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NRS 52 5 Exam #2 Digestion With
Solution
What is an intestinal obstruction? - ANSWER Any condition that prevents the flow of chyme through the intestinal lumen or failure of normal intestinal motility in the absence of an obstructing lesion.
What is a pyloric obstruction? - ANSWER the blocking or narrowing of the opening between the stomach and the duodenum
What is a succussion splash? - ANSWER Rolling or jarring sound of the abdomen produces this sound in a person with a pyloric obstruction.
Clinical manifestations of a pyloric obstruction? - ANSWER -epigastric pain & fullness
-nausea
-succussion splash
-vomiting: if prolonged, can cause dehydration and malnutrition
What is a pyloric stenosis? - ANSWER Intestinal disorder in children in which there is an obstruction of the pyloric sphincter caused by hypertrophy of the
sphincter muscle
Clinical manifestations of pyloric stenosis - ANSWER -projectile vomiting after feeding
-vomiting causes weight loss, fluid & electrolyte imbalances
-constipation
-malnutrition
dehydration
-small, firm, movable mass (approx. size of an olive) felt in RUQ in 70%-90% of infants w/ pyloric stenosis
What is the most common type of intestinal obstruction? - ANSWER Simple obstruction
What is a simple obstruction? - ANSWER Mechanical blockage of the lumen by a lesion, but blood flow is preserved.
*Fibrous adhesions
What is a functional obstruction? - ANSWER Failure of motility, especially after surgery.
ex: paralytic ileus
where are gastric ulcers usually located? - ANSWER in the antral region of the stomach (lower portion, before the pylorus)
Which anemia is related to gastrectomy? - ANSWER Pernicious anemia
-decrease of Vitamin B12 caused by lack of intrinsic factor after gastrectomy
Two types of post-gastrectomy syndromes - ANSWER Malabsorption syndrome
Dumping syndrome
What is Crohn's disease? - ANSWER A chronic inflammatory bowel disease that affects the lining of the digestive tract (anywhere from mouth to anus)
What is ulcerative colitis? - ANSWER A chronic inflammatory disease that causes ulceration of the colonic mucosa (only in sigmoid colon and rectum)
Which disease causes "skip" lesions? - ANSWER Crohn's disease
What is portal hypertension? - ANSWER abnormally high blood pressure in the portal venous system primarily caused by resistance to portal blood flow. Can cause fatal consequences such as varices, splenomegaly, and hepatopulmonary syndrome.
What is the most common clinical manifestation of portal hypertension? - ANSWER hematemesis (vomiting blood)
[from bleeding from esophageal varices]
What is hepatic encephalopathy? - ANSWER A complex neurologic syndrome characterized by:
- impaired cognitive function
- flapping tremor (asterixis)
- EEG changes
What are the most common causes of cirrhosis? - ANSWER Alcohol abuse and HCV
What is cirrhosis? - ANSWER irreversible inflammatory, fibrotic liver disease that disrupts liver function and structure
What is steatosis? - ANSWER alcoholic fatty liver
What is the sequence for the development of alcoholic liver disease? - ANSWER 1. alcoholic fatty liver (steatosis)
What is intussusception? - ANSWER telescoping or invagination of one portion of intestine into another
What are the clinical manifestations of intussusception? - ANSWER -abdominal pain
-infants: irritable (colicky) and flexes the knees
-vomiting occurs soon after pain begins
"sausage-shaped" mass in abdomen
-"currant jelly" stools which appear dark and gelatinous because of their blood and mucus content
What is intestinal malrotation? - ANSWER A condition in which normal rotation does not occur during embryonic development and the colon remains in the RUQ, where and abnormal membrane may obstruct duodenum (periduodunal band/Ladd bands)
What are the clinical manifestations of intestinal malrotation? - ANSWER -bile stained vomiting after feedings
-dehydration & electrolyte imbalance occur as a result of vomiting
What is volvulus? - ANSWER twisting of the bowel
What are clinical manifestations of volvulus? - ANSWER fever, pain, scanty stools, diarrhea, bloody stools, severe dehydration
Why is prolonged diarrhea dangerous in children? - ANSWER Children have lower fluid reserves than adults
What is the leading cause of severe diarrhea in infants and young children worldwide? - ANSWER Rotavirus
What are some different causes of liver disease in children (than what you would see in adults)? - ANSWER -Biliary atresia (congenital malformation of bile duct); no "bile exit"
-Wilson Disease (cannot excrete copper)
What can children experience in result of liver disease? - ANSWER -Growth failure
-Nutritional deficits
-Developmental delays
Precipitating factors of liver disease in both children and adults? - ANSWER Hepatitis A, B, or C
