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142 Cards in this Set
- Front
- Back
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Where is emesis center located?
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Medulla
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Projectile vomiting is an indicator of what condition?
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Pyloric stenosis
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Distention or irritation in the digestive tract causes which subjective effect?
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Nausea
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Stimulated the vestibular apparatus of the inner ear would cause
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Vomitting
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Increased intracranial pressure would cause
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Vomitting
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What type of nerve innervation is involved in increased motility or peristalsis of the digestive system?
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Parasympathetic nervous system through the vagus nerve (cranial nerve X)
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Stimulated the vestibular apparatus of the inner ear would cause
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Vomitting
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Increased intracranial pressure would cause
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Vomitting
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Which cranial nerve innervates the digestive tract
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Vagus nerve
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What enzyme aids in digestion during mastication?
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Amylase
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Where does protein digestion occur?
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In the stomach (Chief cells secrete pepsinogen, which is converted to the active form, pepsin, by HCl (secreted by parietal cells))
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What enzyme stimulates the parietal and chief cells in response to food entering the stomach?
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Gastrin (secreted by G cells)
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In which quadrant is the liver located?
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URQ (upper right quadrant)
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What are the phagocyctic cells of the liver called?
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Kupffer cells
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Where are iron, B6, B12, folic acid, K stored?
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Liver
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Which organ responds to abnormal levels of blood glucose?
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Liver (hepatocytes convert glucose to glycogen to be stored in the liver in response to high levels of blood glucose; convert glycogen to glucose in response to low levels of blood glucose)
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In which organ does the synthesis and control of blood levels of plasma proteins take place?
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Liver
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Where does the clotting cascade take place?
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In the liver
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In which organ is aldosterone secreted? Where is it stored?
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Secreted by the adrenal cortex, stored in the liver
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Which cells produce bile?
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Hepatocytes of the liver
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What effect does bile and pancreatic secretions have on the pH of chyme entering the small intestine?
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Bicarbonate ions present in bile and pancreatic secretions help neutralize the pH of the chyme entering the duodenum
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Which organ secretes bile? Which organ stores bile?
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Liver secretes bile. Gallbladder stores bile.
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The common bile duct is the common pathway into the duodenum from which three organs?
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Liver (common hepatic duct), the gallbladder (cystic duct); and pancreas (pancreatic duct)
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Where does fat digestion occur?
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In the small intestine (bile salts from the liver and lipase from the pancreas aid in fat digestion)
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Where does carbohydrate digestion begin?
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In the mouth (amylase, present in saliva begins carbohydrate digestion. Carbohydrates are absorbed in the small intestine)
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What are the three sections of the small intestine?
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Duodenum, Jejunum, and Ileum
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Which section of the small intestine is the major site of absorption of nutrients?
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Ileum
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What feature of the small intestine increases surface area and absorption?
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Plicae circulares, or transverse folds of the mucosa, and microvilli
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Where does the absorption of large amounts of water and electrolytes take place?
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Large intestine
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Resident bacteria in the large intestine convert bilirubin to
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urobilinogen (gives feces the brown color)
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What do the microbiota in the gut synthesize?
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Vitamin K, folic acid
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Where is your appendix
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LRQ (connected to the cecum)
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When would your digestive tract undergo reverse peristalsis?
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While vomitting
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What would red blood in vomit indicate?
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Hemorrhage in the upper GI tract
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Why does hematemesis appear as "coffee grounds"?
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Comes from HCl action on hemoglobin
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If vomit has a very deep brown color where might it come from?
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Lower intestine
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Vomiting can cause metabolic (acidosis/ alkalosis)
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Alkalosis (due to loss of HCl from stomach)
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Severe vomiting could cause metabolic (acidosis/ alkalosis)
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Acidosis (severe vomiting would cause a loss of bicarbonate ion from the intestines, leading to acidosis)
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What type of diarrhea would infection cause?
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Large-volume diarrhea (secretory or osmotic)
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Diarrhea containing blood, mucus, and pus that is accompanied by cramps and tenesmus is
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Small-volume diarrhea
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What is tenesmus?
