Upper GI Pathologies
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Questions and Answers

What is the primary cause of gastroparesis in patients with diabetes?

  • Peripheral neuropathy of enteric nerves
  • Vagal dysfunction
  • Neuropathy (correct)
  • Poorly coordinated peristalsis

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

  • Pyloric Obstruction
  • Bleeding Ulcer
  • Bezoar (correct)
  • Gastroparesis

    • What is the term for the blocking or narrowing of the opening between the stomach and duodenum?

  • Pyloric Stenosis
  • Pyloric Obstruction (correct)
  • Bleeding Ulcer
  • Gastroparesis

    • What is the classic symptom of pyloric stenosis in babies?

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

    What is the effect of pyloric stenosis on serum pH?

    <p>pH increases</p> Signup and view all the answers

    What is the effect of pyloric stenosis on blood volume?

    <p>Blood volume decreases</p> Signup and view all the answers

    What is the kidney's response to pyloric stenosis?

    <p>Release of renin</p> Signup and view all the answers

    What is the treatment for pyloric stenosis in babies?

    <p>Surgery to un-stenose the sphincter</p> Signup and view all the answers

    What is the physical sign of pyloric stenosis in babies?

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

    What is the treatment for bleeding ulcers?

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

    What is the primary function of the gastric mucosal mechanisms in the GI tract?

    <p>Acid secretion and mucosal protection</p> Signup and view all the answers

    Which of the following pathologies is associated with the blocking or narrowing of the opening between the stomach and duodenum?

    <p>Pyloric stenosis</p> Signup and view all the answers

    What is the primary function of the pancreas in the GI tract?

    <p>Secretion of digestive enzymes</p> Signup and view all the answers

    Which of the following is NOT a function of the liver in the GI tract?

    <p>Secretion of digestive enzymes</p> Signup and view all the answers

    What is the primary function of the intestines in the GI tract?

    <p>Digestion and absorption of nutrients</p> Signup and view all the answers

    What is the primary mechanism by which fetuses absorb amniotic fluid during in utero development?

    <p>By drinking it through the mouth</p> Signup and view all the answers

    What is the typical presentation of a Tracheo-Esophageal Fistula in utero?

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

    What is the primary complication of untreated Tracheo-Esophageal Fistula?

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

    What is the underlying cause of Esophageal Achalasia?

    <p>Neurologic problem– degeneration of myenteric plexus</p> Signup and view all the answers

    What is the primary symptom of Esophagitis?

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

    What is the primary function of mucous cells in the stomach?

    <p>Protecting the stomach against acidic pH</p> Signup and view all the answers

    What is the primary mechanism by which Barrett's Esophagus develops?

    <p>Chronic inflammation of the lower esophageal epithelium</p> Signup and view all the answers

    Which phase of gastric acid production accounts for about one-third of all stomach acid?

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

    What is the primary risk factor for developing Esophageal Stricture?

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

    What is the effect of somatostatin on gastric acid production?

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

    What is the primary treatment for Esophageal Stricture?

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

    What is the name of the tumor that can occur in the pancreas or duodenum and leads to an overproduction of gastrin?

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

    What is the primary complication of Esophagitis?

    <p>Stricture formation</p> Signup and view all the answers

    What is the name of the syndrome characterized by duodenal ulcers and a pancreatic gastrin-producing tumor?

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

    What is the primary association of VACTERL syndrome?

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

    Which organism colonizes the surface of gastric mucosa and produces urease, an enzyme that converts urea into ammonia?

    <p>H. pylori</p> Signup and view all the answers

    What is the effect of H. pylori infection on gastric mucosal cells?

    <p>Changes signal transduction in gastric mucosal cells</p> Signup and view all the answers

    What is the effect of H. pylori infection on the cardia?

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

    What is the effect of H. pylori infection on the antrum?

    <p>Increases gastrin production</p> Signup and view all the answers

    What is the estimated percentage of adults in developed countries infected with H. pylori?

    <p>1/6</p> Signup and view all the answers

    What is a potential consequence of retained gastric contents in gastroparesis?

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

    What is the primary function of the pyloric sphincter?

    <p>To regulate the passage of food into the duodenum</p> Signup and view all the answers

    What is the likely cause of epigastric pain and fullness in pyloric obstruction?

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

    What is the expected change in serum pH in pyloric stenosis?

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

    What is the effect of pyloric stenosis on blood volume?

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

    What is the kidney's response to pyloric stenosis?

    <p>Release of renin</p> Signup and view all the answers

    What is the treatment for pyloric stenosis in babies?

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

    What is the physical sign of pyloric stenosis in babies?

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

    What is the term for the narrowing of the pyloric sphincter in adults?

    <p>Pyloric obstruction</p> Signup and view all the answers

    What is the mechanism of Coca Cola dissolution therapy for bezoars?

    <p>Chemical dissolution</p> Signup and view all the answers

    A patient presents with a lack of desire to eat despite physiologic stimuli that would normally produce hunger. What is the most likely diagnosis?

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

    Which type of pain is felt in the peritoneum or underlying muscles?

    <p>Parietal pain</p> Signup and view all the answers

    What is the term for bloody vomit?

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

    Which of the following is a cause of abdominal pain?

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

    What is the term for a symptom of many gastrointestinal disorders that is characterized by a feeling of discomfort or unease in the abdomen?

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

    Which of the following is a type of GI bleeding that is not visible to the eye but can be detected with tests for heme?

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

    A patient presents with spontaneous vomiting that does not follow nausea or retching. What is the most likely diagnosis?

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

    What is the term for the abnormal narrowing or stricture of an area of the GI tract?

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

    A patient presents with bright red bleeding in emesis. What is the most likely diagnosis?

    <p>Upper GI bleeding</p> Signup and view all the answers

    Which of the following is a mechanism of pathology that can affect the esophagus?

    <p>All of the above</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

    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

    Explore the normal physiology of the gastrointestinal tract, including neural control, food processing, blood flow, and secretory functions. Learn about pathologies related to GI function and the normal stomach, including its functions and related pathologies.

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