Exam 4 Patho Flashcards - Easy Notecards

What anatomical structure is path of both the respiratory system AND digestive system?

It’s role in the respiratory system is to:

It’s role in the digestive system is to:

Pharynx

It’s role in the respiratory system is to: warm and humidify air
It’s role in the digestive system is to: process of swallowing

What enzyme is in your saliva?

Salivary Amylase (enzyme that breaks down carbohydrates)

Amylase job is to breakdown:

carbohydrates

Food in the esophagus moves via:

Is this voluntary or involuntary:

peristalsis
involuntary

G Cells:

produces gastrin

Chief Cells:

produce pepsinogen and gastric lipase

Parietal Cells:

produce HCL (hydrochloric acid) and intrinsic factor

Mucous Cells:

produce mucus

In the small intestine what helps create a large surface area for absorption?

Villi

The enzymes that metabolize the food in the small intestine are located in the:

brush border

Are the Brunner’s Glands alkaline or acidic? What is their purpose?

Alkaline
they help coat and protect the small intense from the acid of the stomach

What is the purpose of the Goblet Cells in the stomach?

Produce mucus for a second layer of protection to small intestine

What ensures FORWARD flow of stomach contents?

Ileocecal valve (prevents backflow)

Does the large intestine have villi?

What two things are absorbed in large intestines?

Water and electrolytes

Where is the skeletal muscle in the GI tract located? (PEMA)

mouth
proximal
esophagus
anus

The autonomic nervous system has a sympathetic and parasympathetic component. In the GI tract know what nervous system plays what role

Sympathetic does:

inhibits gastric secretions
helps with motor activity

Parasympathetic does:

helps with digestion, repair
relaxation via the cranial, vagus nerves

When the body needs to improve digestion will it contract or relax the muscles in the GI tract?

Relax the muscles to allow improve movement

What enzyme is found in the small intestine?

What produced this enzyme?

Pancreatic amylase
pancreas

Where are amino acids broken down?

Stomach
intestines

Carbohydrates are absorbed back as:

Proteins are absorbed as:

monosaccharides
amino acids

If a patient is absorbing a lot of water and becoming overloaded, they will likely also have high levels of ______.

sodium

Dysphagia:

difficulty swallowing food due to neuromuscular incoordination, altered peristalsis esophagus or LES (lower esophageal sphincter) dysfunction.

Reverse peristalsis can eventually lead to:

Mallory-Weiss syndrome, GERD

This is interesting… intestinal gas comes from:

swallowed air
bacterial fermentation releasing gas
lack of mobility

What is the definition of stomatitis?

inflammation of the mouth and lips from (trauma, alcohol, smoking, drugs, radiation, chemo, herpes etc)

Mallory-Weiss syndrome commonly occurs in:

alcoholics

GERD symptoms are often mistaken for the symptoms of:

heart attack

Gastritis:

inflammation of the lining of the stomach

(from alcohol, aspirin, toxins)

Gastroenteritis:

inflammation of the lining of the intestines from bacteria, parasites from a virus (common: salmonella)

Ulcerative Colitis:

inflammation of the rectum and colon, turning to abscesses and ulceration, can progress to cancer

What is the most common abdominal emergency surgery a result of?

appendicitis

How does peptic ulcer disease occur? What becomes damaged?

Painful sores in the lining of the stomach, mucus that is supposed to protect the lining from the acid fails.
Strips mucus: aspirin, alcohol, bile from duodenum

Three examples of mechanical obstruction of GI tract motility include:

Adhesions
Tumors
Twisting
Ileus (from surgery or trauma/external cause)

When the mucus lining in the GI tract is damaged this can lead to malabsorption of nutrient. This commonly occurs in patients with these diseases:

Crohn’s disease (inflammatory bowel disease (IBD) causes swelling of tissues in digestive tract)
Celiac disease (mucosa damages, pt develops intolerance to gluten)
Tropical sprue (bacteria picked up from tropical climates, reduce enzymes in mucus, leaving it unable to develop properly)

Why is malabsorption post surgery so common? Are we damaging the lining like in the case of the other 3 disorders?

Resections of specific parts of GI (stomach, large, small intestines), removing cilia, and all things that help you absorb, limiting space and capability of that organ to absorb once did.
No we are not damaging the lining
Solution- have patient eat smaller meals, to be better digested and properly absorbed

What is a good indication of being at risk for colon cancer?

When patient has other colonic related issues like Crohn’s, polyps, ulcerative colitis- more susceptible to develop cancer from chronic damage

Tumors are likely to grow where in Japanese patients?

Gastric

Chronic damage to the colon from Crohn’s, polyps and ulcerative colitis can lead to:

colon cancer

What are the three functions of bile?

Aids in lipid digestion
Bilirubin transport
Cholesterol transport

What is the primary function of the gallbladder?

Store bile

What stimulates the release of bile in the gallbladder?

cholecystokinin

What two functions does the pancreas have?

Exocrine function:

Endocrine function:

Exocrine function: enzymes help with digestion
Endocrine function: hormones to regulate blood glucose (insulin, glucagon)

What is the proper term for gallstones?

Cholelithiasis

Inflammation of the gallbladder is called:

Cholecystitis (pts have abdominal pain, problems digesting fatty foods)

Inflammation of the gallbladder is most common in:

Obese
Pregnant women

What is the term for abdominal pain resulting from a gallstone blocking the bile duct?

biliary colic

Are cholesterol gallstones typically soft or hard?

