Disorders Of Digestive System

Front 1

what are the Clinical Manifestations of the GI Dysfunction?

Back 1

Anorexia
Vomiting
Constipation
Diarrhea
Abdominal pain
Gastrointestinal bleeding

Front 2

What are causes of abdonomial pain?

Back 2

1. mechanical - streching, distension
2. inflammation stimulated by chemical mediators
3. ischemic - bowel distention causes obstruction of blood flow

Front 3

wehat is parietal pain?

Back 3

Parietal pain: parietal peritoneum, localized, intense, lateralizes (innervation)

Front 4

what is viseral pain?

Back 4

Visceral pain: in organs, near midline, dull, vague (nerve endings sparse and mulisegmeted

Front 5

what is Referred pain?

Back 5

visceral reflected at some distance –skin or deeper tissue that share central nerve afferent pathway

Front 6

what is framk hematemesis?

Back 6

Hemorrhage above the stomach

Front 7

what is coffe-grounds vomitus caused by?

Back 7

Hemorrhage into the stomach with partial digestion of blood:

Front 8

what is cause of occult blood?

Back 8

Hemorrhage in the intestine with blood mixing into stools:

Front 9

what is melena>

Back 9

Hemorrhage into the intestine with large volumes of blood

Front 10

what cuases red blood coated stools?

Back 10

Hemorrhage in the rectum

Front 11

Which symptom accompanies hemorrhage into the stomach?

Back 11

c.Coffee-grounds vomitus
Rationale:Coffee-grounds vomitus is a classic symptom of blood in the stomach (it mixes with chyme to give it the coffee-grounds color and consistency). Hematemesis occurs in hemorrhage above the stomach; occult blood is the result of blood mixing with stool in the small intestine; and melena occurs with large-volume hemorrhages in the intestine.

Front 12

what is the job of the bowel?

Back 12

1. digest food
2. absorbtion of food
3. keeps substances moving at rate good for absorption

Front 13

what does perforation of bowel wall lead to?

Back 13

Peritonitis (inflammation of peritoneum)

Front 14

what does decreased mucosal function of bowel wall cause?

Back 14

malabsorption

Front 15

what does decreased bacterial containment of bowel wall cause?

Back 15

sepsis

Front 16

Which symptom accompanies hemorrhage into the stomach?

Back 16

c.Coffee-grounds vomitus
Rationale:Coffee-grounds vomitus is a classic symptom of blood in the stomach (it mixes with chyme to give it the coffee-grounds color and consistency). Hematemesis occurs in hemorrhage above the stomach; occult blood is the result of blood mixing with stool in the small intestine; and melena occurs with large-volume hemorrhages in the intestine.

Front 17

what is the job of the bowel?

Back 17

1. digest food
2. absorbtion of food
3. keeps substances moving at rate good for absorption

Front 18

what does perforation of bowel wall lead to?

Back 18

Peritonitis (inflammation of peritoneum)

Front 19

what does decreased mucosal function of bowel wall cause?

Back 19

malabsorption

Front 20

what does decreased bacterial containment of bowel wall cause?

Back 20

sepsis

Front 21

What is Dysphagia?

Back 21

trouble swallowing

Front 22

what are the causes of Dysphagia?

Back 22

CNS (stroke)
Narrowing: mechanical obstruction (intrinsic or extrinsic), e.g., cancer, scarring
Escleroderma(fibrous replace// muscle fibers)
Odynophagia: painful swallowing

Front 23

what is Odynophagia?

Back 23

painful swallowing

Front 24

What is Achalasia?

Back 24

achalasia means "failure to relax" and refers to the inability of the lower esophageal sphincter (a ring of muscle between the lower esophagus and the stomach) to open and let food pass into the stomach

Front 25

what causes esophageal diverticulum?

Back 25

weakened muscles

Front 26

what are the main disorders of the esophagus?

Back 26

Dysphagia
Achalasia
Esophageal diverticulum
Gastroesophageal reflux disease
Cancer of the esophagus

Front 27

what age is Gastroesophageal Feflux most common in?

Back 27

infants - risk is aspiration
-usally ends by age 2

Front 28

what are the cause of Gastro -reflux?

