GI

• describe the icteric phase of acute hepatitis & clinical s/s

  duration - 2-3 weeks

  jaundice appears, liver is tender and enlarged, dark urine, clay-colored stools
• describe pathophysiology of liver disease

  non-alcoholic fatty liver disease - fatty infiltration of liver, can lead to cirrhosis and ESLD

  alcoholic liver disease - fatty changes (reversible) -> alcoholic hepatitis -> cirrhosis

  fatty changes - liver yellow, enlarged

  alcoholic hepatitis - inflammation and necrosis; s/s - fatigue, weight loss, anorexia, abdominal pain, jaundice, tenderness, hepatomegaly

  cirrhosis - blockage of bile and blood, loss of hepatocyte regeneration; s/s - hepatomegaly, weight loss, weakness, anorexia, jaundice, liver failure
• describe cirrhosis

  irreversible, inflammatory fibrosis

  scar tissue replaced normal tissue -> nodules form -> disrupted function, blood and biliary flow
• how are hepatitis A, B, & C transmitted?

  A - oral-fecal route (blood, sexual)

  B - blood, body fluids, perinatal

  C - blood, body fluids, sexual, perinatal
• how does ammonia play a role in liver disease?

  decreased blood flow to the liver -> ammonia can't be processed -> buildup of ammonia in blood
• why are liver disease patients at risk for esophageal varices?

  branches of portal vein extend to esophagus -> vessels swell and burst -> esophageal bleed
• what is portal hypertension? what are some complications?

  obstruction to flow causing dilation of veins in abdomen and GI tract

  complications - ascites, esophageal varices, splenomegaly, hemorrhoids, altered pulmonary vasculature (venous congestion, hypertension)
• where is the CTZ located & what is its mechanism?

  located in medulla

  area of the brain involved in nausea and vomiting
• describe GERD & how it differs from PUD?

  stomach acid contents reflux into esophagus -> esophagus inflamed, fragile tissues, erosion and ulceration -> may lead to barret's esophagus

  PUD - acid causes erosion and ulceration of the stomach lining
• describe the pathophysiology & causes of stress ulcers

  patho - SNS issue triggers increase in acid production

  causes - complication of trauma when the SNS is affected
• pathophysiology, causes, & treatment of IBS

  patho - dysregulation of intestinal motor and sensory function of GI tract, abnormal intestinal motility

  causes - altered gut microbiome, food allergies or intolerances, infection, psychosocial factors

  tx - diet (adequate fiber, no alcohol or caffeine), anticholinergics, antidepressants, probiotics
• describe pathophysiology & s/s of crohn's disease, & what is the difference with infectious colitis?

  patho - inflammation of submucosa -> granuloma formation -> diseased bowel alternates normal bowel -> fibrosis of submucosa -> thick, inflexible bowel

  s/s - begin before 30, exacerbations and remissions, intermittent diarrhea, colicky abdominal pain, weight loss, fluid and electrolyte imbalance, vitamin deficiency, progressive disease

  main difference - crohn's can be anywhere between mouth and anus, UC is confined to the large intestine or rectum
• describe hernias

  intussusception - telescoping of one part of intestine into another, strangulating blood supply, common in children

  inguinal hernia - bulging of abdominal contents through a weak area in the lower abdominal wall

  volvulus - twisting of the intestine, occluding blood supply, common in adults

  umbilical hernia - loop of intestines pushes through the umbilical ring
• describe peritonitis

  inflammation of peritoneal membrane

  s/s - abdominal pain (increases with movement), rigidity, vomiting, fever
• describe diverticulitis

  complication of diverticular disease with inflammation and infection of diverticuli

  s/s - LLQ pain, fever, vomiting

  complications - perforation, peritonitis, hemorrhage, obstruction, fistula formation
• describe colon cancer

  patho - adenomatous polyps from mucosal epithelium continually proliferate -> accumulation of abnormal cells

  s/s - often none until late stage, rectal bleeding (anemia), pain, change in bowel habits