HPA 1 Exam 3 - Upper GI Disorders/Dementia, Delirium

Dementia

Progressive irreversible decline in cognitive function that interferes with independence

Delirium

Acute fluctuating disturbance in attention and awareness that is often reversible

Dementia vs delirium

Dementia develops gradually while delirium develops suddenly and fluctuates throughout the day

Aphasia

Impaired ability to understand or express language

Agnosia

Inability to recognize familiar objects despite intact sensory function

Apraxia

Inability to perform learned purposeful movements despite normal muscle strength

Executive functioning

Ability to plan organize solve problems and make decisions

Alzheimer's disease

Most common form of dementia caused by beta amyloid plaques and neurofibrillary tangles

Beta amyloid plaques

Extracellular protein deposits associated with Alzheimer's disease

Neurofibrillary tangles

Intracellular accumulations of abnormal tau protein in Alzheimer's disease

Vascular dementia

Dementia caused by reduced cerebral blood flow often after strokes

Lewy body dementia

Dementia characterized by visual hallucinations fluctuating cognition and Parkinsonian symptoms

Frontotemporal dementia

Dementia causing early personality behavior and language changes due to degeneration of the frontal and temporal lobes

Mild cognitive impairment MCI

Measurable decline in cognition that does not significantly impair daily functioning

MoCA Montreal Cognitive Assessment

Screening tool that is sensitive for detecting mild cognitive impairment

MMSE Mini Mental State Examination

Cognitive screening tool used to evaluate dementia severity

PET scan

Imaging used to identify abnormal brain metabolism or amyloid deposition in dementia

CAM Confusion Assessment Method

Assessment tool used to identify delirium

Sundowning

Increased confusion agitation and behavioral changes occurring later in the day in dementia patients

Nonpharmacologic dementia management

Maintain routines reduce stimulation provide orientation cues and ensure safety

Dysphagia in dementia

Progressive swallowing difficulty that increases aspiration risk

Caregiver burden

Physical emotional and financial strain experienced by caregivers of dementia patients

Xerostomia

Dry mouth caused by decreased saliva production or medications

Dysphagia

Difficulty swallowing

Odynophagia

Pain with swallowing

Esophagitis

Inflammation of the esophagus commonly caused by reflux medications or infection

Pill induced esophagitis

Esophageal injury caused when medications remain lodged in the esophagus

Prevention of pill induced esophagitis

Take pills with plenty of water remain upright after swallowing and avoid taking medications immediately before bed

Hiatal hernia

Protrusion of part of the stomach through the diaphragm into the thoracic cavity

Sliding hiatal hernia

Most common hiatal hernia where the gastroesophageal junction moves above the diaphragm

Paraesophageal hiatal hernia

Hernia where part of the stomach herniates beside the esophagus increasing strangulation risk

GERD Gastroesophageal reflux disease

Chronic reflux of gastric contents causing esophageal irritation and damage

Lower esophageal sphincter LES dysfunction

Primary mechanism responsible for GERD

Pyrosis

Burning substernal chest discomfort commonly known as heartburn

Barrett esophagus

Replacement of normal squamous epithelium with columnar epithelium due to chronic GERD

Barrett esophagus significance

Precancerous condition that increases the risk of esophageal adenocarcinoma

GERD lifestyle modifications

Lose weight elevate the head of the bed avoid late meals avoid trigger foods and stop smoking

Proton pump inhibitors PPIs

Medications that irreversibly block gastric acid secretion by inhibiting the proton pump

Gastritis

Inflammation of the stomach lining that may be acute or chronic

Acute gastritis

Sudden inflammation of the gastric mucosa commonly caused by NSAIDs alcohol severe illness or infection

Chronic gastritis

Persistent inflammation commonly caused by Helicobacter pylori or autoimmune disease

Helicobacter pylori

Spiral shaped bacterium responsible for many cases of chronic gastritis and peptic ulcer disease

Peptic ulcer disease PUD

Breakdown of the gastric or duodenal mucosa caused by acid and pepsin

Gastric ulcer

Ulcer in the stomach that typically worsens with meals

Duodenal ulcer

Ulcer in the duodenum that often improves with meals then returns several hours later

NSAIDs and peptic ulcers

NSAIDs decrease prostaglandin production reducing protection of the gastric mucosa

Prostaglandins

Chemicals that protect the stomach by stimulating mucus bicarbonate and blood flow

Triple therapy for H pylori

Proton pump inhibitor plus two antibiotics used to eradicate Helicobacter pylori

Sucralfate

Medication that coats ulcers creating a protective barrier for healing

Upper GI endoscopy EGD

Procedure used to directly visualize the esophagus stomach and duodenum

Hematemesis

Vomiting blood caused by upper gastrointestinal bleeding

Melena

Black tarry stool caused by digested blood from an upper GI bleed

Fecal occult blood test FOBT

Test used to detect hidden blood in stool

Perforated ulcer

Full thickness ulcer causing leakage of gastric contents into the abdominal cavity leading to peritonitis

Hemorrhagic ulcer

Bleeding peptic ulcer that may cause hematemesis melena hypotension and shock

Peritonitis

Inflammation of the peritoneum caused by leakage of gastric contents after perforation

Intrinsic factor

Protein produced by parietal cells that is required for vitamin B12 absorption

Pernicious anemia

Vitamin B12 deficiency caused by autoimmune destruction of parietal cells and loss of intrinsic factor

Gastrin

Hormone that stimulates gastric acid secretion by parietal cells

Secretin

Hormone that stimulates pancreatic bicarbonate secretion to neutralize gastric acid

Cholecystokinin CCK

Hormone that stimulates pancreatic enzyme secretion and gallbladder contractio