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65 Cards in this Set
- Front
- Back
Dysphagia:
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-difficulty in swallowing
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3 types of dysphagia:
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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 |
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achalasia:
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-failure of a ring of muscle fibers, such as a sphincter of the esophagus, to relax
-needs to be surgically removed |
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diverticulum:
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-disorder where there is a pouch or sac branching out from a hollow organ or structure, such as the intestine
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4 Causes of an altered peristalsis esophagus:
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1. diverticulae (buldge)
2. achalasia (tight) 3. neoplasms (tumor) 4. strictures (narrowing) |
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3 Causes of LES dysfunction:
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1. GERD
2. neuromuscular disorders 3. any obstruction |
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Gastrointestinal disorders:
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1. Dysphagia
2. Esophogeal pain 3. Abdominal pain 4. Vomiting 5. Intestinal gas |
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heartburn:
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-acid noxious to esophagus
-can cause spasm |
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2 disorders causing esophageal pain:
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1. heartburn (acid noxious, spasm)
2. substernal chest pain (spasm, similar to angina, radiation of the pain) |
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3 types of abdominal pain:
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1. visceral (inflammation, distention of gut)
2. somatic (abdominal wall, diaphragm, peritoneal) 3. referred pain (heart attack has pain in arm) |
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Which of the 3 types of abdominal pain required surgery to be corrected?
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visceral pain
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Causes of intestinal gas:
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1. swallowed air and bacteria causing digestive action
2. inadequate lactase from bacterial fermentation 3. alterations in motility |
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List 2 alterations of normal bowel patterns:
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constipation and diarrhea
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constipation:
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=infrequent passage of stools
-caused by diet low in fiber, lack of exercise (stimulates peristalsis), alterations in motility |
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diarrhea:
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-acute or chronic inflammation caused by malabsorption or irritants to GI tract (caffeine)
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4 Mechanisms of diarrhea:
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1. osmotic (solutes in intestine cause water influx-CHO, epsom salt)
2. secretory (bacteria) 3. exudative 4. motility disturbances |
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2 types of exudative mechanisms causing diarrhea:
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1. increased osmolarity from blood, mucus or protein
2. decreased absorption capacity from damage to epithelium |
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3 types of motility disturbances causing diarrhea:
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1. decreased absorptive time
2. overwhelm capacity of colon 3. disorders such as IBS, Crohn's disease, etc |
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4 disorders of the mouth/esophagus:
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1. Stomatitis
2. Gastroesophageal reflux 3. Hiatal hernia 4. Mallory-Weiss syndrome |
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Stomatitis:
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-inflammation of the mucous tissue of the mouth from various causes, such as mechanical trauma, irritants, allergy, vitamin deficiency, or infection (herpes-simplex)
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4 causes of GERD:
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1. esophagitis (esophagus inflamm)
2. increased abdominal pressure 3. alteration closure of LES 4. strictures (Tx: surgery to dilate) |
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LES:
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=lower esophageal sphincter
-ring of smooth muscle fibers at the junction of the esophagus and stomach. -aka cardiac sphincter or gastroesophageal sphincter |
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3 causes of alteration closure of LES:
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1. excess alcohol
2. birth control pills 3. theophylline |
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Tx for alteration closure of LES:
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decrease acidity
increase LES pressure |
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Hiatal hernia:
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-part of the stomach protrudes through the esophageal opening of the diaphragm
-caused by obesity, straining, pregnancy -NOT a hernia of the abdominal wall |
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2 types of hiatal hernia:
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1. sliding (most common)
2. paraesophageal |
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Mallory-Weiss Syndrome:
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-bleeding due to tear in lower esophagus
-caused by forceful, prolonged vomiting -common in alcoholics, violent vomiting -Tx: surgical intervention |
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7 disorders of GI tract wall:
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1. Gastritis
2. Gastroenteritis 3. Peptic ulcer disease 4. Inflammatory bowel disease 5. Enterocolitis 6. Appendicitis 7. Diverticulitis disease |
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Gastritis:
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-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 |
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Gastroenteritis:
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"Traveler's Diarrhea"
-causes potential fluid and electrolyte loss -caused by pathogenic organisms (viral, salmonella, campylobacter) |
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Peptic Ulcer Disease(PUD):
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-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 |
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3 Causes of PUD:
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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 |
