Patho ch. 14 (3/18)

Sadie has irritable bowel syndrome. Her aunt tells Sadie that it is because she eats junk all the time, smokes, and is a nervous Nellie. What can Sadie tell her aunt?

"There may be a psychological component to my IBS, but the real cause is a change in my colonic motility."

You are a medical assistant in a GI clinic and a client asks you why surgery is often necessary for Crohn disease complications. What will you tell the client?

"When medications and corticosteroids don't work, it's often better to remove the inflamed portion of the colon and create a new opening in the small intestine for evacuation purposes."

About 50% of adults over age _____ have hemorrhoids.

50

What is the most effective treatment for celiac disease?

A lifelong and strict adherence to a diet that is gluten-free

Tenderness on pressure at McBurney point is a diagnostic indicator of what illness?

Acute appendicitis

Howard is seen at the clinic close to the end of the day. His spouse called to say Howard could not stop vomiting, had a fever, his heart was racing, and he was having terrible pain in the upper region of his stomach. What might these symptoms indicate?

Acute pancreatitis

What is the etiology of cirrhosis?

Alcohol, hepatitis, nonalcoholic fatty liver disease, biliary cirrhosis

Paroxysmal crying in infants for at least 3 hours per day, for at least 3 days per week, for a period of 3 weeks is recognized as what?

An ailment known as infantile colic.

What are the possible causes of ulcerative colitis?

An autoimmune inflammation, microbiome actions, and high intake of linoleic acid

Describe Barrett's esohagus and why does it need to be checked periodically?

Barrett's is change in the epithelium of the distal esophagus often seen in cancerous tissue - can lead to esophageal adenocarcinoma

What is the definitive method of diagnosing Crohn disease?

Biopsy of the affected site

Audrey has all the symptoms of gastritis. What tests will confirm the diagnosis?

Blood test for H. pylori antibodies and upper GI endoscopy with biopsy

When symptomatic cholecystitis is the diagnosis, what might the treatment be?

Cholecystectomy

Name the treatments for cholelithiasis and cholecystitis.

Cholecystectomy, bowel rest, analgesia, and IV antibiotics and hydration

What radiological diagnostic tools are most likely used to diagnose colorectal cancer?

Colonoscopy, ultrasound, MRI, and CT

Regional enteritis is another name for:

Crohn disease.

Compare and contrast diverticulosis and diverticulitis.

Diverticulosis occurs when small, bulging pouches ( diverticula) develop in your digestive tract. When one or more of these pouches becomes inflamed, the condition is called diverticulitis.

Possible complications of diarrhea might include which of the following?

Electrolyte imbalances and dehydration

Eric was running to catch his dog, which got out of the fenced yard. Suddenly he felt a sharp pain in his groin. He slowed his pace, stopped, and stooped over. The pain did not stop. What might have happened?

Eric may have an inguinal hernia from a weakness in the abdominal wall

Laurel likes to party and her boyfriend's fraternity house is known for its alcohol consumption on campus. Laurel went on a drinking binge that lasted 3 days during homecoming celebrations. When her boyfriend could not get her up at the end of the party, he called 911 and Laurel was taken to the ER. What might Laurel be told?

Even one drinking binge can put you at serious risk for ALD or cirrhosis

What is the medical term for traveler's diarrhea?

Gastroenteritis

What is another name for celiac disease?

Gluten-induced enteropathy

Which of the following types of hepatitis is formally known as infectious hepatitis?

HAV

There are five viral agents for hepatitis. Which ones are most common?

HAV, HBV, AND HCV

Name the 6 types of hepatitis and give a brief description of each.

HAV- infectious hepatitis, spread from person to person HBV- spread through shared needles HCV- most common chronic blood-borne infection in the united stated HDV- delta hepatitis, occurs in persons frequently exposed to blood HEV- high mortality rate in pregnant women, feces- contaminated water is mode of transmission HGV- blood-borne virus, common in drug users

George's dad suffered from ulcers for many years, so when George was told that he, too, had peptic ulcers, he was not surprised. He was, however, surprised at the treatment. Why?

He learned that antibiotics for treatment of H. pylori and medication to reduce acid secretions would cure it.

What are the signs and symptoms of a hiatal hernia?

Heartburn, belching, and esophageal reflux

What is the name for the dilated, tortuous veins in anal or rectal mucous membranes?

Hemorrhoids

What is the likely treatment for a femoral or inguinal hernia?

Herniorrhaphy and/or hernioplasty

What are the major distinctions between irritable bowel syndrome, Crohn disease and ulcerative colitis?