Back 28

Weak/ incompetent lower sphincter
Reflux esophagitis: mucosal injury, erosion
Hiatalhernia: if large

Front 29

what are the complications of persistant G reflux?

Back 29

strictures by scar tissue, spasm and edema→ dysphagia
Barretesophagus: squamousmucosa replaced by columnar epithelium -↑ risk cancer

Front 30

what are the symptoms of GI reflux?

Back 30

Heartburn, belching, chest pain, respiratory symptoms (reflux-associated asthma, chronic cough)

Front 31

what are the most common stomach disorders?

Back 31

1. Acute gastritis
2. Chronic gastritis
4. Ulcer disease
-Peptic ulcer
-Zollinger-Ellison syndrome
-Stress ulcers
4. Cancer of the stomach

Front 32

What is the main function of the gastric mucosal barrier?

Back 32

- protects stomach from digesting itself

Front 33

How does the mucosal barrier prevent self digestion?

Back 33

1. tight epithelial cell juntions --> impermeable.
2. protectve mucos forms hydrophobic lipid bilayer

Front 34

what can cross hydrophoblic mucosal barrire of stomach?

Back 34

aspirin
alochol
H. pylori

Front 35

what do Prostaglandins do?

Back 35

hormones that increase blood low, HCO3 - secretion, and mucose secretion

Front 36

what is gastritis?

Back 36

inflammation of the lining of the stomach

Front 37

what are the causes of acute gastritis?

Back 37

1. bacterial endotoxins
2. alcohol
2. aspirin

Front 38

What are the causes of chronic gastritis?

Back 38

chronic inflammation of stomach liming that causes atrophy of glandular epithelium, and changes in mucosa

Front 39

what are the causes of chronic gastritis?

Back 39

-H. pylori
-Autoimmune
Chemical

Front 40

what is the effect on the stomach of H pylori infection?

Back 40

1. H pylori bacteria secrests urease
2. this toxin disrupts mucosal protection, causing inflammation
3. immune response: releases pro-inflammatory cytokines

Front 41

what is the most common cause of chronic gastritis?

Back 41

H pylori infection.

Front 42

what can H. pylori infection cause?

Back 42

1. chronic gastritis
2. peptic ulcers
3. gastric adenocarcinoma
3.gastric lymphoma

Front 43

what is prevelance of H pylori infection in US? Internationally?

Back 43

internationally half of all people are infected.
in US, more hispanics infected

Front 44

what causes chemical gastritis?

Back 44

due to reflux into stomach from duodenum (w/ alkaline pancreatic and bile secretions)
Common post gastroduodenostomyor gastrojejunostomy
Also in gastric ulcer, gallbladder disease, problems w/ gastric motility

Front 45

what are the main types of ulcer diseases?

Back 45

1. peptic ulcers
2. zollinger-ellimson syndrom
3. stress uclers

Front 46

what is a peptic ulcer?

Back 46

Ulceration of errosion in the protective mucosal lining in upper GI: lower esophagus, stomach (55-77yo) or duodenum (early adult))

Front 47

what is Zollinger-Ellimson syndrome?

Back 47

ulceration gaused by a gastric secreting tumor

Front 48

what is a curlin ulcer?

Back 48

a type of accute peptic ulcer caused by major physiologic stress (burns, trauma, sepsis):

Front 49

what are Cushing ulcers?

Back 49

ulcer in GI tract caused by increased intracranial pressure caused by trama, stroke, or operation

Front 50

what is the second major cause of peptic ulcers?

Back 50

H pylori infection

Front 51

Globally, what is 2nd most common type of cancer?

Back 51

stomach cancer

Front 52

what are causes of stomach cancer?

Back 52

-genetic
-carcinogenic foods
-chronic gastritis
-H.pylori
-gastric polyps

Front 53

what are symptoms of inflammatory bowel disease?

Back 53

Remissions and exacerbations of diarrhea, weight loss, fluid and electrolyte disorders

Front 54

what is Crohn Disease?

Back 54

a form of inflammtory bowel disease, caused by genetic autoimmune disorder

Front 55

what is ulcerative colitius?

