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GI 305

patho GI Capstone College of Nursing

A stomach section protrudes upward through an opening in the diaphragm toward the lung.Risk factors: advancing age and smoking hiatal hernia
es: weakening of the diaphragm muscle, frequently resulting from increased intrathoracic pressure or increased intra-abdominal pressure; trauma; and congenital defects hiatal hernia
CM:indigestion, heartburn, frequent belching, nausea, chest pain, strictures, dysphagia, and soft upper abdominal mass (protruding stomach pouch) Worsen with recumbent positioning, eating (especially after large meals), bending over, and coughing hiatal hernia
Chyme periodically backs up from the stomach into the esophagus Bile can also back up into the esophagus These gastric secretions irritates the esophageal mucosa Gastroesophageal Reflux Disease
Causes: certain food (e.g., chocolate, caffeine, carbonated beverages, citrus fruit, tomatoes, spicy or fatty foods, and peppermint), alcohol consumption, smoking, hiatal hernia, obesity, pregnancy, and delayed gastric emptying Gastroesophageal Reflux Disease
CM:: heartburn, epigastric pain (usually after a meal or when recombinant), dysphagia, dry cough, laryngitis, pharyngitis, regurgitation of food, and sensation of a lump in the throat Often confused with angina and may warrant ruling out cardiac disease Gastroesophageal Reflux Disease
Inflammation of the stomach’s mucosal lining gastritis
Can be a mild, transient irritation, or it can be a severe ulceration with hemorrhage Usually develops suddenly and is likely to be accompanied by nausea and epigastric pain acute gastritis
Develops gradually May be asymptomatic, but usually accompanied by a dull epigastric pain and a sensation of fullness after minimal intake. complications:peptic ulcers, gastric cancer, and hemorrhage chronic gastritis
Inflammation of the stomach and intestines usually because of an infection or allergic reaction Gastroenteritis
Most common cause of chronic gastritis Erode the stomach’s protective mucosal barrier Genetic vulnerability and lifestyle behaviors (e.g., smoking, and stress ) may increase the susceptibility Helicobacter pylori
CM: indigestion, heartburn, epigastric pain, abdominal cramping, nausea, vomiting, anorexia, fever, and malaise Hematemesis and dark, tarry stools can indicate ulceration and bleeding gastritis
Lesions affecting the lining of the stomach or duodenum. Develops because of an imbalance between destructive forces and protective mechanisms peptic ulcer disease
Most commonly associated with excessive acid or H. pylori infections Typically present with epigastric pain that is relieved in the presence of food duodenal ulcer
Less frequent but more deadly Typically are associated with malignancy and nonsteroidal anti-inflammatory drugs Pain typically worsens with eating gastric ulcer
Develops because of a major physiological stressor on the body due to local tissue ischemia, tissue acidosis, bile salts entering the stomach, and decreased GI motility. Most frequently develop in the stomach,Often hemorrhage is the first indicator stress ulcer
stress ulcers associated with burns curlings ulcer
stress ulcers associated with head injuries cushings ulcer
CM: epigastric or abdominal pain, abdominal cramping, heartburn, indigestion, nausea, and vomiting peptide ulcer disease
Gallstones A common condition that affects both genders and all ethnic groups relatively equally Risk factors: advancing age Cholelithiasis
inflammation or infection in the biliary system caused by calculi Cholecystitis
CM: biliary colic, abdominal distension, nausea, vomiting, jaundice, fever, and leukocytosis cholelithiasis
Inflammation of the liver Causes: infections (usually viral), alcohol, medications (e.g., acetaminophen [Tylenol], antiseizure agents, and antibiotics), or autoimmune disease Can be acute, chronic, or fulminant Can be active or nonactive hepatitis
hepatitis: Usually recover May develop liver failure, liver cancer, or cirrhosis Not contagious nonviral
hepatitis: Contagious Usually recover in time with no residual damage Advancing age and comorbidity increase the likelihood that liver failure, liver cancer, or cirrhosis will develop Can result in hepatic cell destruction and scarring viral
