Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pathophysiology > GI: Small Intestine & Colorectal > Flashcards

GI: Small Intestine & Colorectal Flashcards

(65 cards)

Start Studying
1
Q

Congenital Duodenal Obstruction

  • MC form?
  • define
  • what would you see on xray
  • MC etiology?
A

MC=Duodenal atreisa

*complete absence of closure of a portion of the duodenum–>leading to gastric outlet obstruction

DOUBLE BUBBULE*

malformatoin can be a narrowing (stenosis), absence or malrotation of a portion of the intenstine

MCC=vascular compromise (ischemia) in utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Duodenal atreisa is MC associted with?

A

downs syndrome + other congential abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Jejunoileal atresia MC associated with?

A

CF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
intestinal Malrotation 
-define 
-locations? 
-dev during?
CM
A

small intestine lacks normal posterior attachment (top)
**intestine twists upon itself–making a volvulus–and is defined by location: sigmoid, mid-gut, cecal, even gastric

*dev during neonatal period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

define volvulus

  • what can develop if left untreated

- which parts are MC invovled (adults vs kids)

A
  • when a loop of intestine twists around itself
  • mesentery that supports it–is obstructed–and if prolonged can lead to ischemia
  • colonic twisting***
  • twists at its mesenteric attachment site— why ishcemia can occur and MC leads to obstruction of vascular supply

untreated–perforation and/or ischemia

MC involved= sigmoid colon (75%) and cecum (25%)-adults

MC kids=midgut and ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what causes cecal volvulus

A

congenital lack of fixation of the right colon and tends to occur in younger patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Meckel Diverticulum

  • define
  • what is the MC s/s?
  • what can occur with it ?
A

(ileal)
* outpocketing of all layers of the small intestinal wall–MC ileum (lower intestines)
* congenital–left over from the yolk sac/umbilical cord
* pouch may contain ectopic gastric or pancreatic tissue–>that secretes digestive hormones–>leading to bleeding

“rule of 2s”

most are asympto

MC symptom is PANLESS rectcal bleeding

intestinal obstruction, intussusception and volvulus can occur
in adults may cause diverticulutis

MC congenital anomaly of the GI tract!!!****

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rule of two

  • list them (7)
  • for what dz
A 
Mickel Diverticulum 
2% of the population 
2x more common in males 
2 years MC age at presentation 
2% symptopatic 
2 inches in length 
2 types of ectopic tissue (gastric or pancreatic) 
1/2 present before age 2--- the rest usually in first 2 decades life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the MC congenital defect of the GI tract?

A

Meckel Diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Intussusception

  • define
  • MC where/how
  • can lead to if not tx?
  • typical CM buzzword?
A

telescoping (invagination) of a proximal segment of intestine into a distal segment— causing obstruction

MC occurs at the ileocolic junction–>ileum telescopes into the cecum and part of the ascending colon by collapsing through the ileocecal valve

can lead to: bleeding, necrosis, bowel perforation if not treated

blood supply compromise obstructoin–>ischemia–>bleeding–>necrosis–>perforation

CM– currant jelly stools. +abd pain +irritability +vomiting q

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the MCC of bowel obstruction in children 6MO-4 years

A

intussuscpetion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is meconium

A

substance that fills the intestine before birth

-thick black and tarry looking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

meconim ileus assoc with?

A

CF–20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

wht is more severe: meconium ileus or meconium plug

A

ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

meconium ileus

  • what is it
  • types
A

meconium causes intestinal obstruction because the it is extra thicker and stickier than normal–cannot pass–lads to ischemia

  • extra thick secretions from CF creates thicker meconium–gets stuck in terminal ileum–peristalsis fails to propel this thru–becomes impacted
  • small intestine will dilate since impacting is in terminal ileum–distention/backup into SI
  • large intestines will appear collapsed–since cannot propel forward into LI

types:
1. simple
2. complex: medical emergency***** it is so plugged it cannot be moved and ischemia occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Meconium plug syndorme

A

transiet
think of it like a fecal impaction but for babies
*delayed passage of meconium with intestianl dilation

**not as serious as meconium ileum– this is transient and will pass with time or laxative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

distal intestinal obstruction syndrome

-anatomic location of obstruction

A

characterized by complete or incomplete intestinal obstruction of viscid fecal accumulation in the terminal ileum and proximal colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

define aganglionic

A

NS innervating a certain part of the colon is not there– leads to colon enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hirschsprung DZ

