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SPRING 2024
quiz 4
GI
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SPRING 2024 > quiz 4 > GI
6 cards
Cards (39)
Disorders of the oral cavity
oral cancer
:
lips
,
gums
, inside structures of the
mouth
cancerous ulcers
risk factors:
smoking
, chewing tobacco,
HPV exposure
pathophysiology
leukoplakia
(oral cancer)
malignant
transformation (about
20
percent of occurrence)
erythroplasia
(red mucosal plaque
without inflammation
)
Disorders of the oral cavity
cleft lip
and
palate
congenital splitting
or
defect
in
integrity
of
lip
; with or without
splitting
of the
palate
believed
to be
environmental effect
during
pregnancy
pathophysiology
disfigurement
causes
varying degrees
of
impairment
risk
of
aspiration increased
clinical manifestations
facial deformity
,
difficulty feeding
delayed
development
of
teeth
and
speech
Esophageal alterations
gastroesophageal reflux disease
(
GERD
)
regurgitation
of
gastric contents
into the
esophagus
incompetent lower esophageal sphincter
hiatal hernia
esophageal mucosa injury
substernal pain
normally cleared
and
neutralized
esophagitis
chronic
=
increase risk
for
cancer
esophageal alterations
esophageal cancer
risk factors:
alcohol
,
tobacco
,
obesity
Barrett esophagus
normal esophageal lining
replaced by
abnormal epithelium
clinical manifestations
dysphagia
weight loss
,
pain fatigue
esophageal alterations
achalasia
inability of the
cardiac sphincter
to
relax
absence of
esophageal peristalsis
food
is
retained
hypertrophy
and
dilation
of
lower esophagus
symptoms
dysphagia
vomiting
pain
esophageal alterations
esophageal atresia
concurrent abnormality of
trachea common
esophagus ends
in
blind pouch
or
fistula
from
trachea
to
stomach
clinical manifestations
aspiration
of
gastric contents
into
respiratory system
abdominal distention
coughing
and
cyanosis
with
feeding
recurrent pneumonia
alterations in the stomach and duodenum
inflammatory disorders of
gastric mucosa
(
gastritis
)
risk factors:
cigarettes
,
alcohol
,
spicy
foods,
caffeine
,
aspirin
,
NSAIDs
Helicobacter pylori
(
H. pylori
) infection
increases
gastric acid
production and produces
cellular injury
ulcerative lesions
blood vessel erosion
may occur
Zollinger-Ellison syndrome
: pathological secretion of
gastric acid
alterations in the stomach and duodenum
inflammatory disorders of
gastric mucosa
(
gastritis
)
pathophysiology
increased gastric acids
superficial erosion
of
surface epithelium
: usually
regenerates
chronic inflammation
leads to
damage
to
mucosa
=
peptic ulcer disease
one or all
layers
of
mucosa
perforation
of the
bowel
:
peritonitis
chronic
=
scar tissue
alterations in the stomach and duodenum
inflammatory disorders of gastric mucosa (
gastritis
)
clinical manifestations
heart burn
bleeding
epigastric cramping
severe with
perforation
alterations in the stomach and duodenum
stomach cancer
risk factors:
dietary preservatives
,
recurrent gastritis
,
genetics
clinical manifestations: often
asymptomatic
heart burn
,
anorexia
,
weight loss
,
vomiting
,
abdominal mass
,
vague pain
alterations in the stomach and duodenum
hypertrophic pyloric stenosis
obstruction
of
gastric outlet
resulting from
hypertrophy
of
musculature
surrounding
pylorus
projectile vomiting within 3-10 weeks of birth with no bile in emesis (
vomit
)
dehydration
pylorus can often be
palpated
Disorders of small and large intestines
inflammatory
disorders
gastroenteritis
(infectious enterocolitis):
stomach
,
intestines
, or both -- "
stomach flu
"
bacterial toxins
or
irritants
in food
pathophysiology
organisms
multiply rapidly
local inflammation
stimulates
GI smooth muscle
and
secretory cells
clostridium difficile
:
loss
of
normal flora
due to
antibiotic therapy
clinical manifestations:
pain
,
vomiting
,
diarrhea
,
occult blood
Disorders of
small
and large intestines
inflammatory
disorders
inflammatory bowel
disease
Crohn's
disease
"
skip lesions
" interspersed between
normal segments
of bowel
cobblestone
appearance
all
layers
involved
fibrotic changes
to
submucosal layer
absorption
disrupted
Disorders of small and large intestines
inflammatory disorders
ulcerative colitis
inflammatory mucosal lesions
become
necrotic
: filled with
exudate
more
continuous
in bowel
thickening
of the bowel
Disorders of small and large intestines
inflammatory disorders
Crohn's disease
&
Ulcerative colitis
manifestations of both:
diarrhea
,
pain
,
weight loss
,
fluid
and
electrolyte
issues
Disorders of small and large intestines
inflammatory disorders
irritable
bowel
syndrome
: combination of
chronic
and
recurrent
intestinal symptoms not explained by
structural
or
chemical
problems
pathophysiology
: dysregulation of
intestinal motor
and
sensory function
controlled by CNS
clinical manifestations
increased motility
and
intestinal contractions
persistent and
recurrent abdominal pain
relived by defecation
symptoms >
3
months
Disorders of small and large intestines