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straining during urination or bowel movements
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What is the word for "fatty diarrhea"
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Steatorrhea
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Steatorrhea is characteristic of which conditions?
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Celiac disease and cystic fibrosis
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What is frank blood?
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Red blood (usually from lesions right inside rectum or anal canal)
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What is occult blood?
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Microscopic blood in stool usually caused by bleeding ulcers
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What is melena?
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Dark-colored, tarry stool. May result from a significant bleed in the upper digestive tract
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Why does old blood appear dark? What else other than blood could cause very dark or black stool?
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Oxidation ; Ingested substances such as iron or kaopectate
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Occult blood is often a sign of
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Cancer
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What is eructation and what causes it>?
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Belching; Gas
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What is borborgmus and what causes it?
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Audible sounds from GI tract; Gas
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Failure to respond to defecation reflex could cause
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Constipation
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What drugs commonly cause constipation?
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Opiates, antacids, iron supplements
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Burning pain in the chest could be caused by:
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inflammation or ulceration in the upper digestive tract (heartburn)
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Dull, aching pain in the URQ is typical of
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stretching of the liver capsule, cause by swelling
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Cramping or diffuse pain
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inflammation, distention, or stretching of the intestines
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colicky, often severe pain is often due to
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recurrent smooth muscle spasms or contraction (a response to severe inflammation or obstruction)
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Rebound tenderness is characteristic of which type of pain (visceral / somatic / referred)
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Somatic
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What type of pain would you have with appendicitis?
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Rebound tenderness (somatic pain)
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What is an EGD?
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Esophagogastroduodenoscopy
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What type of diet does a person with celiac disease eat?
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Gluten-free
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An infant with cleft lip and cleft palate is at high risk of what type of feeding problem?
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Aspiration of fluid into the respiratory passages
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Who is mostly likely to get Candidiasis?
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People receiving broad-spectrum antibiotics, cancer patients during and after treatment, diabetics, AIDS patients and other immunocompromised patients
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Where does HSV-1 remain dormant?
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Sensory ganglion
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What is another name for a canker sore?
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Apthous ulcer
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Leukoplakia is an example of what condition? What does it cause? What habit might the patient have that worsens the condition? what could it lead to?
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Hyperkeratosis ; whitening or thickening of the oral mucosa ; smoking ; squamous cell carcinoma
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Kaposi sarcoma in the mouth is most common in
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AIDS patients
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Inflammation of the salivary glands
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Sialadenitis
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Esophageal cancer is most common in which part of the esophagus?
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Distal portion
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What puts a patient at risk for esophageal cancer?
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GERD; esophagitis (also, suicidal attempts or accidental consumption by children of acidic solutions can cause damage and dysplasia)
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What is Barrett's esophagus and what is it cause by?
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Dysplasia or metaplasia of the esophagial lining; caused by continuous reflux of acid from stomach
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What is achalasia?
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Failure of the lower esophageal spinchter (LES) to relax due to lack of innervation
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What is it called when part of the stomach protrudes into the thoracic cavity?
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Hiatal Hernia
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If you can hear peristaltic stomach sounds when listening to the lungs, what is wrong with the patient?
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Hiatal hernia (stomach has penetrated through the diaphragm)
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What is the most common kind of hernia? What should a patient with this hernia do while eating?
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Sliding hernia; sit up while eating
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What is the most dangerous kind of hernia? Why is it more dangerous?
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Rolling or paraesophageal hernia (fundus (left side of stomach that sticks up) gets stuck in diaphragm--> constricts blood flow --> ischemia ---> infarction --- > NECROSIS
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What symptoms will patients with hiatal hernia complain of?
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"feels like acid going up and down, up and down"; heartburn; belch a lot (gas caused by the movement); substernal pain that radiates to shoulder and jaw because innervated by same nerve as diaphragm
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GERD depends on the competence of...
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... LES (lower esophageal sphincter
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Peptic ulcers in the antrum of the stomach are called
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Gastric ulcers
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Ulcers in the proximal duodenum are called
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Duodenal ulcers
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What factors predispose a person to PUD?
