Term
1.
What disease is an idiopathic inflammatory disorder that affects ANY part of the GI tract from mouth to anus? |
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Definition
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Term
1.
What are the causative associations of Crohn disease? |
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Definition
gene mutation, family history, ashkenazi jews
(CARD15/NOD2)
-likely overresponse to bacteria, causing inflammation and release of prostaglandins, leukotrienes, proteases, ROS, and nitric oxide |
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Term
1.
Lesions in Crohns differ from Ulcerative Colitis. How?
give 5 features. |
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Definition
Lesions are cobblestone and can 'skip' segments
affects multiple layers of intestinal wall
appears cobblestone
stool is fatty (steatorrhea)
rare antibodies |
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Term
1.
what malabsorptions are associated with Crohn disease? |
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Definition
Especially Vitamin B12 and folic acid.
Also, Vitamins A, E, D, K; Ca++ |
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Term
1.
What are the clinical manifestations? |
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Definition
| abdominal pain, diarrhea (more than 5/day) |
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Term
1.
what is the treatment for Crohn Disease? |
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Definition
Immunomodulatory agents, TNF alpha blocking agens
diet high in fiber, low in residue |
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Term
2.
What happens with Type A gastritis?
What protein will be lacking? |
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Definition
Type A gastritis is when autoantibodies destroy parietal cells
parietal cells produce intrinsic factor |
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Term
2.
What is intrinsic factor?
what disease does it cause when lacking? |
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Definition
a mucoprotein produced by parietal cells
-combines with B12 in the stomach-required for absorption
-atrophic gastritis leads to B12 deficiency and pernicious anemia |
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Term
3.
What are common causes of liver failure? |
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Definition
Autoimmune hepatitis (rare)
Cirrhosis
viral hepatitis
hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E |
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Term
4.
What percent of hepatocytes are destroyed before showing symptoms? |
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Definition
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Term
5.
What are three symptoms of hepatic encephalopathy? |
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Definition
EEG changes
impaired cognitive function
flapping tremor (asterixis) |
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Term
5.
what happens with hepatic encephalopathy?
what chemical is toxic to brain cells? |
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Definition
accumulation of toxins causing a disruption of neurotransmission
-ammonia is toxic, a byproduct of nitrogen containing compounds
-ammonia causes altered blood flow and altered neurotransmission and edema |
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Term
5.
what is the treatment for Hepatic Encephalopathy? |
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Definition
limit protein intake
withdraw drugs metabolized by liver.
give lactulose |
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Term
5. bonus:
how does lactulose work? |
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Definition
| lactulose acidifies the gut and results in decreased absorption of ammonia |
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Term
6.
Neonatal jaundice is caused by? |
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Definition
| impaired bilirubin uptake and conjugation |
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Term
6.
what are the two types of neonatal jaundice? |
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Definition
physiologic-normal for premies- do phototherapy
pathologic-within 24 hours of birth -give intense phototherapy
---most common cause is hemolytic disease of the newborn |
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Term
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Definition
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Term
7.
what are three causes of jaundice? |
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Definition
extrahepatic obstruction (gallstones)
intrehepatic obstruction (cirrhosis, hepatitis)
excessive production of bilirubin (hemolysis of RBCs) |
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Term
7.
is unconjugated bilirubin excreted in urine? |
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Definition
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Term
7.
how can prehepatic obstruction cause jaundice? |
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Definition
excessive bilirubin is caused by hemolysis of red blood cells
-i.e. sickle cell disease |
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Term
8.
pancreatitis is often caused by what? |
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Definition
obstruction to the outflow of pancreatic digestive enzymes causing bile duct or pancreatic duct obstruction (gallstones)
-also, drugs, virus, ETOH use
=causes autodigestion of pancreatic cells, inflammation, necrosis |
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Term
8.
what are S/S of acute pancreatitis? |
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Definition
| epigastric or midabdominal pain, nausea, vomiting, and possibly fever and leukocytosis |
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Term
8.
what is the primary diagnostic marker used to identify pancreatitis? |
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Definition
| SERUM LIPASE (10-140 units/L) |
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Term
8.
what is the most common cause for chronic pancreatitis?/ |
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Definition
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Term
8.
where does calcification occur with chronic pancreatitis? |
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Definition
| intraductal and intracanal |
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Term
9.
what are the 4 steps in the vomiting process? |
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Definition
1.deep inspiration
2. airway closes off
3. forceful diaphragm/abdominal contraction
4. esophageal sphincter relaxation |
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Term
10.
