Patho Exam 2-GI

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Patho Exam 2-GI
2014-10-17 09:29:09
nursing med surg
Digestive, Cancer, Renal, Endocrine
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  1. What is forceful emptying of stomach and intestinal contents or chyme through the mouth?
  2. What is strong, involuntary effort to vomit
  3. Describe the process involved before a person vomits
    • 1. Inspiration
    • 2. Glottis closes
    • 3. Forceful diaphragm and abdominal muscles contract
    • 4. Esophageal sphincter relaxes
  4. What type of vomiting occurs when there is direct stimulation of the vomiting center in the brain caused by lesions, tumors, IICP, or anuerysms?
  5. Increased frequency of defecation accompanied by changes in fecal fluidity and volume
  6. What is the presence of nonabsorbable substances in intestines that causes water to be drawn into the lumen by osmosis which leads to large volume diarrhea?
    Osmotic diarrhea
  7. What is the common cause of Osmotic diarrhea
    Lactase deficiency
  8. What is caused by the excessive mucosal secretion of fluid and electrolytes?
    Secretory diarrhea
  9. what causes secretory diarrhea
    bacterial endotoxins or Ecoli
  10. What is caused by decreased transient time, mucosal surface contact and fluid absorbed?
    Motility diarrhea
  11. What causes motility diarrhea
    resection of small intestine
  12. What is caused by inflammatory disorders of intestines or fecal impaction from severe constipation
    Small volume diarrhea
  13. Name 3 types of abdominal pain
    Visceral, Parietal, Referred
  14. Pain that arises from the organs themselves
  15. Pain that occurs with the peritoneum that is usually localized and intense
  16. Visceral Pain that is felt at some distance from a diseased or affected organ
    Referred pain
  17. What causes abdominal pain (on a cellular level, not a disease)
    organs of abdomen are sensitive to stretching and distention
  18. What is hematemesis
    blood in vomit
  19. What is hematochezia
    frank bleeding from rectum
  20. what is dark tarry stools
  21. what is slow, chronic blood loss that results in iron-deficiency anemia as iron stores in bone marrow slowly deplete
    Occult bleeding
  22. What causes dysphagia
    • esophageal obstruction
    • impaired esophageal motility
    • achalasia
  23. What is denervation of smooth muscle in esophagus or muscle cell atrophy
  24. What GI disorder manifests regurgitation of chyme within 1 hour after eating
  25. Name some causes of GERD
    • Increased abdominal pressure
    • Ulcers
    • Pyloric edema and strictures
    • hiatal hernia
    • lower esophageal sphincter incompetency
  26. What is a protrusion of the upper stomach through the diaphragm into the thorax
    Hiatal hernia
  27. What can cause Hiatal hernia
    • Short esophagus
    • trauma
    • Weak diaphragm at GE junction
    • Increased abdominal pressure
  28. What are symptoms of a hiatal hernia
    • GE reflux
    • dysphagia
    • epigastric pain
  29. What is impaired chyme flow through intestinal lumen
    Intestinal Obstruction
  30. What can cause Intestinal Obstruction
    • hernia
    • inflamed diverticula
    • tumor
    • decreased peristalsis
  31. What happens when there is a twisting or telescoping of one part of the intestine into another and what can it lead to
    hernia-intestinal obstruction
  32. Pt presents to the ER complaining of colicky pain that is severe ad constant, what do you suspect is the problem and what other symptoms may they have
    • Intestinal Obstruction-
    • V/D or constipation
    • dehydration and hypovolemia
    • acidosis
  33. How does intestinal obstruction affect nutrient absorption
    It decreases it
  34. Name 4 motility disorders of the GI
    • Dysphagia
    • Hiatal Hernia
    • Intestinal Obstruction
    • GERD
  35. What is an inflammatory disorder of the stomach that may present as acute or chronic
  36. What type of drugs can cause acute gastritis
    ASA, anti-inflammatory drugs
  37. What does ASA or anti-inflammatory drugs do that causes acute gastrtis
    erodes epithelium by inhibiting prostaglandins that normally stimulate secretion of protective mucous
