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GI Flashcards

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1
Q

upper GI problems occur in the……

A

Esophagus, Stomach, Beginning of small intestines

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2
Q

lower GI problems occur in the…….

A

Small intestines, colon (large intestines), rectum/anus

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3
Q

define dysphagia

A

Difficulty swallowing.

Begins with solids and progresses to liquids

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4
Q

dysphagia: common causes

A
  1. Mechanical obstruction: Stenosis or stricture, Diverticula, Tumors
  2. Neuromuscular dysfunction: CVA, Achalasia – LES can’t open properly
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5
Q

GERD

A

Backflow of gastric acid from the stomach into esophagus.
Occurs via the lower esophageal sphincter (LES).
Highly ACIDIC material!

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6
Q

GERD: Etiology

A

Anything that alters closure strength of LES or increases abdominal pressure

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7
Q

GERD: Clinical Manifestations

A

Heartburn (pyrosis)
Dyspepsia
Regurgitation
Chest pain
Dysphagia
Pulmonary symptoms

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8
Q

GERD: Complications

A

ulceration
scarring
strictures
Barrett esophagus- most severe.

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9
Q

define Hiatal Hernia

A

A defect in the diaphragm that allows part of the STOMACH to pass into the THORAX

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10
Q

Hiatal Hernia: Pathophysiology

A

Exact cause is unknown.
Age related.
Injury or other damage may weaken the diaphragm muscle.
Repeatedly putting too much pressure on the muscles around the stomach: Severe coughing, Vomiting, Constipation and straining to have a bowel movement.

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11
Q

2 types of Hiatal Hernia

A

Sliding hernia – usually small and often do not need treatment.
Paraesophageal hernia- part of the stomach pushes through the diaphragm and stays there.

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12
Q

Hiatal Hernia: risk factors

A

Age
Obesity
Smoking

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13
Q

Hiatal Hernia: clinical manifestations

A

Asymptomatic
Belching
Dysphagia
Chest or epigastric pain

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14
Q

Hiatal Hernia: treatment

A

Mostly a conservative treatment
Teaching: small, frequent meals, avoid lying down after eating
Avoid tight clothing and abdominal supports
Weight control for obese individuals
Antacids for the GERD/esophagitis symptoms
Surgery if the conservative treatments do not work

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15
Q

define Gastritis

A

Inflammatory condition of the stomach

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16
Q

define acute gastritis

A

TEMPORARY inflammation of the STOMACH lining only (intestines NOT affected)

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17
Q

how long does acute gastritis last?

A

Generally last from 2-10 days

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18
Q

Acute Gastritis Etiology

A

Irritating substances (alcohol)
Drugs (NSAIDs)
Infectious agents- H.Pylori

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19
Q

define chronic gastritis

A

PROGRESSIVE disorder with chronic inflammation in the stomach

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20
Q

how long can chronic gastritis last?

A

Can last weeks to years

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21
Q

Chronic Gastritis: etiology

A
  1. Autoimmune: Attacks parietal cells
  2. H. pylori infection
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22
Q

Chronic Gastritis: complications

A

PUD, bleeding ulcers, anemia, gastric cancers

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23
Q

What is H. pylori?

A

Helicobacter pylori bacterium.
Acidic environment.
Destructive pattern of persistent inflammation: Can cause chronic gastritis, PUD, and stomach cancer

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24
Q

how is H.Pylori transmitted?