hepatitis: Has three phases – an asymptomatic incubation phase and three symptomatic phases acute hepatitis
hepatitis: Characterized by continued hepatic disease lasting longer than 6 months Symptom severity and disease progression varies depending on degree of liver damage Can quickly deteriorate with declining liver integrity chronic hepatitis
hepititis: An uncommon, rapidly progressing form that can quickly lead to liver failure, hepatic encephalopathy, or death within 3 weeks fulminant hepititis
Chronic, progressive, irreversible, diffuse damage to the liver resulting in decreased liver function Chronic alcohol abuse is the most frequent cause in the United States Hepatitis is the most common etiology in developing countries cirrhosis
CM: Portal hypertension Varicosities in the esophagus and abdomen Bleeding particularly in the esophagus Ascites Changes in clotting factors Muscle wasting Hyperlipidemia hyper/hypoglycemia Bile accumulation in the liver cirrhosis
Jaundice Clay-colored stools Dark urine Intense itching Numerous toxins and waste products accumulate Neurologic impairment Ulcers and GI bleeding Encephalopathy Spontaneous bacterial peritonitis cirrhosis
Inflammation of the pancreas,Pancreatic injury causes pancreatic enzymes to leak into the pancreatic tissue and initiate autodigestion resulting in edema, vascular damage, hemorrhage, and necrosis pancreatitis
Causes: cholelithiasis , alcohol abuse , biliary dysfunction, hepatotoxic drugs, metabolic disorders , trauma, renal failure, endocrine disorders, pancreatic tumors, and penetrating peptic ulcer pancreatitis
pancreatitis: Considered a medical emergency Mortality increases with advancing age and comorbidity acute pancreatitis
CM:usually sudden&severe: Upper abdominal pain that radiates to the back, worsens after eating, &is somewhat relieved by leaning forward or pulling the knees toward the chest Nausea/vomiting Mild jaundice Low-grade fever Blood pressure&pulse changes acute pancreatitis
CM: tend to be insidious: Upper abdominal pain Indigestion Losing weight without trying Steatorrhea Constipation Flatulence chronic pancreatitis
Change in bowel pattern characterized by an increased frequency, amount, and water content of the stool Results because of increased fluid secretion, decreased fluid absorption, or an alteration in GI peristalsis diarrhea
diarrhea Often caused by viral or bacterial infections or certain medications (e.g., antibiotics, antacids, and laxatives) Usually self-limiting, depending on the cause acute diarrhea
diarrhea Last longer than 4 weeks Causes: inflammatory bowel diseases, malabsorption syndromes, endocrine disorders, chemotherapy, and radiation chronic diarrhea
CM: Stools are large, loose, and provoked by eating Usually accompanied by pain in the right lower quadrant diarrhea origionating in small intestine
CM: Stools are small and frequent Frequently accompanied by pain and cramping in the left lower quadrant diarrhea origionating in large intestine
Change in bowel pattern characterized by infrequent passage of stool in reference to the individual’s typical bowel pattern Stool remains in the large intestine longer than usual, increasing the amount of water removed constipation
Causes: low-fiber diet, inadequate physical activity, insufficient fluid intake, delaying the urge to defecate, laxative abuse, stress, travel, bowel diseases, certain medications, mental health problems, neurologic diseases, and colon cancer constipation
CM: pain during the passage of a bowel movement, inability to pass stool after straining or pushing for more than 10 minutes, no bowel movements for more than 3 days, and hypoactive bowel sounds constipation
Blockage of intestinal contents in the small intestine or large intestine. Causes Mechanical obstructions: foreign bodies, tumors, adhesions, hernias, intussusception, volvulus, strictures, Crohn’s disease, diverticulitis, and fecal impaction intestinal obstruction
causes: Functional obstructions (also called paralytic ileuses): neurologic impairment; intra-abdominal surgery complications; chemical, intra-abdominal infections; abdominal blood supply impairment; and certain medications (e.g. narcotics) intestinal obstruction
