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Flashcards in GI Cont. Deck (51)
1

This is a much deeper peptic ulceration of the stomach wall
-may burrow through the muscular wall

Chronic peptic ulceration

2

What commonly causes Chronic peptic ulceration?

-H. Pylori
-NSAIDS
-Aspirin use
(damage the mucosal barrier)

3

______ junctions of the _______ cell lining of the stomach help prevent acidic stomach contents from damaging the deeper layers of the stomach wall

-Tight junctions
-Epithelial cell lining

4

What are prostaglandins used for in the stomach?

-Improving local blood flow in the stomach
-Allows mucus production and bicarbonate secretion
-This COUNTERBALANCES H+ secretion

5

What do aspirin and NSAIDS do to prostaglandin synthesis?

-Inhibit arachadonic acid metabolic pathways
-Decrease prostaglandin synthesis
-Gastric mucosa=vulnerable

6

What are 3 ways hemorrhage can present with?

-Melena (black poop)
-Hematochezia
-Hematemesis
-Anemia

7

Ulcers increase the risk for _______

Adenocarcinoma of the stomach

8

Ulcer=loss of _______

mucosa

9

What does the floor of the ulcer contain

-granulation tissue
-inflammatory debris

10

Describe the rim of the ulcer

-Erythemateous
-Edematous

11

What are more likely, duodenal or gastric ulcers?

Duodenal ulcers

12

_______ is a rare disease characterized by a gastrinoma in the pancreas.

Zollinger Ellison syndrome

13

Excessive gastrin causes increased acid production =

recurrent ulcers in the stomach

14

What is the most common form of stomach cancer?

-Adenocarcinomas

15

What are risk factors for adenocarcinoma of the stomach?

-Chronic atrophic gastritis
-Smoked/pickled foods
-Nitrate food preserves
-Low fruit/veggie diets

16

This is a rare outpocketing of the jejunum

Meckel diverticulum

17

This is failure of the anterior abdominal wall to form and the intestines protrude

Gastroschisis

18

This is a less severe case of gastroschisis with less bowel protruding

Omphalocele

19

This is a very small deficit at the umbilicus

Umbilical hernia

20

This results from localized, genetic absence of the autonomic ganglionic plexus in the colon wall that controls peristalsis

Hirschsprung Disease

21

What effects does Hirschsprung's disease have on the body

-No peristalsis
-Impaired fecal movement
-Poop backs up upstream
-Overgrowth of bacteria
-Severe inflammation

22

These are dilated anal varices?

-Internal and external hemorrhoids

23

S&S of hemorrhoids

-Bleed regularly
-Leave bight red blood on stool surface
-Painful
-Itchy

24

Who commonly has hemorrhoids?

-Older people
-Pregnancy (due to increased BV and venous stasis)
-Portal hypertension

25

This is the twisting of the bowel

-Volvulus

26

Describe the internal and external infarcted bowel

Infarcted bowel is EDEMATOUS
- Internal= extensive hemorrhage in the mucosa and submucosa

27

What happens to the damaged wall?

-Becomes leaky

28

What results from the leaky damaged wall

-Peritonitis
-Septicemia

29

This occurs when C. Difficle overgrows

Pseudomembranous colitis

30

Describe C. Dif

-Gram Positive
-Anaerobic
-Spore forming bacteria

31

Can C. Dif be part of the normal flora?

Yes

32

What is a major cause of C. Dif infection?

-Broad spectrum antibiotic use
(because it kills normal flora)

33

Pathogenesis of C. Diif

-Secretes enterotoxin
-Binds to epithelium of the colon
-Causes an inflammatory response
-Produces cellular, purulent exudate
-Causes necrosis of colonic mucosa

34

What is the #1 cause of nosocomial diarrhea

C. Dif
-secretes enterotoxin and produces a cellular purulent exudate and causes necrosis

35

This is the poor absorption of fats, electrolytes, minerals, and water

Malabsorption

36

This is malabsorption with fatty stools

Sprue

37

S&S of Malabsorption

-Large, bulky, greasy stools
-Excessive bowel gas
-Distention

38

Describe luminal malabsorpion

-Happens in the lumen
-Usually due to deficiency of pancreatic or liver function
-no lipase or defective bile acids

39

What are causes of intestinal malabsorpion

-Surgically shortened bowel
-Lack of brush border enzyme
-Gluten sensitivity

40

Complications common to sprue

-Anemia (poor B12, iron, or folate)
-Bleeding (from decreased vitamin K)
-Brittle, weak bones (from decreased Ca and Vitamin D)
-Osmotic edema (from decreased proteins)

41

Diverticula have a very _____ wall composed of _____ and ______ only

Thin wall
-Mucosa and submucosa only
-NO MUSCLE present

42

Where do the mucosa and submucosa extrude through the musclular walls?

-Points where small arteries penetrate from the external surface

43

T/F- Colonic diverticulosis is uncommon in people who eat a traditional diet rich in grains, fruits, and veggies

True

44

Diets with small amounts of non-digestible bulk= more compact feces=

Easier to pass

45

Straining at stool causes...

Increased pressure

46

Stasis=

INFECTION

47

Pathogenesis of a blockage in the lumen

-Blockage
-Increase pressure
-Decreased blood flow
-Ischemia
-Infarction
-Necrosis
-Infection/inflammation

48

What are complications for diverticulosis

-Perforation
-Peritonitis
-Abcess
-Hemorrhage
-Fistulas
-Stenosis

49

Pathogenesis for appendicitis

-Obstruction of orifice
-Distension of lumen
-Pressure increases
-Stasis and ischemia
-Proliferation of bacteria
-Necrosis and perforation
-Complications

50

What is the most common cause of an abdominal emergency?

Appendicitis

51

S&S of appendicitis

-Periumbilical carmping/pain
-Localizes to RLQ
-Nausea, vomiting, anorexia
-RLQ tenderness= irritated peritoneum --> ilius