Patho_GI Flashcards

Disorders of the esophagus include

dysphagia hiatial hernia gastrointestinal
reflux disorder (GERD) esophagitis Barrett�s
Esophagus

Esophagitis


inflammation of
esophagus commonly caused by Gastroesophageal reflux
disease (GERD) or infections in immunocompromised individuals.

Objective: Understand common disorders of the esophagus.

Barrett�s Esophagus


replacement of esophageal
cells with intestinal cells; association with
esophageal adenocarcinoma.

Objective: Understand common disorders of the esophagus.

Dysphagia


difficulty swallowing
often due to esophageal narrowing (obstruction)
tumors; lack of salivary section; impaired esophageal motility.

Objective: Understand common disorders of the esophagus.

Hiatal hernia


herniation of stomach into
the thorax through weakness in the diaphragm: asymptomatic,
chest pains, SOB, palpitations, or swallowing discomfort; acid
reflux; increased abdominal pressure (obesity, constipation, smoking
and pregnancy); increases with age; may require surgery.
Objective: Understand common disorders of the
esophagus.

GERD


gastric/duodenal contents
into esophagus acute epigastric pain; altered LES;
food/alcohol/cigarettes lower LES pressure; hiatal hernia; increased
abdominal pressure (obesity/pregnancy); medications (morphine,
anticholinergics); NG intubation; weakened LES. Tx: lifestyle
changes; medications (proton pump inhibitors, H2 receptor blockers,
or antacids).

Objective: Understand common disorders of the esophagus.

Gastritis


inflammation of stomach
lining �chronic: H. pylori infection or
autoimmune gastritis; hemorrhages, gastric gland atrophy, anemia,
vitamin B12 deficiency; alcohol or NSAID use; trauma, surgery,
infection; pain, indigestion, bloating, nausea, vomiting and
pernicious anemia (lack of IF); antacids, proton pump inhibitors,
antibiotics, vitamin B12 supplementation (injection, nasal spray or
high oral doses) for pernicious anemia.

Peptic ulcer disease (PUD)


most common ulcer of GI
trac chronic ulceration of gastric mucosa or duodenum
(most common) caused by H. pylori NSAIDs
use can contribute to PUD may be asymptomatic or include
pain, bloating, nausea or vomiting; GI bleeding, perforation,
obstruction, and cancer Pathogenesis = mast cells
activation R/T H. pylori infection; histamine release to
stimulate acid secretion and contributing to ulceration. Tx: stop
smoking/alcohol/NSAIDs; use of antibiotics, or proton pump
inhibitors.

Gastroenteritis


inflammation of GI tract
(mostly SI); infection (rotovirus, E.
coli, C.
jejuni); bloody diarrhea, vomiting, abdominal
pain, cramping; dehydration, Treatment: (oral rehydration
or iv).fluid replacement

irritable bowel syndrome


spastic colon/spastic
colitis associated with chronic/recurrent symptoms
(pain, alternating constipation/diarrhea, flatus(gas) incomplete
evacuation sense, and distension); common, cause UK, 2X in
women; benign (no abnormal anatomy/inflammation); possible motor
disturbances due to stress; manage stress, avoid stimulants.

inflammatory bowel disease


chronic inflammation of GI tract
Crohn Disease: any segment,
usually terminal ileum ulcerative colitis:non-specific
inflammation of colon/rectum cause UK (genetic, infectious,
immune, psychological)
neutrophil
infiltration/ulceration/fibrosis; bloody diarrhea, abdominal pain,
weight loss; Tx: terminate inflammatory response/ promote
healing.

Crohn�s disease

regional enteritis/granulomatous colitis; sharply demarcated
granulomatous lesions surrounded by normal tissue (�skip
lesions�) that extend through all layers (especially
submucosa); slow spread of inflammation, blockage of nodes (edema),
ulceration (fissures, abscesses, granulomas: �cobblestone�) ;
Cause UK; environment+immune (bacteria)+genetics; variable clinical
course (exacerbations/remission), malnutrition,
fistula/abscess/obstruction; Dx: challenging (Hx,
biopsy); Tx: termination inflammation/promote
healing/nutritional/prevent complications.

ulcerative colitis


inflammatory disease of
colon/rectum; edema/ulcerations; mainly mucosal layer;
constant/confluent inflammation with possible focal crypt abscesses
and lesions that may become necrotic/ulcerate blood
diarrhea; mild to severe, may perforate colon (peritonitis/toxemia),
colon cancer; cyclical between exacerbation/remission, bouts of
diarrhea (months) followed by asymptomatic period
(months/years); cause UK (abnormal immune response, genetics,
more common in women); Tx: reduce manifestations/prevent
recurrence; anti-inflammatory, avoid foods that promote symptoms
(caffeine, lactose).

Diverticulosis


inflammation of
diverticula, herniations in wall of GI tract; mucosa
herniates through weakened muscularis (sigmoid colon); intraluminal
pressure (chronic constipation, obesity) form diverticula
(pocketing) or herniation; bacterial infection (inflammation)
results in obstruction/abscesses/perforation; possible peritonitis,
sepsis, shock.

Peritonitis


inflammation of abdominal
cavity lining due to bacterial invasion/chemical irritation;
bowel perforation exposes cavity to enteric bacteria; perforated
peptic ulcer, ruptured appendix, perforated diverticulum, gangrenous
bowel or gallbladder, and PID; pain, vomiting, fever, tachycardia,
hypotension; fluid accumulation in peritoneal cavity + fluid losses
may result in hypovolemia/shock.

Malabsorption Syndrome

altered absorption of nutrients; gut wall or gut flora abnormality,
enzyme/bile deficiency; impaired digestion, absorption; congenital
defects, pancreatic, liver, gallbladder diseases; inflammation,
infection, injury; associated with cystic fibrosis, chronic
pancreatitis, celiac disease, inflammatory bowel syndrome, and
irritable bowel syndrome; anemia (decreased vitamin B12, iron,
folic acid); diarrhea and steatorrhea, edema malnutrition
and weight loss.

Celiac Disease:

Immune-mediated disorder, inappropriate
gliadin (gluten) response; HLA Class II (DQ2, DQ8);
autoimmune (type 1 diabetes; Addison disease); first or second
degree relatives; increased risk of head/neck cancer;
adenocarcinoma, non-Hodgkin lymphoma;
diarrhea/FTT/malnutrition (infants/young kids); anemia, SS,
constipation (older kids); diarrhea, abdominal pain/discomfort (75%
of new cases are women); Dx: clinical, serology (IgA:
TTG/EMA), biopsy; Tx: remove gluten

GI bleeds

upper (esophagus, stomach, duodenum); varices, PUD, esophageal
tear; Hematemesis/Melena; lower (jejunum, ileum, colon or rectum);
Hematochezia; occult bleeding.