  • define/also called?
  • MC affects what area
  • tx
A

also called: congenital aganglionic megacolon
**functional (secondary to motility issue) “obstruction” of the colon

“obstruction” aka pseudoobstruction bc something is not physically blocking the colon it is just extremely enlarged because the portion below the swollen colon lacks NS innervation so it cannot perform peristalsis

  • absecence of PSYMP nervous system intrinsic ganglionic cells— this is needed for normal peritalsis
  • abnormally innervated colon impairs fecal movements–>colon obstruction and distention

MC affects the rectum—- narrowed rectum and swollen sigmoid colon****

tx: surgrey– remove affected part of the bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anorectal malformations

  • name them
  • associated with
  • when are they IDed
A

anorectal stenosis
imperforate anus–>no butthole on outside
anorectcal atresia–>ends in blind pouch
rectcal atresia–>ends in blind pouch

  • assoc with other congenital developmental anomalies
  • IDed in routine physical exam
  • tx with dilations for stenosis or surgery for other malformations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

celiac dz
-what is it
-what grains?
-

A

autoimmune dz

  • damages small intestinal villous epithelium when gluten ingested
  • GLUTEN=protein component in wheat rye malt and barley

*dietary, genetic and immunologic factors
*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

patho steps for celiac dz—

A

gluten intolerance–>T cell, AB and complement activated:
A: PRIMARY EFFECTS: direct villus injury–>decr surface area–>inflammatory enteritis–>OSMOTIC diarrhea–>SECRETORY diarrhea–>decr absoprtion of proteins and decr electrolytes

B: SECONDARY EFFECTS: mucosal damage of proximal bowel–>decr intestinal homrones–>decr pancreatic function–>decr CHO absoprtion, protein absoprtion and fat absoprtion–>malnutriotn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q 
Constipation 
-deinfe 
primary
secondary
two basic etiologies
A

infreq or difficlt defecation

Primary:

  • normal transit functional
  • slow transit
  • pelvic floor or outlet dysfunction

Secondary:
-caused by many diff factors: diet, medications, dzs, aging

<3 BMs/weeek ***

  1. disordered movement–of the stool thru colon/anus/rectum
  2. slow colonic transit: dz, drugs SE, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

fecal impaction

MC where

A

large hard mass of stool that gets stuck so badly in colon or rectum that PT cannot push it out

  • can be very severe
  • more common in older aduts— imp cause of abdominal pain in elderly

