Patho of GI Diseases Flashcards
(121 cards)
1
Q
Components of Upper GI
A
–Esophagus
–Stomach
–Beginning of small intestines
2
Q
Components of Lower GI
A
–small intestines
–colon (large intestines)
–rectum/anus
3
Q
Esophageal disorders
A
–GERD
–Hiatal Hernia
4
Q
Inflammatory disorders of the stomach (Upper GI)
A
–gastritis
–acute gastroenteritis
–PUD
5
Q
dysphagia
A
difficulty swallowing
6
Q
how does dysphagia progress?
A
begins with solids and progresses to liquids
7
Q
common causes of dysphagia
A
–mechanical obstruction
–neuromuscular dysfunction
–intubation
–tracheostomy
8
Q
examples of mechanical obstruction
A
–stenosis and stricture
–diverticula
–tumors
9
Q
examples of neuromuscular dysfunction
A
–CVA
–achalasia
10
Q
achalasia
A
lower esophageal sphincter can’t open properly
11
Q
GERD
A
gastro esophageal reflux disease
12
Q
GERD aka ________
A
heartburn
13
Q
GERD definition
A
–backflow of gastric acid from stomach into esophagus
–occurs via LES
14
Q
what triggers GERD?
A
–anything that alters closure strength of LES or increases abdominal pressure
–fatty foods
–spicy foods
–tomato based foods
–citrus foods
–caffeine
–large amounts of alcohol
–cigarettes
–sleep position
–obesity
–pregnancy
–pharm agents
15
Q
clinical manifestations of GERD
A
–heartburn (pyrosis)
–dyspepsia
–regurgitation
–chest pain
–dysphagia
–pulmonary symptoms
16
Q
complications of GERD
A
–ulceration
–scarring
–strictures
–Barrett’s esophagus
17
Q
Barrett’s esophagus
A
development of abnormal metaplastic tissue–premalignant
18
Q
treatment for Barrett’s esophagus
A
prevention, no treatment
19
Q
risk associated with Barrett’s esophagus
A
three-fold increased risk of developing adenocarcinoma of the esophagus
20
Q
Hiatal Hernia
A
a defect in the diaphragm that allows part of the stomach to pass into the thorax
21
Q
two main types of hiatal hernias
A
–sliding hernia
–paraesophageal hernia
22
Q
sliding hernia
A
usually small and often do not need treatment
23
Q
paraesophageal hernia
A
part of the stomach pushes through the diaphragm and stays there
24
Q
causes of hiatal hernia
A
–exact cause is unknown
–increased age
–injury or other damage may weaken the diaphragm muscle
–repeatedly putting too much pressure on the muscles around the stomach
25
examples of mechanisms that can cause a hiatal hernia
--severe coughing
--vomiting
--constipation and straining to have a bowel movement
26
clinical manifestations of hiatal hernias
--asymptomatic
--belching
--dysphagia
--chest or epigastric pain
--weaker LES
27
risk factors for hiatal hernias
--age
--obesity
--smoking
28
GERD and hiatal hernias
common for these to coexist
29
treatment of hiatal hernias
--conservative treatment
--surgery if conservative treatments don't work
--antacids for the GERD/esophagitis syndrome
30
teaching for hiatal hernias
--small, frequent meals
--avoid lying down after eating
--avoid tight clothing and abdominal supports
--weight control for obese individuals
31
acute gastritis
temporary inflammation of the stomach lining only (**intestines not affected**)
32
duration of acute gastritis
generally lasts 2-10 days
33
etiology of acute gastritis
--irritating substances (alcohol)
--drugs (NSAIDs)
--infectious agents
34
infectious agent involved with acute gastritis
H. pylori
35
chronic gastritis
progressive disorder with chronic inflammation in the stomach
36
duration of chronic gastritis
can last weeks to years
37
complications of chronic gastritis
--PUD
--bleeding
--ulcers
--anemia
--gastric cancers
38
PUD
peptic ulcer disease
39
etiologies of chronic gastritis
--autoimmune (attacks parietal cells)
--H. pylori infection
40
H. pylori
helicobacter pylori bacterium
41
where does H. pylori thrive?
in acidic environments
42
how does H. pylori work?
destructive pattern of persistent inflammation
43
how is H. pylori transmitted?
