HLTH 2501: lower GI tract disorders Flashcards

(95 cards)

1
Q

gliadin

A

a breakdown product of gluten

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2
Q

celiac disease

A

is a malabsorption syndrome that occurs due to a defect in the intestinal enzymes that prevents the digestion of glidin, causing a toxic effect in the intestinal villi

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3
Q

effect of celiac disease on the villi

A

the villi atrophy, resulting in decreased enzyme product and less surface area available for nutrient absorption

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4
Q

effect of celiac disease

A

mainly is malabsorption and malnutrition which manifest as steatorrhea, muscle wasting, failure to gain weight, and irritability and malaise; individuals are at a higher risk for intestinal lymphoma

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5
Q

steatorrhea

A

excessive amounts of fat in your poop

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6
Q

how is celiac dianogsed?

A

blood tests that check for autoantibodies, a duodenal biopsy, and testing a gluten-free diet

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7
Q

how is celiac disease treated?

A

gluten-free diet

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8
Q

what are chronic inflammatory bowel diseases (2)

A

crohn disease and ulcerative colitis

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9
Q

genetic causes of IBD

A

common in white persons, particularly those from Eastern Europe

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10
Q

serum levels of those with IBD

A

high levels of antibodies, human leukocyte antigen, cytoskins, interleukin, and T lymphocytes

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11
Q

differences between Crohn’s and ulcerative colitis

A

Crohn’s develops during adolescence and ulcerative colitis in later years

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12
Q

what areas of the GI tract does Crohn’s effect?

A

the terminal ileum and sometimes the ascending colon

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13
Q

inflammation in Crohn’s disease

A

occurs in skip lesions, which are affected segments clearly separated by areas of normal tissue; initially occurs in the mucosal layer, but will progress to affect all layers of the wall

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14
Q

intestines of those with Crohn’s disease

A

narrow lumen that may become totally obstructed, granulomas may appear, and motility is decreased, thus decreasing the time for digestion and absorption

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15
Q

effects of Crohn’s disease

A

hypoproteinemia, avitaminosis, malnutrition, and possibly steatorrhea; ulcers may also form

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16
Q

signs of Crohn’s disease

A

diarrhea with cramping, melena may occur if the uclers erode blood vessels, pain in the LRQ, anorexia, weight loss, anemia, fatigue, delayed growth, and psychological implications

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17
Q

where does ulcerative colitis occur

A

in the rectum and throughout the colon

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18
Q

inflammation in ulcerative colitis

A

inflammation occurs in the mucosa and the submucosa, and the tissue becomes edematous (swollen) and friable (easily crumbled), and ulcers develops; in an attempt to heal, granulation tissue develops

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19
Q

toxic megacolon

A

occurs in severe acute episodes of ulcerative colitis; inflammation impairs peristalsis, leading to obstruction and dilation of the colon, usually the transverse colon

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20
Q

risks of ulcerative colitis

A

colorectal carcinoma

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21
Q

signs of ulcerative colitis

A

diarrhea with blood and mucus, cramping pain, tenesmus (persistent spasms of the rectum), rectal bleeding, iron-deficiency anemia, fever, and weight loss

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22
Q

treatment of IBD

A

removing physical and emotional stressors, anti inflammatory medications, antimotility agents, nutritional supplements, antimicrobials, immunotherapeutic agents, and surgical procedures such as an ileostomy and colostomy

