Wk 5 Upper GI Flashcards
(150 cards)
1
Q
What is included in the upper GI? (3)
A
Esophagus
Stomach
Beginning of small intestine
2
Q
The esophagus, stomach, and beginning of small intestine makes up __ GI
A
upper
3
Q
The small intestines, colon, rectum, and anus make up the __ GI
A
lower
4
Q
What is included in the lower GI? (4)
A
Small intestines
Colon
Rectum
Anus
5
Q
What are 2 esophageal problems?
A
GERD
Hiatal hernia
6
Q
GERD and a hiatal hernia are problems of the…
A
esophagus
7
Q
Gastritis, acute gastroenteritis, and PUD are what type of disorders?
A
inflammatory disorders of the stomach
8
Q
What are 3 inflammatory disorders of the stomach?
A
Gastritis
Acute gastroenteritis
PUD
9
Q
What is dysphagia?
A
Difficulty swallowing
10
Q
What is the progression of dysphagia?
A
Begins with colds and then progresses to difficulty swallowing liquids
11
Q
What are the 2 causes of dysphagia?
A
Mechanical and neuromuscular
12
Q
What is mechanical dysphagia?
A
Problem with the structures that assist in swallowing
13
Q
What are 3 examples of mechanical obstructive dysphagia
A
Stenosis or strictures
Diverticula
Tumors
14
Q
What are neuromuscular dysfunctions that lead to dysphasia?
A
CVA (cerebrovascular accident)
Achalasia
15
Q
What is achalasia?
A
Lower esophageal sphincter can’t open properly
16
Q
What are diverticula?
A
Small bulging pouches that form in the GI tract
17
Q
This is an example of..
A
Esophageal diverticuli
18
Q
What are 2 other reasons someone may have dysphasia?
A
Tracheal intubation
Tracheostomy
19
Q
What does GERD stand for?
A
Gastro Esophageal Reflux Disease
20
Q
GERD is a disorder of the…
A
esophagus
21
Q
The general population refers to GERD as __
A
Heartburn
22
Q
What body part does GERD effect?
A
lower esaophageal sphincter (LES)
23
Q
Where is the lower esophageal sphincter?
A
It’s what connects the stomach and the esophagus
24
Q
What is GERD?
A
Backflow of gastric acid from the stomach into the esophagus
25
Why does GERD occur?
Anything that alters the closure strength of LES or increases abdominal pressure
26
What are causes/triggers of GERD? (11)
Fatty foods
Spicy foods
Tomato based foods
Citrus foods
Caffeine
Large amounts of alcohol
Cigarette smoking
Sleep position
Obesity
Pregnancy
Pharmacologic agents
27
What is the medical term for heartburn?
pyrosis
28
What is pyrosis?
Heartburn
29
What is dyspepsia?
Upper abdominal discomfort, described as burning sensation, bloating or gassiness, nausea, or feeling full too quickly after starting to eat
30
What is regurgitation?
Act of bringing back up already swallowed foods
31
What are 6 clinical manifestations of GERD?
Heartburn
Dyspepsia
Regurgitation
Chest pain
Dysphagia
Pulmonary symptoms
32
What clinical manifestations of GERD are associated with the mouth? (3)
Tooth decay
gingivitis
bad breath
33
What clinical manifestations of GERD are associated with the chest? (3)
Chronic cough
worsening asthma
recurrent pneumonias
34
What are 2 abdominal symptoms of GERD?
Abdominal bloating
Belching
35
Someone with GERD might also experience an \_\_ache
earache
36
What throat symptoms might someone with GERD experience? (6)
Hoarseness
Chronic sore throat
Throat clearing
Laryngitis
Lump in throat
Post nasal drip
37
List 4 complications of GERD
Ulceration
Scarring
Strictures
Barrett's esophagus
38
What are esophageal strictures?
Abnormal tightening or narrowing of the esophagus
39
What is Barrett's esophagus?
Development of abnormal metaplastic tissue
40
What is esophageal development of abnormal metaplastic tissue called?
Barrett's esophagus
41
Barrett's esophagus is pre\_\_
premalignant
42
Patients with Barrett's esophagus are three times more likely to develop what?
Adenocarcinoma of the esophagus
43
What is the overall survival rate of esophageal adenocarcinoma?
only 17%
44
A hiatal hernia is a defect in the \_\_
diaphragm
45
When the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm)
Hiatal hernia
46
What is a hiatal hernia?
when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm)
47
What are the 2 types of a hiatal hernia?
Sliding
Paraesophageal
48
This is an example of a...
Paraesophageal hernia
49
This is an example of...
Barrett's esophagus
50
A paraesophageal hernia is often called a...