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1) Damage to the mucosal barrier
2) Increased acid-pepsin secretions |
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What is gastroenteritis and how is it transmitted?
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Inflammation of the stomach and small intestine; transmitted through fecally-contaminated water
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What types of damage to the mucosal barrier lead to PUD?
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-H. pylori infection
-Inadequate blood supply (caused by vasoconstriction) -Excessive glucocorticoid secretion -Ulcerogenic substances that break down the mucus layer (aspirin, NSAIDS alcohol prednisone) -Atrophy of the gastric mucosa (by chronic gastritis) |
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What types of genetic anomalies predispose a person to PUD?
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For gastric ulcers:
- Increased gastrin secretion (which would lead to increased acid-pepsin secretion) - Increased vagal stimulation - Increased sensitivity to vagal stimulation - increased acid-pepsin secretion due to excessive alcohol or coffee intake - interference with normal feedback mechanisms For duodenal ulcers: - Rapid gastric emptying |
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What is the treatment for PUD?
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Antiibiotics (for H. pylori) and Proton pump inhibitors (to decrease acid secretion)
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What does it mean for an ulcer to perforate?
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It erodes completely through the wall
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What types of ulcers are common in the hospital?
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Stress ulcers
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Which types of patients are most likely to form stress ulcers?
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Those who have suffered trauma of systemic problems (examples include severely burned patients and hemorrhage or sepsis)
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What type of ulcers lead to gastric cancer? Where would these ulcers most likely be located?
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Gastric ulcers; in the antrum or pyloric region of the stomach
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What is key factor in developing gastric cancer that can be controlled?
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Diet (smoked foods, nitrites and nitrates (which are common in processed foods and anything with red coloring))
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What is gastric dumping? What does it usually follow?
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When control of gastric emptying is lost and contents are just "dumped" into the duodenum ; gastric ressection (usually when resection causes loss of pyloric sphincter)
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What are the immediate effects of dumping syndrome?
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Hypovolemia and abdominal cramps and/or N&V due to intestinal distention
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What happens 2-3 hrs after eating a meal in a person with dumping syndrome?
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Hypoglycemia (increased intestinal motility, due to sudden hyperglycemia and increased insulin production, causing rebound hypoglycemia once reserve nutrients are depleted)
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What should a person do to lessen the severity of dumping syndrome?
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Eat frequent, small meals with lots of water (to help decrease the hypertonicity and hyperosmolarity of the chyme)
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What is it called when a person has narrowing and obstruction of the pyloric sphincter? What does this cause?
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pyloric stenosis ; projectile vomitting
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What is a biliary calculi?
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Gallstone
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What is the formation of gallstones called?
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Cholelithiasis
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What is the inflammation of the gallbladder and cystic duct called?
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cholecystitis
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What is it called when the bile ducts are infected or inflammed?
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Cholangitis
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What is it called when the biliary ducts are destroyed by gallstones?
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Choledocholithiasis
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What does a gallstone consist of?
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Cholesterol and bile pigment (bilirubin)
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What might be wrong with someone how has subscapular pain?
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Gallstones or cholecystitis (due to referred pain)
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Who is most likely to develop gallbladder disorders?
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4 F's
- Fat - Forty - Female - Fertile |
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What are the three types of jaundice a person can have?
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1) Prehepatic jaundice (result of excessive destruction of rbcs)
2) Intrahepatic Jaundice (when there is disease or damage to hepatocytes) 3) Posthepatic Jaundice (when a block, by a tumor or cholelithiasis, in a biliary duct causes backflow of bile in to the gallbladder or duodenum) |
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How do you know what type of jaundice a person has?
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Type of jaundice is indicated by increases in serum bilirubin level and changes in the stools
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What do you call inflammation of the liver? What are the possible causes of this?
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Hepatitis; Virus, Alcohol, Drugs, Infection somewhere else in the body (mono or amebiasis) , Idiopathic
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What do you call the progressive destruction of the liver>
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Cirrhosis
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What are the major causes of cirrhosis?
