GI system- Exam II Flashcards
(156 cards)
1
Q
Diseases of the GI tract can be classified as: (5)
A
- developmental disorders
- inflammatory diseases
- functional disorders
- circulatory disturbances
- neoplastic diseases
2
Q
Describe the process of digestion (6):
A
- ingestion
- mastication
- deglutition
- digestion
- absorption
- excretion
3
Q
- Hiatal hernia
- Reflux esophagitis
- Barret esophagus
- Achalasia
- Esophageal varices
- Esophageal cancer
These are all GI diseases
A
esophagus
4
Q
- Acute gastritis
- Chronic gastritis
- Peptic ulcer disease
- Stomach cancer
These are all GI diseases involving the:
A
stomach
5
Q
- Meckel diverticulum
- Bowel obstruction
- Herniation
- Adhesions
- Intussusception
- Volvulus
- Adenocarcinoma
- Carcinoid tumor
These are all GI diseases involving the:
A
small intestine
6
Q
- Pseudomembranous colitis
- Diverticulosis
- Crohn disease
- Ulcerative colitis
- Adenomatous polyps
- Colon cancer
These are all GI diseases involving the:
A
Large intestine
7
Q
The layers of the GI system include:
A
- mucosa
- submucosa
- muscularis propria
- adventitia or serosa
- vasculature
8
Q
The layers of the mucosa of the GI system include:
A
- epithelium
- lamina propria
- muscularis mucosae
9
Q
The muscularis propria of the GI system can be either:
A
circumferential or longitudinal
10
Q
Important clinical symptoms and signs relating to the GI system include: (8)
A
- dysphagia
- vomiting
- hematemesis
- hematochezia
- melena
- diarrhea
- constipation
- odynophagia
11
Q
Important clinical symptoms relating to the GI system -
difficulty in swallowing:
A
dysphagia
12
Q
Important clinical symptoms relating to the GI system -
expulsion of stomach contents through the mouth:
A
vomiting
13
Q
Important clinical symptoms relating to the GI system -
vomiting of fresh, red blood:
A
hematemesis
14
Q
Important clinical symptoms relating to the GI system -
bright, red blood in stool:
A
hematochezia
15
Q
Important clinical symptoms relating to the GI system -
black, tarry feces:
A
melena
16
Q
Important clinical symptoms relating to the GI system -
frequent, loose, watery bowel movements:
A
diarrhea
17
Q
Important clinical symptoms relating to the GI system -
hard feces that are difficult to eliminate:
A
constipation
18
Q
Important clinical symptoms relating to the GI system -
painful swallowing:
A
odynophagia
19
Q
Painful swallowing =
Difficulty in swallowing =
A
odynophagia; dysphagia
20
Q
A subspecialty of internal medicine involved with diagnosis, treatment, and procedures involving the GI system:
A
gastroenterology
21
Q
Upper GI endoscopy:
A
esophagogastroduodenoscopy (EGD)
22
Q
Lower GI endoscopy:
A
colonoscopy
23
Q
Describe the layers of the esophagus
A
- Mucosa (epithelium, lamina propria, muscularis mucosae)
- Submucosa
- Muscularis
24
Q
Clinical signs and symptoms of esophageal disease include:
A
- dysphagia
- odynophagia
- heartburn
- acid regurgitation into the mouth
25
A burning behind the sternum related to GERD:
Heartburn
26
Acid regurgitation into the mouth is a sign of:
GERD
27
Dysfunction of ganglion cells of myenteric plexus (Auerbach plexus) that prevents proper relaxation of lower esophageal sphincter- a motility disorder:
achalasia
28
Achalasia can be described as:
a functional motor disorder
29
Achalasia symptoms can include:
1. dysphagia
2. halitosis
3. regurgitation
4. proximal dilation
30
This image describes what disease?
achalasia
31
Plummer-Vinson Syndrome may also be referred to as:
Paterson-Kelly syndrome
32
Severe Fe-deficiency anemia seen in Scandinavian, and Northern European women:
Plummer-Vinson Syndrome (Paterson-Kelly Syndrome)
33
- Mucosal atrophy- atrophic glossitis
- esophageal webs- dysphagia
- increased risk for squamous cell carcinoma
- Severe fe deficiency anemia
These are all symptoms of:
Plummer-Vinson Syndrome (Paterson-Kelly Syndrome)
34
In Plummer-Vinson Syndrome (Paterson-Kelly Syndrome), there is an increased risk for:
squamous cell carcinoma
35
In Plummer-Vinson Syndrome (Paterson-Kelly Syndrome), there is an increased risk for squamous cell carcinoma, especially in what locations? (3)
1. esophagus
2. oropharynx
3. posterior oral cavity
36
What results from portal hypertension that produces venous dilation?
esophageal varices
37
Esophageal varices are caused by:
portal hypertension producing venous dilation
38
What can be seen in the image? What disease does this symptom appear in?