Back 55

nonspecific infl. colon and rectum, mostly mucosal layer

Front 56

what are two causes of Inflammtory Bowel disease?

Back 56

1. Crohn's disease
2. Ulcerative colitiis

Front 57

What is diverticulitis?

Back 57

Diverticulitis is a condition in which diverticula in the colon rupture. The rupture results in infection in the tissues that surround the colon

Front 58

What is diverticulosis?

Back 58

a small bulging sac pushing outward from the colon wall is called a diverticulum.The condition of having these diverticula in the colon is called diverticulosis.

Front 59

Which intestinal disorder is an autoimmune disease?
a.Enterocolitis
b.Crohn disease
c.Ulcerative colitis
d.Diverticulitis

Back 59

b.Crohn disease
Rationale:Crohn disease is an autoimmune disorder that affects the mucous membrane lining of the bowel (it gets thicker and doesn’t function as it should), causing chronic malabsorption

Front 60

what is enteritis?

Back 60

inflammation of the small intestine

Front 61

what is enterocolitis?

Back 61

inflammation of the colon and small intestine.

Front 62

what are the causes of infectious enterocolitis?

Back 62

1. viral infection (rotavirus)
2. bacterial infection - through interotoxin or invasionof intestinal epithelial cells

Front 63

what are the complications of enterocolitis?

Back 63

bowel attempts to get rid of infectious agents through vomiting and diahhrea
Massive fluid loss, destruction of mucosa

Front 64

what are the symptoms of mechanical intestinal obstruction?

Back 64

Severe, colicky pain
Borborygmus
Audible, high-pitched peristalsis; peristaltic rushes
Awareness of intestinal movements

Front 65

what are the symptoms of paralytic intestinal obstruction?

Back 65

Hernia (e.g., inguinal, femoral, umbilical)
Postoperative adhesiobns
Also strictures, tumors, foreign bodies
Volvulus: twisting of bowel in axis formed by imesentery

Front 66

what are causes of mechanical intestinal obstruction?

Back 66

Hernia (e.g., inguinal, femoral, umbilical)
Postoperative adhesiobns
Also strictures, tumors, foreign bodies
Intussusception: telescoping of bowel into adjacent segment (ileum into R colon). Common cause of IO in children <2.
Volvulus: twisting of bowel in axis formed by imesentery

Front 67

what are causes of paralytic obstruction of bowel?

Back 67

Impaired peristalsis caused by:
Post surgery; w/ i
nflconditions; chemical irritation, bacterial toxins

Front 68

what are the results of obstruction of the bowel?

Back 68

-vomiting
-fluids move into interstitial space
-gas build up
-distension of bowel
-eschemia and necrosis
-anerobic bacerial produce endoxemia

Front 69

what is distention?

Back 69

Bloating or swelling of the abdomen.

Front 70

what is Intussusception ?

Back 70

a type of intestinal obstruction caused by movement of one segment of the bowel into another

Front 71

Tell whether the following statement is true or false.
Paralytic intestinal obstruction causes audible paralysis.

Back 71

False
Rationale:Mechanical obstruction results in high-pitched peristalsis (bowel sounds); in paralytic obstruction, bowel sounds are inaudible (silent abdomen).

Front 72

what is compartment syndrome?

Back 72

When An organ expands inside a membrane that will not expand
•The blood vessels feeding the organ are crushed between the organ and the membrane
•Blood supply is cut off

Front 73

what causes malabsorption of nutrients?

Back 73

1. malabsorption syndrome
2. Celiac disease

Front 74

what is celiac disease?

Back 74

inheited immune disease: T-cell mediated response against gluten protein
Loss of absorptive villi in small intestine
Genetic component

Front 75

what is 2nd and 3rd most fatal cancer in men and womein in the US?

Back 75

Colorectal

Front 76

what do hepatocytes impair?

Back 76

Metabolic and synthetic functions of liver
Carbohydrate, protein and fat metabolism
Metabolism and removal of drugs, hormones, toxins, ammonia and bilirrubin from the blood;
Interconversion of aminoacids and protein synthesis
↑ serum aminotransferase levels

Front 77

what do disorders of biliary drainage cause?

