NURS 611 Pathophysiology Exam 4
Study online at https://quizlet.com/_fd0b8s
1. Crohn's disease: Inflammatory disorder that affects any part of the GI tract from
the mouth to the anus
R/F: Smoking, low fiber-high carbohydrate diet, medications such as NSAIDs, al-
tered intestinal microbiome.
P/P: Spreads with discontinuous TRANSMURAL involvement or "skip lesions" that
can involve any part of the GI tract from the mouth to the perianal area.
Skip lesions are distinguished by inflamed areas mixed with uninflamed areas,
noncaseating granulomas, fistulas, and deep penetrating ulcers.
Cardinal Sign: Diarrhea
S/S: Deficiencies in folic acid and vitamin d absorption
2. Appendicitis: Most common in children 10 to 11 years of age, up to 19
Most common surgical emergency in the abdomen
10 cases per 10,000 persons
RLQ pain, low-grade fever, nausea, rebound tenderness at McBurney's point.
P/P: Inflammation of the vermiform appendix, which is a projection from the apex of
the cecum, becomes hypoxic
3. Cirrhosis: Scar tissue replaces healthy hepatocyte tissue and is an irreversible
inflammatory, fibrotic liver disease. It distorts the architecture of the liver parenchy-
ma.
Prevalence 4.5 million
Mortality rate of 44,358 deaths yearly
R/F: Hepatitis C, alcohol-related liver disease, nonalcoholic fatty liver disease
(NAFLD), and hepatitis B is the most common cause of cirrhosis.
4. Colorectal Cancers:
5. Pancreatic Cancer: Fourth leading cause of cancer deaths in the U.S.
6. Celiac Disease: Know as celiac sprue or gluten-sensitive enteropathy, is an
autoimmune disease that damages small intestinal villous epithelium when gluten
(gliadin), the protein component of wheat derivatives, barley, or rye, is ingested.
, NURS 611 Pathophysiology Exam 4
Study online at https://quizlet.com/_fd0b8s
P/P: HLA-DQ2- or HLA-DQ8-induced CD4+ T-cell-mediated autoimmune injury to
genetically susceptible individuals' small intestinal epithelial cells.
7. Gluten Sensitivity: Patients will not have positive antibodies, nor will they exhibit
classic intestinal villous atrophy.
8. Portal hypertension: Thrombosis of the portal vein is the most common cause
of portal hypertension in children, and splenomegaly is the most common sign.
9. Primary lactose intolerance: P/P: The inability to digest milk sugar because of
a lack of the enzyme lactase results in osmotic diarrhea.
S/S: Abdominal pain, diarrhea, and flatulence
TX: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides
and polyols (FODMAPs) or probiotics
10. Intussusception: Telescoping of a proximal segment of the intestine into a distal
segment causes an obstruction. It occurs most commonly in the area of the ileocecal
junction.
11. GERD: Reflux of acid and pepsin or bile salts from the stomach into the esoph-
agus, causing esophagitis
Prevalence: 18% to 27% in North America.
R/F: Age, obesity, hiatal hernia, drugs (anticholinergics, nitrates, calcium channel
blockers, nicotine), asthma, chronic cough.
P/P: Change in 20 mmHG LES resting pressure prevents backflow related to
distention
D/T: Spontaneous relaxation of the LES may be triggered by gastric distention after
meals and trigger acid reflux. Acid reflux may be triggered by diet and lifestyle factors
such as food intake that causes delayed gastric emptying, acidic foods, and obesity.
Sliding hiatal hernia facilitates reflux.21 Vomiting, coughing, lifting, bending, and
pregnancy also increase abdominal pressure, contributing to the development of
reflux esophagitis.
S/S: Pyrosis (heartburn), acid regurgitation, dysphagia, chest pain, chronic cough,
asthma attacks, laryngitis, hoarseness, RUQ 1 hour of eating are less common.
