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99 Cards in this Set

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  • Back
What are some general symptoms of GI diesease?
Pain, Anorexia, Nausea & Vomitting, Retching Vomitting, Abdominal Distention, Constipation, and Diarrhea, and Bleeding (either upper or lower GI)
What is achalasia?
A disorder of motility when peristalsis of lower two-thirds of esophagus is absent.
What is the etiology of achalasia?
Impairment of neurons innervating the esophagus.
What are the manifestations of achalasia?
Dysphagia (especially liquids), substernal chest pain, hallitosis, regurgitation, weight loss.
What is the pathophysiology of retching and vomitting?
1. Deep inspiration (glottis closes leading to intrathoracic pressure falling and esophagus distending)
2. Simultaneously the abd muscles contract creating a pressure gradient.
3. Lower esophagus and body of stomach relaxe but duodenum and antrum spasm
4. Reverse peristalsis occurs
What are the digestive functions performed by the saliva and salivary amylase respectively?
Lubrication and carbohydrate digestion.
Food would pass rapidly from the stomach into the duodenum if it were not for the...
pyloric sphincter
What are the three phases of gastric juice secretion
cephalic, gastric, and intestinal.
What is pepsinogen?
A precursor to pepsin
What happens when the chyme leaves the stomach normally?
The nutrients are ready for absorption into the blood.
Which part of the small intestine is most distal from the pylorus?
The jejunum
What is the pancreas?
A gland with its duct ultimately opening into the the duodenum
What is the chief role of the pancreas?
secrete enzymes, which digest fiood in the small intestine.
Among the structural features of the small intestine are villi, microvilli, and circular folds. What are their functions?
to increase the surface area for absorption.
What is the fate of carbs in the small intestine?
digestion to monosaccharides
What can the absorptive fate of end products of digestion be summarized as?
amino acids and monosaccharides are absorbed into blood capillaries; most fatty acids are absorbed into lymph.
A lobule of the liver contains a centrally located:
vein with radiating hepatocytes and sinusoids.
An obstruction of the common bile duct would cause blockage of bile coming from:
both the liver and the gallbladder.
The human adult liver does not:
produce erythrocytes. it does store glycogen, convert ammonia to urea, and produce blood coagulation proteins however.
How is the chyme that enters the large intestine converted to feces?
By bacteria and water reabsorption
What do splanchnic organs do?
act as blood reservoir for heart and lungs?
What do kupffer cells do?
trap bacteria
What does cholecystokinin do?
stimulates gallbladder to eject bile.
What is constipation due to?
inadequate liquid intake, drugs, motility problems, tumors, and foreign bodies
How does osmotic diarrhea occur?
There are non-absorbable products in the intestine. Those products cause water to be drawn into the intestine by osmosis. There is an increase in stool weight and volume in this case.
How does secretory diarrhea occur?
Is is caused by excessive intestinal secretion because of bacterial endotoxins. Excessive motility decreases transit time and opportunities for fluid absorption.
How does motility diarrhea occur?
referred to as small volume diarrhea which is usually caused by inflammatory disorders of the intestine .
What is abdominal pain a result of?
the sensitivity of stretching and distention of abdominal organs.
What is hematemesis?
Throwing up blood.
What is melena?
Bloody or tarry stools
What is occult bleeding?
Slow, chronic blood loss that results in iron deficiency enemai as iron stores in the bone marrow are slowsly depleted.
Explain Acute gastritis.
antiinflammatory drugs are known to cause acute gastritis. It erotes the epithelium. Gastritis if an inflammotory disorder of the gastric mucosa.
What are the clinical manifestations of acute gastritis?
vague abdominal discomfort, epigastric tenderness and bleeding.
What is hematochezia?
frank bleeding from the rectum.
What is Gastroesophageal Reflux Disease?
a disease characterized by gastric contents moving into the esophagus.
What is the pathophysiology of GERD?
There is an incompetent lower esophageal sphinctor or decreased esophageal motility or delayed gastric emptying that makes it easier for gastric contents to reflux into the esophagus.
What are the manifestations of GERD?
Heartburn, Acid regurgitation of stomach contents, dysphagia, reflux-induced laryngitis, or reflux-induced asthma, or chronic cough.
