Term
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Definition
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Term
| What does dysphagia result from? |
|
Definition
| altered nerve function or narrowing of the esophagus (or scarring) |
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Term
| Persons with dysphagia usually complain of what? |
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Definition
| choking, coughing or abnormal sensation of food sticking in back o f throat when swallowed. |
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Term
| Gastrointestinal Reflux Disease (GERD). What does the "reflex" part mean? |
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Definition
| backward/return movement of gastric contents into esophagus |
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Term
| What is GERD thought to be associated with? |
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Definition
| a weak lower esophageal sphincter |
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Term
| Reflux esophagitis involves what? |
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Definition
| mucosal injury to esophagus, hyperemia and inflammation |
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Term
| Heartburn and chest pain are symptoms of GERD. Describe the manifestations of each. |
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Definition
| Heartburn: 30-60 min.'s after eating. Worse by bending, relieved by sitting upright, belching and chestpain: felt in the epigastric and retrosternal, radiating to throat, shoulder & back, wheezing, cough, hoarsness |
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Term
| The chest pain often associated with GERD may be confused with... |
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Definition
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Term
| Cancer of the esophagus is more common in ________ and is more frequent in men or women? |
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Definition
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Term
| Most squamous cell esophageal cancer is attributed to what? |
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Definition
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Term
|
Definition
| an inflammation of the gastric mucosa |
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Term
| What are the 3 local irritants often associated with acute gastritis? |
|
Definition
| aspirin, alcohol and bacterial endotoxins |
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Term
| What are the symptoms associated with each of these irritants? |
|
Definition
Aspirin Gastritis: they could be unaware or complain of heartburn or sour stomach.
Alcohol Gastritis: often causes distress -> vomiting, bleeding, hematemesis
Bacterial Infectious Organisms: cause abrupt/violent onset with vomiting about 5 hours after consumption |
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Term
| The 3 major types of chronic gastritis are: |
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Definition
| Helicobacter pylori or H. pylori, Autoimmune & Chemical |
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Term
| What is the most common type of chronic gastritis? |
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Definition
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Term
| Peptic Ulcer is a group of ulcerative disorders that occur in the __________ and are exposed to ____________. |
|
Definition
UPPER GI TRACT is where peptic ulcers are found
and they're exposed to ACID-PEPSIN SECRETIONs. |
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Term
| What are the 2 most common forms of peptic ulcer? |
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Definition
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|
Term
| The most common cause of peptic ulcers? |
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Definition
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Term
| The 2nd most common cause of peptic ulcers? |
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Definition
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Term
| How would a person with a peptic ulcer likely describe their pain? |
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Definition
| burning, gnawing, cramplike pain - rhythmic & frequent. Occurs when stomach is empty (between meals and at 1-2 am). Located in epigastrium near xiphoid and radiates back. Ulcer pain is known for its periodicity.. recurs in weeks or months. During exacerbation it occurs daily for several weeks though. |
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Term
List the cause & symptom associated with each of the complications of ulcer disease:
-Hemorrhage
-Obstruction
-Perforation |
|
Definition
-Hemorrhage: cause by BLEEDING FROM GRANULATION TISSUE, or EROISION of ulcer in ARTERY or VEIN. S & S: sudden dizziness, weakness, thirst, COLD/MOIST skin, desire to defecate, passing loose, tarry or even red stools and COFFEE GROUND EMESIS.