Chyme&gas accumulate at the site of the blockage Saliva, gastric juices, bile,&pancreatic secretions begin to collect as the blockage lingers Intestinal blood flow can become impaired, leading to strangulation&necrosis intestinal obstruction
CM: abdominal distension, abdominal cramping,pain, nausea, vomiting, constipation, diarrhea, borborygmi, decreased or absent bowel sounds, restlessness, diaphoresis, tachycardia progressing to weakness, confusion, and shock intestinal obstruction
Inflammation of the vermiform appendix Most often caused by an infection Triggers local tissue edema, which obstructs the small structure Fluid builds inside the appendix, and microorganisms proliferate appendicitis
The appendix fills with purulent exudate and area blood vessels becomes compressed Ischemia and necrosis develop The pressure inside the appendix escalates, forcing bacteria and toxins out to surrounding structures appendicitis
CM: Sharp abdominal pain develops, gradually intensifies (12–18 hours),&becomes localized to the lower right quadrant of the abdomen (McBurney point) Pain may occur anywhere in abdomen appendicitis
CM: Nausea, vomiting, and bowel pattern changes Indications of inflammation and infection (e.g., fever, chills, and leukocytosis) Indications of peritonitis (e.g., abdominal rigidity, tachycardia, and hypotension) appendicitis
Inflammation of the peritoneum Causes: chemical irritation (e.g., ruptured gallbladder or spleen) or direct organism invasion (e.g., appendicitis and peritoneal dialysis) peritonitis
A thick, sticky exudate that bonds nearby structures and temporarily seals them off Abscesses may form in an attempt to wall off the infections Peristalsis may slow down in a response to the inflammation, decreasing the spread of toxins and bacteria protective mechanisms activated for peritonitis
CM: Usually sudden and severe Classical manifestation = abdominal rigidity Abdominal tenderness and pain Large volumes of fluid leak into the peritoneal cavity peritonitis
Chronic inflammation of the GI tract, usually the intestines; Includes Crohn’s disease and ulcerative colitis Characterized by periods of exacerbations and remissions inflammatory bowl disease
Immune cells located in the intestinal mucosa are stimulated to release inflammatory mediators that alter the function and neural activity of the secretory and smooth muscle cells Can be painful, debilitating, and life threateni inflammatory bowl disease
Insidious,progressive condition Often develops in adolescence patchy areas of inflammation involving the full thickness of the intestinal wall&ulcerations (skip lesions) fissures divided by nodules, giving the intestinal wall a cobblestone appearance crohn's disease
The entire wall becomes thick and rigid, and the intestinal lumen becomes narrowed and potentially obstructed Granulomas develop on the intestinal wall and nearby lymph nodes The damaged intestinal wall losses the ability to digest and absorb crohn's disease
Progressive condition of the rectum&colon mucosa Usually develops in the 2nd/3rd decade of life Inflammation causes epithelium loss, surface erosion,&ulceration that begins in the rectum&extends to the entire colon Rarely affects the small intestine ulcerative colitis
The mucosa becomes inflamed, edematous,&frail Necrosis of the epithelial tissue can result in abscesses Granulation tissue forms that's fragile&bleeds easily ulcerative colitis
The ulcers combine, creating large areas of stripped mucosa that results in an adequate surface area for absorption ulcerative colitis
CM: diarrhea (usually frequent [as many as 20 daily], watery stools with blood and mucus), abdominal cramping, nausea, vomiting, weight loss, and indications of inflammation (e.g., fever, fatigue,and malaise) ulcerative colitis
Chronic, noninflmmatory, GI condition characterized by exacerbations associated with stress Includes alterations in bowel pattern &abdominal pain not explained by structural or biochemical abnormalities irritable bowl syndrome
Less serious than IBD and does not cause permanent intestinal damage;Thought to be triggered by stress, food (e.g., chocolate, alcohol, dairy products, carbonated beverages), hormone changes (e.g., menstruation), and GI infections irritable bowl syndrome