R/F: Lying down after meals, ( IP pressure: coughing, vomiting, or straining at stool),
Edema, strictures, esophageal spasm, or decreased esophageal motility, Alcohol or
, NURS 611 Pathophysiology Exam 4
Study online at https://quizlet.com/_fd0b8s
Citrus, Acidic Foods
Eosinophilic esophagitis (EoE) is an idiopathic chronic allergic/immune disease
12. Hirschsprung disease: "Congenital Aganglionic Megacolon"
Caused by a malformation of the parasympathetic nervous system in a segment of
the colon needed for peristalsis, resulting in colon obstruction.
13. Volvulus: Twisting of the bowel on itself, intestinal malrotation, the small intes-
tine lacks a normal posterior attachment during fetal development, may partly or
completely occlude the GI tract and its blood vessels.
14. Lactose malabsorption: Small bowel's inability to absorb ingested lactose due
to lactase deficiency.
15. Lactase Deficiency: Lower than expected activity of lactase at the brush border
of the intestine.
16. Cow Milk Allergy: Diagnosed through hydrogen lactose breath test or an oral
lactose tolerance test
17. Diarrhea: It is defined as three or more watery or loose stools in 24 hours.
18. Acute Infectious Diarrhea: Associated with viral or bacterial gastroenteritis
from contaminated food or water.
Viruses include rotaviruses, noroviruses, and adenoviruses, COVID-19
C. difficile is often associated with previous antibiotic therapy.
E. Coli and Shiga Toxin causes HUS
19. Hemolytic uremic syndrome: Acute thrombotic microangiopathy is character-
ized by hemolytic anemia and thrombocytopenia and may cause acute renal failure.
Caused by E. Coli and Shiga Toxin diarrhea
Secretory Diarrhea
20. Osmotic Diarrhea: Draws fluid into the lumen by osmosis - more water is pulled
into the bowel.
Examples: synthetic absorbable sugars, sorbitol, dumping syndrome associated
with GASTRIC resection), lactulose, celiac disease and lactose intolerance
Large Volume
21. Intestinal Dysmotility: Reduces intestinal transit time with luminal fluid reten-
tion - Increased peristalsis
Study online at https://quizlet.com/_fd0b8s
1. Crohn's disease: Inflammatory disorder that affects any part of the GI tract from
the mouth to the anus
R/F: Smoking, low fiber-high carbohydrate diet, medications such as NSAIDs, al-
tered intestinal microbiome.
P/P: Spreads with discontinuous TRANSMURAL involvement or "skip lesions" that
can involve any part of the GI tract from the mouth to the perianal area.
Skip lesions are distinguished by inflamed areas mixed with uninflamed areas,
noncaseating granulomas, fistulas, and deep penetrating ulcers.
Cardinal Sign: Diarrhea
S/S: Deficiencies in folic acid and vitamin d absorption
2. Appendicitis: Most common in children 10 to 11 years of age, up to 19
Most common surgical emergency in the abdomen
10 cases per 10,000 persons
RLQ pain, low-grade fever, nausea, rebound tenderness at McBurney's point.
P/P: Inflammation of the vermiform appendix, which is a projection from the apex of
the cecum, becomes hypoxic
3. Cirrhosis: Scar tissue replaces healthy hepatocyte tissue and is an irreversible
inflammatory, fibrotic liver disease. It distorts the architecture of the liver parenchy-
ma.
Prevalence 4.5 million
Mortality rate of 44,358 deaths yearly
R/F: Hepatitis C, alcohol-related liver disease, nonalcoholic fatty liver disease
(NAFLD), and hepatitis B is the most common cause of cirrhosis.
4. Colorectal Cancers:
5. Pancreatic Cancer: Fourth leading cause of cancer deaths in the U.S.
6. Celiac Disease: Know as celiac sprue or gluten-sensitive enteropathy, is an
autoimmune disease that damages small intestinal villous epithelium when gluten
(gliadin), the protein component of wheat derivatives, barley, or rye, is ingested.
, NURS 611 Pathophysiology Exam 4
Study online at https://quizlet.com/_fd0b8s
P/P: HLA-DQ2- or HLA-DQ8-induced CD4+ T-cell-mediated autoimmune injury to
genetically susceptible individuals' small intestinal epithelial cells.