--person to person via saliva, fecal matter, or vomit
--contaminated food or water
44
clinical manifestations of acute/chronic gastritis
--sometimes none
--anorexia
--N/V
--postprandial discomfort
--intestinal gas
--hematemesis
--tarry stools
--anemia
45
acute gastroenteritis
inflammation of stomach and small intestine
46
etiology of acute gastroenteritis
--viral infections: norovirus and rotavirus
--bacterial infections: E. coli, salmonella, campylobacter
--parasitic infections
47
duration of acute gastroenteritis
usually lasts 1-3 days, but many last as long as 10 days
48
clinical manifestations of acute gastroenteritis
--watery diarrhea (bloody if bacterial)
--abdominal pain
--N/V
--fever, malaise
49
complication of acute gastroenteritis
fluid volume deficits (dehydration)
50
treatment for acute gastroenteritis
let virus run its course (>72 hours = see PCP)
51
peptic ulcer disease (PUD)
ulcerative disorder of the upper GI tract
52
body parts affected by PUD
--esophageal
--stomach
--duodenum
53
PUD term in stomach
gastric ulcers
54
PUD term in duodenum
peptic ulcer
55
when does PUD develop?
when GI tract is exposed to acid and h. pylori
56
aggressive factors for GI health
--H. pylori
--NSAIDs
--acid
--pepsin
--smoking
57
defensive factors for GI health
--mucus
--bicarbonate
--blood flow
--prostaglandins
58
PUD etiology
--H. pylori
--injury-causing substances
--NSAIDs, ASA, alcohol
--excess secretion of acid
--smoking
--family history
--stress
59
how does stress affect PUD?
remember there is increased gastric acid secreted with the stress response
60
risk factors for PUD
--age
--higher doses of NSAIDs
--hx of PUD
--use of corticosteroids and anticoags
--serious systemic disorders
--H. pylori infection
61
pathogenesis of PUD
--mucosa is damaged
--histamine is secreted, resulting in (1) increase in acid and pepsin secretion - tissue damage, (2) vasodilation - causes edema
--bleeding if BV destroyed
62
duodenal ulcer
--most common type
--age - any; early adulthood
63
gastric/peptic ulcer age and causes
--age: peak 50-70
--increased use of NSAIDs, corticosteroids, anticoagulants, more likely to have serious systemic illnesses
64
clinical manifestations of PUD
--sometimes none
--N/V, anorexia
--weight loss
--bleeding
--burning pain in middle of abdomen that is usually worse when stomach is empty
65
symptomatic characteristics of gastric ulcer
--burning
--cramping
--gas-like
66
location of gastric ulcer
epigastrium, back
67
timing of gastric ulcer
1-2 hours after eating
68
symptomatic characteristics of duodenal ulcer
burning, cramping, gas-like
69
location of duodenal ulcer
epigastrium, back
70
timing of duodenal ulcer
2-4 hours after eating
71
PUD complications
H -- hemorrhage
O -- obstruction
P -- perforation and peritonitis
72
lower GI disorders
--appendicitis
--peritonitis
--IBS (Crohn's, UC)
--IBD
--diverticulosis/diverticulitis
73
etiology of appendicitis
--appendix is obstructed
--leads to inflammation
74
complications of appendicitis
--gangrene
--abscess formation
--peritonitis
75
types of pain with appendicitis
--classic pain (RLQ in periumbilical area)
--rebound pain
--sudden pain relief
76
what might sudden pain relief indicate in appendicitis?
may indicate rupture -- peritonitis
77
peak incidence of appendicitis
10-12 years
78
symptoms of appendicitis
--low grade fever
--nausea
--anorexia
--rebound pain or tenderness at McBurney's point (RLQ)
79
diagnosis of appendicitis
--clinical signs and symptoms
--increased WBC
--abdominal sonogram
--exploratory lap
80
peritonitis
inflammation of peritoneum
81
peritoneum
serous membrane that lines abdominal cavity and covers visceral organs
82
what happens to the peritoneum in peritonitis?
