GI alterations

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nika.steffan
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152824
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GI alterations
Updated:
2012-05-09 22:00:30
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GI alterations Patho Pharm
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GI alterations - Patho/Pharm
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  1. Non-absorbable substance in intestine that causes excess fluid shift into intestine, increasing fluidity of stool.
    Osmotic Diarrhea
  2. Lactose deficiency is an example
    Osmotic Diarrhea
  3. Due to excessive secretion of fluids by intestinal mucosa secondary to foreign invasion of organisms or toxins.
    Secretory Diarrhea
  4. E.Coli infections is an example of this type of dirrhea.
    Secretory Diarrhea
  5. What are the 4 types of diarrhea and what do they run the risk of causing?
    - Osmotic, Secretory, Motility, Malabsorption

    Consequences: Dehydration, Electrolyte Imbalance, Metabolic Acidosis, Weight Loss
  6. Conditions that impair autonomic nervous system innervation of the bowel (ie spinal cord), major cause of which type of diarrhea?
    Motility Diarrhea

    *Caused by conditions that either increase or decrease bowel motility
  7. Conditions that cause chronic inflammation of bowels like ulcerative colitis or Crohn's disease and is a major cause of which type of Diarrhea?
    Motility Diarrhea

    *Caused by conditions that either increase or decrease bowel motility
  8. Upper GI bleeding
    -located
    - caused by
    • - Located in the esophagus, stomach, or duodenum
    • - Caused by bleeding varices or uclers
  9. Lower GI bleeding
    - Location
    - Causes
    • -Jejunum, ileum, colon, and/or rectum
    • - Caused by polyps, inflammatory diseases, cancer or hemorrhoids
  10. What are the acute manifestations of GI bleeding?
    • Hematemasis
    • Melena (dark, tarry stools)
    • Hematochezia (frank bleeding from rectum)
    • *Blood loss leads to hypovolemia and anemia
  11. What are the chronic manifestations of GI bleeding?
    Occult bleeding (undetectable by the naked eye)
  12. Motility Disorders include:
    • 1. Dysphagia
    • 2. GERD
    • 3. Hiatal hernia
  13. Dysphagia
    Impaired or difficulty swallowing
  14. Etiology and Symptoms of Dysphagia
    • Eti= Mechanical obstruciton
    • Sx= vary and may be progressive, pain, aspiration
  15. How do we diagnose Dysphagia...
    • 1. History and Physical
    • 2. Barium Swallow
    • 3. Manometry
    • 4. Endoscopy- visualization, biopsy
  16. Treatment of Dysphagia =
    • - Slowed eating
    • - Postion during eating
    • - Enteral nutrition
    • - Drugs
    • - Mechanical dilation
    • - Myotomy
  17. What does GERD stand for?
    • GastroEsophogeal Reflux Disease
    • -reflux of chyme from stomach to esophagus
  18. Etiology and Clinical Manifestations of GERD
    Etiology: Relaxation of lower esophogeal sphincter, delayed gastric emptying

    Clinical Mani: Inflammation of esophagus, Heartburn/pain, Strictures, Spasms, Dysphagia
  19. How do we diagnose GERD?
    • - symptoms, endoscopy, barium swallow
    • - pH monitoring (instead of manometry like dysphagia)
  20. Treatment of GERD...
    • -Antacid, Proton pump inhibitor (prilosec)
    • -Elevate HOB , remain upright 30 minutes after eating
    • -Weight reduction
    • - Not smoking
    • - Fundoplication
  21. A protuberance of the upper stomach through the diaphragm, into the thorax.
    • Hiatal Hernia
    • (a diaphragmatic hernia)
  22. GERD and dysphagia are clinical manifestations of this disorder as well as pain although it is often asymptomatic.
    Hiatal Hernia
  23. Symptoms of Hiatal Hernia are exacerbated by :
    - Coughing, belching, tight clothing, ascites, obesity, pregnancy
  24. What is the definition of Intestinal Obstruction?
    Acute or chronic condition that prevents movement of chyme through the intestinal lumen. Obstruction can be partial or complete.
  25. What are the different types of intestinal obstructions?
    • -Herniation
    • -Intussusception
    • -Torsion (volvulus)
    • -Paralytic ileus
    • -Adhesions
  26. What are the consequences of Intestinal Obstruction?
    • - Inability to move contents through the GI tract (clogged)
    • - Pain due to gas or severe distention > Decreased O2 to bowel lumen > Bowel necrosis
    • - Electrolyte imbalance (hypokalemia)
    • - Dehydration
  27. Protrusion of intestine through muscular wall of abdomen or inguinal ring
    Herniation
  28. Telescoping of one part of the intestine into another part of the intestine, Blood supply is occluded.
    Intussusception
  29. What is another name for torsion and how would you describe it?
    • Volvulus.
    • Twisting of the intestine causing occlusion of blood supply to intestine.


