NURS 5315 GI MODULE 9, EXAM 5
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 what kind of bleed 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.
Crohn's disease patho - correct answer includes trasmural involvement of the affected area(entire wall of
intestine is affected) and the presence of skip lesions. Disease progression may lead to abscess formation
in GI tract. Possible causes include infectious agents, autoimmune, psychosomatic, impaired T-cell immunity
Crohn's disease S&S - correct answer abd pain, diarrhea, dehydration, bloody stools, malabsorption, malnutrition, weight loss, intestinal obstruction from chronic inflammation, fistulas and perforation of the intestine
