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NSG320 EXAM 3 ACTUAL 2026 VERSION STUDY GUIDE
Incorporate pathophysiology, clinical manifestations, and diagnostic studies related to
upper and lower gastrointestinal and nutritional problems.
Upper GI Problems
Gastroesophageal Reflux Disease (GERD)
● Pathophysiology: Incompetent lower esophageal sphincter (LES) allows stomach acid to
reflux into the esophagus, damaging its lining.
● Clinical Manifestations: Heartburn (pyrosis), chest pain (dyspepsia), regurgitation.
● Complications: Esophagitis, Barrett esophagus, dental erosion.
● Diagnostics: History and physical, upper GI endoscopy, motility studies.
Hiatal Hernia
● Pathophysiology: Protrusion of the stomach into the esophagus through the
diaphragm (sliding or rolling/paraesophageal).
● Clinical Manifestations: Heartburn, chest pain, regurgitation; may be asymptomatic.
● Diagnostics: Barium swallow, upper GI endoscopy, motility studies.
Peptic Ulcer Disease (PUD)
● Pathophysiology: Erosion of GI lining by HCl acid and pepsin; can be gastric or
duodenal, acute or chronic.
● Clinical Manifestations:
○ Gastric: Epigastric pain 1–2 hrs after meals, burning/gaseous.
○ Duodenal: Midepigastric/back pain 2–5 hrs after meals, burning/cramplike.
○ Other: Bloating, nausea, vomiting, early satiety.
● Complications: GI bleeding, perforation (most lethal), gastric outlet obstruction.
● Diagnostics: Upper GI endoscopy with biopsy, H. pylori testing, CBC, liver enzymes, stool for
blood.
Stomach Cancer
● Pathophysiology: Adenocarcinoma of the stomach wall, often linked to mucosal injury (H.
pylori, NSAIDs, tobacco).
● Clinical Manifestations: Unexplained weight loss, indigestion, abdominal discomfort, pain,
anemia.
● Diagnostics: Upper GI endoscopy with biopsy, CT, MRI, PET.
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Esophageal Cancer
● Pathophysiology: Mostly adenocarcinomas; risk factors include Barrett esophagus,
smoking, alcohol, obesity.
● Clinical Manifestations: Dysphagia, pain, bleeding, advanced tumors.
● Diagnostics: Endoscopic biopsy, bronchoscopy, CT, MRI, PET.
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Lower GI Problems
Irritable Bowel Syndrome (IBS)
● Pathophysiology: Chronic disorder with abdominal pain and altered bowel patterns
(diarrhea, constipation, or both).
● Clinical Manifestations: Abdominal pain, distention, nausea, flatulence, bloating, urgency,
mucus in stool, incomplete evacuation.
● Diagnostics: History, physical, Rome IV criteria (abdominal pain/discomfort ≥1 day/week
for 3 months + 2 of: related to defecation, change in frequency/form).
Inflammatory Bowel Disease (IBD)
● Pathophysiology: Chronic GI tract inflammation; includes Crohn’s disease (mouth to anus)
and ulcerative colitis (colon/rectum).
● Clinical Manifestations:
○ Crohn’s: Diarrhea, cramping, abdominal pain, weight loss.
○ Ulcerative colitis: Bloody diarrhea, abdominal pain, severe cases—fever, rapid
weight loss, anemia, tachycardia, dehydration.
● Complications: Hemorrhage, C. difficile, perforation, abscess/fistulas, strictures, toxic
megacolon.
● Diagnostics: History, physical, blood studies, stool tests, imaging.
Bowel Obstruction
● Pathophysiology: Blockage of intestinal contents (partial/complete, simple/strangulated).
● Clinical Manifestations: Abdominal pain, nausea, vomiting, distention, constipation.
● Diagnostics: History, physical, abdominal X-ray, CT, contrast enema, colonoscopy, CBC,
chemistries.
Colorectal Cancer (CRC)
● Pathophysiology: Cancer of colon or rectum; risk factors include family history, IBD,
obesity, smoking, diet, alcohol.
● Clinical Manifestations: Early—fatigue, weight loss; Late—abdominal pain, tenderness,
change in bowel habits, bleeding.
● Diagnostics: History, screening (colonoscopy—gold standard), sigmoidoscopy,
barium enema, CT colonography.
Diverticulitis
● Pathophysiology: Inflammation of diverticula (pouches in colon lining).
● Clinical Manifestations: Acute LLQ pain, distention, hypoactive/no bowel sounds,
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nausea, vomiting, infection.
● Complications: Perforation, abscess, peritonitis, bleeding.
● Diagnostics: Physical assessment, CT scan with contrast.
Nutritional Problems
Malnutrition
● Pathophysiology: Imbalance in essential nutrients (deficit or excess).