CM: Stress and mood disorders often worsen symptoms Abdominal distension, fullness, flatus, and bloating Intermittent abdominal pain exacerbated by eating and relieved by defecation Chronic and frequent constipation or diarrhea, usually with pain irritable bowl syndrome
CM: Nonbloody stool that may contain mucus Bowel urgency Intolerance to certain foods (usually gas forming foods and those containing sorbitol, lactose, and gluten) Emotional distress Anorexia irritable bowl syndrome
Conditions related to the development of diverticula, outwardly bulging pouches of the intestinal wall that occur when mucosa sections or large intestine submucosa layers herniate through a weakened muscular layer May be congenital or acquired diverticular disease
Thought to be caused by a low-fiber diet and poor bowel habits that results in chronic constipation The muscular wall can become weakened from the prolonged effort of moving hard stools More common in developed countries diverticular disease
Asymptomatic diverticular disease Usually there are multiple diverticula present diverticulosis
Diverticula have become inflamed, usually because of retained fecal matter Can result in potentially fatal obstructions, infection, abscess, perforation, peritonitis, hemorrhage, and shock Often asymptomatic until the condition becomes serious diverticulitis
CM:abdominal cramping followed by passing a large quantity of frank blood, low-grade fever, abdominal tenderness (usually left lower quadrant), abdominal distension, constipation, obstipation, nausea, vomiting, palpable abdominal mass, and leukocytosis diverticular disease
Most are squamous cell carcinomas of the tongue and mouth floor; Usually appears initially as a painless, whitish thickening that develops into a nodule or an ulcerative lesion that persists, does not heal, and bleeds easily Multiple lesions oral cancer
CM: a lump, thickening, or soreness in the mouth, throat, or tongue as well as difficulty chewing or swallowing Often metastasizes to neck lymph nodes and esophagus oral cancer
Usually a squamous cell carcinoma in the distal esophagus Associated with chronic irritation Tumors grow the circumference of the esophagus creating a stricture, or they can grow out into the lumen of the esophagus, creating an obstruction esophageal cancer
CM: dysphagia, chest pain, weight loss, and hematemesis esophageal cancer
Occurs in several forms, but adenocarcinoma (an ulcerative lesion) is the most frequent type; Strongly associated with increased intake of salted, cured, pickled, preserved, and smoked foods gastric cancer
CM: abdominal pain, abdominal fullness, epigastric discomfort, palpable abdominal mass, dark stools, melena, dysphagia that worsens over time, excessive belching, anorexia, nausea, vomiting, hematemesis, fullness after meals, unintentional weight loss gastric cancer
`Most commonly occurs as a secondary tumor that has metastasized from the breast, lung, or from other GI structures Primary tumors are rare in the US, but common worldwide Causes of primary tumors: chronic cirrhosis and hepatitis liver cancer
CM: Similar to those of other liver diseases Include: anorexia, fever, jaundice, nausea, vomiting, abdominal pain (usually in the upper right quadrant), hepatomegaly, splenomegaly, portal hypertension, edema, third spacing, ascites, diaphoresis, liver cancer
Aggressive malignancy that can quickly metastasize Usually adenocarcinoma; Risk factors: family history, obesity, chronic pancreatitis, long-standing diabetes mellitus, cirrhosis, alcohol abuse, and tobacco use pancreatic cancer
CM: progressive upper abdominal pain that may radiate to the back, jaundice, dark urine, clay-colored stools, indigestion, anorexia, weight loss, depression, malnutrition, hyperglycemia, and increased clotting tendencies pancreatic cancer
Most often develops from an adenomatous polyp Very common and fatal in the US and worldwide;Associated with excessive intake of fat, calories, red meat, processed meat, and alcohol as well as decreased fiber intake colorectal cancer
CM: lower abdominal pain and tenderness, blood in the stool (occult or frank), diarrhea, constipation, intestinal obstruction, narrow stools, unexplained anemia (usually iron deficiency), and unintentional weight loss colorectal cancer
Created by: nmgroover