Gastrointestinal Disorders Quiz

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Questions and Answers

What characterizes projectile vomiting?

  • It is preceded by nausea and retching.
  • It is caused by gastrointestinal contraction.
  • It occurs intermittently with abdominal pain.
  • It results from direct stimulation of the vomiting center. (correct)

Which type of constipation is primarily linked to a low-residue, low-fluid diet?

  • Secondary constipation
  • Slow-transit constipation
  • Pelvic floor dyssynergia-anismus
  • Functional constipation (correct)

What can cause diarrhea through excessive secretion of fluids by the intestinal mucosa?

  • Increased intestinal motility
  • Inadequate dietary fiber
  • Osmotic imbalance
  • Secretion (correct)

Which term refers to the vomiting of blood?

<p>Hematemesis (D)</p> Signup and view all the answers

Which condition is characterized by an impairment in esophageal motility leading to difficulty in swallowing?

<p>Achalasia (B)</p> Signup and view all the answers

What can be a cause of secondary constipation?

<p>Endocrine disorders (A)</p> Signup and view all the answers

What is the primary origin of visceral abdominal pain?

<p>Stretching of abdominal organs (B)</p> Signup and view all the answers

What is an example of occult bleeding?

<p>Blood detected via stool testing (B)</p> Signup and view all the answers

Which characteristic is specifically associated with Crohn disease?

<p>Skip lesions (A)</p> Signup and view all the answers

What is the primary feature of irritable bowel syndrome?

<p>Altered bowel habits and abdominal pain (B)</p> Signup and view all the answers

What condition is characterized by inflammation of diverticula?

<p>Diverticulitis (B)</p> Signup and view all the answers

Which complication is associated with portal hypertension?

<p>Hepatic encephalopathy (C)</p> Signup and view all the answers

What causes portal hypertension?

<p>Increased resistance to venous flow (C)</p> Signup and view all the answers

What is the most serious potential complication of portal hypertension?

<p>Bleeding varices (A)</p> Signup and view all the answers

What is a common consequence of vascular insufficiency in the intestine?

<p>Abdominal ischemia (A)</p> Signup and view all the answers

Which of the following is a histological form of microscopic colitis?

<p>Collagenous (D)</p> Signup and view all the answers

What type of ulcer is characterized by chronic development near parietal cells in the antrum?

<p>Gastric ulcer (A)</p> Signup and view all the answers

Which syndrome is primarily associated with a gastrinoma?

<p>Zollinger-Ellison syndrome (A)</p> Signup and view all the answers

What is the primary cause of ischemic stress ulcers?

<p>Decreased blood flow to gastric mucosa (B)</p> Signup and view all the answers

Which condition is a direct result of rapid gastric emptying caused by surgery?

<p>Dumping syndrome (C)</p> Signup and view all the answers

What is a common symptom associated with both ulcerative colitis and severe peptic ulcers?

<p>Frequent diarrhea (C)</p> Signup and view all the answers

Deficiency in which enzyme directly leads to osmotic diarrhea due to lactose malabsorption?

<p>Lactase (D)</p> Signup and view all the answers

What type of malabsorption is characterized by a lack of bile salts?

<p>Fat malabsorption (C)</p> Signup and view all the answers

Which ulcer type follows hypersecretion due to overstimulation of the vagal nuclei?

<p>Cushing ulcer (A)</p> Signup and view all the answers

What type of hernia involves the upper part of the stomach protruding through the diaphragm?

<p>Mixed hernia (A), Paraesophageal hernia (B), Sliding hernia (D)</p> Signup and view all the answers

What condition is characterized by delayed gastric emptying without mechanical obstruction?

<p>Gastroparesis (D)</p> Signup and view all the answers

What causes pyloric obstruction?

<p>Congenital defect (D)</p> Signup and view all the answers

Which of the following is a consequence of intestinal obstruction?

<p>Shock (A)</p> Signup and view all the answers

Which type of gastritis is most commonly associated with H. pylori and NSAIDs?

<p>Chronic antral gastritis (D)</p> Signup and view all the answers

What factors contribute to the development of peptic ulcers?

<p>Excessive secretion of gastric acid (B)</p> Signup and view all the answers

Which ulcer type is the most common among peptic ulcers?

<p>Duodenal ulcers (B)</p> Signup and view all the answers

What is a characteristic feature of duodenal ulcers?

<p>Increased parietal cells (D)</p> Signup and view all the answers

What is the primary cause of hepatic encephalopathy?

<p>Impaired metabolism of blood-borne toxins (C)</p> Signup and view all the answers

What characterizes jaundice?

<p>Increased plasma bilirubin concentration (D)</p> Signup and view all the answers

What causes obstructive jaundice?

