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Pathophysiology > GI > Flashcards

Flashcards in GI Deck (64):
1

GERD
(Gastroesophageal reflux disorder)

-HCL and pepsin reflux into esophagus
-Lower esophageal sphincter relaxed or delayed empyting of stomach
-S&S - lying down, aggravated by ETOH, coffee, smoking

2

Barrett's esophagus

-Caused by GERD
-areas of esophagus become dysplastic and can lead to esophageal cancer

3

Endoscopy

General term for passing a scope into GI tract for visualization

4

Esophagogastroduodenoscopy (EGD)

Visualize esophagus, stomach, duedenum

5

Colonoscopy

Visualize rectum, colon, distal small bowel.
-Early detection of colon cancer.

6

XRays

contrast swallowed and x-rays taken of upper GI, barium enema for lower GI

7

hemoccult test

stool tests.
-colon cancer and occult bleeding

8

Hiatal Hernia

herniation of stomach through diaphragm.
-S&S: GERD, epigastric pain, dysphagia or none.
-tX: surgery

9

Gastritis

inflammation of gastric mucosa causes erosions.
S&S pain & burning over epigastric area and bleeding
-Acute & Chronic onsets

10

Peptic Ulcer Disease (PUD)

chronic inflammatory condition of stomach and proximal duodenum that creates ulcers due to dramatic change in mucosa.

11

Peptic Ulcer Disease (PUD)
* (7) Etiology*

1.ASA & NSAID use.
2. chronic steroid use
3. cigarettes
4. ETOH use
5. chronic diseases
6. severe psychological stress
7. H. Pylori ingestion

12

Peptic Ulcer Disease (PUD)
*S&S & tX*

GI bleeds
-antacids, H2-blockers, PPI, antibiotics for H. Pylori

13

Colorectal Cancer

arises from pre-existing benign neoplasm (polyp) that turns malignant

14

Colorectal Cancer
*Risk Factors*

1. over 50
2. high fat diet, obesity, sedentary lifestyle
3. smoking and ETOH consumption
4. family history

15

Colorectal Cancer
*S&S & Dx*

1. blood in stool
2. change in bowel havnits
Dx
1. colonoscopy

16

Colorectal Cancer
*tX*

1. polypectomy if confined to polyp
2. colectomy or colostomy
3. chemo
4. prevention: high fiber diet, active lifestyle

17

Inflammatory Bowel Disease (IBD)

Inflammation of lining and walls of intestines
Crohn's dX& ulcerative colitis

18

IBD
*S&S*

1. bloody diarrhea
2. abdominal cramps
SEQUELA:
1. intestinal obstruction
2. fistula formation
3. perforation of intestinal walls

19

IBD
*tX*

1. control inflammation through steroids
2. bowel surgery

20

Crohn's Dx

1. Any portion of GI tract
2. All bowel layers involved (transmural)
3. random segments of inflamed tissue create a 'patchy' pattern.

21

Ulcerative Colitis

1. Only in colon
2. No patchy tissue pattern
3. Ulcerations do not extend past submucosa.

22

UC
*S&S different from Crohn's Dx*

1. dehydration
2. lower risk of nutritional deficiency.

23

Intestinal Obstruction
*Etiology*

1. adhesions (scar tissue or IBD)
2. hernia
3. tumor
4. intussusception (one section of bowel telescopes into another and causes strangulation of tissue)
5. volvulus (torsion) twisting o intestine
6. paralytic ileus: loss of perisistalic motor

24

Paralytic Ileus prevention

Mobility

25

Diverticular Disease
Diverticulum

herniations of mucosa from the intestinal muscle layer
*Most common occurrence in sigmoid colon*

26

Diverticulosis

Asymptomatic diverticular disease

27

Diverticulitis
*S&S, Sequale, tX*

inflammation of infection of diverticula
S&S: 1) pain in LLQ, fever, leukocytosis
Sequela: abscess formation, rupture, peritonitis
tX: increase in dietary fiber, antibiotics, surgery

28

Appendicitis
*E, tX, S&S*

E: inflammation of appendix.
tX: surgery (appendectomy)
S&S: pain patterns, tenderness, anorexia, fever, leukocytosis, peritonitis

29

Upper GI Bleed
*Etiology*

1. Acute hemorrhaghic gastritis
2. esophageal varices
3. peptic ulcers

30

Upper GI Bleed
*S&S*

1. hematemesis (bloody vomit) a) bright red indicates esophageal; b) coffee ground indicates acute bleeds that has been partially digested.; c) occult blood
2. occult bloody stools
3. melena - loose, dark, tarry stool indicates partial digestion in stomach or duedenum

31

Lower GI Bleed
*Etiology*

1. IBD
2. Diverticulitis
3. Neoplasms

32

Lower GI Bleed
*S&S*

1. occult bleeding
2. frank bleeding (hematochezia) indicates lower GI Bleed in jejunum, ileum, L. intestine

33

Jaundice

bilirubin build up deposits in areas and turn the skin a greenish-yellow

34

Prehepatic Jaundice

increase in unconjugated bilirubin (INDIRECT BILIRUBIN)
-Rate of hemolysis exceeds the livers ability to handle the bilirubin load so it goes into blood before it can be conjugated.
-Newborn jaundice

35

Posthepatic Jaundice

increase in conjugated bilirubin (DIRECT BILIRUBIN)
-liver conjugated bilirubin that then meets an obstruction and backs up into the circulation.
*Gray colored stool*

36

Hepatic Jaundice

increase in unconjugated Bili.
Remains in blood as unconjugated.

