GI Pathophysiology and Gastric Mucosal Mechanisms
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Questions and Answers

What is the primary mechanism of acid secretion in the gastric mucosa?

  • Cholinergic stimulation of acid secretion from parietal cells
  • Neurotransmitter-mediated increase in histamine release from ECL cells (correct)
  • Parasympathetic stimulation of gastrin release from G cells
  • Hormonal regulation of pepsinogen secretion from chief cells

    • Which of the following GI pathologies is characterized by narrowing of the pyloric canal?

  • Acute gastritis
  • Pyloric stenosis (correct)
  • Peptic ulcer
  • Gastroesophageal reflux disease

    • What is the primary cause of parietal pain in the gastrointestinal tract?

  • Stretching of the peritoneum or underlying muscles
  • Mediators of the inflammatory response stimulating afferent nociceptor fibers (correct)
  • Inflammation
  • Ischemia of the peritoneum or underlying muscles

    • What is the primary function of the liver in the GI tract?

    <p>Production of bile salts for fat emulsification</p> Signup and view all the answers

    Which of the following is NOT a pathology related to gastric mucosal function?

    <p>Gastroesophageal reflux disease</p> Signup and view all the answers

    Which of the following is a common symptom of nausea?

    <p>Hypersalivation</p> Signup and view all the answers

    What is the primary site of nutrient absorption in the GI tract?

    <p>Small intestine</p> Signup and view all the answers

    What is the term for the vomiting of bright red blood in the absence of nausea or retching?

    <p>Projectile vomiting</p> Signup and view all the answers

    Which of the following is a type of GI bleeding that can be detected with tests for heme?

    <p>Occult bleeding</p> Signup and view all the answers

    What is the primary function of the esophagus?

    <p>Conduit for food and mechanical digestion</p> Signup and view all the answers

    Which of the following mechanisms of pathology is most likely to occur in the esophagus?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the narrowing or stricture of an area in the gastrointestinal tract?

    <p>Stenosis</p> Signup and view all the answers

    Which of the following is a type of GI disorder that can cause esophageal inflammation or esophagitis?

    <p>Gastroesophageal reflux disease (GERD)</p> Signup and view all the answers

    What is the term for the passage of bright red blood per rectum?

    <p>BRBPR</p> Signup and view all the answers

    Which of the following is a type of GI disorder that can cause abnormalities of movement in the esophagus?

    <p>Esophageal dysmotility</p> Signup and view all the answers

    What is the primary mechanism by which a fetus absorbs amniotic fluid during in utero development?

    <p>Through the fetal GI tract, then into the bloodstream</p> Signup and view all the answers

    What is the primary risk associated with Tracheo-Esophageal Fistula in newborns?

    <p>Aspiration pneumonia</p> Signup and view all the answers

    What is the general process that causes Esophageal Stricture?

    <p>Mucosal inflammation and scarring</p> Signup and view all the answers

    What is the inherent physiological problem in Esophageal Achalasia?

    <p>Neurologic problem</p> Signup and view all the answers

    What is the most common cause of Esophagitis?

    <p>Regurgitant stomach acid</p> Signup and view all the answers

    What is the pathophysiological mechanism underlying Reflux Esophagitis?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of Barrett's Esophagus?

    <p>Growth of columnar epithelium with goblet cells present</p> Signup and view all the answers

    What is the risk associated with Barrett's Esophagus?

    <p>Increased risk of esophageal cancer</p> Signup and view all the answers

    What is the primary cause of VACTERL syndrome?

    <p>Unknown</p> Signup and view all the answers

    What is the treatment for Esophageal Stricture?

    <p>Esophageal dilation</p> Signup and view all the answers

    What is the primary function of mucous cells in the gastric glands?

    <p>Produce mucus</p> Signup and view all the answers

    Which phase of HCl production is stimulated by the sight, smell, or taste of food?

    <p>Cephalic phase</p> Signup and view all the answers

    What is the primary mechanism by which H. pylori flourishes in the stomach?

    <p>Production of ammonia from urea</p> Signup and view all the answers

    What is the result of a decrease in mucus production in the stomach?

    <p>Increased risk of peptic ulcer disease</p> Signup and view all the answers

    What is the term for a gastrin-secreting tumor that can occur in the pancreas or duodenum?

    <p>Gastrinoma</p> Signup and view all the answers

    What is the effect of somatostatin on HCl production?

    <p>Inhibits acid release</p> Signup and view all the answers

    What is the primary mechanism by which anticholinergics decrease HCl production?

    <p>Inhibition of acetylcholine release</p> Signup and view all the answers

    What is the term for the clinical combination of duodenal ulcers and a pancreatic gastrin tumor?

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

    What is the effect of H. pylori infection on the stomach when the cardia is significantly affected?

    <p>Decreased mucus production</p> Signup and view all the answers

    What is the approximate percentage of adults over 50 in developed countries who are infected with H. pylori?

    <p>50%</p> Signup and view all the answers

    What is the most common cause of gastroparesis?