  38. What 3 things can contribute to gastritis?
    • Alcohol
    • histamine
    • digitalis
  39. What disease is caused by thinning and degeneration of stomach wall? Common in what population?
    Chronic Gastritis
  40. What is the breakdown in protective mucosal lining of lower esophagus, stomach, or duodenum?
    Peptic Ulcer Disease
  41. What to breaks in the lining during PUD lead to?
    exposure of submucosal areas to gastric secretions and autodigestion
  42. What are common risk factors of PUD
    • smoking
    • NSAID
    • Alcohol
    • Chronic disease
    • H. Pylori
  43. What chronic diseases put an individual at risk for PUD
    • Emphysema
    • Rheumatoid
    • Cirrhosis
  44. Age of onset for duodenal verse gastric ulcer
    • D-25-40
    • G-50-70
  45. Acid production amount in duodenal verse gastric ulcers
    • D-increased
    • G-nL to low
  46. Sex prevelance of duodenal verse gastric ulcer
    • d-men
    • g-none
  47. Which ulcer type (duodenal or gastric) is common during the night
  48. Duodenal vs Gastric ulcer response to food
    • D-Relieved
    • G-Worsened
  49. How long after a meal does duodenal vs gastric ulcer show sx?
    • D-1.5-3hrs
    • G-30-60 min
  50. Which ulcer (duodenal vs gastric) is hemorrhage more common with?
  51. Which ulcer (duodenal vs gastric) can lead to cancer?
  52. Which ulcer (duodenal vs gastric) usually contains H. pylori
  53. What are s/s of gastric resection called
    postgastrectomy syndrome
  54. What is the rapid emptying of hypertonic chyme from surgically reduced and smaller stomach into small intestine 10-20 min after eating
    dumping syndrome
  55. what is inflammation caused by reflux of bile and alkaline pancreatic secretions that contain proteolytic enzymes that disrupt mucosal barrier
    Alkaline reflux
  56. what is a volvulus, hernia, adhesion, or stenosis in duodenal stump on proxima side of surgery
    Afferant loop obstruction
  57. After a gastric resection what is the diet like for the patient
    can't tolerate carbs or normal sized meals
  58. What is the most common long term alteration of a pt with a gastric resection
  59. What results from iron, vit B12, or folate deficiency?
  60. Name 6 syndromes of Postgastrectomy
    • dumping
    • alkaline
    • afferant loop obstruction
    • diarrhea
    • anemia
    • wt loss
  61. What is the result of mucosal disruption caused by resection, vascular disorders, or intestinal disease?
  62. What occurs with Pancreatic deficiency
    deficient lipase, amylase, trypsin, chymotrypsin
  63. What does lactase inhibit
    breakdown of lactose or milk sugar into monosaccarides in intestinal wall
  64. What do people with lactase deficiency (lactose intolerance) have increased flatulance and distention?
    undigested lactose allows bacteria fermantation to form gases
  65. Name two chronic relapsing inflammatory bowel diseases of unknown etiology
    • Chrohns
    • Ulcerative Colitis
  66. What are lesions on lg intestine in which the mucosal layer is involved and where there are no lesions that are "skipped"
    Ulcerative colitis
  67. What two symptoms are most common in ulcerative colitis
    bloody diarrhea and abdominal pain
  68. What is a pt with ulcerative colitis at risk for
  69. Which disease is more common for positive family hx (ulcerative colitis or Crohns)?
  70. What is lesions on the large intestines or small intestines that "skip" (common on the whole intestinal wall)
  71. What could be seen during Crohns disease inspection
    • fistulas and abcesses of anal/perianal
    • granulomas
    • narrowed lumen (possible obstruction)
    • abdominal mass in small intest.
  72. What sx can abdominal mass on the small intestine have on a person
    • malabsorption
    • steatorrhea
  73. What could be present on the mucosa of small intestine during Crohns disease
    herniations or sac-like pouches
  74. Where is the most frequent site of diverticulitis disease and why
    sigmoid colon because that's where arteries penetrate muscularis
  75. What can pressure increasing as diameter of lumen decreases lead to during diverticulitis
    ruptured diverticula which causes abscess formation or peritonitis
  76. What is the most common cause of appendicitis
    obstruction of lumen with feces, tumors, or foreign bodies followed by bacterial infection
  77. Typical symptom of appendicitis
    epigastric and periumbilical pain
  78. What clinical manifestation occurs when there is an extension of inflammation to the surrounding tissues
    RLQ pain with rebound tenderness
  79. What symptoms follow pain in appedicitis
    n/v, low grade fever, leukocytosis, anorexia
  80. What functional disorder consists of lower abdominal pain with alternating diarrhea or constipation, nausea, bloating
    Irritiable bowel syndrome
  81. What results from the dissecting of aortic aneurysm or emboli arising from cardiac alterations
    Acute mesenteric Insufficiency
  82. Why can't mesenteric insufficiency protect itself from digestive enzymes
    Because ischemic and damaged intestinal muscosa can no longer produce enough mucous
  83. What causes chronic mesentary insufficiency
    any condition that decreases arterial blood flow
  84. What population is at risk for mesenteric insufficiency
    Elderly with arteriosclerosis
  85. What BMI is considered obesity
  86. What hormones regulate appetite and body weight
    • Ghrelin (stomach)
    • Peptide YY (intestines)
    • Insulin (pancreas)
    • Leptin, adinopectin, and resistin (adipose)
  87. What two hormones cause a decrease in appetite by inhibiting neurons that stimulate eating, decrease metabolism, and promote catabolism
    Leptin and insulin
  88. What causes glycogen in liver to convert to glucose through glycogenolysis
    Short term starvation
  89. What is the peak after glucogenolysis and gluconeogenesis in liver to begin by forming glucose from noncarbohydrate molecules
    4-8 hrs
  90. What is decreased dependence on gluconeogenesis and increased use of products from lipid and pyruvates
    Long term starvation
  91. Protein energy malnutrition
  92. Carbohydrate intake without protein
  93. Wasted appearance, muscle atrophy, stunted growth, wrinkled skin, sparse/dry/dull hair, protuberant abdomen, depressed HR/BP/BT, frequent infections, diarrhea, GROWTH FAILURE
  94. Edema, desquamating skin, discolored hair, anorexia, and extreme apathy, flaky paint lesions, sandy-red hair, flag sign (linear depigmentation), subcutaneous fat is normal
  95. Marasmus causes in adults
    Chronic Illnesses (COPD, CHF, cancer, HIV)
  96. Kwashiorkor in adults
    Acute illneses (trauma, burns, sepsis)
  97. What is caused by obstruction or impeded blood flow in portal venous system or vena cava
    Portal Hypertension
  98. What are some common causes of portal hypertension
    cirrhosis, hepatitis, parasites, hepatic vein thrombosis, and right sided heart failure
  99. Pt presents to clinic with esophageal/stomach varices, hematemesis, splenomegaly, thrombocytopenia, ascites, diaphragm displacement, tremors, hepatic encephalopathy, cognitive impairment. What do u suspect they have?