inflammatory disorders
diverticular
disease
diverticulosis
(involves ballooned segments of colon that can herniate)
diverticulitis
(involves herniations)
clinical manifestations:
LLQ
pain,
altered elimination
Disorders of small and large intestines
obstructive disorders
paralytic ileus
:
functional bowel obstruction
lack of
neural stimuli
leads to
mechanical obstruction
clinical manifestations
abdominal distention
crampy pain
absence
of
bowel
sounds
vomiting
Disorders of small and large intestines
obstructive disorders
hirschprung's disease
:
congenital lack
of
colonic innervations
Disorders of small and large intestines
obstructive disorders
mechanical obstrction
intussesception
(bowel telescopes in on itself)
volvulus
(bowel twists)
Disorders of small and large intestines
obstructive disorders
hernia
abdominal wall defect
scrotal
,
inguinal
,
umbilical
incisional
protrusion
of
stomach
or
intestinal wall
through
defect
intermittent
strangulated
Disorders of small and large intestines
obstructive disorders
intestinal ischemia
or
infarction
lack
of
oxygen supply
to
intestine
prolonged ischemia
epithelial cells detach
->
protrusion
of
subendothelial blebs
impaired absorption
mucosal layer
becomes
necrotic
perforation
of
intestine
peritonitis
and
bacteremia
(sepsis) because bacteria enters the
blood
Disorders of small and large intestines
disorders of intestinal absorption
celiac disease
(AKA
celiac spruce
and
gluten-sensitive enteropathy
): genetic component
inappropriate T-cell response against
gluten
intense inflammatory reaction
results in loss of absorptive villi
impaired nutrient absorption:
macro
and
micro nutrients
manifestations:
diarrhea
and
pain
Disorders of small and large intestines
disorders of intestinal absorption
malabsorption
syndromes
lactose intolerance
:
congenital
or
secondary
(enzyme lacking of
lactase
or
infection
/
bowel surgery
)
pathophysiology
of lactose intolerance
carbohydrate malabsorption
results in lack of
carbohydrate
in
blood
carbohydrate
accumulates in
lumen
of
bowel
osmotic pressure
from
unabsorbed carbohydrate
acid production
from bacterial action
manifestations:
flatulence
,
crampy abdominal pain
,
watery diarrhea
Disorders of small and large intestines
Colorectal cancer
risk factors
dietary
:
fat
,
fiber intake
polyps
:
growth protruding
into
intestine
clinical manifestations
bleeding
(
highly significant early clinical manifestation
)
occult blood
change
in
bowel habits
pain
Eating disorders
anorexia nervosa
:
psychological
and
physiological
disorder of
self starvation
,
failure
to maintain
minimum weight
with fear of being
overweight
Eating disorders
anorexia nervosa
pathophysiology:
decrease
in body weight ->
depletion
of body fat and protein stores, muscle wasting
female
hormones:
decreased
estrogen may lead to
absence
of
menstruation
bone loss
male
hormones:
fluctuating testosterone level
thyroid function reduced
:
cold intolerance
,
constipation
,
skin
with
lanugo
(fine hair)
cardiac effects
electrolyte imbalances
=
cardiac rhythm problems
hypotension
ketoacidosis
from
increased breakdown
of fat as
fuel source
renal failure
: due to decrease
CO
and
build up
of
protein byproducts
anemia
Eating disorders
Bulimia nervosa
(binge-purge syndrome)
excessive consumption
of food;
self induced vomiting
, use of
laxatives
and
diuretics
complications
dental disorders
esophagitis
hypokalemia
(potassium loss in
vomiting
)
exocrine disorders of the pancreas
pancreatitis
:
acute
or
chronic inflammation
of
pancreas
risk
factors
obstruction
of
pancreatic ducts
alcohol
:
stimulation
of
pancreatic enzymes
exocrine disorders of the pancreas
pancreatitis
pathophysiology
reflux
of
bile
or
duodenal contents
into
pancreatic ducts
and
inappropriate activation
of
pancreatic enzymes
within the pancreas
begins with activation of
trypsin
trypsin
activates other
digestive enzymes
inflammatory response leading to
autodigestion
destructive effects
elastase
: activated by
trypsin
hemorrhage
release
of
bradykinin
->
increased vascular permeability
leukocyte reaction
exocrine disorders of the pancreas
pancreatitis
clinical manifestations
abdominal pain
,
nausea
,
vomiting
edema
:
plasma shift
from
vasodilation
hypotension
tachycardia
respiratory distress
pleural effusion
from
retroperitoneal fluid
pressure on
diaphragm
hypocalcemia
extension lypolysis
of
tissue
releases
free fatty acids
which combine with calcium
parathyroids
unable to compensate rapidly
elevated serum amylase
and
lipase
hyperglycemia
swollen pancreas
exocrine disorders of the pancreas
pancreatitis
chronic
pancreatitis (
recurrent
inflammation with
alcohol
that gets
worse
each time)
exocrine disorders of the pancreas
pancreatic cancer
risk factors:
age
,
cigarette smoking
,
chronic pancreatitis
genetics
(maybe?)
adenocarcinoma
of the
ductal epithelium
manifestations
jaundice
pain
weight loss
metastasis
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