What is malabsorption? |
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Definition
| failure of the intestinal mucosa to absorb the digested nutrients |
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Term
10.
what is pancreatic insufficiency?
what are causes |
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Definition
insufficient lipase, amylase, trypsin, or chymotrypsin
-caused by pancreatitis, cancer, resection, or cystic fibrosis |
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Term
10.
what are common signs for pancreatic insufficiency?
what is the treatment? |
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Definition
steatorrhea (fatty stools), weight loss
treatment is lipase supplements |
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Term
10.
what is the cause of lactase deficiency?
what is the problem with lactase deficiency? |
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Definition
congenital defect in the lactase gene
-inability to break down lactose |
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Term
10.
what are some signs of lactase deficiency?
how is it treated? |
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Definition
fermentation of lactose by bacteria causing gas, cramping, diarrhea
-avoid milk, take calcium supplements |
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Term
10.
what is the cause for bile salt deficiency?
what do bile salts do? |
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Definition
caused by liver disease and bile obstructions
-bile salts emulsify and absorb fats and vitamins |
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Term
10.
What does a bile salt deficiency result in?
what is the treatment? |
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Definition
poor absorption of fat-soluble vitamins (A,D,E,and K)
-increase medium-chain triglycerides in the diet
-parenteral A, D, and K. |
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Term
10
what do deficiencies in Vitamins A, D, E, and K each result in. |
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Definition
VitA: night blindness
VitD: osteoprosis
Vit E: musclular atrophy, ataxia, testicular atrophy and neuro defects
VitK: bleeding, purpura, petechiae |
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Term
11.
GERD is caused by what? |
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Definition
impaired motility:
acid and pepsin refluxes from stomach into esophagus, causing esophagitis |
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Term
11.
what are some predisposing factors for GERD? |
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Definition
| vomiting, coughing, lifting, bending, or obesity |
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Term
11.
what causes the most damage in GERD? |
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Definition
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Term
11.
What is barret's esophagus? |
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Definition
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Term
11.
Histamines in GERD also can affect what disease? |
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Definition
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Term
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Definition
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Term
12.
what is another name for congenital aganglionic megacolon? |
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Definition
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Term
12.
what is the cause for Hirschprung disease?
what system fails in Hirschprung disease? |
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Definition
unknown, complex familial
associated with down syndrome
Failure of parasympathetic system |
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Term
12.
what happens to the segment affected in Hirschsprung disease? |
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Definition
| section is immotile and allows obstruction |
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Term
12.
what are clinical manifestations of Hirschprung disease? |
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Definition
-distal rectum involved
chronic constipation
diarrhea
abdominal distention
neonates: meconium stool is delayed |
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Term
13.
What is an intussusception? |
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Definition
| ileum goes into the cecum |
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Term
13.
what are signs of intussusception? |
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Definition
abdominal pain, colicky, currant jelly stool***-blood and mucus
-fatal if left untreated |
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Term
13.
what is treatment for intussusception? |
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Definition
| reduce with air or barium enema |
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Term
14.
What is meconium ileus?
when is it common? |
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Definition
congenital impairment of motility
-most common in newborns with cystic fibrosis |
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Term
15.
what is the most common peptic ulcer? |
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Definition
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Term
15.
what are some developmental factors that lead to duodenal ulcer? |
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Definition
increased parietal cells
high gastrin levels
rapid gastric emptying
increased acid production from cigarettes |
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Term
15.
