Upper and Lower GI Flashcards

Question

PEPTIC ULCER DISEASE: Definition

Answer 1

■ Ulcerative disorder of the upper GI tract – Esophageal – Stomach (gastric ulcers) – Duodenum (peptic ulcer in the first part of the small intestine) ■ Develops when the GI tract is exposed to acid and h. pylori

Answer 2

Aggressive factors: -H. pylori -NSAIDS -Acid -Pepsin -Smoking Defensive factors: -Mucus -Bicarbonate -Blood flow -Prostaglandins

Answer 3

* H. pylori * Injury-causing substances -NSAIDs, ASA, alcohol * Excess secretion of acid * Smoking * Family history * Stress - remember there is increased gastric acid secreted with the stress response

Answer 4

-Age -Higher doses of NSAIDs -History of PUD -Use of corticosteroids and anticoagulants -Serious systemic disorders -H. pylori infection

Answer 5

-Mucosa is damaged -Histamine is secreted, resulting in: -Increase in acid and pepsin secretion–causes further tissue damage -Vasodilation– causes edema -If blood vessels are destroyed, this results in BLEEDING

Answer 6

Duodenal ulcer -Most common type -Age – any; early adulthood Gastric/peptic ulcer -Age – peak 50 - 70 -Why? Increased use of NSAIDS, corticosteroids, anticoagulants and more likely to have serious systemic illnesses

Answer 7

-Sometimes none -N/V, anorexia -Weight loss -Bleeding -Burning Pain: in middle of abdomen that is usually worse when the stomach is empty

Answer 8

Gastric: 1-2 hours after eating Duodenal: 2-4 hours after eating

Answer 9

“HOP” Complications H – Hemorrhage O – Obstruction P - Perforation and Peritonitis

Answer 10

Appendicitis Peritonitis Irritable bowel disorder Inflammatory bowel disorder: -Crohn’s, Ulcerative Colitis Diverticulosis/Diverticulitis

Answer 11

-Inflammation of the appendix -Etiology Appendix is OBSTRUCTED Leads to INFLAMMATION

Answer 12

* Classic Pain: RLQ in periumbilical area * Rebound Pain = Pain is SEVERE after release of palpating hand over the RLQ * Sudden pain relief may indicate rupture - Peritonitis

Answer 13

■ Inflammation of the PERITONEUM ■ Serous membrane that lines abdominal cavity & covers visceral organs What happens to the peritoneum? ■ INFLAMMATION ■ Fluid shifts – THIRD SPACING ■ Can lead to hypovolemic shock and sepsis ■ DECREASED PERISTALSIS ■ Can lead to paralytic ileus and intestinal obstruction

Answer 14

Perforated ulcer Ruptured gallbladder Pancreatitis Ruptured spleen Ruptured bladder Ruptured appendix

Answer 15

■ Usually sudden and severe ■ Abdominal pain* ■ Tenderness ■ Rigid “board-like” abdomen ■ N/V ■ Others: – Fever – Elevated WBC – HR: increased – BP: decreased

Answer 16

-IRRITABLE BOWEL SYNDROME -INFLAMMATORY BOWEL DISEASE

Answer 17

■ Chronic condition characterized by: alterations in bowel pattern due to changes in intestinal motility – Chronic and frequent constipation (IBSC) – Chronic and frequent diarrhea (IBSD)

Answer 18

■ Symptoms: vary by individual – Abdominal distension, fullness, flatus, and bloating – Intermittent abdominal pain exacerbated by stress and RELIEVED BY DEFECATION – Bowel urgency – Intolerance to certain foods (sorbitol, lactose, gluten) – Non-bloody stool that may contain mucous

Answer 19

■ A group of life-changing, chronic illnesses ■ TWO SEPARATE DISORDERS: – Crohn’s disease – Ulcerative colitis ■ Characterized by: – Chronic inflammation of the intestines – Exacerbation and remissions ■ More common in WOMEN, Caucasians, persons of Jewish descent, and smokers ■ Etiology? ■ Genetically AUTOIMMUNE activated by an infection

Answer 20

■ Lymph structures of the GI tract are blocked ■ Tissue becomes engorged and inflamed ■ Deep linear FISSURES and ULCERS develop in a ”patchy” pattern in the bowel wall – SKIP LESIONS – COBBLESTONE APPEARANCE

Answer 21

■ Complications: – Malnutrition ■ Anemia – Scar tissue and obstructions – Fistulas – Cancer

Answer 22

■ 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

Answer 23

■ Inflammation of the mucosa of the RECTUM AND COLON ■ Usually develops in the third decade of life ■ More common in white people of European descent, esp. Ashkenazi Jewish descent – Occasionally in Black/African Americans -Rare in Asians

Answer 24

■ Inflammation begins in the rectum and extends in a CONTINUOUS segment that may involve the ENTIRE colon ■ Inflammation leads to large ulcerations ■ Necrosis of the epithelial tissue can result abscesses – CRYPT ABSCESSES ■ Colon and rectum try to repair the damage with new granulation tissue – Why is this a problem? Tissue is fragile and bleeds easily

Answer 25

Complications: -Hemorrhage -Perforation -Cancer ■ Malnutrition ■ Anemia ■ Strictures ■ FISSURES ■ ABSCESSES ■ TOXIC MEGACOLON – a rapid dilation of the large intestine that can be life threatening ■ COLORECTAL CARCINOMA ■ Liver Disease – from inflammation and scarring of bile ducts ■ Fluid, electrolyte and PH imbalances

Answer 26

■ Usually asymptomatic ■ Discovered accidently or with presentation of acute diverticulitis

Answer 27

-Abdominal pain -Bloody diarrhea -Systemic: -Weight loss, fatigue, no appetite, fever

Answer 28

* Development of diverticula: * Small pouches in lining of colon that bulge outward through weak spots * May be CONGENITAL or ACQUIRED * Thought to be caused by low fiber diet with resulting chronic constipation * Usual location: DESCENDING COLON

Answer 29

INFLAMMATION of one or more of the pouches (diverticula) -Usually from retained fecal material

Answer 30

– Abdominal pain: LLQ – Fever – WBC’s: increased – Constipation or diarrhea – Acute: passage large quantity of frank blood – May resolve spontaneously

Answer 31

Complications – Perforation – Peritonitis – Obstruction

Upper and Lower GI Flashcards

(55 cards)