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Txs of PUD:
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-no apparent effect from diet
-antibiotics -antacids -histamine-2 antagonists |
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Inflammatory Bowel Disease:
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-chronic disorder of the gastrointestinal tract
-inflammation of the intestine and resulting in abdominal cramping and persistent diarrhea -increased risk of cancer |
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2 types of inflammatory bowel disease:
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1. Crohn's disease
2. Ulcerative colitis |
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Crohn's disease:
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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 |
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Tx for Crohn's disease:
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sulfas
corticosteroids nutritious diet surgical considerations |
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Ulcerative colitis:
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-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 |
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2 Types of Enterocolitis:
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1. Pseudomembranous
2. Necrotizing |
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Pseudomembranous enterocolitis:
p.901 |
-life-threatening and severe form of colitis
-prompt antibiotic therapy needed to prevent perforation of bowel |
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Necrotizing enterocolitis:
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-more common in premature and small infants
-perforation of bowel causes major complications |
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What is the most common abdominal emergency surgery?
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appendicitis
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Diverticulitis:
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-found at sites of vessel penetration
-age related -asymptomatic, fiber extremely important -Tx ranges from conservative to surgical depending on severity |
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6 Disorders in motility of the GI tract:
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1. IBS
2. Intestinal obstruction 3. Volvulus 4. Intussusception 5. Meckel's diverticulum 6. Hirschsprung's disease |
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Irritable bowel syndrome:
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-disorder of bowel motility involving alterations of diarrhea and constipation of stools
-spastic or mucous colitis, irritable colon -Tx: increased fiber diet |
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2 Types of Intestinal obstruction:
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1. mechanical -complete or incomplete(adhesions, hernia, tumor, stricture, twisting)
2. paralytic or adynamic(mostly from abdominal surgery, also pelvic fractures) |
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Intestinal obstruction:
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-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 |
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Tx for Intestinal obstruction:
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1. xray evaluation
2. decompression 3. fluid-electrolyte replacement 4. surgery |
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Volvulus:
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"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 |
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Intussusception:
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-an infolding (telescoping) of one part of the intestine into another usually causing obstruction
-most common in infants and adults with tumors |
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Meckel's diverticulum:
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-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 |
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Hirschsprung's disease:
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-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 |
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5 Malabsorption disorders:
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1. Crohn's disease
2. Celiac disease 3. Tropical sprue 4. Dumping syndrome 5. Short bowel syndrome |
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Celiac disease:
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-intolerance to gluten (protein in wheat)
-immunologic or enzyme defect -damage to mucosa causing malabsorption -need to eliminate gluten fro diet |
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Tropical sprue:
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-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 |
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Dumping syndrome:
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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 |
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Short bowel syndrome:
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-malabsorption from the small intestine that is marked by diarrhea, malnutrition, and steatorrhea
-results from resection of the small intestine |
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steatorrhea:
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-excessive discharge of fat in the feces
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5 Neoplasms of the GI tract:
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1. Esophageal
2. Gastric 3. Small intestine 4. Colonic polyps 5. Colon cancer |
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Esophageal neoplasm:
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-chronic inflammation from smoking, alcohol, esophagitis
-poor prognosis, usually infiltrating -Tx required |
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Gastric neoplasm:
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-10x more common in Japan than USA
-poor prognosis, spreads in lymph and blood -reduced acid and atrophy predisposing(?) -Tx: surgery |
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Small intestinal neoplasm:
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-not common
-possible degree of obstruction dt severity |
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Colonic polyps:
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-risk factor for cancer is 20%
-sessile (permanently attached) or pedunculated (stalk-like) -Dx using endoscopic evaluation -Tx required |
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Colon cancer:
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-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 |
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Tx for colon cancer:
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1. Dukes classification
2. resection (surgical removal) 3. colonostomy 4. chemotherapy |