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44 Cards in this Set
- Front
- Back
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What cells produce IF in the stomach?
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Parietal cells
-necessary for absorption of B12 |
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What part of the stomach is responsible for the bulk of absorption?
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Jejunum
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Where is B12 absorbed?
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The terminal ileum
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Where is iron absorbed?
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Mostly the duodenum
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If there is small bowel dysfunction will there be more or less stool production?
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more because there will be decreased absorption
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Where are serum proteins made and which is the largest quantity of serum protein?
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Made in the liver
Albumen is in the largest quantity |
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Why do some people have gall stones that damaget the pancreas/
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Their bile duct and pacnreatic duct empty through the same papillae which can be obstructed by the stone
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The large intestine mostly absorbs...
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salt and water
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What do colonic cells use as a food source?
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fatty acids
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What nerve controls swallowing?
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Vagus
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Auerbach's plexus
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helps coordinate secretion and paristalsis in the muscularis layer of esophagus
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Meissner's plexus
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nerve plexuses in the submucosal layer
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Cell changes in the esophagus
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metaplasia
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Abnormal cell changes in the distal esophagus
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squamous cell --> columnar cells
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Type of muscle in the esophagus
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Striated voluntary in the top
involuntary smooth muscle in the bottom (cant control swallowing after its initiated) |
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Causes of esophageal varicies
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portal HTN or cirrhosis
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Esophagus shifting upwards so the LES is in the chest
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Hiatal hernia
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What symptoms will you get with a hiatal hernia
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reflux or heartburn
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Manisfestation of hypersalivation causing heartburn and bringing up acidic fluid into the mouth
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Waterbrash
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Most common cause intermittant solid food dysphagia
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Schatski ring
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When is a Schatzki ring always symptomatic?
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if the lumen is < 13mm on X-ray
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Treatment of a Schatski Ring
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esophageal dilation via catheter
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Most common esophageal diverticulum
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Zenkers Diverticuli
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S&S of Zenkers Diverticuli
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Often Asx
Dysphagia Regurg of old food Halitosis Aspiration Palpable mass |
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Dx of Zenkers Diverticuli
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Barium swallow
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Treatment of Zenkers Diverticuli
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Cricopharyngeal myotomy with diverticuliectomy
Endoscopic stapling |
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Common causes of prehepatic portal HTN
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splenic AV fistula
splenic or portal vein thrombosis splenomegaly |
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Common causes of intrahepatic portal HTN
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sarcoidosis
cirrhosis hepatic fibrosis alcoholic hepatitis veno occulsive disease |
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Common causes of posthepatic portal HTN
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right heart failure
budd-chiari syndrome (occlusion of the hepatic veins) membranous IVC web |
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What causes ascites?
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increased lymph and venous pressure, low albumen cauing seepage of serum into peritoneum
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How do you treat ascites?
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TIPS procedure
transhepatic intramuscular portosystemic shunt or drainage? |
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Number 1 cause for liver transplant
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Hep C
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Side effect of shunt for portal HTN
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may worsen encephalopathy because of increased unfiltered blood to the liver
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How do you diagnose hiatal hernia?
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barium swallow or EGD
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Common motility disorders of the esophagus
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achalasia
diffuse esophageal spasm scleroderma |
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Achalsia Hallmark
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high resting pressure at LES
Incomplete relaxation of LES BIRD BEAK at end of esophagus |
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globus pharyngeus
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feeling of a lump lodged in the throat with unaffected swallowing
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Difficulty with solids
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Mechanical dysphagia
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Difficulty with solids and liquids
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late mechanical dysphagia and early motor dysphagia
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Most common diagnosis to outpatient clinics
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GERD
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Typical sx of GERD
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Heartburn
Chest Pain Dysphagia Regurgitation of food or acid |
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Atypical sx of GERD
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Hoarseness
Laryngitis Cough Asthma sx (try proton pump inhibitors if normal asthma tx isnt working) Dental decay |
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GERD is a motility disorder and is not caused by..
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hyper-production of acid
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Possible complications of GERD
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Barretts metaplasia, dysplasia, cancer, stricture
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