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PBDII Exam 5
Dr.Ellis Disorders of GI
76
Other
Professional
04/21/2011

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Cards

Term
Dry mouth scientific name?
Definition
Xerostomia
Term
What classes of drugs are more likely to cause Xerostomia?
Definition

1. Antidepressants

2. Psychotropics

3. Hypertensives

Term
Xerostomia can be genetic or autoimmune.  Which autoimmune disease targets the salivary glands and causes Xerostomia?
Definition
Siogren Syndrome
Term
What difficulties occur with dry mouth?
Definition

1. Hard to talk

2. Hard to wallow

3. Bad oral hygiene (saliva usually cleans inside mouth)

Term
________________ is difficulty swallowing
Definition
Dysphagia
Term
What things can cause Dysphagia?
Definition

1. Neurological diseases such as Parkinsons

2. Abnormalities in the any part of the swallowing reflex

3. Structural abnormalities

4. Secondary to the lack of saliva

 

Term
What risks are associated with Dysphagia?
Definition

1. Chocking

2. Malnutrition

Term
Peptic Ulcer disease includes ulcerations of these 2 types:  ______________and _____________.
Definition

Gastric

Duodenal

Term
What does PUD cause the breakdown of?
Definition
Gastric Mucosal Barrier
Term
What bacteria is associated with PUD?
Definition
H.Pylori
Term
What types of medicine can cause PUD?
Definition

Aspirin

NSAIDs

Term
An excess secretion of acid can lead to PUD. What syndrome causes this excess and leads to PUD?
Definition
Zollinger Ellison Syndrome
Term
What does GERD stand for?
Definition
Gastroesophagel Reflux Disease
Term
What is GERD?
Definition
The backflow of gastric contents into the distal esophagus.
Term
What is the treatment option for GERD?
Definition

PPIs

like Nexium

Term
PPIs can be used to treat what types of diseases?
Definition

1. PUD

2. GERD

3. Zollinger-Ellison Syndrome

Term
Provide 2 examples of some motor disorders fo the esophagus.
Definition

1. Failure of the lower esophageal sphincter (LES) to relax

2. LES doesnt work properly so permits reflux of acid from stomach into the esophagus.

Term
What things/conditions impair gastric emptying?
Definition

1. Pyloric Stenosis

2. Gastroparesis

3. Vomiting

Term
What is Pyloris Stenosis and why does it affect gastric empyting?
Definition

1. It is a congenital condition

2. Occurs in 1/150 birhts and more common in boys

3. An inability of the Pylorus to relax properly so cant get all contents to the rest of GI system

4. Leads to regurgitation of nonbilious vomit

Term
T/F: With Gastroparesis the gastric empyting is impaired/delayed due to an obstruction.
Definition

False; there is no evidence of obstruction.

Might be due to another disease/condition, injures from treatments, and Rx.

Term
Which medications cause Gastroparesis?
Definition

1. AntiCholingerics

2. Opiates

Term
List some symptoms of Gastroparesis.
Definition

1. Vomiting

2. Early Satiety

3. Bloating

4. Upper ab discomfort

5. Nausea

Term
If there is no gastric emptying then what things can occur?
Definition

Leads to the inability to absorb nutrients and electrolytes because it is not reaching the SI jejunum where most of absorption occurs. 

 

Malnutrition

Dehydration

Term
Define diarrhea.
Definition
Passage of abnormally liquid or unformed stools at an increased frequency
Term
What are some causes of diarrhea?
Definition

1. Infectious agents = 90%

2. Rx, toxic ingestions, ischemia, EtOH  = 10%

Term
What is the duration of diarrhea in Acute, Persistent, and Chronic?
Definition

Acute < 2 weeks

Persistent 2-4 wks

Chronic > 4 weeks

Term
With Travelers Diarrhea, E.Coli is the main cause.  There is a disregulation of Cl-.  The Toxin resembles _____________ which causes an increase in cGMP. This is called _________.
Definition

Guanylin

Molecular Mimicry

Term
______________ is a severe secretory diarrheal disease.
Definition
Cholera
Term
How does Cholera lead to severe diarrhea?
Definition
The Vibrio Cholerae bacteria secretes a toxin that irreversibly binds and enters the intestinal epithelial cells.  The toxin then activates Gs-Gprotein so leads to an increase in cAMP.  This leads to the secretion of many ions and H2O into the lumen of the SI.   
Term
How can Cholera result in death and how do we prevent/treat complications?
Definition

With the severe diarrhea you can lose up to 20L of H2O a day, which can lead to severe dehydration.

 

Oral rehydration of ions and water. Administer a glucose and Saline solution. 

Term
T/F: Lactose Intolerance can cause diarrhea.
Definition
True
Term
For those who are Lactose Intolerant, they have a ____________ level of _____________ enzyme which causes an inability to _______________.
Definition

decreased

Lactase

Digest Lactose

Term
When is there a high expression of Lactase enzyme?
Definition

At birth,

 

Decreases with age

Term
What is constipation?
Definition
A pathological decrease in bowel movements
Term
T/F: Constipation occurs more frequently in young children.
Definition

False; incidence increases with age.