What exacerbates a duodenal ulcer? what relieves it? |
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Definition
Pain is improved when eating,
exacerbated with gastric emptying into duodenum |
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Term
16.
what is the cause for celiac enteropathy? |
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Definition
| gluten-sensitivity enteropathy |
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Term
16.
what mediates celiac enteropathy? |
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Definition
| t-cells, attacking antigen presenting cells in small intestine mucosa |
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Term
17.
what are common characteristics of Ulcerative Colitis? |
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Definition
bloody stools
-continuous lesions
-only affect mucosa
-primarily left colon
-thickening of mucosa
-antineutrophil antibodies
-may cause polyps
-may predispose to carcinoma |
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Term
17
treatment for ulcerative colitis? |
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Definition
| steroids, immunosuppressants, antibiotics |
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Term
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Definition
| Jaundice, yellow pigmentation of skin caused by hyperbilirubinemia |
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Term
18.
what is the most significant etiology of liver failure? |
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Definition
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Term
18.
what are cholesterol deposits called?
what is the cause? |
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Definition
skin xanthomas
associated with hypercholesterolemia, pancreatitis, and biliary cirrhosis |
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Term
18.
what levels of bilirubin are needed to be diagnosed with hyperbilirubinemia? |
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Definition
Total bilirubin:
>2.5-3mg/dL |
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Term
19.
What is the relationship between encephalopathy and liver failure? |
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Definition
| liver failure causes increased ammonia and portal hypertension, leading to hepatic encephalopathy |
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Term
19.
What are normal ammonia levels?
AST?
ALT? |
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Definition
Ammonia: 15-45 mcg/dL
AST: 5-40 units/L
ALT: 7-56 units/L |
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Term
19
can the liver break down ammonia? |
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Definition
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Term
20
What is the most common cause of acute liver failiure? |
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Definition
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Term
20
is hepatic necrosis reversible? |
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Definition
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Term
20
is there an underlying cause of acute liver failure? |
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Definition
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Term
20
what is treatment for acetaminophen overdose? |
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Definition
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Term
20.
What is the treatment for acute liver failure related to viral hepatitis |
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Definition
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Term
21.
What are the causes of IBS?
there are 6... |
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Definition
1. visceral hypersensitivity
2. abnormal GI motility
3. post-infectious: altered gut bacteria
4. overgrowth of intestinal flora
5. food allergy
6. psychosocial stress |
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Term
| 21. what is treatment for IBS? |
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Definition
| laxatives, fiber, antidiarrheals, antispasmodics, SSRI (for treatment of pain. |
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Term
22.
Liver cancer is associated with what gene? |
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Definition
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Term
22.
What causes the mutations in TP53? |
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Definition
| aflotoxins (aspergillus-mold from rotten corn) |
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Term
23.
what is HBsAg? what does it mean? |
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Definition
hepatitis B surface antigen
positive means infection (acute or chronic) |
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Term
23.
what is HBcAb?
what does it mean? |
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Definition
hepatitis B core antibody
positive means past or present infection |
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Term
23.
what is HBsAb?
what does it mean? |
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Definition
hepatitis B surface antibody
positive means immunity to future exposure to HB (could mean vaccinated) |
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Term
24
with what type of ulcer is pain relieved with eating? |
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Definition
| duodenal ulcer pain relieved immediately after eating |
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Term
24.
what is a stress-related ulcer? |
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Definition
| related to severe illness, multi-system organ failure, trauma |
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Term
24.
what is zollinger ellison syndrome? |
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Definition
gastrin-secreting tumor causes ulcer
common to also have gallstone |
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Term
24.
what is the most frequent cause of gastric ulcers? |
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Definition
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Term
24.
what is a curling ulcer? |
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Definition
| fluid shift from burn wound causes ulcer in stomach |
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Term
24.
what is a cushing ulcer? |
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Definition
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Term
24.
what is the pH of intestine? |
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Definition
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Term
bonus
what is the most common small intestinal obstruction? |
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Definition
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Term
bonus
what is a wrong when there is paralytic ileus? |
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Definition
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Term
bonus
what is ogilvie syndrome? |
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Definition
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Term
bonus
what are orexins and anorexins? |
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Definition
orexins: stimulate eating
anorexins: inhibit hunger |
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Term
bonus
what is the effect of short-term starvation? |
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Definition
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Term
bonus
what is the most common adenocarcinoma? |
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Definition
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