    (Intestinal Obstruction)
  30. Loss of peristalsis associated with surgery, peritonitis, narcotics, hypokalemia, ischemic bowel, spinal trauma, pneumonia.
    Paralytic Illeus
  31. Scarring within the lumen or structures that attach to the lumen
    Adhesion
  32. What are the clinical manifestations associated with intestinal obstruction?
    i. Intermittent colicky pain and vomiting

    ii. Increased pain with peristalsis

    iii. When ischemia occurs -> pain becomes constant and severe. Perforation, sepsis, shock more likely
  33. What are the inflammatory disorders of the gut?
    • 1. Gastritis
    • 2. Peptic Ulcer Disease
    • 3. Stress Ulcers
    • 4. Inflammatory bowel disease- Ulcerative colitis and Crohn's
    • 5. Diverticular Disease
    • 6. Appendicitis
  34. Inflammation of gastric mucosa resulting in edema and possible degenerative changes in the epithelial tissue of the mucosa
    Acute and chronic Gastritis
  35. What does PUD stand for?
    What is the most common type?
    Peptic Ulcer Disease

    Duodenal and Gastric
  36. A break or ulceration in the mucosal lining of the esophagus, stomach, or duodenum resulting in auto-digestion of the stomach.
    Peptic Ulcer Disease
  37. What are the risk factors associated with PUD?
    H. pylori -- Primary cause

    Habitual use of NSAIDS

    Alcohol

    Chronic Illness
  38. What is the acute form of PUD?
    • Stress ulcers- develop within hours
    • 1. Cushings (Vagal nerve stim- neural injury)
    • 2. Curlings ( burns)
    • 3. Ischemic

    formation accompanied by severe illness, systemic trauma, neural injury or burns
  39. What is Ulcerative Colitis and who's at risk of this?
    Chronic inflammatory disease that causes ulceration of mucosa of large colon (usually sigmoid or rectum)

    >Auto-immune disorder<

    • - young adults esp women, jewish, caucasion
    • - onset btwn 15-30 and again 50-70
  40. What is the goal for treatment of ulcerative colitis?
    To control the inflammation, replace nutritional losses and blood volume and prevent complications.
  41. Idiopathic inflammatory disorder that affects any part of GI tract from mouth to anus, entire thickness of intestinal wall may be affected
    Crohn's disease
  42. Outpouching of intestinal mucosal through intestinal wall.
    Diverticular Disease
  43. What are some complications of Diverticular Disease?
    • wall thins and can break (perforate)
    • Peritonitis - inflam of the peritoneum
  44. Inflammatory diverticular disease
    Diverticulitis
  45. What is the Law of Laplace?
    As wall pressure increases, diameter of bowel decreases. Increased pressure forces herniation of mucosa through muscle wall of intestine.
  46. What is inflammation of "veriform" appendix called and who is at greatest risk?
    • Appendicitis
    • - men between puberty-25
  47. What is the definition of Hepatitis?
    • Acute or Chronic Inflammation or infection of the liver.
    • Hepatitis type A, B, or C
  48. What are the phases of viral hepatitis?
    • 1. Prodromal - flulike Sx
    • 2. Icteric - jaundice and itching MOST COMMUNICABLE during this phase
    • 3. Recovery "post-icteric"- may take several wks or months to recover
  49. What is Fulminating Hepatitis?
    • Severe liver impairment, cellular necrosis, and liver failure
    • A complication of type B and C
  50. What is the yellow pigmentation of skin caused by hyperbilirubinemia?
    Jaundice
  51. What is the etiology of Jaundice?
    • - Liver or bile disease
    • - Bile duct obstruction
    • - Excessive RBC hemolysis

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