NSG320 EXAM 3 ACTUAL 2026 VERSION STUDY GUIDE
Incorporate pathophysiology, clinical manifestations, and diagnostic studies related to
upper and lower gastrointestinal and nutritional problems.
Upper GI Problems
Gastroesophageal Reflux Disease (GERD)
● Pathophysiology: Incompetent lower esophageal sphincter (LES) allows stomach acid to
reflux into the esophagus, damaging its lining.
● Clinical Manifestations: Heartburn (pyrosis), chest pain (dyspepsia), regurgitation.
● Complications: Esophagitis, Barrett esophagus, dental erosion.
● Diagnostics: History and physical, upper GI endoscopy, motility studies.
Hiatal Hernia
● Pathophysiology: Protrusion of the stomach into the esophagus through the
diaphragm (sliding or rolling/paraesophageal).
● Clinical Manifestations: Heartburn, chest pain, regurgitation; may be asymptomatic.
● Diagnostics: Barium swallow, upper GI endoscopy, motility studies.
Peptic Ulcer Disease (PUD)
● Pathophysiology: Erosion of GI lining by HCl acid and pepsin; can be gastric or
duodenal, acute or chronic.
● Clinical Manifestations:
○ Gastric: Epigastric pain 1–2 hrs after meals, burning/gaseous.
○ Duodenal: Midepigastric/back pain 2–5 hrs after meals, burning/cramplike.
○ Other: Bloating, nausea, vomiting, early satiety.
● Complications: GI bleeding, perforation (most lethal), gastric outlet obstruction.
● Diagnostics: Upper GI endoscopy with biopsy, H. pylori testing, CBC, liver enzymes, stool for
blood.
Stomach Cancer
● Pathophysiology: Adenocarcinoma of the stomach wall, often linked to mucosal injury (H.
pylori, NSAIDs, tobacco).
● Clinical Manifestations: Unexplained weight loss, indigestion, abdominal discomfort, pain,
anemia.
● Diagnostics: Upper GI endoscopy with biopsy, CT, MRI, PET.
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Esophageal Cancer
● Pathophysiology: Mostly adenocarcinomas; risk factors include Barrett esophagus,
smoking, alcohol, obesity.
● Clinical Manifestations: Dysphagia, pain, bleeding, advanced tumors.
● Diagnostics: Endoscopic biopsy, bronchoscopy, CT, MRI, PET.
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Lower GI Problems
Irritable Bowel Syndrome (IBS)
● Pathophysiology: Chronic disorder with abdominal pain and altered bowel patterns
(diarrhea, constipation, or both).
● Clinical Manifestations: Abdominal pain, distention, nausea, flatulence, bloating, urgency,
mucus in stool, incomplete evacuation.
● Diagnostics: History, physical, Rome IV criteria (abdominal pain/discomfort ≥1 day/week
for 3 months + 2 of: related to defecation, change in frequency/form).
Inflammatory Bowel Disease (IBD)
● Pathophysiology: Chronic GI tract inflammation; includes Crohn’s disease (mouth to anus)
and ulcerative colitis (colon/rectum).
● Clinical Manifestations:
○ Crohn’s: Diarrhea, cramping, abdominal pain, weight loss.
○ Ulcerative colitis: Bloody diarrhea, abdominal pain, severe cases—fever, rapid
weight loss, anemia, tachycardia, dehydration.
● Complications: Hemorrhage, C. difficile, perforation, abscess/fistulas, strictures, toxic
megacolon.
● Diagnostics: History, physical, blood studies, stool tests, imaging.
Bowel Obstruction
● Pathophysiology: Blockage of intestinal contents (partial/complete, simple/strangulated).
● Clinical Manifestations: Abdominal pain, nausea, vomiting, distention, constipation.
● Diagnostics: History, physical, abdominal X-ray, CT, contrast enema, colonoscopy, CBC,
chemistries.
Colorectal Cancer (CRC)
● Pathophysiology: Cancer of colon or rectum; risk factors include family history, IBD,
obesity, smoking, diet, alcohol.
● Clinical Manifestations: Early—fatigue, weight loss; Late—abdominal pain, tenderness,
change in bowel habits, bleeding.
● Diagnostics: History, screening (colonoscopy—gold standard), sigmoidoscopy,
barium enema, CT colonography.
Diverticulitis
● Pathophysiology: Inflammation of diverticula (pouches in colon lining).
● Clinical Manifestations: Acute LLQ pain, distention, hypoactive/no bowel sounds,
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nausea, vomiting, infection.
● Complications: Perforation, abscess, peritonitis, bleeding.
● Diagnostics: Physical assessment, CT scan with contrast.
Nutritional Problems
Malnutrition
● Pathophysiology: Imbalance in essential nutrients (deficit or excess).
