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31 Cards in this Set
- Front
- Back
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Name the 4 causes of upper GI bleeding.
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1) Peptic ulcer Dz
2) Esophageal varices (an ominous event) 3) Abnormalities of clotting 4) Carcinoma (stomach, esophagus) |
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A 59 y/o smokers presents wit hematuria, what Dz does he likely have?
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BL cancer
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What is the terms for blood in the vomitus?
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Hematemesis
It indicates blood is from the upr digestive tract. |
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What is the term for BRIGHT RED blood in the stool?
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Hematochezia.
It indicates blood is from the LWR GI tract. |
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What is the term for black, tarry stools?
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Melena
It indicates the source of the bleeding is above the level of the ileocecal valve. The black color is due to oxidation of the heme. |
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What is the term meaning that blood (in excrement) is hidden?
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Occult blood.
Found by the use of hemoccult test. |
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Many patients with ulcers don't complain about pain, what do they complain about?
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Vomitting blood!!!
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What can GERD evolve into if not properly treated?
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Barrett's Esophagus
It's a type of dysplasia. refers to an abnormal change (metaplasia) in the cells of the lower end of the esophagus thought to be caused by damage from chronic acid exposure, or reflux esophagitis.[1] The normal lining of the esophagus (squamous epithelium) is replaced by an intestinal-type lining (columnar epithelium). [WIKI] |
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What does Dysphagia mean?
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Difficulty swallowing. It's a SYMPTOM not a Dz.
It is the MOST COMMON Sx of esophageal cancer (1st w/ solid foods, then soft, then liquids, which is a late sign) Can indicate CNS injury (CN's V, IX, X, XII) or a primary esophegeal Ds like cancer. |
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What is the term for painful swallowing?
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Odynophagia
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What are the the Sx of Esophageal Cancer?
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Dysphagia, weight loss, anorexia, fatigue, odynophygia
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What type of esophageal cancer has risk factors of tobacco products and alcohol abuse?
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Squamous Cell
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What type of esophageal cancer is attributable to the malignant transformation of Barett's Esophagus?
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Adenocarcinoma
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Gastritis and Peptic ulcers are mostly due to which infectious agent?
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H-pylori
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What is the major cause of cancer death worldwide?
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Stomach Cancer! And it's the 7th leading cause of DEATH (fo' reals, ya'll)!
Likely b/c it goes undetected. Test for occult blood in stool. |
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What are the risk factors for ST cancer?
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1) Genetic predisposition
2) Dietary carcinogens (N-nitrosos compounds found in smoked/preserved foods) 3) Autoimmune gastritis (this can also lead to pernicious anemia) 4) Gastric adenomas and polyps |
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What is the def for IBS?
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Irritable Bowel Syndrome is:
"A functional GI Ds characterized by a variable combination of chronic and RECURRENT intestinal Sx NOT explained by STRUCTURAL or BIOCHEMical ABnormalities. |
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What are some Sx of IBS?
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AB pain, altered bowel function, flatulence (or burping), bloating, anorexia, nausea, constipation and diarrhea.
Sx commonly relieved by defecation. Pain not normally at night or interfere with sleep. Cause: NOT CLEAR; perhaps a dysregualtion of intestinal motor and sensory functions of CNS. Dr. Stewart says it's a complex, psycho-e phenomena. |
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What does Dr. Stewart recommend as Tx for IBS or Inflammatory Bowel Dz?
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1) Chew food well (get fanatical!)
2) Pancreatic enzymes 3) Proper food combo (avoid protein and carbs together) |
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Ulcerative colitis has what type of legions?
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Contiguous
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Crohn's Dz has what type of legions?
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Skip lesions
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Which type of colon ds is a risk factor for colon cancer?
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Ulcerative colitis
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Name 4 risk factors fo diverticular Dz.
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1) Lack of Dietary Fiber
2) Decreased physical activity 3) Poor bowel habits 4) Aging |
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What are likely presentations of appendicitis?
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1) ABRUPT onset, brief
2) PERIumbical or EPIgastric pain that shifts tot he RLQ 3) Nausea, anorexia, vomiting, diarrhea 4) LEUKocytosis, NEURTROphilia 5) Palpation tenderness in RLQ (McBurney's point) w/ or w/out rebound tenderness |
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Celiac Dz
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Aka Gluten-sensitive enteropathy (or ceiac sprue) is an T-cell immune-mediated Ds (response against ingested alpha-glandin) trigged by ingestion of gluten-containing grains (including wheat, barley and rye).
COMMON: 1 in 120-300 (rare in African-Carribean, Chinese or JPN background). Genetic component is supported by 10% prevalence of 1st degree relatives. Women compromise about 75% of newly Dx adult celiac Dz. GI Sx include diarrhea, constipation of other Sx of malasorption such as bloating, flatus or belching. May also get legions that look similar to herpes simplex. Test: IgA antiendomysial antibody test and intestinal biopsy. [Test is 85-100% sensitive for celiac's Dz.] See pg. 908, or 624 Eat multiple small meals a day |
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Name the 4 colorectal cancer risk factors.
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1) Age (over 50)
2) Genetic 3) Other Ds (inflammatory bowel Dz, familial poyposis) 4) Diet (high fat & sugar, lower fiber, deficient in Vit A, C, E) |
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What is a cardinal sign of colorectal cancer after hemmeroids (sp?) are ruled out?
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Painless hematochezia
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What is a key to avoiding colon cancer?
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Early screening
Hemoccult "Guaiac" test at time of annual exam (home kits) |
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What common OTC lowers the risk for colorectal cancer?
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Calcium, aspirin and NSAIDs
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Name 6 causes of lower GI bleeding.
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1) Carcinoma of the colon
2) Colon polyps 3) Inflammatory bowel Dz (ulcerative colitis, Crohn's Dz) 4) Hemorrhoids 5) Abnormalities of clotting 6) Some types of infectious diarrhea (dysentery, eneterotoxigenic E coli) HEMATOCHEZIA |
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Describe GERD
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Gastroesophageal reflux Dz
- Due to an incompetence of the LWR esophageal sphincter - ST contents reflux into lower esophagus - ST acid irritates the esophageal mucosa, causing heartburn and esophagitis in some pt -> can evolve into Barrett's Esophagus |