What is the esophagus?
a straight tube that carries food from thepharynx to the stomach.
What is the lower end of the stomach called?
The pylorus
What is the gallbladder?
a distention of the common bile duct that becomes a storage reservoir for bile.
What is the pancreas?
A long, narrow, glandular organ lying horizontally and retroperitoneally in the midabdomen region.
What is a complication of GERD?
What are the three types of peptic ulcers?
1. Duodenal
2. Gastric
3. Stress
What is the age incidence for duodenal, gastric and stress ulcers?
1. Duodenal at 25-50 years typically
2. Gastric ulcers at 50-70 years typically
3. Stress ulcers are related to severe stress, trauma, sepsis, or head injuries rather than age.
Is there a relation between gender and ulcers?
Only in duodenal ulcers which are seen more in men.
How does the acid production differ in duodenal, gastric, and stress ulcers?
1. Duodenal: increased
2. Gastric: normal to low
3. Stress: increased
How does stress factor into ulcer incidence?
There is an increased stress level with gastric and stress ulcers.
Is there an associated gastritis present with ulcers?
Not with duodenal but definitely with gastric.
What pain is associated with peptic ulcers?
1. Duodenal: food brings relief, there is often nocturnal pain, there are remissions and exacerbations.
2. Gastric: food brings releif, noctural pain, chronic pain without remissions & exacerbations.
3. Stress: usually asymptomatic until hemmorhage occurs or perforation.
Is hemorrhage common with peptic ulcers?
It is common with duodenal and less common with gastric. It is very common with stress ulcers.
How does malignancy relate to peptic ulcers?
There is almost never malignancy with duodenal ulcers but it is possible with gastric ulcers.
What similarities are there between Chron Disease and Ulcerative colitis?
Both result in abdominal pain, diarrhea, and
What differences are there between Chron Disease And Ulcerative colitis?
UC: family history is uncommon, lesions do not skip, the mucosal layer is involved, granulomas, anal and perianal fistulas, narrowed lumen, abdominal masses, small intestine malabsorption, and steatorrhea are rare. There is an increased risk for cancer and bloody stools.
CD: family history, ganulomas, anal and perianal fistulas, narrowed lumen, obstruction, abdominal masses, small intestine malabsorption, and steatorrhea are common. Cancer risk is not increased.
What are the five major complications of liver dysfunction?
1. Portal hypertension
2. Ascites
3. Hepatic encephalopathy
4. jaundice
5. hepatorenal syndrome
What is portal hypertension?
abnormally high BP in portal venous system that develops scar tissue in the liver. It is usually from cirrhosis.
What are the causes of portal hypertension?
cirrhosis, viral hepatitus, right heart failure.
What are the manifestations of portal hypertension?
esophageaql and stomach varices with vomiting of blood, splenomegaly, ascites.
What is ascites?
accumulation of luid in the peritoneal cavity.
What causes ascites?
portal hypertension, reduced serum albumin levels, cirrhosis, nephrotic syndrome, malnutrition, impaired sodium excretion and water retention, caput medusa
What causes hepatic encephalopathy?
blood that contains toxins such as ammonia is shunted from GI tract to systemic circulation, toxins reach brain
What are the S/S of hepatic encephalopathy?
changes in brain function, confusion, tremor of hands, stupor, convulsions, coma.
What are the S/S of ascites?
abdominal distension, displaced diaphragm, syspnea, peritonitis
What is jaundice?
yellow coloration of the skin and conjunctiva
What causes jaundice?
excess bilirubin, secondary to liver disease.
What are the S/S of jaundice?
dark urine, light colored stools, anorexia, malaise, fatigure, pruritus.
What causes hepatorenal syndrome?
decrease in blood volume: intrarenal vasoconstriction because the liver may fail to remove excessive vasoactive substances from the blood.
What are the signs and symptoms of hepatorenal syndrome?
oliguria, sodium and water retention, hypotension, BUN and creatinine increases.
Describe pathophysiology of alcoholic cirrhosis
Alcohol directly damages the liver cells in steps.
There is an irreversible inflammation of the liver. Fibrosis replaces normal tissue leading to a "hobtail" appearance. This disrupts liver structure and function.
