2) patho : digestive and GI

gastritis

inflammation of stomach

gastritis acute clinical manifestations

-anorexia
-rapid epigastric pain
-hematemesis
-hiccups
-melena/hematochezia
-nausea/vomiting
-possible sign of shock
(pt recovers in ab 1 day)

chronic gastritis clinical manifestations

-belching
-early satiety
-intolerance of spicy/fatty foods
-nausea/vomiting
-psoriasis
-sour taste in mouth
-vague epigastric discomfort relieved by eating
-anemia/fatigue

acute gastritis timing

rapid onset symptoms caused by dietary indiscretion
-pain right after eating
-can last several hours to days

chronic gastritis timing

prolonged inflammation due to benign/malignant ulcers of stomach or H. pylori
-sone pain can be relieved by eating

gastritis diet recommendations

-no caffeine, alc, spicy foods
-inc vitamin B12

acute gastritis risk factors

-age
-inc use of NSAIDs (aspirin)
-alc
-gastric radiation therapy
-acute illnesses (by major trauma)
-H. pylori

chronic gastritis risk factors

-H. pylori
-chemical gastric injury
-autoimmune disorders

gastritis patho

-disruption of mucosal barrier
-impaired mucosal barrier allows corrosive HCl, pepsin, and other agents to come into contact with gastric mucosa leading to inflammation

acute gastritis patho

-inflammation transient and self-limiting
-gastric mucosa edematous and hyperemic
-gastric mucosa undergo superficial erosion
(leads to superficial ulceration to hemorrhage)

chronic gastritis patho

chronic inflammatory changes and atrophy of gastric tissue

Crohn's disease

subacute and chronic inflammation of GI tract wall extends through all layers

Crohn's location of inflammation

ileum
ascending colon

early Crohn's patho

transmural thickening

late Crohn's patho

deep, penetrating granulomas

Crohn's clinical manifestations

-RLQ abdominal pain
-diarrhea unrelieved by defecation
-cramps
-abdomen tender and spasm
-fever
-leukocytosis

chronic Crohn's clinical manifestations

-diarrhea
-abdominal pain
-steatorrhea
-anorexia
-weight loss
-nutritional deficiencies

Crohn's lab work

-string sign on x-ray
-CT and MRI
-CBC for hematocrit and hemoglobin levels
-WBC, ESR, albumin, and protein

Crohn's hematocrit and hemoglobin levels

dec

Crohn's WBC levels

inc

Crohn's ESR levels

inc

Crohn's albumin and protein levels

dec

normal hemoglobin level

males: 14-17.4 g/dL
females: 12-16 g/dL

normal potassium level

3.5-5 mEq/L

Crohn's course

prolonged, variable

ulcerative colitis course

exacerbations, remissions

early ulcerative colitis patho

mucosal ulceration

late ulcerative colitis patho

minute, mucosal ulcerations

ulcerative colitis location

rectum
descending colon

ulcerative colitis clinical manifestations

-bleeding
-severe diarrhea