Essentials of Pathophysiology – Exam #2 Review Sheet
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Covers Modules 4, 5, and 6 – Chapters 27, 28, 29, 31, 33, 34, 36, 37, 38, 40, 41
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1. Review common signs and symptoms of gastrointestinal disorders as a
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whole
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Abdominal pain, nausea, vomiting, diarrhea, dysphagia, and constipation.
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2. What is gastritis? What are causes?
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Inflammation of the stomach lining
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Causes: Precipitated by ingestion of irritating substances
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Example: alcohol and aspirin, NSAIDs, viral, bacteria, autoimmune
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3. What is GERD? What are causes to this condition? What are complications
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of GERD if left untreated?
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Gastroesophageal Reflux Disease- Backflow of gastric contents into esophagus through lower
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esophageal sphincter (LES)
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Inflammation caused by reflux of highly acidic material (esophagitis)
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Causes
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Any condition or agent that alters closure strength of LES or increases abdominal pressure, fatty
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foods, caffeine, large amounts of alcohol, cigarette smoking, pregnancy, anatomic features (ex:
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hiatal hernia)
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Complications: Barrett esophagus- Structural changes in tissue of esophagus over time (columnar tissue
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replaced normal squamos epithelial) can increase risk for esophageal cancer sh
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Progression can lead to ulceration, fibrotic scarring
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Esophageal strictures
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Pulmonary symptoms - cough, asthma, and laryngitis - from reflux in breathing passages
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4. Review signs and symptoms of peptic ulcer disease. What is the role of H.
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pylori in this condition?
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Caused by NSAIDs, stress (glucocorticoids), smoking, genetics
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No relation b/w diet and PUD
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H. pylori plays a key role in promoting both gastric and duodenal ulcer formation
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Thrives in acidic conditions
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Slow rate of ulcer healing
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High rate of recurrence
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Clearance of H. pylori promotes ulcer healing
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Signs and symptoms- epigastric burning that is usually relieved by the intake of food (especially
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dairy products) or antacids.
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Pain of gastric ulcers typically occurs on an empty stomach but may present soon after a
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meal
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Pain of duodenal ulcer classically occurs 2 to 3 hours after a meal and is relieved by
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further food ingestion
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Life threatening complication: GI bleed
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Treatment: treat with antibiotic and then stomach acid with Sucralfate (Carafate)
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5. What is pseudomembranous colitis? What contributes to this condition?
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What are ways that it can be treated?
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Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis).
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Acute inflammation and necrosis of large intestine
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Caused by overgrowth of Clostridium difficile c.diff (exposure to antibiotics)
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Treatment= Stop current antibiotic (if possible)
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Treat contributing conditions
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Oral antibiotics - metronidazole (flagyl) or vancomycin
Recurrence common
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Fecal transplant - transfer of fecal material from another healthy person to the source patient
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via enema or gastric tube
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Colectomy – removal of portion of colon
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6. Review examples of inflammatory bowel conditions.
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Ulcerative Colitis
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Chronic inflammatory disease of the mucosa of the rectum and colon
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Large ulcers form in mucosal layer of colon and rectum
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Hallmark clinical manifestations are bloody diarrhea and lower abdominal pain
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Crohn’s Disease
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Also called regional enteritis or granulomatous colitis
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Affects proximal portion of the colon or terminal ileum
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Chronic inflammation of all layers of intestinal wall resulting from blockage and inflammation of
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lymphatic vessels
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Intermittent bouts of fever, diarrhea (with or without blood), chronic RLQ pain, may have RLQ mass,
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tenderness
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7. Review signs and symptoms of appendicitis. How do we assess for this
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condition?
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Signs and symptoms- Periumbilical pain, RLQ pain “McBurney’s point”, nausea, vomiting, fever,
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diarrhea, RLQ tenderness, systemic signs of inflammation
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Mcburney- better with pressure exacerbated after – rebound tenderness
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8. Review causes of bowel obstructions. Know the difference between functional obstruction versus
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mechanical obstruction. Know examples of each type
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Mechanical
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