30-40% of persons > 65 yro experience this

Term
What disorder is from an Fe2+ deficiency?
Definition
Anemia
Term
What causes Hemosiderin?
Definition
An Fe2+ overload
Term
If you have Hemosiderin (high # of Fe2+ in body) then what tissue damages can occur?
Definition

1. Pigmentation of the skin

2. Pancreatic damage (in DM peeps)

3. Cirrhosis of the liver

Term
Disorders of Fe2+ uptake can also be due to Heredity.  Give a mutation and how it affects the Fe uptake. 
Definition
A HFE mutation leads to an excess absorption of Iron.  It is more common in White and can also be due to Xs EtOH. 
Term
T/F: Iron Deficiency leads to Hemochormatosis.
Definition
False; an Iron overload with a HFE mutation that absorbs Xs # of Fe leads to it.
Term
Define Cholestasis.
Definition
The production of bile is impired or bile flow is obstructed
Term
___________ can obstruct bile flow and lead to Cholestasis.
Definition
Gallstones
Term
What can happen to the liver with Cholestasis and why does it occur?
Definition
Atrophy of the liver can occur due to the increased toxicity.
Term
What is Hyperbilirubinemia?
Definition
Accumulation of unconjugated and conjugated bilirubin in the blood.
Term
What does Hyperbilirubinemia result in?
Definition

Yellowness of skin, sclera and mucous membranes.

 

Leads to Jaundice

Term
What things can cause Hyperbilirubinemia?
Definition

1. Cirrohosis of the liver

2. Increased breakdown of red blood cells that create an increase in biliburin in the blood.

3. Cholestatsis

Term
Hepatitis refers to liver disorders in which _________________ lasts for at least ___________ months.  (Varying causes and severity)
Definition

Hepatic Inflammation

6

Term
T/F: Fibrosis is irreversible.
Definition
False; it is reversible
Term
What are the causes for Hepatitis?
Definition

1. Viral

2. Chronic EtOH use

Term
What 2 terms refer to deposition of excess collagen in the liver?
Definition
Fibrosis and cirrhosis
Term
What causes cirrhosis of the liver?
Definition
Chronic EtOH use causes Kupffer cells to produce excess cytokines.  Stellate cells then produce lots of collagen. 
Term
What does Cirrhosis result in?
Definition
It reduces the hepatic mass which compresses RBCs and decreases the blood flow to the liver.
Term
_________________ is an alteration in mental status and cognitive function that occurs with liver failure.
Definition
Hepatic Encephalopathy
Term
What is Cholelithiasis?
Definition
Gallstones
Term
What are the 2 types of Gallstones that can form?
Definition

1. Cholesterol Gallstones

2. Bile Pigment Gallstones

Term
What leads to the formation of cholesterol gallstones in the liver/gallbladder?
Definition
If more cholestrol is present in the bile then the bile is supersaturated with cholesterol and crystals form in the bile.  
Term
What do Bile Pgiment Gallstones consist of?
Definition
Calcium salts of unconjugated bilirubin
Term
What does Cystic Fibrosis a result of?
Definition
A disease resulting from mutations in the gene that encodes the CF transmembrane conductance regulator (CFTR) protein.
Term
CF leads to an inadequate regulation of ____________ and others.
Definition
Cl-
Term
CF is a monogenic disorder that presents as a multisystem disease that is characterized by _______________ and _____________.
Definition

Exocrine Pancreatic dysfunction

Intestinal dysfunction

Term
CF causes an overproduction of ______________, because Cl- is coupled to HCO3-.
Definition
Mucus
Term
When does small bowel bacterial overgrowth occur?
Definition

When there is an abnormal motility or obstruction

 

"Stagnant Loop System"

Term
With the overgrowth of bacteria in the small bowel, what things can occur?
Definition

1. Fermentation of Carbohydrates which alter the pH  (causes gas/bloating)

2. Deconjugation of bile acids

3. Lack absorption of Vit.B12 because the bacteria competes for it.

Term
Overgrowth of bacteria in small bowel causes deconjugation of bile acids. What does this result in?
Definition

Passive absorption of bile.

This interefers with the emulsification and transportation of bile to the enterocytes. So you end up with Malabsorption of fats and steatorrhea.

Term
What is Steatorrhea?
Definition
Fat in the stool
Term
Inflammatory Bowel Diseases are caused by inflammation of the mucosa. What diseases can occur?
Definition

1. Crohn's disease

2. Ulcerative Colitis

Term
Crohn's Disease can lead to inflammation of any part of the GI system from mouth to anus. What things occur due to this disease?
Definition

1. Mal-absorption

2. Mal-digestion

3. Impaired bile acid reabsorption

4. Fal Mal-absorption

5. Diarrhea

 

 

Term
T/F: Crohn's Disease can lead to starvation.
Definition

True

 

Not absorbing/digesting anything due to inflammation of mucosa

Term
Celiac Disease is a permanent ____________ disorder caused by an _____________ response to _______.
Definition

Dietary

Immunologic

Gluten

Term
What does Celiac disease result in?
Definition

Diffuse damage to the proximal small intestinal mucosa.

Mal-absorption of nutrients

 

Term
What is the reason why some people cant eat certains grains like cereal?
Definition
Celiac disease
Term
What is the name of the genetic disease that is due to abnormal colonic motility?
Definition
Hirschsprung Disease
Term
When is Hirschsprung disease diagnosed?
Definition

At infancy,

after delivery

Term
With Hirschsprung disease, peristalsis causes feces to pass the ______________ region with difficulty and children with this disease may defecate as infrequently as _____________.
Definition

Aganglionic region

1 every 3 wks

Term
Why does Fecal incontinence occur?
Definition
Due to the inability of the external anal sphincter to maintain appropriate tone of the anal canal. 
Term
T/F: Fecal incontinence increases with a decrease in age.
Definition
False; increases with age.
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