NURS 5315 GI UPDATED ACTUAL
Questions and CORRECT Answers
Upper GI organs - CORRECT ANSWER - mouth,pharynx, esophagus, stomach, and
duodenum
Lower GI organs - CORRECT ANSWER - small intestine, large intestine, rectum and anus
Hepatoportal circulation - CORRECT ANSWER - hepatic artery receives oxygenated
blood from the inferior mesenteric, gastric, and cystic veins. The hepatic portal vein receives
deoxygenated blood from the inferior and superior mesenteric vein and splenic vein and delivers
nutrients that have been absorbed from the intestinal system
Osmotic diarrhea - CORRECT ANSWER - Caused by the presence of a nonabsorbable
substance in the intestines. This pulls water by osmosis into the intestinal lumen and results in
large volume diarrhea. This is how mag citrate, lactulose and miralax work. Causes include:
excessive ingestion of nonabsorbable sugars, tube feedings, dumping syndrome, malabsorption,
pancreatic enzyme deficiency, bile salt deficiency, small intestine bacterial overgrowth or celiac
disease
Secretory diarrhea - CORRECT ANSWER - Results in large volume losses secondary to
infectious causes such as rotavirus, bacterial enterotoxins, or c-diff.
Motility diarrhea - CORRECT ANSWER - AKA short bowel syndrome. Results from
resection of small intestine or surgical bypass of small intestine, IBS, diabetic neuropathy,
hyperthyroidism, and laxative abuse. Fatty stools and bloating are common in malabsorption
syndrome. Complications include: dehydration, electrolyte imbalance, metabolic acidosis, weight
loss and malabsorption.
Upper GI bleed - CORRECT ANSWER - bleeding that occurs in the esophagus, stomach
or duodenum commonly caused by bleeding varices, peptic ulcers or Mallory-Weiss tear(tearing
of esophagus from stomach) Characterized by frank, bright red or coffee ground emesis.
, Lower GI bleed - CORRECT ANSWER - Bleeding in the jejunum, ileum, colon or rectum
from inflammatory bowel disease, cancer, diverticula or hemorrhoids. Hematochezia, or the
presence of bright red blood in the stools, suggest a lower GI bleed usually in the rectum,
sigmoid colon or descending colon
Peptic Ulcer Disease - CORRECT ANSWER - Is a break in the integrity of the mucosa of
the esophagus, stomach or duodenum resulting in exposure of the tissue to gastric acid. Risk
factors include smoking, advanced age, NSAID use, ETOH, chronic disease, acute pancreatitis,
COPD, obesity, socioeconomic status, gastrinoma, and infection with Helicobacter pylori. S&S:
Epigastric pain is worse with eating, melena or hematemesis
Duodenal ulcers - CORRECT ANSWER - most common and tend to develop in younger
patients. S&S: epigastric pain that is relieved by food. Patients may have melena(black and tarry
stool) or hematemesis
Ulcerative colitis (UC) - CORRECT ANSWER - Inflammatory disease of the large
instestine in persons 20-40y/o. Less common in people who smoke. Has periods of remission and
exacerbations. Characterized by inflammation and ulcerations that remain superficial and in the
small intestine.
UC S&S - CORRECT ANSWER - recurrent diarrhea, bloody stools, febrile, polyarthritis,
uveitis, sclerosing cholangitis, erythema nodosum and pyoderma gangrenosum
UC complications - CORRECT ANSWER - fissures, hemorrhoids, perirectal abscess,
toxic megacolon, colon perforation, and colorectal adenocarcinoma. Increased risk of VTE and
microthrombi, and colon cancer
Crohn's disease - CORRECT ANSWER - Chronic inflammatory disorders that can affect
any portion of the GI tract but most often in the ileum and proximal colon. Affects persons in
their 20-30s and of jewish decent. CARD15/NOD2 gene mutation commonly associated.
Crohn's disease risk factors - CORRECT ANSWER - smoking, family history, Jewish
decent, age less than 40, slight predominance in women and altered gut microbiome.