-Obstruction: causes edema, spasm or contraction of scar tissue-> interference with passage f gastric contents past pylorus. S & S: feelings of epigastric fullness after meals. with severe obstruction? vomiting after meals
-Perforation: occurs when an ulcer erodes through all the layers of the stomach or duodenum wall. With perforation the GI contents enter and cause peritonitis (by penetrating adjacent structures like the pancreas). S & S: pain radiating to back, night distress, no relief from eating or antacids if history of peptic ulcer |
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Term
| Why do stress ulcers develop? |
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Definition
| (major) Physiological Stress |
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Term
| What persons are at highest risk for development of stress ulcers? |
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Definition
| persons with large-surface area burns, traumas, sepsis, acute respiratory distress syndrome, severe liver failure and major surgical procedures. Common in ICU patients. |
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Term
| Stomach cancer is the _______ most common cause of cancer worldwide. |
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Definition
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Term
| What factors increase the risk of stomach cancer? |
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Definition
| genetics, a carcinogenic diet (smoked/preserved foods), autoimmune gastritis, gastric adenomas/polyps |
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Term
| Why is stomach cancer often advanced by the time it is diagnosed? |
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Definition
| Stomach cancer is asymptomatic until late stages |
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Term
| Irritable Bowel Syndrome describes a _____________ gastrointestinal disorder that is NOT explained by __________ or ____________ abnormalities. |
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Definition
| IBS is a FUNCTIONAL GI disorder, not explained by STRUCTURAL or BIOCHEMICAl abnormalities. |
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Term
IBS is characterized by:
What is the hallmark of IBS symptoms? |
|
Definition
abdominal pain relieved with defecation and varying stools (consistency frequency), varying flatulence, bloating, nausea, anorexia, constipation, diarrhea and anxiety or depression.
Hallmark of IBS: abdominal pain relieved with defecation! Also, changes in frequency or consistency of stools. |
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Term
| IBS is thought to result from dysregulation if intestinal _______ & ___________ function in response to ___________ & ________ stress. |
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Definition
IBS results from dysregulation of MOTOR & SENSORY function.
IBS responds to PSYCHOLOGIC & PHYSIOLOGIC stress. |
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Term
| What charcteristics do the 2 Inflammatory Bowel Diseases (Crohn Disease & Ulcerative Colitis) have in common? |
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Definition
| Both cause inflammation of the bowl, neither have a proven causative agent, both have a pattern of familial occurence and both are accompanied by systemic manifestations. |
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Term
What part of the bowel is affected in Crohn Disease?
What about in Ulcerative Colitis? |
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Definition
Crohn Disease: affects the PROXIMAL COLON and also the terminal ileum (less often).
Ulcerative Colitis: affects the RECTUM & the COLON. |
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Term
What kind of lesions are left in Crohn Disease?
What about Ulcerative Colitis? |
|
Definition
Crohn Disease lesions are sharply demarcated, GRANULOMATOUS surrounded by normal mucus tissue. Mouth to anus ship lesions.
Ulcerative Colitis: Exudative colon continuous lesions, crypt abcesses. |
|
|
Term
What part of the intestinal mucosa is affected in Crohn Disease?
What about Ulcerative Colitis? |
|
Definition
Crohn Disease = SUBMUCOSAL
Ulcerative Colitis = MUCOSAL |
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|
Term
What are the principal symptoms/characteristics of Crohn Disease?
Ulcerative Colitis? |
|
Definition
Crohn Disease: effects people in 20's-30's, slightly more women then men. sharp, demarcated GRANULOMATOUS surrounded with NORMAL MUCOSAL tissue. colicky, pain (lower rt. quad), fluid & electrolyte disorders, low fever, nutritional deficiencies, intermittent diarhhea.
Ulcerative Colitis: diarrhea, multiple BM/day, bloody, mucus stools, abdominal cramping, incontinence, anorexia, fatiguability |
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|
Term
What are complications with Crohn Disease?
Ulcerative Colitis? |
|
Definition
Crohn Disease Complications: fistula formation, abdominal abcess and intestinal obstruction
Ulcerative Colitis: colon cancer, toxic megacolon |
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Term
| Viral Infections usually affect the _____________ of the small intestine. |
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Definition
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|
Term
| How is Rotavirus spread, who is it most common in and what are the symptoms? |
|
Definition
Rotavirus is spread through the ORAL/FECAL route.
it is most common in: children aged 3 months - 2 years.
