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Patho Exam 4 Questions and answers
Patho Exam 4 Questions and answers
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Patho Exam 4gastroesophageal reflux disease - ✅✅
-backward reflux of acidic gastric
contents from stomach to the esophagus
GER -✅✅-short term or intermittent do not cause issues
GERD - ✅✅-weak/incompetent LES (lower esophageal sphincter) allows
reflex to occur
GERD patho (progressive) - ✅✅ -repeated injury -- metaplasia -- squamous
cells change to columnar epithelium
NERD - ✅✅-non-erosive reflux disorder
Barrett's Esophagus - ✅✅-esophageal adenocarcinoma
GERD manifestations - ✅✅-- AKA pyrosis
-retrosternal can radiate to throat, shoulder, back
-belching
-lying WORSENS symptoms
GERD diagnosis - ✅✅-FIRST - before get invasive - try acid suppression
medications
- endoscopy
-manometry
24-hour pH testing
GERD treatment - ✅✅
--avoid stimulants (coffee/caffeine, chocolate)
-sit up after eating
-HOB increases (can use blocks or wedge booster)
✅✅-linked to smoking and alcohol use
squamous cell esophageal cancer -
adenocarcinoma esophageal cancer - ✅✅-linked to GERD and Barrett's
esophagus
manifestations of esophageal cancer - ✅✅-- progressive dysphagia
- unintentional weight loss = anorexia
- pain
,- fatigue
treatment of esophageal cancer - ✅✅-- depends on tumor stage (poor
prognosis)
gastric mucosal barriers - ✅✅ -protective mucosal barrier
- 2 main causes which are Aspirin and NSAID use, and infection
✅✅-inflammation of gastric mucosal
gastritis -
peptic ulcer disease - ✅✅-- ulcerative disorder in the upper GI tract that are
exposed to acid-pepsin secretions
(erosion in one or all layers of the stomach or duodenum)
most common peptic ulcer disease - ✅✅ -- duodenal (5x more common)
- gastric (average age middle and older adults)
causes of peptic ulcer disease - ✅✅ -H. pylori produces an enzyme that
breaks down urea --- h. pylori-bacterial infection
- NSAID inducer
(NSAIDS and Aspirin)
peptic ulcer disease manifestations - ✅✅ -- burning, gnawing, cramp-like
- pain in small area midline in epigastric near xyphoid
- stomach is empty
- pain CAN BE relived from food or antacids
what screening to do with peptic ulcer disease? - ✅✅-H. pylori screening
treatment for H.pylori -✅✅ -- antibiotics - avoid NSAIDS and Aspirin, as well
as, anticoagulants
- cauterize vessels and insert a balloon to dilate
stress ulcers -✅✅ -- GI ulcers can develop in relation to major physiological
stress
- Types are Curling's and Cushing
curling stress ulcer -✅✅ -- gastric stress ulcer in severely ill patients
- burns, trauma, sepsis, ARDS
- ischemia to mucosa and alteration in gastric mucosa barrier
, cushing stress ulcer - ✅✅ -- with intracranial injury (traumatic brain injury
TBI) operation, tumors
causes: hyper secretion of gastric acid
stomach cancer etiology -✅✅-nitriso compounds benopyrene
manifestations of stomach cancer - ✅✅-early: indigestion and burning
late: bloating after meals, and pain NVD/C
- Wt. loss, bleeding melena
stomach cancer DX and TX - ✅✅-DX: barium xray
TX: gastrectomy
crohn's disease - ✅✅-anywhere GI tract
ulcerative colitis - ✅✅-colon and rectum
etiology of inflammatory bowel disease - ✅✅-- unregulated and over-active
immune response against bacteria in the normal intestinal flora of susceptible
individuals
- genetic predisposition
- environmental trigger or infectious trigger
crohn's disease - ✅✅ -- granulomas type inflammatory response
- slowly progressive relentless
- onset of 20s and 30s
- sharply demarcated granulomatous lesions
- can lead to fibrosis and obstruction
crohn's disease manifestations - ✅✅ -- diarrhea, colicky pain, wt. loss
- occasional, but less bloody diarrhea compared to UC
- fluid and electrolyte disturbance
- malaise, low-grade fever
- absorption surface altered
complications of crohn's disease - ✅✅-- increase risk of infection or
abscesses
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