<p>Obstruction of bile ducts or bile canaliculi (B)</p> Signup and view all the answers

Which condition is characterized by functional renal failure due to liver disease?

<p>Hepatorenal syndrome (C)</p> Signup and view all the answers

What is a typical consequence of hemolytic jaundice?

<p>Destruction of red blood cells leads to excess unconjugated bilirubin (D)</p> Signup and view all the answers

What is considered a main trigger for acute liver failure?

<p>Toxic overdose of acetaminophen (C)</p> Signup and view all the answers

Which group of hepatitis viruses can be transmitted via the fecal-oral route?

<p>HAV and HEV only (A)</p> Signup and view all the answers

What is a significant clinical manifestation during the prodromal phase of viral hepatitis?

<p>Anorexia and malaise (C)</p> Signup and view all the answers

What are the primary manifestations of esophageal cancer?

<p>Dysphagia and chest pain (C)</p> Signup and view all the answers

Which factors are associated with gastric carcinoma?

<p>High salt intake and H.pylori (A)</p> Signup and view all the answers

What type of cancer is more common, metastatic or primary cancer of the liver?

<p>Metastatic invasion of the liver (C)</p> Signup and view all the answers

Which statement about colorectal cancer is correct?

<p>Familial adenomatous polyposis coli is a genetic risk factor. (A)</p> Signup and view all the answers

What is the most common type of cancer found in the gallbladder?

<p>Adenocarcinoma (D)</p> Signup and view all the answers

Which statement is true regarding tumors of the colon?

<p>Tumors may cause pain and bloody stools. (D)</p> Signup and view all the answers

What is a common characteristic of pancreatic cancer?

<p>It accounts for about 2.6% of all cancers. (C)</p> Signup and view all the answers

Which of the following is a common cause of esophageal carcinoma?

<p>Nutritional deficiencies (C)</p> Signup and view all the answers

Flashcards

Vomiting

The forceful emptying of the stomach caused by muscle contractions and the reverse movement of food up the esophagus.

Nausea

The feeling of nausea before vomiting, often accompanied by retching.

Projectile vomiting

A type of vomiting that occurs suddenly and forcefully, often without prior nausea or retching.

Dysphagia

Difficult or painful swallowing, often feeling like an obstruction.

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Achalasia

A condition where the lower esophageal sphincter doesn't relax properly, causing food to get trapped in the esophagus.

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Gastroesophageal reflux disease (GERD)

The backflow of stomach contents into the esophagus.

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Esophagitis

Inflammation of the esophagus, often caused by frequent GERD events.

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Melena

Dark, tarry stools caused by blood in the digestive tract.

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What is a hiatal hernia?

A protrusion of the upper part of the stomach through the diaphragm at the gastroesophageal junction.

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What is gastroparesis?

Delayed gastric emptying in the absence of any physical blockage of the stomach outlet.

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What is pyloric obstruction?

A narrowing or blockage of the pylorus, the opening between the stomach and the duodenum.

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What is intestinal obstruction?

Interruption of the normal movement of food through the small or large intestine.

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What is gastritis?

An inflammation of the stomach lining.

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What is a peptic ulcer?

A circumscribed area of mucosal inflammation and ulceration caused by excessive acid secretion or disruption of the protective mucosal barrier.

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What is a duodenal ulcer?

A peptic ulcer located in the duodenum, the first part of the small intestine.

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What is a gastric ulcer?

A peptic ulcer located in the stomach lining.

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Gastric Ulcer

A type of peptic ulcer that occurs in the stomach, often near parietal cells, and tends to become chronic. It may cause pain after eating and can have normal or decreased gastric secretions.

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Zollinger-Ellison Syndrome

A condition caused by a gastrinoma, a tumor that secretes excessive gastrin, leading to chronic overproduction of gastric acid and ulcers in both the stomach and duodenum.

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Stress Ulcer

An acute form of peptic ulcer that develops in response to severe illness or critical injury. It's characterized by rapid ulceration of the stomach or duodenum caused by stress-induced mucosal damage.

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Cushing Ulcer

A type of stress ulcer caused by head trauma. It develops due to the overstimulation of vagal nuclei, leading to excessive hydrochloric acid production.

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Postgastrectomy Syndromes

A collection of digestive problems that occur after gastric resection, a procedure removing part or all of the stomach. They can occur after surgeries for peptic ulcers, gastric cancer, or obesity.

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Dumping Syndrome

A gastrointestinal condition characterized by rapid emptying of food from the stomach into the small intestine after gastric surgery. This can lead to osmotic shifts and malabsorption issues.

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Malabsorption Syndrome

A condition where the body has difficulty digesting or absorbing nutrients, often associated with pancreatic insufficiency, lactase deficiency, or bile salt deficiency.

