Patho - Exam 6 Gastrointestinal Disorders

Front 1

Dysphagia:

Back 1

-difficulty in swallowing

Front 2

3 types of dysphagia:

Back 2

1. Problems in delivery of bolus of food into esophagus dt neuromuscular incoordination (pain, neuromuscular disorder, lesion esophagus)
2. Altered peristalsis esophagus
3. LES dysfunction

Front 3

achalasia:

Back 3

-failure of a ring of muscle fibers, such as a sphincter of the esophagus, to relax
-needs to be surgically removed

Front 4

diverticulum:

Back 4

-disorder where there is a pouch or sac branching out from a hollow organ or structure, such as the intestine

Front 5

4 Causes of an altered peristalsis esophagus:

Back 5

1. diverticulae (buldge)
2. achalasia (tight)
3. neoplasms (tumor)
4. strictures (narrowing)

Front 6

3 Causes of LES dysfunction:

Back 6

1. GERD
2. neuromuscular disorders
3. any obstruction

Front 7

Gastrointestinal disorders:

Back 7

1. Dysphagia
2. Esophogeal pain
3. Abdominal pain
4. Vomiting
5. Intestinal gas

Front 8

heartburn:

Back 8

-acid noxious to esophagus
-can cause spasm

Front 9

2 disorders causing esophageal pain:

Back 9

1. heartburn (acid noxious, spasm)
2. substernal chest pain (spasm, similar to angina, radiation of the pain)

Front 10

3 types of abdominal pain:

Back 10

1. visceral (inflammation, distention of gut)
2. somatic (abdominal wall, diaphragm, peritoneal)
3. referred pain (heart attack has pain in arm)

Front 11

Which of the 3 types of abdominal pain required surgery to be corrected?

Back 11

visceral pain

Front 12

Causes of intestinal gas:

Back 12

1. swallowed air and bacteria causing digestive action
2. inadequate lactase from bacterial fermentation
3. alterations in motility

Front 13

List 2 alterations of normal bowel patterns:

Back 13

constipation and diarrhea

Front 14

constipation:

Back 14

=infrequent passage of stools
-caused by diet low in fiber, lack of exercise (stimulates peristalsis), alterations in motility

Front 15

diarrhea:

Back 15

-acute or chronic inflammation caused by malabsorption or irritants to GI tract (caffeine)

Front 16

4 Mechanisms of diarrhea:

Back 16

1. osmotic (solutes in intestine cause water influx-CHO, epsom salt)
2. secretory (bacteria)
3. exudative
4. motility disturbances

Front 17

2 types of exudative mechanisms causing diarrhea:

Back 17

1. increased osmolarity from blood, mucus or protein
2. decreased absorption capacity from damage to epithelium

Front 18

3 types of motility disturbances causing diarrhea:

Back 18

1. decreased absorptive time
2. overwhelm capacity of colon
3. disorders such as IBS, Crohn's disease, etc

Front 19

4 disorders of the mouth/esophagus:

Back 19

1. Stomatitis
2. Gastroesophageal reflux
3. Hiatal hernia
4. Mallory-Weiss syndrome

Front 20

Stomatitis:

Back 20

-inflammation of the mucous tissue of the mouth from various causes, such as mechanical trauma, irritants, allergy, vitamin deficiency, or infection (herpes-simplex)

Front 21

4 causes of GERD:

Back 21

1. esophagitis (esophagus inflamm)
2. increased abdominal pressure
3. alteration closure of LES
4. strictures (Tx: surgery to dilate)

Front 22

LES:

Back 22

=lower esophageal sphincter
-ring of smooth muscle fibers at the junction of the esophagus and stomach.
-aka cardiac sphincter or gastroesophageal sphincter

Front 23

3 causes of alteration closure of LES:

Back 23

1. excess alcohol
2. birth control pills
3. theophylline

Front 24

Tx for alteration closure of LES:

Back 24

decrease acidity
increase LES pressure

Front 25

Hiatal hernia:

Back 25

-part of the stomach protrudes through the esophageal opening of the diaphragm
-caused by obesity, straining, pregnancy
-NOT a hernia of the abdominal wall

Front 26

2 types of hiatal hernia:

Back 26

1. sliding (most common)
2. paraesophageal

Front 27

Mallory-Weiss Syndrome:

Back 27

-bleeding due to tear in lower esophagus
-caused by forceful, prolonged vomiting
-common in alcoholics, violent vomiting
-Tx: surgical intervention

Front 28

7 disorders of GI tract wall:

Back 28

1. Gastritis
2. Gastroenteritis
3. Peptic ulcer disease
4. Inflammatory bowel disease
5. Enterocolitis
6. Appendicitis
7. Diverticulitis disease

Front 29

Gastritis:

Back 29

-chronic or acute inflammation of the mucous membrane of the stomach
-acute caused by alcohol, aspirin, bacterial toxins
-chronic caused by atrophy of epithelium of the stomach

Front 30

Gastroenteritis:

Back 30

"Traveler's Diarrhea"
-causes potential fluid and electrolyte loss
-caused by pathogenic organisms (viral, salmonella, campylobacter)

Front 31

Peptic Ulcer Disease(PUD):

Back 31

-symptoms of epigastric burning and relief from food
-non-permeable junctions of epithelial cells that usually provide protection barrier
-*causes an increase in vagus activity where gastrin is secreted by the antrum stimulating parietal cells to secrete more HCL

Front 32

3 Causes of PUD:

Back 32

1. aspirin & alcohol (bile acids from duodenum which can strip gastric mucus)
2. Helicobacter pylori cause 90% duodenal ulcers and 70% gastric ulcers
3. stress causes an increase in corticosteroids increasing acid

Front 33

Txs of PUD:

Back 33

-no apparent effect from diet
-antibiotics
-antacids
-histamine-2 antagonists

Front 34

Inflammatory Bowel Disease:

Back 34

-chronic disorder of the gastrointestinal tract
-inflammation of the intestine and resulting in abdominal cramping and persistent diarrhea
-increased risk of cancer

Front 35

2 types of inflammatory bowel disease:

Back 35

1. Crohn's disease
2. Ulcerative colitis

Front 36

Crohn's disease:

Back 36

aka Regional enteritis and Granulomatous colitis
-a serious chronic and progressive inflammation of the ileum
-more pain, less bleeding
-"skip lesions" found inbtn normal cells
-producing frequent bouts of diarrhea with abdominal pain and nausea and fever and weight loss
-interference with absorption

Front 37

Tx for Crohn's disease:

Back 37

sulfas
corticosteroids
nutritious diet
surgical considerations

Front 38

Ulcerative colitis:

Back 38

-a nonspecific inflammatory disease of the rectum and colon
-diarrhea with discharge of mucus and blood, cramping abdominal pain
-inflammation and edema of the mucous membrane with patches of ulceration
-inability to absorb H2O and Na

Front 39

2 Types of Enterocolitis:

Back 39

1. Pseudomembranous
2. Necrotizing

Front 40

Pseudomembranous enterocolitis:
p.901

Back 40

-life-threatening and severe form of colitis
-prompt antibiotic therapy needed to prevent perforation of bowel

Front 41

Necrotizing enterocolitis:

Back 41

-more common in premature and small infants
-perforation of bowel causes major complications

Front 42

What is the most common abdominal emergency surgery?

Back 42

appendicitis

Front 43

Diverticulitis:

Back 43

-found at sites of vessel penetration
-age related
-asymptomatic, fiber extremely important
-Tx ranges from conservative to surgical depending on severity

Front 44

6 Disorders in motility of the GI tract:

Back 44

1. IBS
2. Intestinal obstruction
3. Volvulus
4. Intussusception
5. Meckel's diverticulum
6. Hirschsprung's disease

Front 45

Irritable bowel syndrome:

Back 45

-disorder of bowel motility involving alterations of diarrhea and constipation of stools
-spastic or mucous colitis, irritable colon
-Tx: increased fiber diet

