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GI for Patho
Terms in this set (51)
A chronic, progressive disease of the liver, characterized by diffuse damage to cells with fibrosis and nodular regeneration
Types of Cirrhosis
Cellular necrosis causes eventual widespread scar tissue, with fibrotic infiltration of the liver
Alcohol-induced, nutritional, or portal cirrhosis
Scar tissue causes destruction of liver lobules and entire lobes
Occurs after massive liver necrosis
Results as a complication of acute viral hepatitis or exposure to hepatotoxins
In cirrhosis the repeated destruction of what type of cells occurs?
hepatic cells causes the formation of scar tissue
Complications of cirrhosis
portal hypertension and ascites
A persistent increase in pressure within the portal vein that develops as a result of obstruction to flow
The accumulation of fluid within the peritoneal cavity that results in venous congestion of the hepatic capillaries
What does the fluid in ascites leak into?
plasma leaking directly from the liver surface and portal vein
decreased oncotic and decreased albumin
2 main symptoms of cirrhosis
Spider angiomas on the nose, cheeks, upper thorax, and shoulders
Ecchymosis b/c they are at high risk of bleeding and the vessels are very fragile
A chronic inflammatory disease of the bowel characterized by patchy inflammation of all layers of the GI tract - submucosal layer and ileum and colon
is a chronic inflammatory disease of the colon manifested by diffuse ulceration of the colonic mucosa, especially the rectum and sigmoid colon
a functional bowel disorder in which abdominal pain is associated with defecation or a change in bowel habits, with features of disordered defecation and distention.
irritable bowel syndrome
An inflammation of the liver caused by a virus, bacteria, or exposure to medications or hepatotoxins
goals of treatment for hepatitis
include resting the inflamed liver to reduce metabolic demands and increasing the blood supply, thus promoting cellular regeneration and preventing complications
rest rest rest
stages of hepatitis
1. preicteric stage
2. icteric stage
3. posticteric stage
The first stage of hepatitis preceding the appearance of jaundice
Flu-like symptoms: malaise, fatigue
The second stage of hepatitis, which includes the appearance of jaundice and associated symptoms such as elevated bilirubin levels, dark or tea-colored urine, and clay-colored stools
The convalescent stage in which the jaundice decreases and the color of the urine and stool return to normal
What happens in the posticteric stage?
1. Energy levels increase
2. Pain subsides
3. GI symptoms are minimal to absent
4. Serum bilirubin and enzyme levels return to normal
transmitted primarily be fecal-contaminated drinking water and food
Raw shellfish grown in contaminated water, fresh fruits and vegetables cleaned with contaminated water or fertilized with human waste
The virus is transmitted through exchange of body fluids
IVDU with needle sharing
occupational exposure in health care workers
Acute infection is usually symptomatic and mild to life threatening
Physical examination hep B
hepatomegaly with usually mild RUQ tenderness without rebound is found in about 50%
Transmitted through the exchange of blood and body fluids
>50% of cases of HCV are caused by IVDU with needle sharing.
sexual transmission is low
maternal-fetal transmission is also uncommon and is usually limited to women with high circulating HCV levels.
HDV can only occur concurrently in the presence of HBV, it is only found in those with acute or chronic HBV
Can only occur if the patient has hepatitis B
Very SEVERE form - very sick patient
Inflammation of the Peritoneum
most common symptom is a board like abdomen
of severe abdominal pain that lasts several hours or longer and requires medical attention.
what are some symptoms of acute abdomen?
Tenderness, guarding by the patient, rebound tenderness (when you press and then let go the patient has more pain)
Inflammation of one or more diverticula in the bowel wall with microperforation and abscess formation in the pericolic fat.
For patients to have diverticulutis they will have diverticulosis
herniation of mucosa through the muscular wall of the colon; found most often in the sigmoid colon but may occur anywhere in the GI tract
Signs and symptoms of diverticulitis
Abdominal pain most often acute LLQ - steady and severe lasting for several days
low grade fever
Inflammation of the vermiform appendix
Signs of appendicitis
Triad: Right lower quadrant tenderness, leukocytosis, and anorexia
Chronic calcifying pancreatitis
Calcified proteins plugs form in the pancreatic ducts
Most often seen in alcoholics
Chronic obstructive pancreatitis
Lesions are more prominent in the head of the pancreas
Usually caused by cholelithiasis
Associated with the escape of activated pancreatic enzymes into the pancreas and surrounding tissues
These enzymes cause fat necrosis of the pancreas and produce fatty deposits in the abdominal cavity with hemorrhage from the necrotic vessels
What is the most common obstruction in the biliary tract?
How to diagnose acute pancreatitis?
How to assess? Pancreatic ezymes : amylase and lipase
Which is more specific to the pancreas? Lipase
With elevation in these ezymes diagnosis will be able to be made
Inflammation of the gallbladder occurring acutely or chronically, often secondary to previously asymptomatic gallstones
-stone in gallbladder (no inflammation/ no obstruction of common bowel duct )
Signs and symptoms of acute choleystitis
Right Upper Qudarant pain radiates to back or shoulder.
Nausea/Vomiting (75%) Recurrent attacks following
Positive Murphy's sign - tenderness on palpating RUQ
(obesity of very big risk factor)
Duodenal ulcer (DU)
4 times more common than GU
Epigastric burning 2-3 hrs PC; relief with foods or antacids
Awakening at 1-2 am with symptoms are common
Otherwise has periods of feeling well
Relief when they eat
Pain 2 -3 hours after eating
Tend to gain weight
More common among NSAID users
55-65 yrs. (rare prior to age 40)
Pain often reported with or immediately after meals
N/V, weight loss is common
Very painful when eating
results from the rapid emptying of partially digested food (hypertonic chyme) from the residual stomach directly into the small intestine
Leads to break or ulceration in the mucosa of the stomach or duodenum
Too rapid movement of stomach contents and acid into the duodenum (dumping syndrome) can overwhelm protective layer of mucus
Increased delivery of acid
Leaves mucosal cells unprotected from acid environment
Decreased mucus production
What is a cofactor in gastric cancers?
Ulceration of the GI mucosa in areas bathed by acid pepsin when there is an imbalance between gastric protective mechanism and irritating factors.
peptic ulcer disease
The partial or complete non-mechanical blockade of the small and / or large intestine
decrease in motility
Impaired movement of intestinal contents
Caused by any condition that affects the potency of the lumen of the bowel
3. Severe constipation (hard stool)
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