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Ulcerative Colitis

An inflammatory bowel disease characterized by ulcerations, abscess formation, and necrosis in the colon and rectum. It can cause severe symptoms such as abdominal pain, bleeding, diarrhea, dehydration, and weight loss.

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What is ascites?

Fluid accumulation in the peritoneal cavity, often due to high portal pressure, low plasma proteins, and sodium retention.

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What is hepatic encephalopathy?

Impaired brain function caused by toxins (like ammonia) not processed by the liver.

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What is jaundice?

Yellowing of the skin and eyes caused by increased bilirubin in the blood.

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What is obstructive jaundice?

Jaundice caused by blockage either within the liver or in the bile ducts outside the liver.

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What is hemolytic jaundice?

Jaundice caused by the breakdown of red blood cells exceeding the liver's ability to process bilirubin.

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What is hepatorenal syndrome?

Kidney failure caused by advanced liver disease, often associated with cirrhosis and high portal pressure.

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What is acute liver failure?

Severe liver malfunction, possibly due to acetaminophen overdose or hepatitis complications.

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What is autoimmune hepatitis?

Liver inflammation caused by an immune system attack, with elevated antibodies, enzymes, and absence of viral hepatitis.

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What is Crohn Disease?

A condition caused by frequent remissions and exacerbations, affecting the entire GI tract, including the large and small intestines. It involves all layers of the lumen and is characterized by "skip lesions" and granulomas.

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What is Irritable Bowel Syndrome (IBS)?

A disorder of the brain-gut interaction characterized by abdominal pain with altered bowel habits (diarrhea, constipation, or both).

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What are Diverticula?

Outpouchings of colonic mucosa through the muscle layers of the colon wall. Diverticulosis is the presence of these outpouchings, while diverticulitis is inflammation of the diverticula.

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What is Appendicitis?

Inflammation of the appendix caused by obstruction of the lumen, leading to increased pressure, ischemia, and inflammation. If not surgically removed, it can progress to gangrene, perforation, and peritonitis.

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What is Portal Hypertension?

A condition where the portal venous pressure is elevated to at least 10 mmHg, caused by increased resistance to venous flow in the portal vein and its tributaries. It is a serious complication of liver disease, potentially leading to fatal complications.

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What are Varices?

Distended, tortuous, collateral veins associated with portal hypertension, often caused by the increased pressure in the portal vein.

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What is Splenomegaly?

Enlargement of the spleen resulting from increased splenic vein pressure caused by portal hypertension.

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What is Hepatopulmonary Syndrome?

Pulmonary hypertension associated with portal hypertension and severe liver disease, caused by the release of vasodilators that affect pulmonary arterioles.

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Squamous cell esophageal carcinoma

This type of esophageal cancer arises from the cells lining the esophagus and is linked to tobacco and alcohol use, reflux esophagitis, and nutritional deficiencies.

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Adenocarcinoma of the esophagus

This type of esophageal cancer develops from the glandular cells in the esophagus and is often associated with Barrett's esophagus, a condition where the normal lining of the esophagus changes.

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Gastric adenocarcinoma

This type of gastric cancer is linked to the bacterium Helicobacter pylori, high salt intake, and food preservatives.

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Familial adenomatous polyposis coli

This type of colon cancer is characterized by multiple polyps (abnormal growths) in the colon, inherited and usually diagnosed at a young age.

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Hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome

This type of colon cancer is also inherited but doesn't involve multiple polyps. Instead, it's associated with an increased risk of developing colorectal cancer, endometrial cancer, and other cancers.

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Hepatocellular carcinoma

This type of liver cancer is the most common type and originates from the liver cells themselves.

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Cholangiocellular carcinoma

This type of liver cancer originates from the bile ducts within the liver, which carry bile from the liver to the gallbladder.

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Adenocarcinoma of the gallbladder

This type of cancer is the most common type of gallbladder cancer and arises from the glandular cells lining the gallbladder.