IDS- complex group of symptoms marked by abdominal pain and altered bowel function Crohn disease - chronic inflammation, usually of t he ileum ulcerative colitis- inflammation and ulceration of the colon

What are the major causes of pancreatitis?

It is caused by cholelithiasis and/or alcoholism

What is the survival rate for colorectal cancer when discovered early?

It is potentially curable in about 90% of cases.

What is the major problem for the new drug that can cure hepatitis C?

It is super expensive and not everyone can afford it.

How would you best describe GERD to a client?

It is the backup of gastric or duodenal contents into the esophagus that may cause heartburn.

Which of the following is true of colorectal cancer?

It is usually treated with surgery.

What is a "rolling" hiatal hernia?

It occurs when the gastroesophageal junction is fixed but some portion of the stomach passes through the esophageal hiatus.

How is acute appendicitis described?

It responds well to appendectomy, the only recommended treatment.

What are at least 5 common symptoms of digestive diseases and disorders?

Loss of appetite, weight loss, anorexia Dehydration Fever Jaunice Nausea and vomiting

occult blood

Minute quantities of blood which can only be seen with a microscope

What might a complementary therapy diet for diverticulitis/diverticulosis include?

Only whole foods, low-fiber diet, with soluble fibers, such as ground flax, psyllium, and bran

What is a leading cause of cancer deaths, which produces symptoms of abdominal pain, anorexia, jaundice, and weight loss, and usually has a poor prognosis?

Pancreatic cancer

What complementary therapy might be helpful when there is nausea and vomiting?

Sips of cold ginger ale, herbal teas, eating soda crackers and toast

Where are peptic ulcers most likely found?

Stomach and duodenum

Constipation is named when any two of the following symptoms exist for 12 weeks. What are they?

Straining at stool, lumpy stool, bloating, and fewer than three bowel movements per week

What statement best describes hemorrhoids?

They can be internal or external

What are the two types of hemorrhoids?

Those involving veins below the anorectal line and those involving veins above or along the anorectal line

villi

Tiny finger-shaped structures that cover the inner surface of the small intestine and provide a large surface area through which digested food is absorbed

What is the treatment for celiac disease?

Treatment consist of lifelong strict adherence to a gluten-free diet.

What is the treatment for pancreatitis?

Treatment is largely symptomatic but may require hospitalization. the aims to maintain circulation and fluid volume, decrease pain and pancreatic secretions and control any complications. treatment for acute pancreatitis requires IV fluids, and medication to relieve pain.

What are the complications of pancreatitis?

Type 2 diabetes and shock due to toxins in the blood

Bloody diarrhea, often containing pus and mucus, is a classic symptom of what disease?

Ulcerative colitis

cachexia

a marked weakness of the body

exudate

a protein-rich fluid that oozes from blood vessels to surrounding tissues in the presence of inflammation

fistula

abnormal, tubelike passage between two internal organs or between an internal organ and the body surface

ascites

accumulation of fluid in the peritoneal cavity

viral hepatitis

acute inflammation of the livr

What cancer type is usually prevalent in colorectal cancer?

adenocarcinoma

Barrett esophagus may lead to:

adenocarcinoma.

Which of the following is NOT a cause of peptic ulcers?

antibiotics

peptic ulcer

associated with h. pylori

GERD

backup of gastric contents into the esophagus

Why is the prognosis poor for pancreatic cancer?

because 80%-85% of individuals have advanced disease at first diagnosis

hematochezia

bright red blood in stool

What are the causes of pancreatitis?

caused by the presence of gallstones that cause inflammation in the pancreas as they pass through the common bile duct alcoholism, biliary tract diseases, trauma to abdomen, virus, drug reactions, immunologic disorders. cancer, complication from a duodenal ulcer

Which of the following is NOT a part of the small intestine?

cecum

A chronic,irreversible, degenerative disease of the liver characterized by the replacement of normal liver cells with fibrous scar tissue is called:

cirrhosis

What is the likely surgical treatment for Crohn disease?

colectomy or ileostomy

Societies that have a diet high in red meat and low in fiber have a higher incidence of:

colorectal cancer.