    Portal Hypertension
  100. What is blood that contains toxins such as ammonia, and is shunted from GI tract to systemic circulation allowing toxins to reach brain
    Hepatic Encephalopathy
  101. Pt presents to the clinic with sudden changes in cerebral function, confusion, tremor of hands, stupor, convulsions, which could eventually lead to coma. What do u suspect they have?
    Hepatic Encephalopathy
  102. 3 types of jaundice
    • Hemolytic
    • obstructive
    • hepatocellular
  103. What type of jaundice is caused by unconjugated bilirubin
  104. What type of jaundice is caused by conjugated bilirubin
  105. what type of jaundice is caused by intrahepatic disease, obstruction of bile calculi, genetic enzyme defects, or infections? (Is has both obstructive and hemolytic jaundices)
  106. What are some manifestations of jaundice
    • malaise
    • dark urine
    • light colored stools
    • anorexia
    • fatigue
    • pruitis
  107. What can cause viral hepatitis
    • Hepatic cell necrosis
    • scarring
    • Kupffer Cell Hyperplasia
    • Infiltration of monocytes
  108. 3 phases of viral hepatitis
    • Prodromal
    • Icteric
    • Recovery
  109. Phase of viral hepatitis that begins 2 weeks after exposure and ends with appearance of jaundice
  110. Phase of viral hepatitis that begins 1-2 weeks after prodromal period and lasts about 6 weeks. The actual phase of illness.
  111. Phase of viral hepatitis that begins with resolution of jaundice at about 6-8 weeks after exposure
  112. Clinical syndrome resulting in severe impairment of necrosis of liver cells and potential liver failure
    Fulminant hepatitis
  113. What is fulminant hepatitis a possible complication?
    hep B or C
  114. What virus is fulminant hepatitis compounded with
  115. How would fulminant hepatitis be treated
    liver transplant
  116. What is irreversible inflammation of the liver commonly cause by alcohol, biliary, or postnecrotic problem?
  117. What causes secondary biliary in cirrhosis
    obstruction of neoplasms
  118. What is viral hepatitis due to Hep C, drugs, toxins, or chonic and severe liver disease that leads to cirrhosis
  119. What are the most common disorders of the gallbladder
    Cholelithiasis and Cholecystitis
  120. What is cholelithiasis?
    Gallstone formation
  121. Two types of gallstone formation
    cholesterol and pigmented
  122. What is obstruction of the gallbladder
  123. What is inflammation of the gallbladder
  124. Symptoms of Cholelithiasis
    • Jaundice
    • Epigastric and right hypocondrium pain
  125. Preferred treatment of cholelithiasis
    Laparoscopic cholecystectomy
  126. What is cholecytitis almost always caused by
    lodging of gallstone in cystic duct
  127. What is injury or disruption of the pancreatic ducts that permits leakage of pancreatic enzymes into pancreatic tissue
    Acute pancreatitis
  128. What is chronic pancreatitis caused by
    chronic alcohol abuse
  129. 6 cancers of the digestive system related to p53 gene
    • Esophagus
    • Stomach
    • colorectal
    • liver
    • gallbladder
    • pancreas
  130. Risk factors of esophageal cancer
    • alcohol
    • malnutrition
  131. Symptoms of esophageal cancer
    chest pain and dysphagia
  132. Risk factors of stomach cancer
    • H pylori
    • Dietary Salty foods
    • nitrates
  133. Symptoms of Stomach cancer
    • anorexia
    • malaise
    • OB
  134. Causes of colorectal cancer
    • chromosomal deletion
    • polyps
  135. Symptoms of colorectal cancer
    • Pain
    • Anorexia
  136. Common causes of Liver cancer
    Hepatitis B,C,D
  137. Symptoms of liver cancer
    • pain
    • anorexia
  138. Causes of Gallbladder cancer
    • cholelithiasis
    • cholecystitis
  139. Symptoms of Gallbladder cancer
    • steady RUQ pain
    • diarrhea
  140. Common causes of Pancreatic cancer
    • Chronis pancreatitis
    • smoking
  141. Symptoms of pancreatic cancer
    • Wt loss
    • weakness