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Study Notes

Disorders of the Gastrointestinal Tract

  • Anorexia, loss of appetite, vomiting, constipation, diarrhea, abdominal pain, and evidence of gastrointestinal bleeding are clinical manifestations of many gastrointestinal disorders.
  • Vomiting involves forceful stomach emptying via esophageal reverse peristalsis. It's often preceded by nausea and retching, except in projectile vomiting which directly stimulates the vomiting center.
  • Constipation is categorized as functional (low-residue diet), slow-transit (impaired colonic function), or pelvic floor dyssynergia-anismus. Secondary constipation arises from neurogenic, drug-related, endocrine/metabolic issues, or obstruction.
  • Diarrhea can be osmotic (excessive fluid draw), secretory (excessive fluid secretion), or motility-related (excessive motility).
  • Abdominal pain can be visceral (originating from organs) or parietal (originating from peritoneum) due to stretching, inflammation, or ischemia.
  • Gastrointestinal bleeding can manifest as hematemesis, melena, or hematochezia. Occult bleeding needs tests for detection.
  • Dysphagia is difficulty swallowing, caused by mechanical or functional esophageal obstruction. Achalasia is a functional dysphagia related to esophageal innervation and relaxation loss.
  • Gastroesophageal reflux disease (GERD) is chyme regurgitation into the esophagus, causing esophagitis from acidic gastric content exposure.
  • Hiatal hernia is the stomach protruding through the esophageal opening of the diaphragm.
  • Gastroparesis is delayed gastric emptying without mechanical obstruction. Pyloric obstruction arises from narrowings or blockages of the pylorus.
  • Intestinal obstruction prevents normal chyme movement, often due to torsion, herniation, or tumors (mechanical). Paralytic ileus causes functional obstruction. Severe consequences include fluid loss, hypovolemia, shock, necrosis, and perforation.
  • Gastritis is acute or chronic gastric mucosa inflammation. Regurgitation of bile, anti-inflammatory drugs, alcohol, infection (H. pylori), and some system diseases are associated.
  • Chronic fundal gastritis is rare, with autoimmune response against parietal cells leading to gastric atrophy and pernicious anemia. Chronic antral gastritis is frequent, related to H. pylori and NSAIDs. Alkaline reflux gastritis arises from bile and pancreatic secretion reflux into the stomach.
  • Peptic ulcers are mucosal inflammation and ulceration due to high gastric acid secretion or barrier disruption. Duodenal, gastric, and stress ulcers are the types, often associated with H. pylori and NSAIDs. Duodenal ulcers occur near the duodenum, generally with rapid gastric emptying, and resolve with food or antacids. Gastric ulcers commonly occur in the antrum.
  • Zollinger-Ellison syndrome causes chronic gastric acid secretion and ulcers due to gastrinoma.

Other Disorders

  • Stress ulcers (acute mucosal damage) result from severe illness, trauma, neural injury, or burns.
  • Postgastrectomy syndromes are post-surgical complications.
  • Malabsorption syndromes comprise impaired nutrient digestion or absorption. Pancreatic insufficiency is associated with inadequate digestive enzyme production. Lactase deficiency inhibits lactose digestion, causing osmotic diarrhea. Bile salt deficiency may prevent fat absorption, resulting in fatty stools.
  • Ulcerative colitis is an inflammatory bowel disease causing colonic and rectal mucosal ulceration, frequent relapses. Crohn's disease involves the entire GI tract, often with skip lesions and granulomas. Microscopic colitis is chronic inflammation affecting microscopic levels of the colon. Irritable bowel syndrome (IBS) is a brain-gut interaction disorder with altered bowel habits.
  • Diverticula are sac-like outpouchings in the colon wall. Diverticulosis is their presence, and diverticulitis involves inflammation. Appendicitis is obstruction causing inflammation and potential complications.
  • Vascular insufficiency in the intestines arises from insufficient blood flow due to mesenteric vessel occlusion leading to ischemia and necrosis with symptoms including abdominal pain, fever, bloody diarrhea, hypovolemia, and shock.
  • Portal hypertension, ascites, hepatic encephalopathy, jaundice, and hepatorenal syndrome are complications from liver disorders. Portal hypertension is high portal venous pressure due to resistance. Ascites is fluid build-up in the peritoneal cavity. Hepatic encephalopathy arises from unmetabolized toxins (ammonia) by the impaired liver. Jaundice is yellowing due to elevated bilirubin.
  • Various hepatitis types cause liver inflammation (necrosis, Kupffer cell hyperplasia, infiltration). Fulminant hepatitis is a severe and often fatal complication of hepatitis B or C infection.
  • Cirrhosis is an irreversible liver disease characterized by fibrosis, and nodular regeneration that leads to impaired function. Alcoholic liver disease arises from acetaldehyde-induced impairment of hepatocyte function. Non-alcoholic fatty liver disease represents fat build-up in hepatocytes and can advance.
  • Primary biliary cirrhosis damages intrahepatic bile ducts through inflammatory destruction. Secondary biliary cirrhosis arises from bile duct obstruction. Primary sclerosing cholangitis involves fibrosis of medium and large bile ducts.
  • Cholelithiasis involves gallstone formation (cholesterol or pigmented stones). Cholecystitis is related to gallstone-induced gallbladder inflammation. Acute pancreatitis is serious inflammation frequently due to biliary obstruction or alcohol. Chronic pancreatitis is recurrent inflammation usually related to alcoholism or recurrent acute pancreatitis.
  • Cancers of the esophagus, stomach, colon, rectum, gallbladder, and pancreas are discussed, along with their risk factors and symptoms.

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