NUR 2063 Pathophysiology Exam 4
1. What is gastritis?
Answer
Inflammation of the stomach lining. The lining will be red and inflamed and irritated
2. What are the causes of gastritis?
Answer
Ingestion of irritating substances such a alcohol, aspirin, NSAIDS, viruses and bacteria
3. What is GERD?
Answer
the back flow of gastric contents into the esophagus through the lower esophageal sphincter. The
inflammation occurs from the reflex of highly acidic stomach acid that comes up.
4. What are the causes of GERD?
Answer
Any condition or agent that alters closure of the lower esophageal sphincter or increases in
abdominal pressure, fatty food, caffeine, large amounts of alcohol, smoking, pregnancy and
anatomical features like hiatal hernia
5. What are complications of GERD?
Answer
Barrett's esophagus where columnar tissue replaces normal squamous tissue in the distal
esophagus that carries a high risk for cancer. Progression can lead to ulcers and scarring.
Esophageal strictures, pulmonary symptoms such as cough, asthma and laryngitis from reflux in
breathing passages.
6. What are the signs and symptoms of peptic ulcer disease?
Answer
epigastric burn- ing pain that is usually relieved by food or antacids (gastric ulcers present on
empty stomach but can be after food, duodenal ulcers present 2-3 hours after food and
is relieved by food). Can also be life threatening as GI bleeding can occur without warning and
cause a drop in H/H and dark tarry stools and hematemesis.
,7. What is the role of H.pylori in peptic ulcer disease?
Answer
promotes both gastric and duodenal ulcer formation and thrives in acidic areas. It slows down
ulcer healing and can reoccur frequently, and taking it away can help ulcers heal.
8. What is pseudomembranous colitis?(C.diff)
Answer
acute inflammation and necrosis of large intestine. The intestinal lining cannot absorb well.
9. What is the cause of pseudomembranous colitis?
Answer
clostridium difficile, expo- sure to long term antibiotics that off set the e.coli and c.diff balance
in intestine
10. What are the manifestations of pseudomembranous colitis?
Answer
foul smelling/bloody stool, abdominal pain, fever, leukocytosis, sepsis, colonic perfora- tion.
11. How do we treat pseudomembranous colitis?
Answer
stop current antibiotics, treat ischemia and contributing conditions, give oral antibiotics like
metronidazole or vancomycin, fecal transplant or colectomy if severe
12. How do we prevent the spread of pseudomembranous colitis?
Answer
wearing appropriate PPE and washing hands with soap and water only
13. What are the signs and symptoms of appendicitis?
Answer
Periumbilical pain, RLQ pain, presence of a positive McBurneys point with pain, nausea,
vomiting, fever, diarrhea, RLQ tenderness, systemic signs of infection
14. How do we assess for appendicitis?
,Answer
McBurney's point technique when pressing on the belly button and RLQ hip region and
removing the pressure causes intense pain, indicates positive appendicitis
15. What are the causes of bowel obstructions?
Answer
previous surgery of the in- testines with adhesions, congenital abnormalities of the bowel,
metastatic cancer of the intestinal tract or female reproductive organs, accumulation of fluid,
gas, water and electrolytes in the bowel.
16. What is a functional bowel obstruction?
Answer
a problem with the act of the bowel actually moving, such as things that inhibit movement from
surgery, medications, opioids, low fiber diets that can slow motility or shut off the GI system
from the SNS stimulation.
17. What is a mechanical bowel obstruction?
Answer
due to adhesions, hernia, tumors, impacted feces, volvus or twisting of the intestines,
intussusception
18. What are the signs and symptoms of liver disease?
Answer
hepatocellular failure (jaundice, decreased clotting, hypoalbuminemia, decreased vitamin D and
K) and portal hypertension (GI congestion due to blockage of blood, more esophageal or gastric
varies, hemorrhoids, enlarged spleen,)
19. Explain what jaundice is?
Answer
green- yellow staining of tissues from increased level of bilirubin as the liver cannot metabolize
extra bilirubin
20. Where can you find jaundice on assessment?
Answer
eyes, skin, and mouth
, 21. Explain what ascites is?
Answer
pathological accumulation of fluid in the peritoneal cavity due to the loss of albumin in the liver,
causing fluid to be free amongst the cells. It can cause a lot of pain in the abdomen, and it must be
drained with a parenthesis
22. Explain hepatic encephalopathy?
Answer
neuropsychiatric syndrome from too much ammonia in the blood as the liver cannot break it
down. results in dementia and psychotic symptoms common along with jerking
23. What is another name for end stage liver disease?
Answer
cirrhosis
24. What are the signs and symptoms of gallstones?
Answer
sudden pain in the RUQ/ center of the abdomen, back pain, and nauseas and vomiting.
25. Why do gallstones occur?
Answer
due to often a blockage of a duct from a cholesterol filled stone
26. What are the three stages of gallstone formation?
Answer
supersaturation, nucle- ation, hypo motility
27. Explain supersaturation phase
Answer
bile is saturated with cholesterol, causing precipitation of cholesterol
28. Explain nucleation phase
Answer
the bile crystals begin to stick together and become larger stones