Rolling hernia
51
A sliding hernia is often small and...
does not require treatment
52
With a sliding hernia the peritoneum stays \_\_
intact
53
During a sliding hernia, because the peritoneum stays intact...
it restrains the size of the hernia
54
What type of hiatal hernia slides through the stomach and stays there?
paraesophageal hernia
55
This is an example of a...
Sliding hiatal hernia
56
What happens to the peritoneum that allows for a paraesophageal hernia?
the membrane becomes thinner or defective allowing for the stomach to sit above the diaphragm
57
During a paraesophageal hernia, the peritoneum becomes thin which allows for the sack to...
become even larger by entering into the intrathoracic pressure
58
What is unique about hiatal hernias considering the types?
You can have a mix, or have both types at the same time
59
What are the complex cases of hiatal hernias?
Type 3 and 4
60
What is the cause of hiatal hernias?
Exact cause if unknown
61
Hiatal hernias are thought to be __ related
age
62
What 2 things may weaken the diaphragm muscle?
Injury
Repeatedly putting too much pressure on the muscles around the stomach
63
What are 3 examples of actions that can cause injury to the diaphragm?
Severe coughing
Vomiting
Constipation and straining to have a bowel movement
64
\_\_ increases the risk of hiatal hernias.
Obesity
65
In general people who have hiatal hernias are \_\_
asymptomatic
66
What are 3 risk factors for hiatal hernias?
Age
Obesity
Smoking
67
What are 3 manifestations of hiatal hernias?
Belching
Dysphagia
Chest or epigastric pain
68
The clinical manifestations of hiatal hernias often present as...
GERD
69
It's common for hiatal hernias and GERD to __ in the same patient
coexist
70
What is a teaching point for patients with hiatal hernias concerning eating? (2)
Small, frequent meals
Avoid lying down after eating
71
What is a teaching point for hiatal hernias concerning obesity?
Weight control
72
What is a teaching point for hiatal hernia and what the patient wears?
Avoid tight clothing and abdominal supports
73
What is recommended pharmacologically for the GERD/hiatal hernia symptoms?
Antacids
74
If conservative treatments do not work for hiatal hernias, what is the next step?
Surgery
75
What are 3 inflammatory disorders of the stomach?
Gastritis
Acute gastroenteritis
PUD
76
Inflammation of the stomach
Gastritis
77
What is acute gastritis defined by?
Temporary inflammation of the stomach, intestines are NOT involved
78
What is not involved in acute gastritis?
the intestines
79
How long does gastritis usually last?
2-10 days
80
What are 3 causes of acute gastritis?
Irritating substances such as alcohol
NSAIDs
Infectious agents
81
Why do NSAIDs cause acute gastritis?
They block prostaglandin synthesis?
82
What do prostaglandins do concerning the stomach?
Stimulate secretion of mucus in the stomach
83
How do prostaglandins contribute to the development of acute gastritis? (2)
They stimulate mucus production that gives the stomach it's protective coating
They also inhibit gastric acid secretion
84
What is the most common infectious agent that causes acute gastritis?
H. pylori
85
What other types of infectious agents are typically associated with acute gastritis? (besides H. pylori)
Viruses
86
Chronic gastritis is a __ disorder
progressive
87
How long does chronic gastritis last?
Weeks to years
88
Chronic gastritis is defined by:
Progressive disorder with chronic inflammation of the stomach
89
What is chronic gastritis classified by?
Immune related or non-immune related
90
What GI disorder is PUD?
Peptic ulcer disease
91
What are 4 complications of chronic gastritis?
PUD
Bleeding ulcers
Anemia
Gastric cancers
92
What is the autoimmune type of chronic gastritis?
Attacks parietal cells
93
What is the non-immune type of chronic gastritis?
H. pylori infection
94
What does H. pylori stand for?
Helicobacter pylori
95
What type of bacteria is H. pylori?
Gram-negative, spiral bacteria
96
What type of environment does H. pylori proliferate in?
Acidic environment
97
Persistent infection with H. pylori can cause what 3 conditions?
Chronic gastritis
Peptic ulcer disease
Stomach cancer
98
Patients who develop a gastric infection with H. pylori are often \_\_
asymptomatic
99
What is the MOT of H. pylori? (2)
Person to person via saliva, fecal matter, or vomit
Contaminated food or water
100
The symptoms for actue and chronic gastritis are...
Often the same
101
Vomiting blood and black stool are symptoms that are more common in which type of gastritis?
Chronic gastritis
102
What are the symptoms of chronic and acute gastritis? (6)
Vomiting
Stomach burn (postprandial)
Upset stomach
Loss of appetite
Vomiting blood
Black stool
103
What is postprandial discomfort?
Discomfort after eating a meal
104
What is the definition of acute gastroenteritis?