Soft, because they are made of cholesterol.

Two treatment options for gallstones:

Dissolve with bile salts
Lithotripsy not as effective

Best diagnostic test to visualize gallstones:

ultrasound

Two causes of acute pancreatitis:

Alcoholism (most common)
Biliary tract disease

For a patient with a severe case of acute pancreatitis it can lead to necrosis of the tissue. Lead to spread of bacterial infections Treatment options here is to ‘clean-up’:

Debridement (remove dead tissue)
Peritoneal lavage (remove any fluid/bacterial mess in area of infection)

What is our concern with a pseudocyst as a result of acute pancreatitis?

It could rupture and bacterial travels into other parts of GI tract

What does ERCP stand for?

Endoscopic retrograde cholangiopancreatography
It is not only used for diagnostic imaging but also to administer treatments.

Two findings that differentiate a patient having chronic pancreatitis versus acute include:

Calcification
Parenchyma will be damaged, fibrosis will occur from scarring

Many patients with chronic pancreatitis will also develop other diseases and symptoms:

Diabetes mellitus
Malabsorption
Weight loss (from malabsorption)
Vitamin Deficiencies (from malabsorption

What are tell-tale signs of chronic pancreatitis on x-ray?

Calcium, bone on x-ray, so in these patients you see calcifications will show up on abdominal x-ray

What is the purpose of a sphincterotomy?

What disease does it help treat?

Enlarge bile or pancreatic opening
Treat diabetes, pain, and inflammation

What covers and protects the liver?

Visceral Peritoneum

The liver can function at _______% capacity.

Hepatic disease often occurs secondary to:

CHF
Cancer
Alcoholism
infections

The liver has three hematologic/regulatory functions including:

can temporarily store blood
synthesize bilirubin
synthesizes blood clotting factors

The liver also has excretory functions that can help

excrete bile pigment
cholesterol
helps detox the body from drugs and other foreign substances

Jaundice is:

And occurs due to high levels of:

yellowing of the skin, whites of eyes and membranes

bilirubin

Damage to the liver causes patients to poorly absorb the following vitamins:

What supplies most of the blood to the liver? What is the disease process associated with it?

Portal vein- supplies blood to liver
Portal systemic encephalopathy: pts confused or vegetated/comatose from high ammonia levels

High ammonia levels as a result of liver disease can lead to: Portal systemic encephalopathy

These patients are often:

Vegetated
comatose

There are many types of Hepatitis but let’s focus on three and their routes of transmission:

Hepatitis A:
Hepatitis B:
Hepatitis C:

Hepatitis A: (HAV) found in feces of infected people
Hepatitis B: (HBV) spread through infected body fluids
Hepatitis C: (HCV) most serious type, spreads through blood

Which type of chronic hepatitis is the most progressive and destructive?

Chronic active- leads to cirrhosis

In alcohol related Liver Disease patients often have a ______ liver.

Fatty

Hemochromatosis is high __________ absorption.

Wilson’s Disease is high ___________ levels.

iron

copper

What over the counter drug is known to cause the most damage to the liver?

Tylenol

Is liver transplant a common treatment option for liver cancer patients?

Why is liver resection commonly practiced and an optimal treatment option?

Cuts off blood supply to the tumor

Role of hormones in the body. They help to:

Reproduce
Grow and develop
Maintain homeostasis
Produce energy for body via metabolism

What are three categories of hormones?

Amines (Thyroid, catecholamines)
Peptides (ANH (atrial natriuretic hormone) from atrium of heart, growth hormone, LH, FSH, insulin/glucagon, vasopressin/oxytocin)
Steroids (sex hormones, corticosterone, aldosterone, vitamin D)

Describe specificity versus affinity in relation to hormones:

Specificity:
Affinity:

Specificity: receptor matches the hormone
Affinity: the strength of the bon to the hormone is strong

Describe up regulation versus down regulation of cells:

Up regulation:
Down Regulation:

Up regulation: cell produces MORE receptors to pick up more hormone
Down Regulation: the cell reduces amount of receptors, reduce it’s specificity (remember the more receptors, the higher specificity- less receptors, lower the specificity)

What is an example of hormones that practice permissiveness?

Estrogen
Progesterone
Most effective together, the more estrogen, the more receptors a cell develops for progesterone

What is a gland responsible for the production and release of the most hormones?

Pituitary gland

What TWO hormones are produced by the hypothalamus?

Where are these hormones then stored?

Vasopressin (anti diuretic hormone)
Oxytocin (contractions during labor, milk excretion from breasts)
Posterior pituitary gland

Metabolism is the balance between __________ and __________.

anabolism

catabolism

Examples of anabolism (building of molecules, is constructive) include:

Rest
Healing
Growth
pregnancy

Examples of catabolism (breaking down of molecules, is destructive) include:

stress
disease
fever
starvation

The largest increase in basal metabolic rate occurs during:

pregnancy 20-28% due to stress and demand on body

Is it normal for BMR to reduce as you age?

Yes declines 2% per decade as you age

What is your body’s main energy source?

Carbs (metabolized into glucose, which is ‘basic’ and simple energy source)

What supplies 2/3 of all cell’s energy requirements?

Fats (all tissues use fat for energy (except brain cells), turn to adipose tissue when not metabolized)

How many amino acids are there in total?

How many are essential?

Why does skeletal muscle mass reduce as you age?

Reduction in capability of synthesizing proteins