Ou Tulsa Pa Gi Etiology

Front 1

Ingestion of gluten containing foods (wheat, rye, barely) leads to malabsorption

Back 1

Celiac Disease

Front 2

Developmental lactase deficiency

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Primary Lactose intolerance

Front 3

caused by a condition injuring the intestinal mucosa/reduction of mucosal surface

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Secondary Lactose intolerance

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Alcoholism
Drug-nutrient interaction
inborn error of metabolism

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Niacin Deficiency (vitamin B3)

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Mutated gene for enzyme phenylalanine hydrolase
Autosomal recessive disorder

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Phenylketonuria (PKU)

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Almost always occurs in combination with deficiencies of other vitamins

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Riboflavin (B2)

Front 7

MC = Chronic Alcoholism

Chronic renal dialysis
Malabsorption disorder

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Thiamine Deficiency ( B1)

Front 8

Diets low in animal source
Iron deficiency
Alcoholism

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Vitamin A (retinol)

Front 9

inadequate dietary intake, impaired absorption

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Vitamin B12 (cobalamin, cyanocobalamin)

Front 10

Dietary inadequacy in urban poor, elderly and alcoholics

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Vitamin C (ascorbic acid)

Front 11

GERD
Infection (Candida, HSV, CMV, HIV)
Chemical (EtOH, cigarette smoke, hot fluids, drugs)

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Esophagitis

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common when taking pills:
NSAIDs, Iron, KCl, Vit. C, Doxycylcine, Fosamax

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Pill induced Esophagitis

Front 13

Complication of GERD
Chronic reflux causes changes of squamous cell to metaplastic columnar cell

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Barrett Esophagus/ Gastroesophageal Reflux Disease

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Partial thickness tear at gastroesophogeal junction that follows prolonged period of severe vomiting or retching

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Mallory-Weiss Tear

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Loss of elasticity of UES = restricted opening during swallowing

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Zenker's Diverticulum

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Esophageal Neoplasm associated with alcohol and smoking

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Squamous Cell Carcinoma

Front 17

Esophageal Neoplasm associated with Barrett's metaplasia
Strong association with Obesity
More Common in Caucasians

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Adenocarcinoma

Front 18

PORTAL HTN
Most common cause of Portal HTN is cirrhosis.
MC in lower 3rd of esophagus

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Varicies

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Increased LES resting pressure and failure of LES to relax in response to swallowing

Motility disorder

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Achalasia

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Erosive form = Most common cause are drugs (esp. NSAIDs) alcohol, and stress due to severe illness

Non-erosive = MC H. pylori

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Gastritis

Front 21

Most are fundic gland polyps (no tx needed)

Benign Polyps, Fundic Gland Polyps, Adenomatous Polyps, and Malignant Polyps

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Gastric Neoplasms

Front 22

H. Pylori
Nsaid induced
Acid hypersecretory states

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Peptic Ulcer Disease

Front 23

Bacterial infection caused by an obstruction, such as a gallstone, tumor, stricture, or parasite

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Cholangitis

Front 24

**Infections agents or vasculitis** causes obstruction of the cystic duct and inflammation of the gallbladder

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Cholecystitis

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Gall stones can be cholesterol, Ca2+, Bilrubin, Mucus, or mixed

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Cholelithiasis

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Common bile duct stones that usually arise from the gallbladder but may form spontaneously

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Choledocholithiasis

Front 27

May result from infection or noninfectious causes (alcohol, drugs, autoimmune)

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Hepatitis

Front 28

Disease that alter fat absorption (celiac, CF, cholestasis)
Abx and drugs that interfere w/ vitamin metabolism
Breastfeeding babies increased risk for hemolytic disease of newborns

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Vitamin K deficiency
(Phylloquinone)

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History of allergies and atopic conditions

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Eosinophilic esophagitis

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Incomplete LES pressure
Hiatal Hernia
Elevated acid level in stomach
Delayed gastric emptying

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GERD - Gastroesophageal Reflux Disease

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Thin diaphragm-like membranes of squamous mucosa

_____ = usually mid or upper esophagus
_____ = generally distal, associated with hiatal hernia

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Esophageal Webs and Rings

(Webs)
(Rings)

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Gastric outlet obstructed by pyloric hypertrophy

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Pyloric Stenosis

Front 33

Caused by gastrin secreting tumor that results in hypergastric acid secretion

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Zollinger-Ellison Syndrome (Gastrinoma)

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MC = alcohol abuse
2nd MC = cholelithiasis

hyperlipidema, trauma, drugs, hypercalcemia

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Acute Pancreatitis

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MC = alcohol abuse

hyperparathyroidism, severe malnutrition, obstruction of pancreatic duct

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Chronic Pancreatitis

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MC = postoperative adhesions
2nd = malignant tumors or strictures
3rd = hernias

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Acute intestinal obstruction

Front 37

obstruction by: fecalith, inflammation, foreign body, neoplasm

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Appendicitis

Front 38

MC = poor dietary and behavioral habits (inadequate fiber or fluid intake)
Structural abnormality or physical inactivity

Peds = consider Hirschsprung disease

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Constipation

Front 39

MC = infectious
Viral = 50-70% (rotavirus, coronavirus, parvovirus, norovirus)
Bacterial = 15-20% (salmonella, E. coli, campylobacter, V. cholera)
Protozal
Travelers

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Acute Diarrhea

Front 40

medications, osmotic, secretory, inflammatory, malabsorptive, motility, chronic disease, systemic disorder

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Chronic Diarrhea

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Idiopathic
Genetic - genetic mutation (NOD2/CARD15), 1/4 have family history of IBD

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Crohn's Disease and Ulcerative Colitis

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MC = Occlusion --> Reduction in intestinal blood flow

vasospasm or hypoperfusion

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Ischemic Bowel Disease (Ischemic Colitis)

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Complication
ABx induced pseudomembranous colitis
infections of the colon

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Toxic Megacolon (Hirschsprung's Enterocolitis)

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Environmental/lifestyle factor
Usually follows many years of diet deficient in fiber

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Dicerticulosis/Diverticulitis

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MC affected Ilieum
(can affect Duodenum, Jejunum, or colon)
Caused by interruption of normal GI tract development

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Intestinal Atresia