GI System Flashcards by Thomas Bryan

what secretes HCL

parietal cells

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is there increased or decreased gastric acidity with aging?

decreased

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what secretes GIF

parietal cells

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what happens when we do not have enough GIF as we age

we cannot absorb vitamin B12 which leads to atrophic gastritis, hematologic disorders, pernicious anemia (macrocytic, normochromic)

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chronic lack of GIF =

atrophic gastritis

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pernicious anemia is caused by what

lack of GIF

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can Atrophic Gastritis (chronic lack of GIF) lead to neurlogical disorders

yes

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what are the types of neurological disorders that can occur with Atrophic Gastritis

Peripheral Neuropathy

Subacute combined dengeration (affects dorsal white matter columns and SC Motor Pathways)

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Megaloblastic Madness occurs with what

B12 deficiency

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sypmtoms of esophageal disorders

) Dysphagia- tough time swallowing
Pyrosis- burning feeling in neck and chest
Odenphagia- painful swallowing
Waterbrush- reflux of acid up from stomach and mixing with saliva (can lead to pneumonia aspiration)

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Type of esophagitis that comes from eating or drinking too much and goes away in 24-48 hours

Acute Esophagitis

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When acid from stomach splashes up to the Lower Esophagus. The lower esophageal sphicter is not working well

Chronic Esophagitis

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what can chronic esophagitis lead to

Barrett’s esophagus

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what is usually not working well with GERD (or chronic esophagitis)

the LES

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what are cells normally in the esophagus and what are they changed to with Barrett’s esophagus

normally they are stratified squamous. change to simple columnar with barretts

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herniation of the stomach thru the diaphragm

hitial hernia

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does the LES close when not swallowing with both a rolling and a sliding (most common) hiatial hernia

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how does scleroderma lead to an esophageal issue

the esophageal collagen hardens and this leads sto esophageal dysmotility and dysphagia.

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what will a cork screw esophagus be seen in

Esophagitis

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what is a slack esophagus with loss of muscle tone seen in

Scleroderma

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Waterbrush is seen with what

Esophageal Tumors

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where are most of esophageal tumors located

the lower 1/3 of the esophagus

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risk factors for esophageal disorders

smoking
alcohol excess
GE Reflux
Age
Being male

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what is esophageal achalasia

failure of the LES to relax when swallowing, so food accumulates in the esophagus and causes esophageal dilatation

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loss of the myenteric plexus

Auerbach's

loss of submucosal plexus

Meissner's

what is Mallory Weiss Syndrome (MWS)

LES bleeding from mucosal tears

what is the major cause of Mallory Weiss Syndrome (MWS)

Bulimia (occasionally alcohol and antibiotics)

What is a Tracheo-esophageal Fistula with Esophageal Atresia

an opening between the esophagus and trachea.

what can a tracheo-esophageal fistual lead to

aspiration penumonia

What are the 3 C's of Tracheo-esophageal fistula

Cough, choke, cyanosis

common things that can lead to acute gastritis

1. Overindulgence in alcohol or eating 2. NSAIDS, ASA 3. GI viral infection 4. Antibiotics 5. Oral Corticosteriods

is acute gastiris focal or diffuse inflammation

diffuse

Does eating help or make pain worse with acute gastritis

makes it better (pain relief food pattern seen with acute gastitris)

what causes Peptic Ulcer Disease

H. Pylori

Is a peptic ulcer focal or diffuse

focal lesion in the duodenum of the stomach

how does H. pylori cause peptic ulcers (describe the whole process)

by eroding the mucosa of the stomach. This causes HCL to get into the mucosa of the stomach which leads to ECL cells being stimulated. H2 receptors on the ECL cells release histamine leading to bleeding and vasodilatation. The histamine released from the H2 receptors on the ECL cells also sitimulate the pariteal cells to make more HCL which further leads to damage of this one part of the duodenum of stomach

where do most of the peptic ulcers occur

in the duodenal bulb (proximal part of the duodenum)