A

Person to person via saliva, fecal matter, or vomit
Contaminated food or water

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25
Acute or Chronic Gastritis: Clinical Manifestations
Sometimes none Anorexia N/V Postprandial discomfort Intestinal gas Hematemesis Tarry Stools Anemia
26
define Acute Gastroenteritis
Inflammation of stomach & SMALL INTESTINE
27
Acute Gastroenteritis: etiology
Viral infections: Norovirus and rotavirus Bacterial infections: E. col, salmonella, campylobacter Parasitic infections
28
how long does Acute Gastroenteritis last?
Usually lasts 1-3 days but may last as long as 10 days
29
Acute Gastroenteritis: clinical manifestations
Watery Diarrhea: May be bloody if bacterial. Abdominal pain N/V Fever, malaise
30
Acute Gastroenteritis: complications
fluid volume deficits
31
Peptic Ulcer Disease (PUD)
Ulcerative disorder of the upper GI tract Esophageal Stomach: gastric ulcers Duodenum: peptic ulcer in the first part of the small intestine Develops when the GI tract is exposed to acid and h. pylori.
32
PUD: Etiology
H. pylori Injury-causing substances: NSAIDs, ASA, alcohol. Excess secretion of acid Smoking Family history Stress - remember there is increased gastric acid secreted with the stress response
33
Risk factors: NSAID-Induced Peptic Ulcer Disease
Age Higher doses of NSAIDs History of PUD Use of corticosteroids and anticoagulants Serious systemic disorders H. pylori infection
34
PUD: Pathogenesis
Mucosa is damaged Histamine is secreted, resulting in: Increase in acid and pepsin secretion- causes further tissue damage, Vasodilation– causes edema. If blood vessels are destroyed, this results in BLEEDING.
35
PUD: Classification
Duodenal ulcer Most common type, Age – any; early adulthood Gastric/peptic ulcer: Age – peak 50 - 70; Why? Increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses
36
PUD: Clinical Manifestations
Sometimes none N/V, anorexia Weight loss Bleeding Burning Pain: in middle of abdomen that is usually worse when the stomach is empty
37
gastric ulcers: characteristics, location, timing
characteristics: burning, cramping, gas-like location: epigastrium, back timing: 1-2 hours after eating
38
duodenal ulcers: characteristics, location, timing
characteristics: burning, cramping, gas-like location: epigastrium, back timing: 2-4 hours after eating
39
PUD: Complications
“HOP” Complications H – Hemorrhage O – Obstruction P – Perforation and Peritonitis
40
name 5 lower GI problems
appendicitis peritonitis irritable bowel disorder inflammatory bowel disorder: crohns, ulcerative colitis. diverticulosis/diverticulitis.
41
define Appendicitis
Inflammation of the appendix
42
Appendicitis: etiology
Appendix is OBSTRUCTED Leads to INFLAMMATION
43
Appendicitis: complication
Gangrene Abscess formation PERITONITIS
44
Appendicitis s/s
Classic Pain: RLQ in periumbilical area. Rebound Pain= Pain is SEVERE after release of palpating hand over the RLQ. Sudden pain relief may indicate rupture: Peritonitis. low grade fever, Nausea, anorexia
45
define Peritonitis
Inflammation of the PERITONEUM. Serous membrane that lines abdominal cavity & covers visceral organs.
46
Peritonitis: What happens to the peritoneum?
INFLAMMATION Fluid shifts – THIRD SPACING, Can lead to hypovolemic shock and sepsis. DECREASED PERISTALSIS. Can lead to paralytic ileus and intestinal obstruction.
47
Peritonitis: Causes
Perforated ulcer Ruptured gallbladder Pancreatitis Ruptured spleen Ruptured bladder Ruptured appendix
48
Peritonitis: Clinical Manifestations
Usually sudden and severe Abdominal pain* Tenderness Rigid “board-like” abdomen N/V Fever Elevated WBC HR increased BP decreased
49
define Irritable Bowel Syndrome
Chronic condition characterized by: alterations in bowel pattern due to changes in intestinal motility, Chronic and frequent constipation (IBSC) Chronic and frequent diarrhea (IBSD)
50
Irritable Bowel Syndrome: Symptoms
Abdominal distension, fullness, flatus, and bloating. Intermittent abdominal pain exacerbated by stress and RELIEVED BY DEFECATION. Bowel urgency. Intolerance to certain foods (sorbitol, lactose, gluten). Non-bloody stool that may contain mucous.
51
Psychosocial Stress and IBS
is almost never the result of primarily psychological causes. can be exacerbated by stress can cause stress and psychological problems
52
causes of IBS
Cause UNKNOWN but thought to be “triggered” by stress, food, hormone changes, GI infections, menses
53
define Inflammatory Bowel Disease (IBD)
A group of life-changing, chronic illnesses
54
IBD Characterized by:
Chronic inflammation of the intestines. Exacerbation and remissions.
55
TWO SEPARATE DISORDERS of IBD
Crohn’s disease Ulcerative colitis
56
etiology for IBD
Genetically AUTOIMMUNE activated by an infection
57
IBD is most common in
WOMEN, Caucasians, persons of Jewish descent, and smokers
58
Crohn’s Disease Pathogenesis
Lymph structures of the GI tract are blocked. Tissue becomes engorged and inflamed. Deep linear FISSURES and ULCERS develop in a ”patchy” pattern in the bowel wall. SKIP LESIONS COBBLESTONE APPEARANCE
59
Crohn’s Disease: complications
Malnutrition: Anemia Scar tissue and obstructions Fistulas Cancer
60
Crohn’s Disease: Clinical Manifestations
Crampy lower Abdominal pain (RLQ). Watery diarrhea SYSTEMIC: Weight loss, fatigue, no appetite, fever, malabsorption of nutrients. Palpable abdominal mass (RLQ). Mouth ulcers. S/S of fistulas.
61
Ulcerative Colitis: define
Inflammation of the mucosa of the RECTUM AND COLON. Usually develops in the third decade of life.
62
Ulcerative Colitis is most common in...
white people of European descent, esp. Ashkenazi Jewish descent Occasionally in Black/African Americans Rare in Asians
63
Ulcerative colitis: pathogenesis
Inflammation begins in the rectum and extends in a CONTINUOUS segment that may involve the ENTIRE colon. Inflammation leads to large ulcerations. Necrosis of the epithelial tissue can result abscesses – CRYPT ABSCESSES. Colon and rectum try to repair the damage with new granulation tissue.
64
Ulcerative Colitis: Clinical Manifestations
Abdominal pain Bloody diarrhea Systemic: Weight loss, fatigue, no appetite, fever
65
ulcerative colitis: complications
*Hemorrhage *Perforation *Cancer Malnutrition Anemia Strictures *FISSURES *ABSCESSES *TOXIC MEGACOLON – a rapid dilation of the large intestine that can be life-threatening COLORECTAL CARCINOMA Liver Disease – from inflammation and scarring of bile ducts Fluid, electrolyte and PH imbalances
66
Diverticulosis: Pathogenesis
Small pouches in lining of colon that bulge outward through weak spots. May be CONGENITAL or ACQUIRED
67
causes of Diverticulosis
low fiber diet with resulting chronic constipation
68
Diverticulosis: usual location
DESCENDING COLON
69
Diverticulosis: Clinical Manifestations
Usually asymptomatic Discovered accidentally or with presentation of acute diverticulitis.
70
define Diverticulitis
INFLAMMATION of one or more of the pouches (diverticula) Usually from retained fecal material.
71
Diverticulitis: Clinical manifestations
Abdominal pain – LLQ Fever WBC’s increased Constipation or diarrhea Acute – passage large quantity of frank blood. May resolve spontaneously
72
Diverticulitis: complications
Perforation Peritonitis Obstruction

NUR 326 (13 decks)

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