*MC in distal rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
name some drugs that cause constpation name motor disorders that can cause constipation outlet delay dz causing constpation?
verapamil opioids DM colorectcal CA hypothryoid Hirschsprung's dz
26
diarrhea - define - acute - chronic - mild - moderate - severe - large volume vs small volume--- what is the cause for each
* rapid transit of bowel contents so there is insufficent time for reabsoprtion of water to firm feces * stools=loose and liquid * passed more frequently (usually>3/day) - acute: <2 weeks (usually infectious) - chronic: >2 weeks, usually >4 weeks - Mild: 3 or less/ day - mod: 4+ stool/day with local s/s: abdom cramps, nausea, tenesmus - severe: 4+/day with systemic symtpms: fever, chills, dehydration large volume: excess amt of water or secretions or both in the intestines small volume: usually results from excessive intestinal motility
27
what is responsible for the absoprtion of 90% of all nutrients?
SI
28
where is Vit B and K absoprted?
colon
29
name the different types of diarrhea
osmotic inflammatory/infectious/infiltrative abrnomal GI motility secretory
30
Osmotic diarrhea - define - causes and ex - typical CM
* additional water is pulled into the GI tract * something is pulling the water into the colon * *anytime something is not digested/absorbed-- it pulls water in CAUSES 1) ingestion: antacids, laxatives, sugar free candies 2) maldigestion: pancreatic insuff, diassacch insufficency 3. Malabsoprtion: CHO malabsoprtion, congenital choridorrhea CM: - abdmoinal distention - blaoting - flautlence due to increased colonic gas production
31
Disorders of intestinal transit diarrhea - define - causes + ex
contents move through intetines too quickly for normal water absoprtion to occur causes 1) rapid transit--insuff contact time: intestinal resection, hyperT, IBS-D
32
Secretory Diarrhea - define - causes + ex - CM
epithelial cells lining the intestines actively secrete more water than they absorb--causing large volumes of fluid diarrhea and rapid dehydration causes: 1) bacterial endotoxins: Vibrio cholerae, E. coli 2) Secretagogoues: bile acids, fatty acids, ethanol, prostaglandins, gastrin, calcitonin CM: - high volume (>1L/day) of watery diarrhea - dehydration - elect imabal
33
drugs that cause diarrhea
* Cholinesterase inhibitors * Selective serotonin reuptake inhibitors * Angiotensin II-receptor blockers * Proton pump inhibitors * Nonsteroidal anti-inflammatory * Metformin * Allopurinol * Orlistat * Lactulose * Antacids--mag * Rx’s for constipation
34
Exudative Diarrhea | -define
**inflammatory** Causes: 1) increased passage of body fluids into lumen due to inflammatory intestinal mucosal damage--UC, CD
35
describe visceral pain - patho? causes? - ex
vague dull poorly localized PATHO: - inflammation ischemia or distention that causes it - can start diffuse/midline--stemming from embryological bilateral innvervation of organs EX: -early appendicitis -
36
describe parietal pain - patho? causes? - ex
sharp, localized PATHO: - parietal peritoneum inflammation or irritation - complete involement of the parietal peritoneum - pain can become more diffuse in advnaced dz ``` EX: -late stages of appendicitis: +localized RLQ pain +rebound tenderness +rigidity ```
37
Describe referred pain - patho/causes - ex
Distant to orginial pathology PATHO: -related usually to embryological origins EX: MI presenting as epigastric pain pancreatitis with back pain
38
reff pain to the shoulder is involving what nerve
irritation of phrenic nerve
39
stomach can have reff pain to?
shoulders
40
pancreas can have ref pain to?
left sohulder | back
41
GB can have ref pain to?
right subscapular area
42
list the types and ex for each of LGIB
1. anatomic--diverticulosis 2. Vascular--radiation induced, ischemic, 3. neoplasm 4. inflammatory---infectious or non infectius * infectious: salmonella, shigella * noninfectious: CD
43
what is there incr levels of if GIB?
BUN (blood urea nitrogen) | because there is protein in the blood--- we digest it absorb it... increases our BUN
44
what is the typical lab work indication for a GIB?
BUN>>>>>> | creatinine stays same
45
what anatomical parts are part of the UGIB
duodenum stmoach esophagus
46
intestinal obstruction - define - types - MC in woh - CM for small intestinal obstruction vs large - MCC? adults and kids and then other general causes
any condition that prevents flow of chyme through the intestinal lumen SIMPLE: mechanical blockage of the lumen FUNCTIONAL: aka paralytic ileus - failure of intestinal motlity - often occurs after intestinal or abdominal surgery, pancreatitits, or hypokalemia MC in adults CM for Small intestinal ob: - colicky (episodic) pains - N/V--- usually bilious CM for large intestinal ob: -hypogastric pain and distention MCC in adults is: 1. intestinal adhesions 2. colin CA MCC kids: 1. intussusuception other general causes: - hernias - IBD--CD - Diverticulitis - Volvulus - Impacted feces
47
intestinal adhesions
bans of firbous tissue in abd cavity that can come after abd or pelvic surgery
48
list the patho steps when an intestional obstruction occurs
