Essentials of Pathophysiology – Exam #2 Review Sheet
Covers Modules 4, 5, and 6 – Chapters 27, 28, 29, 31, 33, 34, 36, 37, 38, 40, 41
1. Review common signs and symptoms of gastrointestinal disorders as a
whole
Abdominal pain, nausea, vomiting, diarrhea, dysphagia, and constipation.
2. What is gastritis? What are causes?
Inflammation of the stomach lining
Causes: Precipitated by ingestion of irritating substances
Example: alcohol and aspirin, NSAIDs, viral, bacteria, autoimmune
3. What is GERD? What are causes to this condition? What are complications
of GERD if left untreated?
Gastroesophageal Reflux Disease- Backflow of gastric contents into esophagus through lower
esophageal sphincter (LES)
Inflammation caused by reflux of highly acidic material (esophagitis)
Causes
Any condition or agent that alters closure strength of LES or increases abdominal pressure, fatty
foods, caffeine, large amounts of alcohol, cigarette smoking, pregnancy, anatomic features (ex:
hiatal hernia)
Complications: Barrett esophagus- Structural changes in tissue of esophagus over time (columnar tissue
replaced normal squamos epithelial) can increase risk for esophageal cancer
Progression can lead to ulceration, fibrotic scarring
Esophageal strictures
Pulmonary symptoms - cough, asthma, and laryngitis - from reflux in breathing passages
4. Review signs and symptoms of peptic ulcer disease. What is the role of H.
pylori in this condition?
Caused by NSAIDs, stress (glucocorticoids), smoking, genetics
No relation b/w diet and PUD
H. pylori plays a key role in promoting both gastric and duodenal ulcer formation
, Thrives in acidic conditions
Slow rate of ulcer healing
High rate of recurrence
Clearance of H. pylori promotes ulcer healing
Signs and symptoms- epigastric burning that is usually relieved by the intake of food (especially
dairy products) or antacids.
Pain of gastric ulcers typically occurs on an empty stomach but may present soon after a
meal
Pain of duodenal ulcer classically occurs 2 to 3 hours after a meal and is relieved by
further food ingestion
Life threatening complication: GI bleed
Treatment: treat with antibiotic and then stomach acid with Sucralfate (Carafate)
5. What is pseudomembranous colitis? What contributes to this condition?
What are ways that it can be treated?
Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis).
Acute inflammation and necrosis of large intestine
Caused by overgrowth of Clostridium difficile c.diff (exposure to antibiotics)
Treatment= Stop current antibiotic (if possible)
Treat ischemia
Treat contributing conditions
Oral antibiotics - metronidazole (flagyl) or vancomycin
Recurrence common
Fecal transplant - transfer of fecal material from another healthy person to the source patient
via enema or gastric tube
Colectomy – removal of portion of colon
6. Review examples of inflammatory bowel conditions.
Ulcerative Colitis
Chronic inflammatory disease of the mucosa of the rectum and colon
Large ulcers form in mucosal layer of colon and rectum
Hallmark clinical manifestations are bloody diarrhea and lower abdominal pain
, Crohn’s Disease
Also called regional enteritis or granulomatous colitis
Affects proximal portion of the colon or terminal ileum
Chronic inflammation of all layers of intestinal wall resulting from blockage and inflammation of
lymphatic vessels
Intermittent bouts of fever, diarrhea (with or without blood), chronic RLQ pain, may have RLQ mass,
tenderness
7. Review signs and symptoms of appendicitis. How do we assess for this
condition?
Signs and symptoms- Periumbilical pain, RLQ pain “McBurney’s point”, nausea, vomiting, fever,
diarrhea, RLQ tenderness, systemic signs of inflammation
Mcburney- better with pressure exacerbated after – rebound tenderness
8. Review causes of bowel obstructions. Know the difference between functional obstruction versus
mechanical obstruction. Know examples of each type
Mechanical
Covers Modules 4, 5, and 6 – Chapters 27, 28, 29, 31, 33, 34, 36, 37, 38, 40, 41
1. Review common signs and symptoms of gastrointestinal disorders as a
whole
Abdominal pain, nausea, vomiting, diarrhea, dysphagia, and constipation.
2. What is gastritis? What are causes?
Inflammation of the stomach lining
Causes: Precipitated by ingestion of irritating substances
Example: alcohol and aspirin, NSAIDs, viral, bacteria, autoimmune
3. What is GERD? What are causes to this condition? What are complications
of GERD if left untreated?
Gastroesophageal Reflux Disease- Backflow of gastric contents into esophagus through lower
esophageal sphincter (LES)
Inflammation caused by reflux of highly acidic material (esophagitis)
Causes
Any condition or agent that alters closure strength of LES or increases abdominal pressure, fatty
foods, caffeine, large amounts of alcohol, cigarette smoking, pregnancy, anatomic features (ex:
hiatal hernia)
Complications: Barrett esophagus- Structural changes in tissue of esophagus over time (columnar tissue
replaced normal squamos epithelial) can increase risk for esophageal cancer
Progression can lead to ulceration, fibrotic scarring
Esophageal strictures
Pulmonary symptoms - cough, asthma, and laryngitis - from reflux in breathing passages
4. Review signs and symptoms of peptic ulcer disease. What is the role of H.
pylori in this condition?
Caused by NSAIDs, stress (glucocorticoids), smoking, genetics
No relation b/w diet and PUD
H. pylori plays a key role in promoting both gastric and duodenal ulcer formation
, Thrives in acidic conditions
Slow rate of ulcer healing
High rate of recurrence
Clearance of H. pylori promotes ulcer healing
Signs and symptoms- epigastric burning that is usually relieved by the intake of food (especially
dairy products) or antacids.
Pain of gastric ulcers typically occurs on an empty stomach but may present soon after a
meal
Pain of duodenal ulcer classically occurs 2 to 3 hours after a meal and is relieved by
further food ingestion
Life threatening complication: GI bleed
Treatment: treat with antibiotic and then stomach acid with Sucralfate (Carafate)
5. What is pseudomembranous colitis? What contributes to this condition?
What are ways that it can be treated?
Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis).
Acute inflammation and necrosis of large intestine
Caused by overgrowth of Clostridium difficile c.diff (exposure to antibiotics)
Treatment= Stop current antibiotic (if possible)
Treat ischemia
Treat contributing conditions
Oral antibiotics - metronidazole (flagyl) or vancomycin
Recurrence common
Fecal transplant - transfer of fecal material from another healthy person to the source patient
via enema or gastric tube
Colectomy – removal of portion of colon
6. Review examples of inflammatory bowel conditions.
Ulcerative Colitis
Chronic inflammatory disease of the mucosa of the rectum and colon
Large ulcers form in mucosal layer of colon and rectum
Hallmark clinical manifestations are bloody diarrhea and lower abdominal pain
, Crohn’s Disease
Also called regional enteritis or granulomatous colitis
Affects proximal portion of the colon or terminal ileum
Chronic inflammation of all layers of intestinal wall resulting from blockage and inflammation of
lymphatic vessels
Intermittent bouts of fever, diarrhea (with or without blood), chronic RLQ pain, may have RLQ mass,
tenderness
7. Review signs and symptoms of appendicitis. How do we assess for this
condition?
Signs and symptoms- Periumbilical pain, RLQ pain “McBurney’s point”, nausea, vomiting, fever,
diarrhea, RLQ tenderness, systemic signs of inflammation
Mcburney- better with pressure exacerbated after – rebound tenderness
8. Review causes of bowel obstructions. Know the difference between functional obstruction versus
mechanical obstruction. Know examples of each type
Mechanical