Atrophic glossitis (mucosal atrophy); Plummer-Vinson Syndrome (Paterson-Kelly syndrome)
39
1. Rupture of esophageal varices lead to ____ & ____
2. Rupture of varix is associated with ____
3. Rupture of varix accounts for _____
1. hematemesis & massive upper GI bleed
2. high mortality
3. half of the deaths in advanced cirrhosis
40
These images are all showing:
esophageal varices
41
What accounts for half of deaths in advanced cirrhosis?
esophageal varices
42
Seen in chronic alcoholics, where vigilant retching causes esophageal lacerations and hemorrhage:
Mallory-Weiss tears (mallory-weiss syndrome)
43
These images show:
Mallory-Weiss tears (mallory-weiss syndrome)
44
Widened diaphragmatic hiatus that allows protrusion of the stomach through the diaphragm:
hiatal hernia
45
In a hiatal hernia, the ____ is pulled into the thorax
gastroesophageal junction
46
Gastric metaplasia of lower esophageal mucosa- columnar epithelium replaces stratified squamous epihtelium
barretts esophagus
47
What are the symptoms associated with Barretts esophagus?
1. odoynophagia
2. ulceration
3. hemmorhage
48
Individuals with Barretts esophagus are at an increased risk for:
adenocarcinoma
49
In barretts esophagus, ___ replaces ___
columnar epithelium replaces stratified squamous epithelium
50
What are two types of esophageal cancer?
1. squamous cell carcinoma
2. adenocarcinoma
51
In cases of ____ individuals experience dysphagia due to narrowing of lumen or interference with peristalsis
esophageal cancer
52
Esophageal squamous cell carcinoma, occurs more often in ___ , has ___ variation, and has ___ prognosis
older adults; geographical variation; poor prognosis
53
What is the most common type of esophageal cancer world wide? What is the most common esophageal cancer in the U.S?
squamous cell carcinoma; adenocarcinoma of the esophagus
54
Esophageal squamous cell carcinoma is most common in the ____ of the esophagus
middle third
55
What are some risk factors associated with esophageal squamous cell carcinoma?
1. alcohol & tobacco
2. Plummer vinson syndrome
3. diet
56
Esophageal adenocarcinoma typically is located in the:
lower segment of esophagus
57
What is a risk factor for esophageal adenocarcinoma?
barret esophagus
58
What esophageal cancer is most common in the u.s?
esophageal adenocarcinoma
59
What are the steps of an esophagus developing esophageal adenocarcinoma?
1. squamous epithelium
2. esophagitis
3. barretts esophagus (columnar epithelium)
4. dysplasia
5. carcinoma
60
List the epithelial cells of the stomach:
1. mucous cells
2. parietal cells
3. chief cells
4. endocrine cells
61
The parietal cells of the stomach are responsible for secreting:
HCL and intrinsic factor
62
The chief cells of the stomach are responsible for secreting:
pepsin
63
The endocrine cells of the stomach (also called ____) are responsible for secreting:
G-cells; gastrin
64
Inflammation of the gastric mucosa:
gastritis
65
Gastritis that is purely erosive in nature, due to irritant and NSAIDS
acute gastritis
66
Gastritis that is either erosive or non-erosive, due to infection or autoimmune process
chronic gastritis
67
What are the symptoms of acute erosive gastritis
1. epigastric burning
2. pain
3. nausea
4. vomiting
68
Describe the erosions seen in acute erosive gastritis:
shallow erosions
69
What may be the cause of acute erosive gastritis?
