G.I

Question 1

Lack of appetite, may be associated with nausea

Answer 1

Anorexia

Question 2

_______ _____ is located in the medulla

Answer 2

Vomiting Center

Question 3

_________ _____ located on the floor of the fourth ventricle and mediates emetic effects of blood-borne drugs and toxins

Answer 3

Chemoreceptor center

Question 4

“white plaque”

Answer 4

Oral leukoplakia

- a precancerous lesion

Question 5

The _____ is the most common site for oral cancer

Answer 5

Tongue

lift up the tongue and check with finger (gloved) for lesions

Question 6

Risk factors for oral, head, and neck cancer

Answer 6

• Smoking
• Chewing tobacco
• Heavy alcohol (Ethanol) intake
• Other chronic irritants

Question 7

Probably due to a weak or incompetent lower esophageal sphincter that allows reflux to occur.

May be associated delayed gastric emptying that is causing the increased pressure and forcing contents upward instead of allowing for normal movement downwards.

Answer 7

G.E.R.D

Gastroesophageal reflux disease (stomach content reflux up the esophagus)

Question 8

Signs and Symptoms of G.E.R.D

Answer 8

• Heartburn (most severe at night)
• Reflux of stomach contents into mouth
• Pain and hoarseness
• Respiratory symptoms (wheezing, chronic cough, hoarsness)
• Evidence linking asthma and reflux

Question 9

Treatment for GERD

Answer 9

1. Small meals; sit upright after eating
2. Avoid foods that lower esophageal tone (caffeine, choco, fats, alcohol, smoking)
3. Sleep with head elevated
4. Lose weight
5. No eating after 5pm
6. H2 blockers, Proton Pump inhibitors

Question 10

Barrett’s Esophagus

Answer 10

Esophageal Cancer (adenocarcinoma

• Dysphagia
• Weight loss

Question 11

Inflammation of the gastric (stomach) lining

Answer 11

Gastritis

Question 12

Common factors that can disrupt the mucosal protective barrier: _____, ______, _ _____, ______, __________

Answer 12

• NSAIDS
• Aspirin
• H. pylori
• Alcohol
• Corticosteroids

Question 13

Aspirins and NSAIDS inhibits __________ _______

Answer 13

Prostaglandin secretion

-improve gastric mucosal blood flow, decrease acid secretion, increase bicarbonate ion secretion and enhance mucous production

Question 14

Sudden symptoms of inflammation of the gastric mucosa

Answer 14

Acute Gastritis

-Life threatening hemorrhage can occur from NSAIDS w/o warning

Question 15

• Hemorrhage
• Heartburn
• Hematemesis (bloody vomit)
• violent vomiting

Answer 15

Symptoms of Acute Gastritis

-Treatment: IV fluid replacement, removal of irritant, self limiting in nature

Question 16

Absence of grossly visible erosions and presence of chronic inflammatory changes, leading to atrophy of the glandular epithelium of the stomach

Answer 16

Chronic Gastritis

Question 17

3 types of Chronic Gastritis

Answer 17

1. Helicobacter pylori
2. Autoimmune
3. Chemical gastropathy

Treatment of H. pylori difficult; simultaneous two or more antibiotics plus prilosec for 10-14 days

Question 18

Ulcerative disorder affecting all or some of the stomach layers and the proximal duodenum

Answer 18

Peptic ulcer disease (PUD)

Patho- H. pylori stimulate release of cytokines which increase mucosal damage

Question 19

PUD:
-Pain is midline, in ________, may radiate to costal margins, into the back and rarely to right shoulder

-Pain is usually relieved by ___ and/or ____

Answer 19

• epigastrum

- food, antacids

Question 20

GI ulcerations that develop in response to a major physiologic illness

Also called Curling’s ulcer

Answer 20

Stress Ulcers

Question 21

_______ _____ refers to a similar type of gastric ulcer occurring in those with intracranial tumors, surgery, trauma

Answer 21

Cushing Ulcer

Question 22

Diffuse inflammation of the gallbladder, with most cases associated with stones

Answer 22

Cholecystitis

• Acute onset of RUQ or epigastric pain, with mild fever, anorexia, N&V
• DX by ultrasound
• Surgery by laparoscopy

Question 23

Cholecystitis labs:

Answer 23

• Increased WBC’s
• Mild elevations in:
  1. AST
  2. ALT
  3. Alkaline phosphatase
  4. Bilirubin

Question 24

Intolerance to ____ ____, episodes of ______ pain

Answer 24

fatty foods

colicky

Question 25

Stone in common bile duct

Answer 25

Choledocholithiasis -can cause jaundice or pancreatitis

Question 26

Risk factors for Cholelithiasis (gallstones)

Answer 26

Obesity Female Multiple pregnancies Oral contraceptives

Question 27

Inflammatory process of the pancreatic acini

Answer 27

Acute pancreatitis - Etiology: Stones in duct, alcohol abuse. More on ppt. - Complications include MODS, SIRS, Pancreatic psuedocysts

Question 28

Premature activation of _____ causes autodigestive process of the pancreas, eventually causing multisystem organ failure and SIRS (systemic inflammatory response syndrome)

Answer 28

Trypsin

Question 29

ACUTE PANCREATITIS Increased serum ______ and _____ Increased ___

Answer 29

amylase, lipase CRP

Question 30

- Fourth leading cause of cancer death in U.S - Cancer has usually metastasized before diagnosis - 5 yr survival 20%, only 4% will live 18-20 months

Answer 30

Pancreatic Cancer -Jaundice, pain, pruritis, development of thrombi due to activation of clotting factors by proteases