BIO 250 Patho

BIO 250 Patho Exam 6 Study Guide (Gastrointestinal Disorders) GI Lecture Movement of food along the GIT (1 Question) Mouth, pharynx, esophagus, stomach, duodenum Name the sphincters along the GIT and which sections of the GIT they move contents between: 1) Upper esophageal sphincter- between trachea and esophagus 2) Cardiac sphincter-lower esophageal sphincter (between the esophagus and stomach) 3) Pyloric sphincter- between stomach and duodenum 4) Ileocecal valve- between the small intestine and large 5) Anal sphincter GERD (2 Questions) Acid coming up in the stomach because of a weakened cardiac sphincter Potential complications: • heart burn • Barret’s Esophagus (precancer), • ulcers, • scarring- strictures, • esophagitis Function of the lower esophageal sphincter: keeps the stomach acid in the stomach Upper GI Bleeds (2 Questions) Causes: • Ulcers pyloric ulcers • NSAIDs, Aspirin • Esophageal varices (enlarged veins) • Steroids • GERD • Inflammation • Cancer Signs & symptoms • dark stools – melena • red streaks in poop • hematemesis – bright red vomit • coffee ground emesis (vomit) • s/s of shock – hypotension, bradycardia Gastritis & Peptic Ulcers (4 Questions) Risk factors/causes: • stress – shock (give PPI to decrease risk of developing an ulcer) • gastritis (inflammation) • NG tube damage • HPylori • Alcohol/smoking • NSAIDs, Aspirin, steroids Laboratory findings of a GI bleed or Peptic Ulcer • Guaiac test (can’t see bleeds with eyes so use this test) • Endoscopy -EGD upper scope • Abdominal x-ray to check for free air • HPylori -breath test for blood Differences in symptoms & type of pain between a gastric & duodenal ulcer: Gastric: • Pain 1-2 hours after eating. Food stimulates acid production and puts pressure on the ulcer • Lose weight Duodenal: • Pain starts 2-5 hours after meals. Feel better when they eat • Gain weight H. pylori treatment regimen: • Two antibiotics – amoxicillin and metronidazole (Flagyl) or clarithromycin • Pepto-Bismal and /or PPI (omeprazole) Gastric Cancer (1 Question) Risk factors: • Smoking • 60 y/o • Male • Barret’s Esophagus • Obesity • Gastritis • Family hx • Smoked and pickled foods Celiac Disease (1 Question) Foods to avoid: • GLUTEN • Wheat, grains, processed foods, barely, rye, oats, beer, sauces, malt Short bowel syndrome (1 Question): Parts of small intestine removed, shortening of it Causes: • Surgical resection of small bowel – trauma, Chrons, or bypass surgery • Leave less than 7 feet Diarrhea (2 Questions) Potential complications: • Dehydration • Malnutrition • Weight loss • Metabolic acidosis • Electrolyte imbalance • Mega Toxic Bowel (losing of peristalsis, bowel builds up with air and food, so they perforate) • Blood loss Causes: • Chrons • C-Diff • Antibiotic induced • Foodborne illness – bacteria, virus, parasite • Gastroenteritis • Celiac disease • Lactose intolerance Laboratory tests used to identify the problem: • Guiac test • Culture – stool • CBC – ck WBC Bowel obstruction (3 Questions) Signs & symptoms of small bowel vs large bowel obstruction: Small Intestine: • Abdominal pain • Distended • N/V from small intestine • Electrolyte imbalances • Dehydration • No bowel movement (obstipation) • Distal – fecal odor appearance Large Intestine: • Pain (not as severe), dull • Distension later • None to minimal vomiting Causes of small bowel or large bowel obstructions: Small Bowel: • Adhesions • Herniation – strangulated hernia Large Bowel: • Colon cancer -tumors • Volvulus (loose bowels twisting and folding over of stools causing an obstruction) Consequences of bowel herniation: • Death- sepsis- perforation of intestine Inflammatory bowel diseases (1 Question): Signs and symptoms of ulcerative colitis: • Bloody diarrhea • Weight loss • Abdominal pain • Fever • Tired/fatigue Colon Cancer (1 Question) Risk factors: • 50 y/o need scoping for this • Colon polyp (clump of cells in colon-precancer) • Before age 50- Family hx polyposis • Red meats/processed meats (bacon) • Smoking/ETOH • Constipation Chronic • Low fiber diet • Inactivity Appendicitis (2 Questions) Signs/symptoms: • Start umbilicus changes to the RLQ (McBurney’s Point)