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Week 12
Diseases of the GI tract
| Question | Answer |
|---|---|
| What is the "gut"? | A hollow tube connecting the mouth and anus. |
| What is the "gut" composed of? | 1. Esophagus, 2. Tomach, 3. Small bowel, 4. Large Bowel |
| What are the parts of the small bowel? | 1. duodenum, 2. jejunum, 3. ileum. |
| What are the parts/sections of the large bowel? | cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum |
| Where is the appendix attached to? | The cecum |
| What are the stomach and esophagus separated by? | The lower esophageal sphincter |
| What is the function of the gut? | Digestion and absorption. |
| Where does the esophagus move food to? | The stomach |
| Where does digestion begin? | In the stomach |
| What stomach produces _____ to break down _____. | Pepsin (an enzyme), proteins. |
| Where does most of digestion occur? | In the duodenum |
| What enzyme does the pancrease secrete into the duodenum? | Pancreatic JUICE |
| What does the liver release into the duodenum? What is it important for? | Bile, important for absorption of fat. |
| What is the small bowel important for? | Digestion of food. |
| What is the large bowel important for? | Absorption of water and electrolytes and producing formed dookies. |
| Where is bacteria usually found? | Large bowels |
| What are some Signs and symptoms indicative of disease in the GI? | 1. Loss of appetite, 2. nausea, 3. Vomitting, 4. diarrhea (mud butt), 5. pain, 6. bleeding, 7. obstruction |
| What is blood in vomit called? | Hematemesis |
| If you have blood in your poo, what colour is your poo? Where is the blood from? | Black (melena) if bleeding is coming from the stomach or duodenum b/c of the action of acid and digestive enzymes on the blood. |
| What does red poo indicate? | Bleeding from intestines (large or small) (hematochezia) |
| In Canada, esophagus cancer accounts for ___% of GI tract cancers. | 6% |
| ___% of esophageal cancers are ________ and ____% are squamous cell carcinomas. | 60% are adenocarcinomas and 40% are squamous cell. |
| Incidence of esophagus cancer is highest amoung ______ (males/females) ____ of age | males greater than 50 years of age. |
| Long standing gastroesophageal reflux may result in the following sequence of events in the lower esophagus... | intestinal metaplasia---> dysplasia ---> adenocarcinoma |
| What is the major risk factors for squamous cell carcinoma in Canada? | alcohol and tobaco. |
| What doesn't play a role in squamous cell carcinoma? | REFLUX. |
| What are some signs and symptoms of esophogeal cancer? | Difficulty swallowing (dysphasia). |
| What happens by the time symptoms happen? | Cancer has progressed too far to be treated. |
| How can adenocarinoma of the esophagus be diagnosed? | At an early stage because the preceding long period of reflux is usually associated with heartburn, which prompts for referral to a specialist. |
| What is the survival rate of adenocarcinoma of the esophagus? | 5 year survaval rate is 5-10% |
| *How can esophageal tumurs cause harm? | Via local obstruction and spread due to proximity to several important structures (trachea, large vessels of the heart). |
| What is a peptic ulcer? | Breakdown in the mucosal gastrointestinal tract produced by the action of gastric secretions. |
| When do peptic ulcers happen? | When mucosa is damaged, leaving it susceptible to breakdown by gastric acid and pepsin. |
| Where do most peptic ulcers happen? | Stomach and duodenum. |
| What % of the population do peptic ulcers affect? | 10%. |
| What age do duodenal ulcers occur mostly? | Most frequent around the age of 20 |
| What age are gastric ulcers most frequent? | Around the age of 40 |
| Duodenal ulcers are more common in the ____ sex, while gastric ulcers occur _______. | Duodenal are more common in males while gastric occurs EQUALLY in both sexes. |
| What are the major causes of peptic ulcers? | Helobacter pylori bacteria & NSADs. |
| What are some risk factors for PU's? | smoking and genetic predisposition |
| HP is the cause of up to ___% of gastric ulcers and over ___% of duodenal ulcers. | 80% & 90% |
| In Canada, HP is found in the stomach of ___% of the people under the age of ___ and ___% of the people over the age of ___. | 20% under age 40, and 50% over age 50. |
| It is thought that ulceration is due to: | increased gastric acid production. |
| How can HP infection be diagnosed? | Antibody tests. |
| Gastric and duodenal ulcers not caused by HP are mostly due to______, which block ______ synthesis. | NSAIDs, prostoglandin. |
| Why are prostoglandins important? | they are importnt in maintaining an intact mucosal barrier. |
| What is the most common symptom of a peptic ulcer? | Upper abdominal pain. |
| What are some complications of peptic ulcers? | 1. Bleeding, 2. Obstruction, 3. perforation with peritonitis. |
| What medical treatments are available for peptic ulcers? | Antacids and drugs inhibiting acid secretion. As well as Antibodies that eradicate HP (if present). |