--inflammation
--third spacing
--decreased peristalsis
83
what can third spacing lead to?
can lead to hypovolemic shock and sepsis
84
what can peritonitis lead to?
paralytic ileus and intestinal obstruction
85
causes of peritonitis
--perforated ulcer
--ruptured gallbladder
--pancreatitis
--ruptured spleen
--ruptured bladder
--ruptured appendix
86
s/s of peritonitis
--sudden and severe
--abdominal pain
--tenderness
--rigid "board-like" abdomen
--N/V
--fever
--elevated WBC
--HR increased
--BP decreased
87
treatment of peritonitis
--antiinflammation
--treat the cause
88
causes of increased HR and decreased BP in peritonitis
SNS activation from pain; fluid shifts
89
lower GI problems
--inflammatory bowel syndrome
--inflammatory bowel disease
90
irritable bowel syndrome
--chronic condition
--alterations in bowel pattern due to changes in intestinal motility
91
types of irritable bowel syndrome
--chronic and frequent constipation (IBSC)
--chronic and frequent diarrhea (IBSD)
92
symptoms of IBS
varies by individual
93
potential symptoms of IBS
--abdominal distention, fullness, flatus, and bloating
--intermittent abdominal pain exacerbated by stress and relieved by defecation
--bowel urgency
--intolerance to certain foods
--non-bloody stool that may contain mucous
94
psychosocial stress and IBS
--almost never the result of primarily psychological causes
--can be exacerbated by stress
--can cause stress and psych problems
95
cause of IBS
unknown, but thought to be "triggered" by stress, food, hormone changes, GI infections, menses
96
inflammatory bowel disease
(1) Crohn's disease
(2) Ulcerative colitis
97
what is IBD characterized by?
--chronic inflammation of the intestines
--exacerbation and remissions
98
who is IBD most common in?
--women
--Caucasians
--Jewish people
--smokers
99
etiology of IBD
genetically autoimmune; activated by an infection
100
pathogenesis of Crohn's disease
--lymph structures of GI tract are blocked
--tissue becomes engorged and inflamed
--deep linear fissures and ulcers develop in "patchy" pattern along the bowel wall (skip lesions, cobblestone)
101
complications of Crohn's disease
--malnutrition
--scar tissue and obstructions
--fistulas
--cancer
102
clinical manifestations of Crohn's disease
--crampy lower abdominal pain (RLQ)
--watery diarrhea
--systemic (weight loss, fatigue, no appetite, fever, malabsorption of nutrients)
--palpable abdominal mass (RLQ)
--mouth ulcers
--s/s of fistulas
103
what are specific to Crohn's disease?
--skip lesions
--granulomas
104
complications of Crohn's disease
VTE/DVT
105
ulcerative colitis
inflammation of the mucosa of the rectum and colon
106
development of UC
third decade of life
107
who gets UC?
white people of European descent (Ashkenazi Jewish)
--occasionally in AA
--rare in Asians
108
UC patho
--inflammation in rectum and extends in continuous segment that may involve the entire colon
--inflammation = large ulcerations
--colon and rectum try to repair the damage with new granulation tissue
109
crypt abscesses
necrosis of the epithelial tissue can result in abscesses
110
symptoms of UC
--abdominal pain
--bloody diarrhea
--systemic (weight loss, fatigue, no appetite, fever)
111
complications of UC
--hemorrhage
--perforation
--cancer (colorectal carcinoma)
--malnutrition
--anemia
--strictures
--fissures
--abscesses
--toxic megacolon
--liver disease
--F/E, pH imbalances
112
significance of bloody diarrhea
only happens with UC, not Crohn's
113
toxic megacolon
rapid dilation of large intestine that can be life-threatening
114
diverticulosis
--development of diverticula
--may be congenital or acquired
--thought to be caused with low fiber diet with resulting chronic constipation
115
usual location of diverticulosis
descending colon
116
diverticula
small pouches in lining of colon that bulge outward through weak spots
117
diverticulitis vs. diverticulosis
diverticulitis = with infection or inflammation
diverticulosis = without inflammation
118
symptoms of diverticulosis
--asymptomatic
--discovered accidentally or with presentation of acute diverticulitis
119
diverticulitis
inflammation of one or more of the pouches (usually from retained fecal matter)
120
symptoms of diverticulitis
--abdominal pain (LLQ)
--fever
--WBCs increased
--constipation or diarrhea
--acute passage of large quantity of frank blood
--may resolve spontaneously
121
complications of diverticulitis
--perforation
--peritonitis
--obstruction