What are the three phases of viral hepatitus?
prodromal, icteric, and recovery
What are the S/S of the prodromal stage of hepatitis?
jaundice, fatigue, anorexia, malaise, N/V, HA, hyperalgia, cough, low-grade fever.
What are the signs and symptoms of the icteric phase of hepatitis?
hepatomegaly, smooth and tender liver, percussion over the liver causes pain.
What are the S/S of the recovery phase of hepatitis?
liver function return to normal, jaundice resolves.
What are the types of viral hepatitus?
A, B, C, D, E, & G
Complications of hepatitus are...
fulminant hepatitus, cholestatic hepatitus, and relapsing hepatitis
What is fulminant hepatitus?
a clinical syndrome resulting in severe impairment or necrosis of liver cells.
How is hepatitis transmitted?
A: fecal-oral, parenteral, sexual
B: parenteral, sexual
C: perenteral
D: parenteral, fecal-oral, sexual
E: fecal oral
G: parenteral, sexual
What is pancreatitis?
inflammation of the pancreas
How does acute pancreatitis develop?
It develops due to an injury or disruption of the pancreatic ducts or acini that permits leakage of pancreatic enzymes into pancreatic tissue. The leaked enzymes initiate autodigestion and actue pancreatitis.
What is chronic pancreatitis a result of?
alcohol abuse
What causes pancreatitis in general?
alcoholism, obstructive biliary tract, trauma (post-surgical), viral infections, drugs, idiopathic (no cause)
Discuss pancreatitis pathogenesis.
1. injury to acinar cells in pancreas
2. activation of proteolytic enzymes
3. autodigestion of pancreatic tissue
Complications of pancreatitis
Shock, DIC, ARDS, Pain, hemorrhage, peritonitis
What are the clinical manifestations of acute pancreatitis?
abdominal pain and tenderness, NV, low grade fever, leukocytosis, hypotension, tachycardia, jaundice, bowel sounds decreased or absent, lung involvement, turner's/cullen's sign.
What are the manifestations of chronic pancreatitis?
abdominal pain, malabsorption, weight loss, mild jaundice, dark urine, steatorrhea(Excessive discharge of fat in the feces), DM
What two forms can chronic pancreatitis be found in?
chronic obstructive (associated with biliary disease) and chronic calcifying (associated with alcohol-induced)
What drugs can be used for pancreatitis?
Pancreatin (viokase)

Pancrelipase (cotazym)
What is the action and uses of pancreatitis drug therapy?
actions: replace pancreatic enzymes when needed

uses: chronic pancreatitis, cystic fibrosis, pancreatectomy, pancreatic duct obstruction.
List common gallbladder disorders.
What is cholecystitis?
inflammation of the gallbladder or cystic duct.
What is cholelithiasis?
gallstone formation or stones in the gallbladder.
What is the cause of cholecystitis?
it is commonly associated with obstruction where the inflammation may involve mucous lining or entire wall of GB.
What are common manifestations of cholecystitis?
vary from indigestion to moderate to severe pain, N/V, restlessness, diaphoresis, leukocytosis, fever, jaundice
What is the cause of cholelithiases
unknown but stones develop when blance that keeps cholesterol, bile salts and calcium in solution is altered.
What clinical manifestations are seen with cholelithiasis
pain and jaundice. Vague symptoms seen include heartburn, flatulence, epigastic discomfort, and fatty food intolerances.
What are the risks for developing stomach cancer?
dietary salty foods, nitrates, nitrosamines, gastric atrophy, H. pylori associated gastritis, family history, low intake of fruits and veggies, blood type A, food additive
What are the manifestations of stomach cancer/gastric cancer?
anorexia, malaise, weight loss, upper abdominal pain, vomiting, occult blood, symptoms of organ involved in metastisis from stomach.
What types of bowel obstructions exist?
mechanical, vascular, and neurogenic
How do mechanical, vascular, and neurogenic bowel obstructions differ?
Mechanical: when movement of material through bowel is blocked physically
Vascular: when there is not enough blood supply to the region to move material
Neurogenic: obstruction due to malfunction of bowel.
How can you evaluate a patient with a bowel obstruction
CT scan, barium enema, upper GI and small GI series, abdominal film