    <p>Neuropathy</p> Signup and view all the answers

    What is the result of bacterial overgrowth of retained gastric contents in gastroparesis?

    <p>Malabsorption and diarrhea</p> Signup and view all the answers

    What is the term for a mass of hardened, undigested food or other material trapped in the digestive system?

    <p>Bezoar</p> Signup and view all the answers

    What is the treatment for pyloric obstruction due to inflammatory disorders?

    <p>Gastric drainage and IV fluid and electrolytes</p> Signup and view all the answers

    What is the classic symptom of pyloric stenosis in babies?

    <p>Projectile vomiting</p> Signup and view all the answers

    What is the result of un-treated pyloric stenosis on blood volume?

    <p>Decreases</p> Signup and view all the answers

    What is the kidney's response to decreased blood volume and sodium content in pyloric stenosis?

    <p>Increased aldosterone release</p> Signup and view all the answers

    What is the physical sign of pyloric stenosis?

    <p>A mass in the epigastric region</p> Signup and view all the answers

    What is the treatment for pyloric stenosis?

    <p>Surgery</p> Signup and view all the answers

    What is the result of increased pH in pyloric stenosis?

    <p>Metabolic alkalosis</p> Signup and view all the answers

    Study Notes

    GI Pathophysiology

    • Normal GI tract physiology:
      • Neural control of GI function
      • Processing of food through the GI tract
      • GI blood flow
      • Secretory functions of the mouth, stomach, pancreas, liver, and intestines
      • Digestion and absorption in the GI tract

    Gastric Mucosal Mechanisms

    • Gastric acid secretion:
      • Mediated by parietal cells
      • Stimulated by acetylcholine, histamine, and gastrin
      • Inhibited by somatostatin
    • Mucosal protection:
      • Mucous cells produce mucus to protect against acidic pH
      • Decreased mucus production can lead to peptic ulcer disease

    Clinical Manifestations of GI Pathology

    • Anorexia:
      • Loss of appetite
      • Lack of desire to eat despite physiologic stimuli
    • Nausea:
      • Subjective experience associated with various conditions
      • Common symptoms include hypersalivation and tachycardia
    • Vomiting:
      • Forceful emptying of stomach and intestinal contents through the mouth
      • Can lead to fluid, electrolyte, and acid-base disturbances
    • Abdominal pain:
      • Can be caused by stretching, inflammation, or ischemia
      • Can be parietal (somatic), visceral, or referred pain
    • GI bleeding:
      • Upper GI bleeding: from esophagus, stomach, or duodenum
      • Lower GI bleeding: from jejunum, ileum, colon, or rectum
      • Clinical manifestations: melena, hematochezia, or bright red blood in stool

    Esophagus Pathologies

    • Stenosis:
      • Narrowing or stricture of the esophagus
      • Causes: chronic inflammation, genetic predisposition, and iatrogenic injury
    • Regurgitation or insufficiency:
      • GERD: can cause esophageal inflammation and esophagitis
      • Abnormalities of movement: esophageal dysmotility
    • Inflammation/trauma:
      • Esophagitis: inflammation of the esophagus
      • Barrett's esophagus: premalignant lesion with increased risk of esophageal cancer
      • Malory-Weiss tear: longitudinal tear in the esophageal mucosa
    • Embryology:
      • Week 3: lung and esophageal development
      • Week 4: tracheo-esophageal fistula formation
      • Tracheo-esophageal fistula: abnormal connection between the esophagus and trachea
      • Polyhydramnios: excessive amniotic fluid

    Stomach Pathologies

    • Pyloric stenosis:
      • Narrowing or stenosis of the pyloric sphincter
      • Causes: hypertrophy of the pyloric sphincter
      • Clinical manifestations: vomiting, epigastric pain, and fullness
    • Gastroparesis:
      • Delayed gastric emptying
      • Causes: neuropathy, poorly controlled diabetes, and vagal dysfunction
      • Symptoms: satiety, anorexia, vomiting, and retained gastric contents
    • Gastritis:
      • Inflammation of the stomach
      • Causes: H. pylori, NSAIDs, and cigarette smoking
      • Symptoms: epigastric pain, nausea, and vomiting
    • Peptic ulcer disease:
      • Loss of mucous balance
      • Causes: H. pylori, NSAIDs, and cigarette smoking
      • Symptoms: epigastric pain, nausea, and vomiting

    Treatment and Management

    • Decreasing HCL production:
      • Turning down the PSNS
      • Turning down histamine
      • Turning down gastrin
    • Managing bleeding ulcers:
      • Cautery
      • Clips
    • Managing gastroparesis:
      • Gastric drainage
      • IV fluid and electrolytes
      • Proton pump inhibitors or H2 blockers
      • Surgery or stenting

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    Description

    Understand the normal physiology of the GI tract and the mechanisms of gastric acid secretion and mucosal protection. Learn about the neural control, processing of food, and secretory functions of the mouth, stomach, pancreas, liver, and intestines.

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