1. aspirin
2. NSAIDs
3. alcohol
4. stress
5. shock
6. sepsis
70
One of the major causes of hematemesis in alcoholics:
acute erosive gastritis
71
Chronic gastritis is referred to as ___ or ___ gastritis
infectious or autoimmune
72
The most common form of chronic gastritis is due to:
infection by helicobacter pylori
73
Why does autoimmune chronic gastritis occur?
autoantibodies to parietal cells (HCL)
74
Helicobacter pylori gastritis can be responsible for causing: (3)
1. peptic ulcer disease
2. adenocarcinoma
3. MALT lymphoma
75
H. Pylori is considered a potential:
human carcinogen
76
How do we test for H. Pylori?
1. visualize gram-negative S-shaped rods
2. biopsy and silver stain
3. urea breath test
4. antibody test for H. pylori
77
autoimmune gastritis may also be called:
atrophic gastritis
78
autoantibodies against gastric parietal cells causing gastric mucosal atrophy:
autoimmune (atrophic) gastritis
79
What are some risk factors for autoimmune (atrophic) gastritis
1. no intrinsic factor
2. low serum vitamin b-12
3. pernicious anemia
80
deeper than erosions and may extend to muscularis
gastric stress ulcers
81
Risk factors for gastric stress ulcers include:
ICU patients- shock, trauma, burn, sepsis
82
Most peptic ulcers are generally:
solitary lesions
83
Most peptic ulcers occur in the ____
duodenum
84
98% of peptic ulcers are located in the:
duodenum and stomach
85
sharply-demarcated ulcer with clean, smooth base
peptic ulcer
86
Chronic peptic ulcer lesions may exhibit:
puckering due to fibrosis
87
describe the clinical course/symptoms of peptic ulcer disease:
1. acute/chronic blood loss
2. nausea, vomiting, hematemesis, & melena
3. perforation (major cause of death in PUD)
88
What is the major cause of death in PUD?
perforation
89
In peptic ulcer disease, immediate pain =
gastric ulcer
90
In peptic ulcer disease, delayed pain =
duodenal ulcer
91
Peptic ulcer disease can be described as a ____ disease with decreased ___
multifactorial disease; decreased mucosal resistance
92
A common infectious cause of peptic ulcers is:
infection with H.pylori
93
What drugs may cause peptic ulcers?
Aspirin & NSAIDs
94
Hormonal hyper secretion syndromes leading to peptic ulcers can be described as:
neuroendocrine
95
What are two neuroendocrine syndromes associated with peptic ulcers?
Cushing syndrome (corticosteroids) & Zollinger-Ellison syndrome (gastrin)
hyper secretion of these hormones
96
What are 5 complications of peptic ulcer disease?
1. minor hemorhage
2. marhor hemorhage
3. perforation
4. stenosis & obstruction
5. penetration into pancreas
97
condition characterized by gastrin-secreting tumor in pancreas or duodenum ("gastrinoma")
Zollinger-Ellison syndrome
98
Gastrinoma:
Zollinger-Ellison syndrome
99
In Zollinger-Ellison syndrome hypergastrinemia causes:
hyper secretion of gastric acid
100
Can be described as severe peptic ulcer disease with multiple ulcers in unusual locations:
Zollinger-Ellison syndrome
101
gastric adenocarcinoma is seen more often in ___ individuals and has a ___ prognosis
older individuals; poor
102
Risk factors for gastric adenocarcinoma include:
1. smoked fish (nitrosamines)
2. H. Pylori infection
3. chronic atrophic gastritis
4. gastric adenomatous polyps
103
gastric adenocarcinoma most often occurs in the:
lesser curve of antropyloric region
104
Describe the intestinal type of adenocarcinoma:
bulky tumors composed of glandular structures
105
Describe the diffuse type of gastric adenocarcinoma:
infiltrative growth of poorly differentiated cells (linitis plastica)
106
Metastatic adenocarcinoma to the ovaries:
Krukenburg tumor
107
B/L ovarian metastases is commonly seen in:
Krukenberg Tumors
108
Krukenberg tumors are frequently of ____ origin caused by ____ cells
gastric origin; mucus producing cells
109
Gastrointestinal tract lymphomas include:
1. non-hodgkin lymphoma
2. primary lymphomas
3. secondary lymphomas
110
Is hodgkin lymphoma or non-hodgkin lymphoma associated with gastrointestinal tract lymphoma:
NON-hodgkin
111
Primary lymphomas of the gastrointestinal tract:
MALT-omas and other NHLs
112
Secondary lymphomas of the gastrointestinal tract involve:
extranodal spread
113
Gastric MALT lymphoma: What is the most common site for extranodal lymphomas?