Symptoms are: fever, vomiting and diarrhea. Dehydration may develop rapidly. |
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Term
| Generally BACTERIAL infections do cause more severe symptoms than viral infections! Why? The complications that result from _____________________ or _____________________ . |
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Definition
| b/c of massive fluid loss (Dehydration) or destruction of intestinal mucosa. |
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Term
The development of C. dif is usually preceded by what?
(In other words, when does it normally occur...? ) |
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Definition
| comes after antiobiotic therapy for enteric disease |
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Term
| C. dif is transmitted by the fecal-oral route & is usually acquired where? |
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Definition
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Term
| What are the most common manifestations of C. dif? |
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Definition
| diarrhea, intestinal cramping |
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Term
| E. Coli transmission is usually _____________ and it's why you can't order a rare hamburger. There may be no manifestations or there may be what? |
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Definition
e.coli is FOOD-BORNE.
Could have: bloody diarrhea, abdominal cramping (watery->bloody stools) |
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|
Term
What are the manifestations of the 2 complications?
-Hemolytic-uremic Syndrome
&
-Thrombotic Thrombocytopenic purpura |
|
Definition
-Hemolytic-uremic Syndrome: hemolytic anemia, thrombocytopenia & renal failure. *Occurs in infants & kids. most common cause of renal failure.
&
-Thrombotic Thrombocytopenic purpura: thrombocytopenia, renal failure, fever & neurologic manifestations. |
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Term
| Diverticular Disease (Diverticulosis) is a condition in which the ____________ layer of the colon ____________ through the ____________ layer. |
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Definition
| MUCOSAL layer of the colon HERNIATES through the MUSCULARIS layer. |
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Term
| What factors are thought to contribute to the development of Diverticulosis? |
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Definition
| aging, lack of fiber, decreased physical activity, ignoring urge to defecate. It occurs in developed countries, but not in Africa. |
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Term
| Most persons with diverticular disease remain ______________. |
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Definition
| Asymptomatic (often found when x-rays are done for something else). |
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Term
| What are the complaints associated with the complication diverticulitis? |
|
Definition
| Lower abdominal discomfort, change in bowel habits (diarrhea/constipation), bloating, flatulence |
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Term
| What are the complications associated with diverticulitis? |
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Definition
| Perforation with peritonitis, hemorrhage and bowel obstruction |
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Term
Appendicitis usually has an abrupt onset manifested by what symptoms?
As the inflammatory process extends, what symptoms are experienced? |
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Definition
LR quadrant pain and tenderness, N/V, increased WBC
Later, get increased temperature and increased WBC count, tender LR quadrant (finger tip sized area), rebound tenderness |
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Term
| What is rebound tenderness? |
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Definition
| Pain after area is pressed and released |
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Term
| Acute Diarrhea lasts less then _____ days & is usually caused by _________________ . |
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Definition
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Term
| Chronic diarrhea lasts longer then ________ weeks and is usually caused by |
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Definition
3-4 weeks of diarrhea!
caused by: conditions like inflammatory bowel disease, IBS, malabsorption syndrome, endocrine disorders (hyperthyroidism, diabetic autonomic neuropathy) or radiation colitis. |
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Term
| Physiologically, what happens with osmotic diarrhea? |
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Definition
| Water is pulled into the bowel d/t hyperosmotic contents |
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Term
| What is a common cause of osmotic diarrhea? |
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Definition
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|
Term
When does secratory diarrhea occur?