Front 46

2 Types of Intestinal obstruction:

Back 46

1. mechanical -complete or incomplete(adhesions, hernia, tumor, stricture, twisting)
2. paralytic or adynamic(mostly from abdominal surgery, also pelvic fractures)

Front 47

Intestinal obstruction:

Back 47

-gas and fluid distention aggravated by increase in secretion into bowel
-no bowel sounds are heard upon auscultation
-impeded absorption function
-causes vomiting, fluid and electrolyte depletion
-incarceration or strangulation can occur causing necrosis

Front 48

Tx for Intestinal obstruction:

Back 48

1. xray evaluation
2. decompression
3. fluid-electrolyte replacement
4. surgery

Front 49

Volvulus:

Back 49

"Closed-loop obstruction"
-a mechanical bowel obstruction
-twisting of bowel caused by vascular compression
-cecum and sigmoid are the most common sites
-causes impairment of blood leading to gangrene or perforation

Front 50

Intussusception:

Back 50

-an infolding (telescoping) of one part of the intestine into another usually causing obstruction
-most common in infants and adults with tumors

Front 51

Meckel's diverticulum:

Back 51

-congenital abnormalities
-connection between the intestine and the umbilical cord doesn't completely close off during fetal development
-a small outpouching of the small intestine
-most common symptom is painless bleeding from the rectum

Front 52

Hirschsprung's disease:

Back 52

-cogenital obstruction of the large intestine caused by inadequate motility
-enlargement of the colon caused by bowel obstruction resulting from an aganglionic section of bowel (the normal enteric nerves are absent)
-dt absent autonomic nerve ganglia in smooth muscle
-usually segment rectosigmoid
-most common in infants and children
-Tx: surgical intervention

Front 53

5 Malabsorption disorders:

Back 53

1. Crohn's disease
2. Celiac disease
3. Tropical sprue
4. Dumping syndrome
5. Short bowel syndrome

Front 54

Celiac disease:

Back 54

-intolerance to gluten (protein in wheat)
-immunologic or enzyme defect
-damage to mucosa causing malabsorption
-need to eliminate gluten fro diet

Front 55

Tropical sprue:

Back 55

-common in tropical climates
-atrophy of the mucosa causing lack in enzymes
-chronic disorder
-nutrients are not absorbed
-symptoms include foul smelling diarrhea and emaciation

Front 56

Dumping syndrome:

Back 56

aka postgastrectomy syndrome
-A condition occurring after eating in patients with shunts of the upper alimentary canal
-bowel motility causes diarrhea
-increase in blood glucose, increasing insulin causing rebound hypoglycemia
-limit CHO intake and more frequent small meals

Front 57

Short bowel syndrome:

Back 57

-malabsorption from the small intestine that is marked by diarrhea, malnutrition, and steatorrhea
-results from resection of the small intestine

Front 58

steatorrhea:

Back 58

-excessive discharge of fat in the feces

Front 59

5 Neoplasms of the GI tract:

Back 59

1. Esophageal
2. Gastric
3. Small intestine
4. Colonic polyps
5. Colon cancer

Front 60

Esophageal neoplasm:

Back 60

-chronic inflammation from smoking, alcohol, esophagitis
-poor prognosis, usually infiltrating
-Tx required

Front 61

Gastric neoplasm:

Back 61

-10x more common in Japan than USA
-poor prognosis, spreads in lymph and blood
-reduced acid and atrophy predisposing(?)
-Tx: surgery

Front 62

Small intestinal neoplasm:

Back 62

-not common
-possible degree of obstruction dt severity

Front 63

Colonic polyps:

Back 63

-risk factor for cancer is 20%
-sessile (permanently attached) or pedunculated (stalk-like)
-Dx using endoscopic evaluation
-Tx required

Front 64

Colon cancer:

Back 64

-require high fat, low fiber diet
-commonly caused by Crohn's disease, adenomatous polyps, ulcerative colitis
-severity related to location of tumor in large intestine

Front 65

Tx for colon cancer:

Back 65

1. Dukes classification
2. resection (surgical removal)
3. colonostomy
4. chemotherapy