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- Alcoholism
- Biliary cirrhosis (from gallstones for example) - Chronic hepatitis - Hemochromatosis (or other metabolic disorders) |
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What is hemochromatosis?
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When the body is unable to breakdown iron--> leads to increased iron storage in the liver --> cirrhosis
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Which stage(s) of alcholic liver disease are reversible?
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Only the inital "fatty liver" stage
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What precaution, as pharmacists, will we need to take when a person has Cirrhosis?
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drug dosages must be carefully monitored to avoid toxicity
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Why would a person with with cirrhosis develop ascites?
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decreased albumin levels and increased aldosterone and ADH will lead to edema
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What are the common characteristics in a patient with ESLD?
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-development of esophageal varices (extremely dilated veins)
- development of ascites |
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What is the most common kind liver cancer?
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Hepatocellular carcinoma
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What is the most common cause of acute pancreatitis?
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Alcoholism
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What happens when trypsin inhibitors fail and the proenzyme trypsinogen is prematurely converted to trypsin?
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Acute Pancreatitis (inflammation and autodigestion of the pancreas tissues)
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Why is acute pancreatitis considered a medical emergency?
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Because severe hypovolemia and circulatory collapse occurs(due to release of damaging products because pancreas does not have fibrous capsule, such as cytokines and PGs that lead to widespread inflammation of the peritoneal membranes)
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Chemical peritonitis leads to
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Bacterial peritonitis
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A defect in intestinal enzymes that prevent digestion of ________ is characteristic of celiac diease.
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Gliadin (the breakdown product of gluten)
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Celiac disease is considered a _____syndrome
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Malabsorption
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What are the two types of chronic inflammatory bowel disease?
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Crohn's disease and ulcerative colitis
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Skip lesions are characteristic of what GI disease?
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crohn's disease
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What part of the GI tract does Crohn's disease usally affect?
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small intestine
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The interference with digestion and absorption caused by Crohn's disease is most likely to cause
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Hypoproteinemia, avitaminosis, malnutrition, possibly steatorrhea
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What physical changes occur in the small intestine as a result of Crohn's disease>
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Adhesions and fistulas (happens when subserosa is inflamed)
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Among the two chronic inflammatory bowel diseases, which would cause more diarrhea?
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Ulcerative collitis
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Among the two chronic inflammatory bowel diseases, which would cause more pain?
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Crohn's disease
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Toxic megacolon is a serious complication of which GI disease? What can it lead to
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Ulcerative colitis; inflammation impairs peristalsis, leading to obstruction and dilation of the colon, usually in the tranverse colon
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what GI tract disease causes up to 12 stools per day?
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Ulcerative colitis
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What usually causes appendicitis? What type of exudate is formed? What type of peritonitis would this cause?
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Obstruction of the appendiceal lumen by a fecalith, gallstone or foreign material; Purulent; Bacterial peritonitis
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What might LRQ rebound tenderness and a "boardlike abdomen indicate?
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Appendicitis
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what is asymptomatic diverticular disease called?
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Diverticulosis
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What type of treatment is used for diverticulitis?
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Antimicrobial drugs (because inflammation usually also causes infection) and dietary modifications
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How do most colorectal malignancies develop?
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From adenomatous polyps
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Which type of chronic inflammatory bowel disease causes cancer?
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Ulcerative colitis (Crohn's disease does NOT cause cancer)
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What is volvulus?
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Twisting of the intestine
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What is Hirschsprung's disease?
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Congenital megacolon
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Paralytic ileus is a major caustive factor in what GI disorder?
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Intestinal obstruction
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Which infection causes chancres in the early stage and red macules or papules on the palate? What is the treatment?
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Syphilis ; long-acting penicillin
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Which type of cancer is most common in pipe smokers?
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Lip cancer
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Give an example of infectious parotitis
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Mumps
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In which patients is non-infectious parotitis most common?
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Older adults who lack adeqiate fluid intake and motuh care
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Chronic irritation caused by chronis esphagitis, achalasia, hiatal hernia, or alcohol abuse and smoking may lead to
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esophageal cancer
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