7. Gluten Sensitivity: Patients will not have positive antibodies, nor will they exhibit
classic intestinal villous atrophy.
8. Portal hypertension: Thrombosis of the portal vein is the most common cause
of portal hypertension in children, and splenomegaly is the most common sign.
9. Primary lactose intolerance: P/P: The inability to digest milk sugar because of
a lack of the enzyme lactase results in osmotic diarrhea.
S/S: Abdominal pain, diarrhea, and flatulence
TX: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides
and polyols (FODMAPs) or probiotics
10. Intussusception: Telescoping of a proximal segment of the intestine into a distal
segment causes an obstruction. It occurs most commonly in the area of the ileocecal
junction.
11. GERD: Reflux of acid and pepsin or bile salts from the stomach into the esoph-
agus, causing esophagitis
Prevalence: 18% to 27% in North America.
R/F: Age, obesity, hiatal hernia, drugs (anticholinergics, nitrates, calcium channel
blockers, nicotine), asthma, chronic cough.
P/P: Change in 20 mmHG LES resting pressure prevents backflow related to
distention
D/T: Spontaneous relaxation of the LES may be triggered by gastric distention after
meals and trigger acid reflux. Acid reflux may be triggered by diet and lifestyle factors
such as food intake that causes delayed gastric emptying, acidic foods, and obesity.
Sliding hiatal hernia facilitates reflux.21 Vomiting, coughing, lifting, bending, and
pregnancy also increase abdominal pressure, contributing to the development of
reflux esophagitis.
S/S: Pyrosis (heartburn), acid regurgitation, dysphagia, chest pain, chronic cough,
asthma attacks, laryngitis, hoarseness, RUQ 1 hour of eating are less common.
R/F: Lying down after meals, ( IP pressure: coughing, vomiting, or straining at stool),
Edema, strictures, esophageal spasm, or decreased esophageal motility, Alcohol or
, NURS 611 Pathophysiology Exam 4
Study online at https://quizlet.com/_fd0b8s
Citrus, Acidic Foods
Eosinophilic esophagitis (EoE) is an idiopathic chronic allergic/immune disease
12. Hirschsprung disease: "Congenital Aganglionic Megacolon"
Caused by a malformation of the parasympathetic nervous system in a segment of
the colon needed for peristalsis, resulting in colon obstruction.
13. Volvulus: Twisting of the bowel on itself, intestinal malrotation, the small intes-
tine lacks a normal posterior attachment during fetal development, may partly or
completely occlude the GI tract and its blood vessels.
14. Lactose malabsorption: Small bowel's inability to absorb ingested lactose due
to lactase deficiency.
15. Lactase Deficiency: Lower than expected activity of lactase at the brush border
of the intestine.
16. Cow Milk Allergy: Diagnosed through hydrogen lactose breath test or an oral
lactose tolerance test
17. Diarrhea: It is defined as three or more watery or loose stools in 24 hours.
18. Acute Infectious Diarrhea: Associated with viral or bacterial gastroenteritis
from contaminated food or water.
Viruses include rotaviruses, noroviruses, and adenoviruses, COVID-19
C. difficile is often associated with previous antibiotic therapy.
E. Coli and Shiga Toxin causes HUS
19. Hemolytic uremic syndrome: Acute thrombotic microangiopathy is character-
ized by hemolytic anemia and thrombocytopenia and may cause acute renal failure.
Caused by E. Coli and Shiga Toxin diarrhea
Secretory Diarrhea
20. Osmotic Diarrhea: Draws fluid into the lumen by osmosis - more water is pulled
into the bowel.
Examples: synthetic absorbable sugars, sorbitol, dumping syndrome associated
with GASTRIC resection), lactulose, celiac disease and lactose intolerance
Large Volume
21. Intestinal Dysmotility: Reduces intestinal transit time with luminal fluid reten-
tion - Increased peristalsis