do peptic ulcers hurt more during the day or night

night

do peptic ulcers get worse or better with eating

better (pain relief food pattern)

where do stress ulcers most often form

the fundus of stomach

how do stress ulcers in the stomach occur

major trauma, SCI, serious illness or other stress causes blood to be routed elsewhere in the body, so there can be generalized GI ischemia bc not enough blood flow to the stomach

what is usually present with stomach cancers

H.pylori

most common type of gastric cancer

Gastric Adenocarcinoma-Excavated

gastric cancer that is invaginated growth

Gastric Adenocarciona

gastic cancer that may form a poyp and invades the stomach wall

gastric squamous cell carcioma

which type of gastric cancer is most commonly seen with H. pylori

MALT

where does MALT originate from

B lymphocytes

is MALT slow or fast moving

slow (indolent)

gastric neuroendorcine tumor that causes a wide range of symptoms and chemicals are secreted into the bloodstream

Carcinoid

when the entire wall of the stomach is thick and fibrous and cannot undergo peristalsis

Linitis Plastica

signs and symptoms of Gastric Neoplasia

``` Epigastric Pain Weight Loss Bloating Dysphagia Nausea Vomiting Blood Black "tarry" stools ```

what is Regional Enteritis (Crohn's Dz) and where does it occur

Autoimmune disease of the terminal ileum. Basically this is a narrow and inflammed ileum

what induces Celiac Disease (spure)

gluten

what is the issue in Celiac Disease

villi/microvilli are lost

signs and symptoms of Malabsorption Syndrome

``` weight loss diarrhea steatorrhea (fatty stools) flatulence nocturia fatigue Anemia (megaloblastic anemias....folic acid deficiency and pernicious anemia Neuro issues (B12) Brusing (Ecchymosis) ```

physiological causes of obstructive syndrome (can also be due to a mechanical obstruction....volvulus, intusseuspetion, or tumor)

loss of peristalsis (ileus) | fecal impaction

what is a volvulus

mechanical obstruction. twisted intestines

what is an intussusception

intestinal folding so there is partial obstuction and things cannpt pass thru as easily

where is a common place to see an intussception

Ileo-cecal area

What is Hirschpsrung's Disease (aka Congential Megacolon)

Congential Ileus caused by failure to form nerve networks that allow for peristalsis to occur. The colon is usually seeen as enlarged and static (rectal collapse can also be seen with this)

what is senile ileus

degeneration of the plexi that cause peristaliss as we age

what a paralytic ileus due to

SCI and parastmpathetic loss to the lower bowel (S2-S4)

signs and symptoms of bowel obstruction

cramping/abdominal pain abdominal distention and bloating Nausea/vomiting alternating constipation and diarrhea

altered stool size or color is commonly seen with what

colon disorders

hematochezia is commonly seen with what

colon disorders

alternating constipating and diarrhea is seen wit hwhat

small bowel obstructive disorders OR IBS

what nerve levels innervate the small bowel and cause ileus

s2-s4

where is McBurneys point

between the right ASIS and the navel (closer to ASIS tho)

describe Blumberg's sign

lie the pt. down on back and press into mcburneys point. if they have pain when you let go then this is postivie

where does most diverticulosis occur

90% occur in the sigmoid colon

what is diverticulosis

associated with aging. weakneing in the bowel wall

true or false: hematochezia can be seen with diverticulitis

true

potential outcomes of diverticulitis

1. resolution 2. bleeding 3. necrosis 4. rupture

what is idiopathic Ulcerative Colitiis (IUC)

an autoimmune disease that is more common in females and affects the mucosa only

too much clostridium difficile can come from what

taking antibiotics killing other bacteria so this stuff takes over leading to pseudomembranous colitis

what is a way to treat a C. Difficile infection

fecal transplant to have normal bacteria displace the abnormal ones

where does carcionoma of the colon most often occur

the left side in the rectosigmoid colon

a tumor on which side of the colon is tougher to detect with bleeding

right side (ascending colon)

alternating hyperactivity/spasm/sluggishness

IBS