Inflammation of the stomach AND the small intestine
105
Acute gastroenteritis is typically related to...
Stomach viruses such as norovirus or rotavirus
106
What are 3 bacterial infections common for acute gastroenteritis?
E. coli
Salmonella
Campylobacter
107
What else might cause acute gastroenteritis?
Parasitic infections
108
How long does acute gastroenteritis typically last?
1-3 days
109
How long CAN acute gastroenteritis last?
10 days
110
What typically causes acute gastroenteritis?
Food poisoning
111
What are the clinical manifestations of acute gastroenteritis? (7)
Watery Diarrhea
Hemorrhagic diarrhea if infection if bacterial
Abdominal pain
Nausea
Vomiting
Fever
Malaise
112
Acute gastroenteritis can cause hemorrhagic diarrhea is the infection is \_\_
bacterial
113
What does malaise mean?
A general feeling of discomfort, illness, or uneasiness whose exact cause is difficult to identify
114
What is a concerning problem for the nurse in a patient who has acute gastroenteritis?
Fluid volume deficit
115
What doesn't work for acute gastroenteritis?
Antivirals
116
You may need antibiotics for gastroenteritis if it is...
bacterial
117
What is peptic ulcer disease?
Painful ulcers develop in the lining of the stomach or the first part of the small intestine (the duodenum)
118
If ulcers are in the esophagus what are they called?
Esophageal ulcers
119
An ulcer that is in the stomach is called a __ \_\_
gastric ulcer
120
An ulcer that is in the duodenum is called a __ \_\_
peptic ulcer
121
How do peptic, esophageal, or gastric ulcers develop?
Most commonly when the GI tract is exposed to acid and H. pylori
122
What 5 factors increase your risk for developing an ulceration?
H. pylori
NSAIDs
Acid
Pepsin
Smoking
123
Is bicarbonate acidic or alkaline?
Alkaline
124
What 4 factors are protective against the development of an ulcer?
Mucus
Bicarbonate
Blood flow
Prostaglandins
125
3 common substances that can be responsible for causing ulcers
Alcohol
NSAIDs
Aspirin
126
Stress can increase production of __ \_\_
gastric acid
127
What are 3 miscellaneous risk factors of developing uclers
Excess secretion of gastric acid
Family history
Smoking
128
Stress does not __ gastric ulcer development
CAUSE
129
What are 6 risk factors for the development of NSAID-induced PUD?
Age
Higher/frequent doses of NSAIDs
History of PUD
Corticosteroids/Antigoagulants
Systemic disorders (autoimmune)
H. pylori infection
130
What is the pathogenesis of peptic ulcer disease (PUD)? (3)
1. Mucosa damage
2. Histamine release
3. Blood vessels destroyed which causes bleeding
131
PUD Pathogenesis:
Histamine release results in an increase in... (2)
Acid and pepsin secretion which causes further damage
132
PUD Pathogenesis:
Release of histamine causes what inflammatory response that can cause further damage to the area?
Vasodilation by increasing edema
133
What causes the bleeding in the pathogenesis of peptic ulcers?
If blood vessels are close in proximity to the ulcer and are destroyed, this will cause a bleeding ulcer
134
Where is the most common area for a peptic ulcer to develop?
In the duodenum
135
A duodenal ulcer can happen at...
Any age
136
When do peptic ulcers typically develop?
Young adulthood
137
What age range do gastric/peptic ulcers peak?
50-70
138
Why are patients in the age range of 50-70 more likely to get peptic/gastric ulcers? (4)
Increased use of NSAIDs
Corticosteroids
Anticoagulants
More likely to have a systemic illness
139
If the peptic ulcers are bleeding a patient may have no...
clinical manifestations
140
If a patient with PUD does have symptoms, what are they? (6)
Nausea
Vomiting
Anorexia
Weight loss
Bleeding
Burning pain
141
The abdominal burning pain that is associated with PUD is usually worse when...
the stomach is empty
142
What are symptoms associated with GASTRIC ulcers?
Burning, cramping, gas-like pain
143
Where on the body does gastric ulcer pain occur?
Epigastrum, back
144
When does GASTRIC ulcer pain usually occur?
1-2 hours after eating
145
Where does DUODENAL ulcer pain occur?
Epigastrum, back
146
What does DUODENAL ulcer pain feel like?
Burning, cramping, gas-like pain
147
When does DUODENAL ulcer pain occur?
2-4 hours after eating
148
What differentiates between a gastric ulcer and a duodenal ulcer?
The timing of the pain symptoms (1-2hrs versus 2-4 hrs after eating)
149
What are the H.O.P. complications associated with PUD?
Hemorrhage
Obstruction
Perforation and peritonitis
150
H.O.P. complications are associated with what disease?
PUD - peptic ulcer disease