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23
Q

anti inflammatory drugs for IBDs

A

sulfasalazine or glucocorticoids

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24
Q

antimotility drugs for IBDs

A

loperamide or anticholinergic drugs

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25
recommended diet for IBDs
high in protein, vitamins, and calories, but low in fat
26
antimicrobials for IBDs
metronidazole or ciprofloxacin
27
IBS
a gastrointestinal disorder characterized by abdominal pain/discomfort and changes in normal bowel habits
28
primary symptoms of IBS
symptoms of diarrhea, constipation, or pain
29
different types of IBS
abnormal GI motility and secretion, visceral hypersensitivity, post infectious IBS, overgrowth of flora, food allergy or intolerance, and psychosocial factors
30
abnormal GI motility and secretion IBS
diarrhea or constipation that is caused by hypersensitivity or serotonin on the ENS
31
visceral hypersensitivity IBS
increased sensitivity to visceral pain; can be abnormal motility but also activated mast cells and T lymphocytes or the CNS
32
postinfectious IBS
caused by low-grade inflammation in the gut and an abnormal immune response; often is associated with bacterial enteritis
33
overgrowth of flora IBS
can cause constipation and bloating due to methane gas production which is a result of overgrowth of the normal flora in the gut
34
food allergy or intolerance IBS
certain food antigens activate the immune response in the mucosa, causing a hypersensitivity reactions and IBS symptons
35
psychosocial factors for IBS
IBS symptoms may be caused by emotional stress, which in turn affects the ANS and the neuroendocrine pathway
36
signs of IBS
lower abdominal pain, diarrhea, constipation, alternating diarrhea and constipation, gas, bloating, and nausea
37
diagnosis of IBS
based on the signs and symptoms and the exclusion of any metabolic problems; tests for food intolerances can confirm the diagnosis
38
rome criteria
an established guide for diagnosing IBS
39
treatment for IBS
may include laxatives, fiber supplements, antidiarrheal medication, antidepressants, analgesics for pain, antispasmodic medications, and medication to balance serotonin levels
40
two medications suggested for IBS treatment
alosetron (lotronex), this relaxes the colon and slows the movement of waste through the lower bowel; and lubiprostone (amitiza) which works by increasing fluid secretion in the intestine to help with the passage of stool
41
appendicitis
is an inflammation and infection in the vermiform appendix
42
how does appendicitis develop?
obstruction of the appendiceal lumen, fluid and microorganism buildup in the appendix, inflamed appendiceal wall, purulent exudate forms, ischemia and necrosis of the wall which results in increased permeability, bacteria and toxins escape the wall and which leads to abscess formation or localized bacterial peritonitis, local infection around the appendix which causes pressure, appendix will rupture or has to be removed
43
what obstructs the appendiceal lumen in appendicitis?
a fecalith (mass of feces), gallstone, or foreign material
44
abscess
a pocket of pus
45
why would the appendix bursting be dangerous?
because it would release its contents into the peritoneal cavity
46
signs of appendicitis
steady and severe pain and tenderness in the LRQ, nausea and vomiting, low-grade fever, and sometimes tachycardia or hypotension
47
treatment for appendicitis
surgical removal and antimicrobial drugs
48
diverticular disease
refers to problems related to the development of the diverticula
49
what is a diverticulum?
a herniation or outpouching of the mucosa through the muscle layer of the colon wall (commonly in the sigmoid colon)
50
diverticulosis
asymptomatic diverticular disease whereas multiple diverticula are present
51
diverticulitis
inflammation of the diverticula; common in the Western world
52
where do diverticulum develop?
in gaps between bands of longitudinal muscle that coincide with opening in the circular muscle bands, often in the sigmoid colon
53
what causes diverticula?
low-residue diets, irregular bowel habits, and aging lead to constipation and then to muscle hypertrophy, leading to the development of diverticula
54
problems that may arise with diverticula
intestinal obstruction, perforation with peritonitis, and abscess formation
55
signs of diverticular disease
usually is asymptomatic but signs may be mild discomfort, diarrhea, constipation, flatulence, LLQ pain, nausea, and vomiting
56
treatment for diverticula
increasing the bulk in the diet and omitting foods such as seeds and popcorn
57
colorectal cancer prevalence
common cancer and is the second leading cause of cancer-related deaths
58
polyp
is a mass, often on a stem that protrudes into the lumen; as they grow, they carry an increased risk of dysplasia and malignant changes
59
what do most malignant neoplasms result from in colorectal cancer?
adenomatous polyps
60
napkin-ring growth
