GI - Patho E3

Question 1

IBS key points

Answer 1

-IBS D&C
-distention, fullness, bloating, flatus
-intermittent
-exacerbated by stress, relieved by defecation
-intolerance to certain foods (sorbitol, lactose, gluten)
-non bloody stools

Question 2

what can trigger IBS

Answer 2

stress, food, hormone changes, GI infections, menses

Question 3

IBD is most common in

Answer 3

women
Caucasians
jewish descent
smokers

Question 4

etiology of IBD

Answer 4

genetically autoimmune activated by an infection

Question 5

Crohn’s patho

Answer 5

lymph structures get blocked -> tissues become engorged & inflamed -> fissures & ulcers develop in patchy patterns skip lesions w/ cobblestone apperance

Question 6

complications of Crohn’s disease

Answer 6

-malnutrition (anemia)
-scare tissue & obstructions
-fistulas
-cancer

Question 7

Crohn’s disease clinical manifestations

Answer 7

-cramping in RLQ
-watery diarrhea
-systemic wt loss, fatigue, no appetite, fever, malabsorption
-palpable abdominal mass (RLQ)
-mouth ulcers
-s/s of fistulas

Question 8

Crohn’s disease affects what part of the GI tract

Answer 8

mostly the upper portion and small intestines with a little bit of the rectum

Question 9

UC affects what what part of the GI tract

Answer 9

the rectum & colon

Question 10

UC pathogenesis

Answer 10

inflammation begins in the rectum & extends in a continuous segment that may involve the entire colon -> inflam leads to large ulcerations & necrosis which can cause crypt abscesses -> body tries to repair w/ new granulation tissue but tissue is fragile & and bleeds easily

Question 11

UC clinical manifestations

Answer 11

-abdominal pain
-bloody diarrhea
-systemic: wt loss, fatigue, no appetite, fever

Question 12

complications of UC

Answer 12

hemorrhage, perforation, cancer, malnut, anemia, liver disease, fluid/lyte/pH imbalances
toxic megacolon: rapid dilation of the large intestine that be life threatening

Question 13

both UC & Crohn’s disease put a patient at risk for

Answer 13

DVTs & PEs

Question 14

what causes diverticulosis

Answer 14

low fiber diet resulting w/ chronic constipation

Question 15

clinical manifestations of diverticulitis

Answer 15

abdominal pain (LLQ)
fever
inc WBCs
constipation or diarrhea
acute passage of frank stool

Question 16

complications of diverticulitis

Answer 16

peritonitis
obstruction
perforation

Question 17

the upper GI includes

Answer 17

esophagus
stomach
beginning of the small intestine (duodenum)

Question 18

the lower GI includes

Answer 18

small intestine
colon
rectum
anus

Question 19

what do we want to prevent in people w/ gerd

Answer 19

barrett esophagus (development of abnormal metaplastic tissue that - premalignant)
3 fold increase of developing esophageal cancer

Question 20

hiatal hernia

Answer 20

a defect in the diaphragm that allows part of the stomach to pass into the thorax

Question 21

sliding hiatal hernia

Answer 21

usually small & often does not need treatment

Question 22

paraesophageal hiatal hernia

Answer 22

part of the stomach pushes through the diaphragm & stays there

Question 23

hiatal hernia clinical manifestations

Answer 23

-belching
-dysphagia
-chest or epigastric pain
-too much pressure on the muscles around stomach leading to severe coughing, vomiting, & constipation

Question 24

hiatal hernia treatment / education

Answer 24

-SFM
-don’t lay after meals
-avoid tight clothing
-wt control
-antacids

Question 25

acute gastritis

Answer 25

temporary inflammation of **only the stomach lining** (no intestines included) that lasts 2-10 days

Question 26

acute gastritis etiology

Answer 26

irritating substances (alc) drugs (NSAIDs) infectious agents (H.pylori)

Question 27

chronic gastritis

Answer 27

progressive disorder with chronic inflammation in the stomach

Question 28

complications of chronic gastritis

Answer 28

PUD bleeding ulcers anemia gastric cancers

Question 29

chronic gastritis etiologies

Answer 29

1) autoimmune -> attacks the parietal cells 2) H.pylori infection

Question 30

what can H.pylori cause

Answer 30

chronic gastritis PUD stomach cancer

Question 31

how is H.pylori transmitted

Answer 31

-person to person via salvia, fecal matter or vomit -contaminated food or water

Question 32

acute or chronic gastritis sx

Answer 32

anorexia N/v postprandial discomfort intestinal gas hematemesis tarry stools anemia

Question 33

acute gastroenteritis

Answer 33

inflammation of the **stomach & small intestine**

Question 34

acute gastroenteritis etiologies

Answer 34

1) viral infections- norovirus & rotavirus 2) bacterial infections- E.col, salmonella, campylobacter 3) parasitic infections

Question 35

acute gastroenteritis clinical manifestations

Answer 35

-watery diarrhea (possibly w/ blood if bacteria) -abdominal pain -N/v -fever, malaise

Question 36

acute gastroenteritis complication

Answer 36

fluid volume deficit because of mass amount of diarrhea

Question 37

acute gastroenteritis treatment

Answer 37

let the patient right it out but may need to give fluids

Question 38

when does PUD develop

Answer 38

**when the GI tract is exposed to acid and h. pylori** (+NSAIDs, ASA, Alc) +smoking +stress bc inc gastric acid is a stress response

Question 39

why can NSAIDs induce PUD

Answer 39

they inhibit prostaglandins synthesis so the upper GI loses the mucus coating

Question 40

PUD clinical manifestations

Answer 40

-N/v -anorexia -wt loss -bleeding -burning pain (middle abdomen)

Question 41

gastric ulcer

Answer 41

CM: burning, cramping, gas like location: epigastrium, back timing: **1-2 hr after eating**

Question 42

duodenal ulcer

Answer 42

CM: burning, cramping, gas like location: epigastrium, back timing: **2-4 hrs after eating**

Question 43

complications of PUD

Answer 43

hemorrhage obstruction perforation / peritonitis

Question 44

complications of appendicitis

Answer 44

gangrene abscess formation peritonitis

Question 45

key points of appendicitis

Answer 45

-RLQ pain -rebound pain -sudden relief of pain if it ruptures

Question 46

peritonitis

Answer 46

inflammation of the peritoneum that causes 3rd spacing which can lead to hypovolemic shock, sepsis, & decreased peristalsis -> paralytic ileus

Question 47

peritonitis clinical manifestations

Answer 47

-sudden & severe pain -abdominal pain -tenderness -rigid, board like abdomen -N/v

Question 48

vitals/labs seen during peritonitis

Answer 48

fever elevated WBCs increased HR decreased BP