Back 77

obstruct flow of bile
Interfere with elimination of bile salts and bilirrubin
Cholestatic liver damage → backup of bile into liver lobules
↑bilirrubin and alkaline phosphatase

Front 78

What causes jaundice?

Back 78

Increased bilirubinlevels
Rationale:Erythrocytes are normally broken down in the spleen at the end of their life span. The end product of RBC metabolism is bilirubin. Bilirubinis sent to the liver to be metabolized; if the liver is not functioning properly, the bilirubin accumulates and causes jaundice (an abnormal yellowing of the skin and mucous membranes).

Front 79

Which hepatitis viruses are most likely to be the problem in:
An asymptomatic drug abuser?
A nursing student who has spent the last two months volunteering in an orphanage in Mali?
An infant whose mother has hepatitis?

Back 79

Caused by HBV, HCV, and HDV
Principal worldwide cause of chronic liver disease, cirrhosis, and hepatocellular cancer
Chief reason for liver transplantation in adults

Front 80

Hepatitis A virus (HAV) transimssion? causes?

Back 80

-fecal to oral transmission
- usually beningn and does not become chronic

Front 81

Hepatitis B virus (HAB) transimssion? causes

Back 81

- transitted through blood or serum thro sex
- causes accute and chronic hepatitis --> cirhosis
-particupates in hep D development

Front 82

How is Hep C transmitted?
What does it cause?

Back 82

-IV drug use, tattoing, accupuncture, sexual
-causes chronic hepatitis, cirrhosis and liver cancer

Front 83

what causes Hep E infection? Who does it infect?

Back 83

-Fecal oral, acute hepatitis similar to hepA

-High mortality rate among pregnant women
-Mostly in India, southeast Asia, Africa, Mexico
- does nto progress to chronic or carrier state

Front 84

What is steatosis?

Back 84

Fatty liver

Front 85

What liver diseases does alcoholism cause?

Back 85

1. fatty liver -- liver is enlarged from fat deposits
2. alcholic hepatitis - liver inflammation --> cell failure
3. Cirrhosis - scare tissue blocks sinusoids and bile canaliculi

Front 86

what is Cirrhosis?

Back 86

consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules leading to progressive loss of liver function

Front 87

Which of the following is the least virulent strain of hepatitis?

Back 87

a.HAV
Rationale:HBV, HCV, and HDV are all virulent strains that may lead to chronic viral hepatitis. HAV is most commonly transmitted by the fecal-oral route (e.g., contaminated food or poor hygiene) and does not typically have a chronic stage (it does not cause permanent liver damage).

Front 88

what is portal hypertension?

Back 88

Obstruction of blood flow→ portal hypertension: ↑ hydrostatic pressure in peritoneal capillaries→ ascites, splenicengorgement (sequestration and destruction of blood cells and platelets), and shunting of blood to collateral venous channels →varicosities of hemorrhoidaland esophageal veins.

Front 89

What does portal hypertension cause?

Back 89

causes pressure in veins to hepatic pressure to increase, which causes shunting of blood and organ to engorge with blood

Front 90

what is Cholestasis ?

Back 90

Cholestasis is any condition in which the flow of bile from the liver is blocked.

Front 91

what what happens while bile flow is blocked?

Back 91

- bile accumlates in ducts
-ducts rupture and damage liver cells
-liver cannot process bilirubin, so increased bile acids in blood and skin

Front 92

what causes choleithiasis (gall stones)

Back 92

deposits of cholestera and/ or calcium in gallbladder

Front 93

what is cholecystisis

Back 93

inflammtion of the gall bladder caused by concentrated bile

Front 94

Choledocholithiasis

Back 94

Stones in the common bile duct

Front 95

Cholangitis

Back 95

Inflammation of the common bile duct

Front 96

what are signs and symptoms of chronic pancreatitis and pacnreatic cancer?

Back 96

Digestive problems because of inability to deliver enzymes to the duodenum
Glucose control problems because of damage to islets of Langerhans
Signs of biliaryobstruction because of underlying bile tract disorders or duct compression by tumors