gas and fluid build up proximal to obstruction-->distention that causes: A) Pressure on diagraphm-->decr respiratory volume-->atelectasis-->pneumoina B) Colicky abdominal pain-->N/V (decr food intake), decr nutrient abs, decr CHO reserves--KETOSIS-->loss of water and electrolytes--dehydration, hypok, hypochloremia,
49
when does acidosis start in a PT with intesitanl obstruction
late in the prcess or if the obstruction is low
50
when does alkalosis start in a PT with an intestinal obstruction
Early in process or if obstruction is high
51
Inflammatory bowel Dz - general definiton for IBD - general cause
Ulcerative colitis and Crohn's dz IBD: chronic, replasing, inflammator bowel disorders RF genetics, environmental factors, alterations of epithelieal barrier functions, altered imune reactions to intestinal flora CAUSE FOR BOTH: acute on chronic inflammatory response 1. tissue immune cells activated 2. cytokines + inflammation 3. disrupt mucosal barrier 4. T cell medicated response * **this cycle continues
52
Ulcerative Colitis - define - locations MC - dz is defined by - where does it start - general s/s
chronic inflamma dz that causes ulcerations of colonic mucosa - begins in the rectum-->may extend proximally all the way to the entire colon - defined by the LOCATION and severity * intermittent periods of remision and exacerabtion CM: - diarrhea (10-20/day) - urgency - bloody stools *****NOT SEEN IN CD**** - cramping
53
which has bloody stools-- UC or CD>
UC
54
``` Chohn Dz -define -location -causes? -what can develop - ```
granulomatous colitis, ileocolitis or regional enteritis * idiopathic inlflam disorder * affects ANY part of GI tract * casues SKIP LESIONS -can cause fissues tht extend into the lymphatics** s/s simialr to UC except no bloody stool B12 anemia can develop bc ileum is point of origin always (ilitiis)
55
CD: - site of origin - patttern of progression - thickness of inflammation - s/s - complications - radiographic findings - rick of colon CA - surgery
- site of origin--terminal ileum - patttern of progression--skip lesions/irregular - thickness of inflammation--transmural (full thickness) - s/s--crampy abd pain - complications--fistulas, abscess, obstruction - radiographic findings--string sign on barium X-ray - rick of colon CA--slight increase - surgery--for complications like strictures
56
UC: - site of origin - patttern of progression - thickness of inflammation - s/s - complications - radiographic findings - rick of colon CA - surgery
- site of origin--rectum - patttern of progression--proximally contiguously - thickness of inflammation--submucosa or mucosa - s/s--bloody diarrhea - complications--hemorrhage, toxic megacolon - radiographic findings--lead pipe colon on barium XR - rick of colon CA--marked incr (more than CD) - surgery--curative
57
microscopic colitis
relatively common cause of nonbloody diarrhea *chronic watery watery diarrhea--everyday FORMS: 1. Lymphocytic - causd by inflammation due to invasion of lymphocytes (meds or infection can trigger) 2. Collagenous - thick layer of collagen along with inflammation
58
IBS - define - characterixed by? - F or M mC? - assoc with? - causes - mainfestations - s/s relieved?
disorder of brain-gut interaction *recurrent abd pain with altered bowel habits F>>>M assoc with: - stress - anxiety - depression - reduced quality of life possible causes: bc really unsure what causes it 1. visceral hypersensitivity or hyperalgesia 2. abnormal intestinal permeability, motiltiy and secrertion 3. postinflammatory (infectious or noninfectious) 4. alteration in gut microbiota (dysbiosis) 5. Food allergy/intolerance 6. psychological factors CM: - lower abdominal pain or discomfort and bloating - some s/s can be grouped: 1. diarrhea-predominant 2. constipation predominant 3. alternating C and D s/s usually relieved with defication and DO NOT INTERFR WITH SLEEP ******* No cure-----
59
PT is waking up at night with s/s--- what do you think of
chronic colitis | *not being woken up is more IBS
60
Diverticula define | -MC where
herniations of mucosa through the muscle layers of colon wall - ESP sigmoid * form at weak points in colon wall
61
diveticulosis
asymptomatic diverticular dz
62
diverticulitis
inflammatory stage of diverticulosis | -can cause fistula, bleeding, asbcess, obstruction perforation it it becomes complicated
63
``` appendicitis define causes complications tests? ```
inflammation of the vermiform appendix causes: obstruction (fecaliths), FB, infection periumbilical or epigastric pain **rebound tenderness to RLQ most serious complications: peritonitits, perf and abscess formation Obturator: flexion + inteneral rotation of hip Psoas: irritation to the iliopsoas group of hip flexsors with hip flexion or hyperextension Rovsing: palpLLQ-->pain in RLQ
64
Mesenteric Vascular Insufficiency aka? -vasc supply to stomach and intestines comes from? -typical CM?
ischemia blood supply to the stomach and intestine: - celiac artery - superior and inferior mesenteric arteries **PAIN OUT OF PROPORTION TO `EXAM****
65
what is very commonly associated with UC
Primary Sclerosing Cholangitis

Pathophysiology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions