

**Alcoholic liver disease** *More common in middle aged men but woman develop more serious injury *Most prevalent form *25% of alcoholics 3 stages: **1. Steatosis** *Fat deposits in liver. Lipids from adipose tissue or dietary intake contribute to fat accumulation *Can be caused by low volumes alcohol *Reversible if pt stops drinking **2. Fibrosis** *Increased hepatic storage of fat *Inflammation and degeneration leads to necrosis of hepatocytes *Stimulates irreversible fibrous characteristics **3. Cirrhosis** *Caused by chronic alcoholism and malnutrition *Cell damage initiates an inflammatory response that results in excessive collagen formation *Fibrosis and scarring alter structure of liver which obstructs biliary and vascular channels *Irreversible

Answer 19

Systemic disease that primarily affects the liver Inflammatiry process of liver can damage and obstruct bile capillaries, leading to bile obstruction and obstructive jaundice. Damage most severe in hepatitis B and C S&S: Range from asymptomatic to liver failure and coma Prodromal phase: 2 weeks after exposure, ends with appearance of jaundice - fatigue, anorexia, malaise, nausea, vomiting, headache, cough, fever Icteric phase: 1-2 weeks after prodromal. Lasts 2-6 weeks. Jaundice, dark urine, clay stools, enlarged liver, tender Recovery phase: resolution of jaundice, liver remains large and tender, return of normal liver function 2-12 weeks after jaundice Chronic B, C and D may not become jaundiced and may not be diagnosed - can become carriers

Answer 20

High blood pressure in portal venous system Causes: pre-hepatic: any disease that obstructs blood flow Hepatic: Cirrhosis of liver or viral hepatitis that cause inflammable or fibrosis Post-hepatic: Cardiac disorders that impair pumping ability of the right side of the heart Hematemesis is most common sign of portal hypertension due to esophageal varices rupture. Caused by liver dysfunction si can have hx of jaundice and hepatitis, alcoholism, cirrhosis

Answer 21

**Ascites:** fluid buildup in abdomen. trapped fluid in peritoneal space. Biggest cause is cirrhosis but can also happen from heart failure, abdominal malignancies, nephrotic syndrome, malnutrition Decreased synthesis of albumin in liver with portal hypertension will cause capillary hydrostatic pressure to exceed capillary osmotic pressure, pushing water into peritoneal cavity **Hepatic Encephalopathy** Decline in brain function due to liver disease. Impaired behavioural, cognitive, and motor function. Can develop quickly in hepatitis or slowly in cirrhosis. Toxins normally removed by liver eventually travel to brain.

Answer 22

Gall stones. Formed from impaired metabolism of cholesterol, bilirubin, and bile acids. Three types: 1. Cholesterol (70-80%) 2. Black (rare. chronic liver disease, hemolytic disease) 3. Brown (biliary stasis, bacterial infection, biliary parasites) S&S: Can be asymptomatic, epigastric and right upper quadrant pain. Intolerance for fatty foods manifested as heartburn, flatulence, epigastric discomfort and food intolerance

Answer 23

Inflammation Can be acute or chronic. Caused by gall stones lodged in cystic duct. Obstruction causes gall bladder to become distended and inflamed. Pressure against distended wall of gall gladder can cause decreased blood flow, ischemia, necrosis and perforation S&S: Fever, leukocytosis (high WBC), rebound tenderness, abdominal muscle guarding

Answer 24

Equal between men and women. More likely in black individuals Risk factors: cholethiasis, alcoholism, peptic ulcers, obesity, trauma, dyslipidemia, hypercalcemia, smoking, genetics Acute: Obstruction of the outflow of pancreatic digestive enzymes - bile and pancreatic duct obstruction. Can also result from alcohol, meds, viral infections Chronic: Progressive fibrotic destruction of pancreas. Chronic alcohol abuse most common cause. May also come from gallstones, smoking, genetics

Answer 25

More common in males Risk: malnutrition, alcohol, tobacco S&S: chest pain, dysphagia

Answer 26

More common in males Risk: Salty food, red meat, nitrates S&S: Anorexia, weight loss, vomiting occult blood, RUQ pain

Answer 27

More common in males Risk: Polyps, IBD, Diverticulitis, high fat, low fiber S&S: Pain, mass, anorexia, bloody stool, distension

Answer 28

more common in males risk: hepatitis B, C, D, Cirrhosis S&S: pain, anorexia, weight loss, ascites, jaundice

Answer 29

More common in females Risk: chronic pancreatitis, smoking, alcohol, diabetes S&S: weight loss, weakness, nausea, vomiting, abd pain, depression, jaundice

Answer 30

Benign growth. starts from mucosal epithelium

Answer 31

In infants Most common cause of postprandial vomiting (vomiting several hr after eating) Unknown cause Muscle fibers thicken so pyloric sphincter becomes enlarged and inflexible. Extra effort to force gastric contents. Stomach muscles can become hypertrophied S&S: •Occurs 2-8 wks after birth •Forceful, non-bilious vomiting after feeding •Needs to be refed •Constipation (fluid doesn’t reach intestine)

Answer 32

**Hirschsprung’s disease** •Most common cause of colon obstruction 1/3 of all obstructions in infants Causes: •Absence of nerve cells in PART of colon •Causes decreased peristalsis and distention to proximal colon •”megacolon” **Intussusception** •Telescoping of proximal segment of intestine into a distal segment, causing obstruction (functional). Most common cause of small bowel obstruction in children. age 5-7 months.

Answer 33

**Hernias** Bowel protrudes through weakening in abdominal wall ligament

Gestrointestinal Flashcards

(58 cards)