Describe the "rule of 3" in infantile colic?

crying occurs during the first 3 months, last longer than 3 hours a day, and occurs more than 3 days a week, and continues for at least 3 weeks.

hemorrhoids

dilated, tortuous veins in the mycosis membrane

A high-residue diet that includes bran, bulk additives, and stool softeners is a treatment for:

diverticulosis

What is the name for bulging pouches in the GI tract wall that push through surrounding muscle?

diverticulosis

What purpose does the pancreas serve in the body?

endocrine - secretes hormones insulin and glucagon exocrine - produces digestive enzymes

What are the 2 kinds of hemorrhoids and give a brief description of each.

external hemorrhoids - those involving veins below the anorectal line internal hemorrhoids - those involving veins above or along the anorectal line

polyposis

formation of numerous small masses

diarrhea

frequent passage of loose, watery stools

A major cause of death in developing countries is:

gastroenteritis.

fissure

groove or crack-like sore

What is the cause of acute herpetic stomatitis?

herpes simplex type 1

Which of the following is caused by the herpes simplex virus, type I?

herpetic stomatitis

What are the 2 kinds of stomatitis and give a brief description of each.

herpetic- highly contagious virus caused by herpes simplex virus, cold sore aphthous-cause unknown but lack of vitamin D, floic acid and iron is suspect, canker soures

The "rule of 3" is often used in diagnosing:

infantile colic

What are the 3 major causes of peptic ulcers?

infection with H. pylori, use of NSAIDs, and pathological hypersecretion disorders

cholecystitis

inflammation of the gallbladder

gastroenteritis

inflammation of the stomach and intestines

Name the 3 functions of the GI tract.

ingest, digest, and absorb nutrients taken in digestion, absorption and elimination of wastes

cirrhosis

irreversible, chronic degenerative hepatic diease

Abdominal pain with constipation or constipation alternating with diarrhea is the hallmark symptoms of:

irritable bowel syndrome.

What is the main symptom of gallstones?

many individuals remain asymptomatic, the telltale symptom is the acute onset of URQ abdominal pain radiating to the shoulder and back

irritable bowel syndrome

marked by abdominal pain and altered bowel function

Name the digestive organs and briefly describe each.

mouth or oral cavity - first part, break down food and mix with saliva salivary glands - secrete saliva in mouth to moisten food pharynx - throat, carries food to esophagus esophagus - carried farther by peristlis into the stomach stomach - holds food, gastric juice turnes food into chyme small intestine - digestion is completed, nutrients are absorbed large intestine - any undigested food and water pass into the cecum, then colon and rectum and finally the anal canal

What is cholelithiasis?

name for gallstones in the gallbladder or bile ducts

What are some proposed treatments for irritable bowel syndrome?

no one successful treatment. Dietary modification may be attempted, advised to get adequate sleep and exercise, a sedative or an antispasmodic drug may be prescribed

What are the 5 basic medications used for Crohn disease?

oral forms of mesalamine and sulfasalizin, cortiocosteroids, immunomodulators, antibiotics, and biological therapies are targeted to particular enzymes and proteins

Which of the following is NOT an accessory gland of the digestive system?

pharynx

What are some causes of cirrhosis?

portal, nutritional, or alcoholic. hepatitis B, C, and D. nonalcoholic fatty liver disease, biliary cirrhosis, certain inherited diseases, toxins, CHF

What is the role of the liver?

produces bile and regulates the level of most chemicals in the blood

What is the role of the pancreas?

produces insulin and glucagon and digestive enzymes

What are 2 other names for Crohn disease?

regional enteritis and granulomatous colitis

What are the 2 type of hiatal hernias and describe each?

sliding hernias- most common, gastroesophageal junction and the upper portion of the stomach slide upward through the esophageal hiatus paraoesophageal- rolling hernias, gastroesophageal junction remains fixed, but some portion of the stomach passes through the esophageal hiatus

Describe an ileostomy.

surgically creating an opening in the ileum, bringing it to the abdominal surface for the purpose of evacuating feces

appendicitis

symptoms include pain that settles in the lower right quadrant of the abdomine

What is McBurney point?

the point that is on the right side of the abdomen that is one-third the distance from the anterior superior iliac spine to the navel where the pain of appendicitis settles in the RUQ

Name the treatments for peptic ulcers.

treated at least once to eradicate H. pylor infection with antibiotic. meds may be given to reduce acid secretion, antiacids and PPIs are often prescribed. Surgery is indicated for perforation, suspected malignancy, or when conservative treatment is unsuccessful.

A chronic inflammation and ulceration of the colon, often beginning in the rectum or sigmoid colon and extending upward into the entire colon is:

ulcerative colitis.

What are the 3 types of abdominal hernias and which is the most common?

umbilical inguinal (most common) occur more in men than women femoral hernias

hematemesis

vomiting blood

How is constipation generally described by professionals?

when it has two of the following symptoms exist for at least 12 weeks: straining at the toilet, lumpy or hard stool, bloating or feeling of a full bowel, and fewer then three bowel movements per week

jaundice

yellowish discoloration of the skin