carcinomas that commonly develop in the left colon
61
projecting polypoid masses
carcinomas that often develop in the right colon
62
what other areas of the body do colorectal neoplasms affect?
the mesentery, the abdominal wall, the lymph nodes, and the liver
63
what is staging of colorectal cancer based on?
the degree of local invasion, lymph node involvement, and the presence of disant metastases
64
what antigen do adenocarcinomas release into the blood?
CEA
65
risk population for colorectal cancer
those 55+, Western countries, familial multiple polyposis, long-term ulcerative colitis, genetic factors, and diets high in fat, sugar, and red meat, and low in fibre
66
signs of colorectal cancer in the rectosigmoid area
is often asymptomatic but can be obstruction in the proximal colon, vague cramping pain, ribbon stool, and feelings of incomplete emptyings
67
signs of colorectal cancer in the right colon
liquid fecal material, fatigue, weight loss, and iron-deficiency anemia
68
treatment for colorectal cancer
surgical removal of the involved area, usually requiring a colostomy; chemotherapy and radiation therapy may be used after surgery
69
colostomy
an artificial opening into the abdominal wall where feces may be collected in a bag
70
intestinal obstruction
refers to a lack of movement of the intestine contents through the intestine; more common in the small intestine than the large
71
two forms of intestinal obstruction
mechanical or functional
72
mechanical obstructions
result from tumors, adhesions, hernias, scar tissue, volvulus, or other tangible obstructions
73
functional obstructions
result from neurological impairment such as a spinal cord injury or a lack of propulsion
74
paralytic ileus
refers to functional intestinal obstructions resulting from neurological impairment
75
sequence of events for mechanical intestinal obstruction
gases and fluids accumulate, strong contractions occur to move contents, increased pressure leads to more secretions into the intestines, persistent vomiting, ischemic and necrotic intestinal wall, decreased peristalsis, rapid reproduction of bacteria, and generalised peritonitis
76
sequence of events for functional obstruction
peristalsis cease, fluids and electrolytes accumulate in the intestine, and reflex spasms do not occur; the result of the process is similar to mechanical obstruction
77
causes of functional intestinal obstructions
spinal cord injuries, after abdominal surgeries due to anesthesia combined with inflammation and ischemia, pancreatitis, peritonitis, ro infection in the abdominal cavity, and hypokalemia
78
volvulus
twisting of a section of intestine on itself
79
hirschsprung disease
a condition which parasympathetic innervation is missing from a section of the colon; can cause mechanical intestinal obstruction
80
how would Crohn's or diverticulitis lead to mechanical intestinal obstruction?
chronic inflammation of the GI tract
81
signs of intestinal obstruction
abdominal pain, constipation, borborygmi, vomiting, restlessness, diaphoresis, tachycardia, dehydration and weakness due to electrolyte imbalances
82
borborygmi
audible rumbling sounds caused by movement of gas in the intestine
83
treatment for intestinal obstruction
treating the underlying causes and replacing fluids and electrolytes
84
peritonitis
an inflammation of the peritoneal membrane that may result from chemical irritation or from bacterial invasion; chemical irritation will lead to bacterial peritonitis
85
why might the peritoneal membrane be inflamed?
chemical irritants, chyme, or foreign objects in the cavity; this inflammation then increases permeability, allowing enteric bacteria to enter the cavity; necrosis of perforation also allows for bacterial entry
86
what initially occurs when local inflammation develops in the abdominal cavity?
the peritoneum and omentum produce a thick, sticky exudate to seal the area and localize the problem
87
peritoneum anatomy
a large sterile expanse of highly vascular tissue that covers the viscera and lines the abdominal cavity
88
results of peritonitis
increased permeability of vessels leads to large volumes of fluid in the cavity, followed by hypovolemic shock; fluid, proteins, and electrolytes are not circulating
89
causes of peritonitis
chemical peritonitis, bacterial peritonitis. abdominal surgery, and pelvic inflammatory disease
90
signs of peritonitis
generalized abdominal pain, vomiting, hypovolemia, dehydration, decreased skin turgor, dry buccal mucosa, pallor, low BP, tachycardia, fever, and decreased bowel sounds
91
treatment for peritonitis
surgery is often required to correct the cause and drain infection sites, antimicrobials, fluid and electrolyte replacement, and sometimes nasogastric suction
92
fistulas
form in those with Crohn's when ulcers may erode through the abdominal wall; occur often between loops of intestine
93
immunotherapeutic agent for IBD
azathioprine
94
what in general does celiac disease cause?
a digestive block and an immune response
95