| What is Acute apendicitis? | Acute inflammation of the appendix |
| what is the lifetime risk of getting appendicitis? | 10% |
| What age is appendicitis most common? | Ages 10-25. |
| In what percent of the cases of acute appendicitis is the lumen obstructed? | 50-80% |
| What are signs and symptoms of appendicitis? | Pain that begins around the umbilicus, but then localizes in the lower right abdomen. |
| What kind of treatment is there? | Appendectomy, after diagnosis. |
| What is a diverticulum? | An outpouching of the gut wall. |
| What subgroups do diverticulums fall under? | Diverticulosis (uncomplicated) and diverticulitis (inflamed diverticula) |
| Diverticula is found ____ with age and is found in ___% of people over the age of ____. | increases with age and found in 50% of the people over the age of 60. |
| What are 2 important pathogenic factors of diverticular disease? | increased intraluminar pressure (due to low fibre diets) and foci of muscular weakness in the abdominal wall (where muscles pass through the muscle layer) |
| Where are most diverticula found? | in the sigmoid colon |
| What do most patients with divertulitis have? | Pain, feer and often a tender mass. |
| Inflammatory bowel disease consists of: | ulcerative colitis and Cron's disease. They are both chronic inflammatory diseases |
| What are the peak age categories of IBD? | 15-35 |
| What is IBD thought to be due to? | Unregulated and exaggerated local immune response to the gut microbes. |
| What parts of the gut may be involved in Crohn's disease? | Any part |
| What part of the gut is more frequently involved in Chron's disease? | Small bowel, and/or large bowel |
| What does Crohn's disease do? | Produces chronic inflammation and scaring. |
| What are some signs and symptoms of Crohn's disease? | Diarrhea, pain and fever. |
| Treatment of Crohn's disease is...? | Anti inflammatory agents to help. It can not be cured surgically. Several lifetime operations may be necessary. |
| What part of the gut does Ulcerative Colitis (UC) involve? | ONLY the large bowel; not transmural like CD |
| Do abscesses occur with UC? | No, because it is not transmural. |
| What are some signs and symptoms of UC? | chronic bloody diarrhea and pain |
| Patients with UC are at risk for devoping what? | Large bowel cancer |
| What kind of medical treatments are there for UC? | anti-inflammatory agents |
| If anti-inflammatory agents fail in trying to treat UC, what step is taken? | Removing of section of the large bowel involved. |
| Where is obstruction of the bowel most common and why? | Obstruction is most common in the small intestine because it is the narrowest, so is more susceptible to being obstructed. |
| What are some symptoms of bowel obstruction? | Pain, vomitting and abdominal distenation |
| ______ ,____, _____, and _____ account for ___% of obstruction. Tumor and infarction only account for ___% to ___% | Hernia, adesions and intussuception and volvulus account for 80% of obstruction. Tumor and infarct account only for 10-15% |
| What is a hernia? | An outpouching of the peritoneum through an area of weakness in the abdominal wall. |
| Where is the most common site for a hernia? | The groin, umbilicus and old abdominal surgical scars. |
| What happens when a loop of the small bowel enter a herniated sac? | OBSTRUCTION!, trapped or infarcted due to cut off of blood supply to that area |
| What is an adhesion? | an abnormal band of fibrous tissue which grows between abdominal organs following abdominal surgey or inflammatory conditions which involve the peritoneum. |
| What is intussusception? | When a segment of the small bowel becomes telescoped into the immediately distal bowel and peristalsis propels it further. Causes obstruction and eventually infarction. |
| What is volvulus? | twisting of a bowel loop, resulting in obstruction and eventually infarction. |
| Where is volvulus most common? | Small bowel, but sometimes occurs in the sigmoid colon. |
| What is the second most common cause of cancer death in Canada? | Colorectal cancer |
| Where is there a high incidence of colorectal cancer, and why? | Western world, related to high caloric food rich in animal fat, combined with a sedentary lifestyle. |
| What plays a major protective role in large bowel carcinoma? Why? | High fibre diet, because it moves the bowel contents along quicker, less time for carcinogensto sit and potentially be harmful. |
| What are some risk factors in large bowel carcinoma? | Meat consumption, smoking and alcohol consumption |
| In about __% of patients, genetics play a role | 25% |
| Almost all large bowel cancers are ________! | Adenocarcinomas |
| What are some symptoms of large bowel cancer? | Asymptomatic for year with only occult bleeding, but presents bleeding, change in bowel habit, obstruction or anemia. |
| What is the most common site for metastais of large bowel cancer? | Liver, followed by lung and bone |
| What's the treatment for large bowel carcinoma? | Surgery |
| When is large bowel cancer completely treatable? | when detected early! |
Created by:
mex200m