GI

Question 1

What is the role of serotonin in the gut?

Answer 1

stimulates gut motility

Question 2

What is the primary cause of GERD?

Answer 2

LES malfunction

Question 3

What tissue is damaged from exposure to stomach acid in GERD?

Answer 3

squamous cell lining of the lower esophagus

Question 4

What causes Esophagitis?

Answer 4

GERD (most common cause)
Allergies
Meds (NSAIDS and Antibiotics)
Smoking, excessive ETOH
Obesity

Question 5

What cell changes occur in Barretts Esophagus?

Answer 5

squamous cells turn into metaplasic columnar epithelium

Question 6

Barretts esophagus is a precursor to…

Answer 6

adenocarcinoma of the esophagus

Question 7

What are the complications of GERD?

Answer 7

Esophagitis
Barrett’s Esophagus
Esophageal CA
Strictures

Question 8

What is Odynophagia

Answer 8

painful swallowing

Question 9

Why is Barrett’s Esophagus often diagnosed late?

Answer 9

early symptoms are subtle; leads to poor prognosis

Question 10

What happens in the GI tract when cells are damaged?

Answer 10

inflammation, ulceration

Question 11

Major risk factors for esophageal CA?

Answer 11

Smoking
ETOH
Obesity
Barretts Esophagus/GERD

Question 12

Most common cause of peptic ulcer disease

Answer 12

H. Pylori infection

Question 13

How do NSAIDS damage the mucosa in gastritis?

Answer 13

inhibits production of prostaglandins which maintain mucus production and protective barrier against stomach acid

Question 14

How does autoimmune gastritis affect the hematological system?

Answer 14

Causes B12 deficiency, leading to pernicious anemia

Question 15

How does autoimmune gastritis cause B12 deficiency?

Answer 15

destroys parietal cells in stomach lining, which are responsible for producing intrinsic factor

Question 16

Major risk factors of gastric CA…

Answer 16

Chronic gastritis
H pylori
Epstein Barr Virus
poor diet
pernicious anemia

Question 17

What sub-type of gastritis is H pylori associated with?

Answer 17

Type B

Question 18

Epigastric pain with duodenal ulcer is typically ______ by eating

Answer 18

relieved

Question 19

Epigastric pain with gastric ulcer is typically _____ with eating

Answer 19

increased or worsened

Question 20

Basic Pathophysiology of Chron’s disease

Answer 20

immune system mistakenly attacks the GI tract lining and causes chronic inflammation

Question 21

What cells from the innate immune system are involved in Chrons

Answer 21

Dendritic cells and Macrophages
-antigen presenting cells constantly sense bacterial antigens d/t impaired mucosal barriers=constant T1H cell activation

Question 22

What cells from the adaptive immune system are involved in Chrons?

Answer 22

-T1H produce interferon gamma= activates macrophages and continues inflammation loop
T17 releases cytokines that sustain/escalate inflammation

Question 23

What happens with cytokine storm in Chrons?

Answer 23

Excessive release of cytokines = tissue damage, which worsens symptoms

Question 24

Transmural inflammation in Chrons leads to what?

Answer 24

thickening/scarring of the intestinal wall as it tries to heal
-causes fibrosis/strictures=obstructions

Question 25

What is the hallmark of Chrons?

Answer 25

Granulomas form and cause skip lesions-Cobblestone appearance

Question 26

What is dybiosis?

Answer 26

an imbalance in the gut microbiota that contributes to immune system misfire in the gut

Question 27

Where in the GI tract is Ulcerative Colitis (UC) found?

Answer 27

large intestine and rectum

Question 27

Where in the GI tract is Chrons found

Answer 27

Can be found anywhere in the GI tract but commonly in the ileum and beginning of the lrg intestine

Question 28

What are the lab values for Chrons

Answer 28

-Elevated CRP (higher than in UC) -Elevated fecal calprotectin (indicate inflammation) -Anemia, Leukocytosis, Thrombocytosis

Question 29

Patho of UC

Answer 29

-genetic predisposition- disruption of the epithelial barrier fxn of the colon (starts in rectum) = abnormal immune response causing inflammation and ulceration in the mucosal lining

Question 30

Epithelial barrier dysfunction leads to...

Answer 30

decreased goblet cell production which = decrease in protective mucus which leaves lining vulnerable to bacteria and toxins -Leaky gut d/t tight junctions btween cells weaken and allow bad things to pass through

Question 31

What does chronic ulceration of the lrg intestine do in the long run?

Answer 31

exposes deeper tissue layers over time, which attracts more immune cells that cause further damage (neutrophils and lymphocytes)

Question 32

What is the hallmark of UC?

Answer 32

Crypt abscess formation (clusters of neutrophils w/in colonic crypts) -indicates severe inflammation and bacterial invasion

Question 33

How does dysbiosis contribute to UC?

Answer 33

Short Chain Fatty Acids(SCFA's) are produced by beneficial bacteria; loss in this=decreased SCFA production =impaired mucosal barrier

Question 34

Lab values in UC

Answer 34

-Elevated CRP (lower than in Chrons) -Elevated fecal calprotectin (indicate inflammation) -Anemia, Leukocytosis, Thrombocytosis

Question 35

What is IBS?

Answer 35

chronic functional GI disorder- altered bowel habits with an identifiable cause

Question 36

How does IBS differ from IBD?

Answer 36

IBS does not cause inflammation or cause permanent harm to the GI tract IBS DOES cause inflammation and damage to the

Question 37

Characteristics of IBS

Answer 37

abd pain accompanied by change in bowel habits (diarrhea, constipation, or both), bloating

Question 38

Triggers of IBS

Answer 38

Changes in routine Stress certain foods