37

Prehepatic Jaundice
*LABS*

High Indirect Bilirubin.
High Serum Bilirubin
Normal Direct Bilirubin

38

Posthepatic Jaundice
*LABS*

High Direct Bilirubin.
High Serum Bilirubin
Normal Indirect Bilirubin

39

Hepatic Jaundice
*LABS*

High Indirect Bilirubin
Direct Bilirubin Low
High or Low serum Bilirubin

40

Cholycystitis

Gall Bladder inflammation caused by gall stone

41

Cholycystitis
*S&S*

1. pain in RUQ
2. referred back pain
3. nausea & vomiting
4. Large stones may cause blockages of bile ducts -> obstructive jaundice & gray stools

42

Cholycystitis
*Risk Factors*

1. obesity
2. high cholesterol diet.
3. estrogen increase
4. starvation or rapid weight loss
5. genetics
6. 5 F's - Female, Fat, Forty, Fertile, Fair

43

Gall Bladder Problems
*dX & tX*

dX:
1. leukocytosis
2. ultrasound
3. High Direct Bilirubin
tX
Cholycystectomy surgery

44

Acute Pancreatitis

pancreatic enzymes leak into surrounding areas and causes autodigestion and hemorrhage

45

Acute Pancreatitis
*Etiology*

Gallstones or alcohol

46

Acute Pancreatitis
*S&S*

epigastric pain, jaundice

47

Acute Pancreatitis
*dX*

Labs: serum amylase & Lipase elevated w/ high WBC
Abdominal CAT scan

48

Pancreatic Cancer

4th leading cause of death in US
-idiopathic cause
S&S: pain, jaundice, weight loss.
-Normally metastasized by the time dX

49

Cystic Fibrosis

autosomal recessive dx developed by 6 months of age that affects the chloride channel on pancreas.

50

Cystic Fibrosis
*S&S*

1. Thick phlegm/mucous on lungs
Sequela: occludes bronchi & bronchioles
2. extra salty sweat
3. disabled ability to release pancreatic enzymes to assist w/ digestion

51

CF
*dX & tX*

dX: Sweat test
tX: pulmonary toilet & antibiotics; pancreatic enzymes taken before each meal

52

Hepatitis

Inflammation of liver

53

Hepatitis A (HAV)

acute onset: fever, malaise, jaundice
Mild onset & full recovery.
transmitted via infected foods.

54

HBV & HCV

transmitted via IV drug abuse, needlestick, sexually, or receiving blood.
Insidious onset w/ heavy destruction to liver cells.
HBV can be prevented & treated, HCV cannot

55

Cirrhosis

End stage, irreversible liver disease.
-Normal hepatocyte function ceases and disrupts vascular channels and biliary duct systems.
-Recovery based on amount of normal tissue left

56

Cirrhosis
*Etiology*

1. excessive ETOH intake
2. toxic reactions to drugs or chemicals
3. viral hepatitis
4. bile duct diseases
5. genetic disorders

57

Cirrhosis
*S&S re: digestion*

1. diminished hepatocyte function causes impaired nutritional absorption.
2. cannot metabolize fat & cholesterol
3. Glyco/gluco-genesis causes hypoglycemia

58

Cirrhosis
*S&S re: protein depletion*

1. decreased plasma proteins causes fluid shift problems
2. ascites & generalized edema
3. decreased clotting factor due to lack of fibrinogen.
4. easy bleeding

59

Cirrhosis
*S&S re: metabolism*

1. cannot break down ammonia into urea -> affects CNS ie. brain inflammation -> confusion, blurred vision, tremors
2. sex hormones can't break down and can cause opposite sex organ growth (gynecomastia in men - hirsutism in women)
3. glucocorticods can't break down -> hypercoricolism -> Cushing's
4. Aldosterone can't break down -> salt & fluid retention -> ascites and edema
5. drugs can't be broken down
6. Kupferr cells malfunction, increase infection risk.
7. jaundice

60

Portal Hypertension (HTN)

Liver resistant to normal portal venous flow.
Venous pressure rises in liver area and become HTN
Sequela:
1. Ascites
2. Splenomegaly
3. Varices

61

Ascites

increased back pressure in portal veins pushes fluid into abdominal cavity

62

Splenomegaly

Shunting of blood into splenic veins enlarges spleen.
Breakdown of RBC/WBC increases due to blood stasis of blood in spleen

63

Varices

enlarged, thin-walled veins.
occurs in esophagus, rectum, and umbilicus.
Esophageal varices can easily rupture and bleed out.

64

Cirrhosis
*dX & tX*

dX: Elevated indirect serum bilirubin, low direct bilirubin.
elevated serum liver enzymes (AST, ALT, ALP)
tX: nutrition and no alcohol; establish appropriate fluid balance (diuretics or albumin) ; control ammonia w/ low protein diet and drugs; protection against infection, trauma, or overdose: Liver transplant.