What kind of diarrheas are this type? |
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Definition
Secratory processes of the bowel are INCREASED. Makes sense :)
Most ACUTE INFECTIONS diarrheas are this type |
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Term
| Small Volume Diarrhea is commonly associated with: |
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Definition
| acute/chronic inflammation or intrinsic disease of the colon |
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Term
| Constipation is defined as: |
|
Definition
| the infrequent passage of stools |
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Term
| Constipation is either caused by a _________ problem or associated with another ________. |
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Definition
| PRIMARY problem or another DISEASE |
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Term
| What are the causes of primary constipation and which one do you think nurses see a lot? |
|
Definition
| failure to respond to the urge to defecate, inadequate fiber in diet, inadequate fluid in diet, weak abdominal muscles, pregnancy, hemorrhoids, INACTIVITY/BEDREST. |
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Term
| What diseases are associated with chronic constipation? |
|
Definition
| Spinal cord injury, parkinsons, MS, hyperthyroidism and obstructive lesions of the GI tract |
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Term
| What categories of drugs have constipation as a side effect? |
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Definition
| Narcotics, Anticholinergic, Calcium channel blockers, diuretics, calcium (antacid supplements), Iron supplements, Aluminum Supplements |
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Term
| Mechanical obstruction of the intestine can result from both inside and outside of the bowel. List the causes of mechanical obstruction.... |
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Definition
| external hernia, post-operative adhesions, strictures, tumors, foreign bodies, intussception (telescoping the bowel), and volvulus (twisint on mesentary axis). |
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Term
| Paralytic obstruction from neurogenic or muscular impairment of peristalsis. When is paralytic ileus most commonly seen? |
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Definition
| Post-abdominal surgery (get continuous pain, no bowel sounds) |
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Term
| What are the major effects of both types of obstruction? |
|
Definition
| Abdominal distention and loss of Fluid & Electrolytes |
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Term
| What are the cardinal symptoms of intestinal obstruction? |
|
Definition
| pain, absolute constipation, abdominal distention and vomiting |
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Term
|
Definition
| inflammatory response of the serous membrane on abdominal cavity & visceral organs |
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Term
| Common causes of peritonitis? |
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Definition
| Bacterial invasion or chemical irritation -> perforated peptic ulcer, ruptured appendix, perforated diverticulum and gangrenous bladder, pelvic inflammatory disease, gangrene bowel, gangrene gallbladder |
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Term
| The most important manifestations of peritonitis are hypovolemia (decreased blood volume) & shock. What causes these? |
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Definition
| ECF moves into perioneal cavity via weeping/serous fluid and from inflamed peritoneum and into bowel d/t bowel obstruction |
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Term
| What patient symptoms would you see with peritonitis? |
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Definition
| pain & tenderness, patient lies still, shallow breathing, abdomen is rigid (almost boardlike stomach b/c of reflex muscle guarding), vomiting, fever, increased WBC's, tachycardia, hypotension |
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Term
| What are the 3 broad categories of malabsorption in the intestine? |
|
Definition
-Intraluminal Maldigestion
-Transepithelial transport
-Lymphatic obstruction |
|
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Term
| What does the first, Intraluminal Maldigestion, involve and what are its causes? |
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Definition
| It is a defect in processing nutrients in the intestinal lumen, caused by pancreatic insufficiency, helpatobiliary disease and intraluminal bacterial growth |
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Term
| What does the second, Transepithelial transport, involve and what is it caused by? |
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Definition
| mucosal lesions impair uptake of nutrients across mucosal surface of intestine. caused by celiac disease & crohn disease. |
|
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Term
| What does the last, Lymphatic Obstruction, involve and what's it caused by? |
|
Definition
| products of fat digestion prevented from systemic circulation after intestinal mucosa absorption |
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|
Term
| What are the symptoms of malabsorption syndrome? |
|
Definition
| diarrhea, steatorrhea, flatulence, bloating, abd. pain, cramps |
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Term
|
Definition
|
|
Term
|
Definition
| Immune-mediated disorder triggered by ingestion of gluten-containing grains. |
|
|
Term
| Celiac Disease results from an inappropriate: |
|
Definition
| T-cell mediated immune response against ingested ox-gliadin (in-gluten) protein, in genetically predisposed people |
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Term
| Colorectal Cancer is the ________ most common cause of cancer and the _______ leading cause of cancer death in the U.S. |
|
Definition
2nd most common cause of cancer
3rd leading cause of cancer death |
|
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Term
| What are the risk factors for colorectal cancer? |
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Definition
| older than 50 years old, family history of cancer, presence of Crohn's or ulcerative colitis, family incidence of adenomatous polyposis of the colon, poor diet (high fat, high refined sugar, low fiber, low vitamins A, C & E). |
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