stomach
114
B-cell lymphomas of mucosa-associated lymphoid tissue:
MALT lymphomas
115
Gastric MALT lymphoma is associated with:
H. Pylori infection
116
What can be found in the innermost layer of the small intestine?
villi
117
Developmental defect of the ileum- a blind pouch containing all layers:
meckel diverticulum
118
Meckel diverticulum may be referred to as:
"left-sided appendix"
119
What may produce symptoms similar to appendicitis?
mocked diverticulum
120
causes of bowel obstruction include: (4)
1. herniation
2. adhesions
3. intussusception
4. volvulus
121
Herniation is caused by:
weakness in peritoneum
122
Locations of hernias include: (4)
1. inguinal
2. femoral
3. umbilicus
4. incisional
123
Fibrotic bridges of peritoneum:
intestinal adhesions
124
Intestinal adhesions may:
trap and kink bowel segments
125
Adhesions are usually a sequelae of:
prior surgery or infection
126
When the small intestine invaginates into itself, and becomes necrotic unless everted:
intussusception
127
When small intestine invaginates into itself, it will become ____ unless ___
necrotic; everted
128
Rotation of a loop of intestine about its own mesenteric root
volvulus
129
Where are volvulus most commonly occur?
small intestine and sigmoid colon
130
Volvulus leads to:
necrosis
131
adenocarcinoma of the small intestine is:
rare
132
A low-grade malignancy of neuroendocrine cells, appearing as mucosal nodules:
carcinoid tumor
133
A carcinoid tumor is a low-grade malignancy of ____ cells, appearing as ____
neuroendocrine cells; mucosal nodules
134
A carcinoid tumor may occur throughout the GI tract but are most common in the:
appendix
135
A carcinoid tumor may produce hormones such as:
serotonin
136
Caused by a serotonin producing carcinoid tumor that is asymptotic until metastasis to the liver:
carcinoid syndrome
137
Carcinoid syndrome is caused by a ____ producing carcinoid tumor that is:
serotonin; asymptomatic until metastasis to the liver
138
In carcinoid syndrome, what happens to the serotonin that is no longer metabolized by the liver?
causes cramping, diarrhea, flushing and bronchospasm
139
Name the characteristic feature of the large intestine:
Crypts
140
Name the characteristic feature of the small intestine:
villi
141
The large intestine may be referred to as the:
colon
142
What plexi are in the enteric nervous system?
myenteric (Auerbach) and submucosal (messier)
143
The colon is colonized by:
non-pathogenic strains of bacteria
144
Hirschsprung disease may also be referred as:
congenital megacolon
145
Developmental defect of enteric nervous system- angangliosis of terminal colon (myenteric plexus):
Hirschsprugn disease- congenital megacolon
146
consists of out-pouching of mucosa and submucosa through muscular layer of colon:
diverticulosis
147
Diverticulosis is associated with:
a low bulk diet & straining during defecation
148
If diverticulosis becomes inflamed it transitions to:
diverticulitis
149
neoplastic polyps of the intestine may also be called:
adenomatous polyps or adenomas
150
What are the two categories of intestinal polyps?
1. neoplastic polyps
2. non-neoplastic polyps
151
What are the two types of neoplastic polyps in the intestine?
1. tubular adenoma
2. villous adenoma
152
What are two types of non-neoplastic polyps in the intestine?
1. hyperplastic polyp (most common)
2. hamartomatous poly (Peutz-Jeghers syndrome)
153
Non-neoplastic hyperplasia of the epithelium; most common:
hyperplastic polyp
154
A hyperplastic polyp is considered:
NOT pre-malignant
155
- large, pedunculate polyp, consisting of all layers of the mucosa
- may be associated with Peutz-Heghers syndrome
- risk for intussusception
- no malignant change
hamartomatous polyp
156
- autosomal dominant condition
- pigmented macula's of oral mucosa and peri oral skin
- hamartomatous polyps of bowel
-incrased risk for adenocarcinoma outside GI tract (pancreas, breast, lung, ovary, uterus)
Peutz-Jegher Syndrome
