Unit 5 - Pathophys
Which cells in the gastric mucosa produce intrinsic factor?
Which nerve stimulates motility and secretions in the digestive system?
Which enzyme breaks down protein into peptides?
In which structure is oxygenated blood mixed with unoxygenated blood to support the functions of the structure?
Why is an alkaline environment required in the duodenum?
Activation of intestinal and pancreatic enzymes
What is periodontitis?
Bacterial destruction of the attachments of teeth to the bone
Lack of a nerve plexus to relax the lower esophageal sphincter
What does esophageal atresia cause?
No fluid or food entering the stomach
What are common locations for oral cancer?
Floor of the mouth or tongue borders
What is a common cause of hiatal hernia?
Increased abdominal pressure
What are common signs of acute gastritis?
Vomiting with epigastric tenderness
What does the pathophysiology of chronic gastritis include?
the pathophysiology of chronic gastritis includes atrophy of the gastric mucosa with decreased secretions
Why does severe stress lead to peptic ulcer?
Reduced blood flow to the gastric wall and mucous glands, and reduced motility, leading to stasis of chyme and increasing glucocorticoid effects.
What would result from a perforated gastric ulcer?
Chemical peritonitis would result from a perforated gastric ulcer
What is often the first manifestation of a stress ulcer?
Hematemesis and hypotension
What does hematemesis indicate in an individual with peptic ulcer?
Erosion of large blood vessel
What would be a result of chronic bleeding from gastric carcinoma?
Occult blood in the stool and anemia
What is the most common location for peptic ulcers?
What are some causes of gastric carcinoma?
Ingestion of smoked foods, genetic factors, ingestion of foods preserved with nitrates
How would hemolytic jaundice manifest itself?
Increased unconjugated bilirubin in the blood
Why does mild hyperbilirubinemia occur in newborns?
The immature liver cannot process bilirubin quickly
Obstruction of the biliary tract by gallstones
What are predisposing factors to cholelithiasis?
Bilirubin or cholesterol concentration in the bile
What is a major result of a gallstone obstructing the cystic duct?
Severe colicky pain in the upper right quadrant
Following a cholecystectomy, what happens to bile that is produced?
Small amounts of bile are continuously secreted and flow into the duodenum
How is Hepatitis A transmitted?
It is transmitted by the oral-fecal route
What is the most common type of hepatitis transmitted by blood transfusions?
Hepatitis C (HCV)
What condition is indicated if the hepatitis B antigen level remains high in the serum?
Chronic infection is present
Long term exposure to a hepatotoxin would result in what?
Gradual irreversible damage to the liver and cirrhosis
Why would encephalopathy result from cirrhosis?
Why is an increased tendency to bleed associated with cirrhosis?
Deficit of Vitamin K and prothrombin
What changes are seen in serum bilirubin in a patient with cirrhosis?
Increased conjugated and unconjugated bilirubin
What factors lead to ascites in patients with cirrhosis?
Increased aldosterone and deficit of albumin leads to ascites in patients with cirrhosis.
Why would serum ammonia increase in patients with cirrhosis?
Bleeding occurs in the digestive tract
What is the initial pathological change in alcoholic liver disease?
Accumulation of fat in hepatocytes with hepatomegaly
What are some causes of hepatic cancer?
Metastatic tumors, chronic hepatitis, and exposure to certain chemicals
Which types of hepatitis increase the risk of hepatocellular cancer?
Hepatitis B and Hepatitis C
What causes massive inflammation and necrosis in acute pancreatitis?
Activation and spread of proteolytic enzymes causes massive inflammation and necrosis in acute pancreatitis.
Why does chemical peritonitis and shock frequently result from acute pancreatitis?
Acute pancreatitis leads to inflammation and increased vascular permeability of the peritoneum, which affects fluid balance, leading to chemical peritonitis and shock.
Bulky, fatty, foul-smelling stools
Why may celiac disease cause malnutrition in children?
Damage to the intestinal villi
What are the dietary requirements for children with celiac disease?
What are the typical changes occurring in the GI tract in Crohn's Disease?
Inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas
Why do fistulas form with Crohn's Disease?
Recurrent inflammation, necrosis, and fibrosis forms connections between intestinal loops
What do the stools of patients with ulcerative colitis look like?
Stools that are liquid with mucus, frank blood, and pus
Why does iron-deficiency anemia develop with ulcerative colitis?
Chronic blood loss in stools
What result would you see if the sigmoid colon was obstructed because of diverticulitis?
Small, hard stool
What kind of pain is typical with diverticulitis?
Lower left quadrant
What usually precipitates acute appendicitis?
Obstruction of the lumen of the appendix
What causes the localized pain and tenderness in the lower right quadrant in acute appendicitis?
Local inflammation of the parietal peritoneum
Why does localized peritonitis develop from acute appendicitis prior to rupture?
Intestinal bacteria escape through the necrotic appendiceal wall
Why does a volvulus cause localized gangrene in the intestine?
The mesenteric arteries are compressed in the twisted section of intestine
Why does hypovolemic shock develop with intestinal obstruction?
Vomiting and fluid shift into the intestine
What is the first change in arterial blood gases with diarrhea.
Decreased bicarbonate ion
Why does dehydration cause acidosis?
Hypovolemia and lactic acid production caused by dehydration leads to acidosis.
Why does dehydration limit compensation for acid-base imbalance that results from prolonged vomiting and diarrhea?
Hypovolemia limits renal function
Blood in a dark-colored stool
What occurs 2 to 3 hours after a meal in patients with dumping syndrome?
Why do deficiencies if vitamins A, D, and K occur in patients with cirrhosis?
Decreased production of bile
What are some factors that lead to inflammatory bowel diseases?
Genetic and immunologic
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