Patho 2- Gi

Front 1

The primary functions of the GI tract is to?

Back 1

provide the body a supply of...
-water
-nutrients
-electrolytes

Front 2

The digestive tract is made up of the?

Back 2

-mouth
-esophagus
-stomach
-small intestine
-large intestine

Front 3

The digestive tract is necessary for the ______, _____ and _____ of food.

Back 3

passage, storage and digestion of food

Front 4

What are the 4 accessory organs to the digestive tract?

Back 4

-salivary glands
-liver
-gallbladder
-pancreas

Front 5

The bulbar muscle disorders put someone at risk for _____. The signs and symptoms are, dysphonia, dysarthia, dysphasia, dyspagia and difficulty chewing.

Back 5

risk for aspiration

Front 6

The upper 1/3 of the esophagus is striated muscle controlled by the ____ and ____ nerves.

Back 6

vagus and glossopharyngeal nerves

Front 7

the lower 2/3 of the esophagus is made of smooth muscle strongly controlled by the _____ nerve and ____ nervous system.

Back 7

vagus nerve and enteric nervous system

Front 8

What controls air and gastric contents from entering the esophagus?

Back 8

upper and lower esophageal sphincters

Front 9

____ is a functional structure comprised of smooth muscle of the esophagus and skeletal muscle of the crural diaphragm

Back 9

lower esophageal sphincter (LES)

Front 10

The biggest risk in the upper GI system is that it is ________ and easily _______.

Back 10

thin walled and easily perforated
-if this occurs it is urgent not emergent, wake pt up and talk about it.

Front 11

____ is a classic symptom of esophageal disorders.

Back 11

dysphagia (difficulty swallowing)
-diagnostic test: barium contrast study or esophagoscopy

Front 12

Zenker's diverticulum is characterized by _____ diverticula. (herniation of cricopharyngeus muscle)

Back 12

esophageal
*out pouching of esophagus (captures things=risk for aspiration)

Front 13

Zenker's diverticulum appears in the weakened posterior ________ wall (killian's triangle). As it gets larger, it can lead to the compression of the esophagus and cause _____ or complete obstruction.

Back 13

-hypopharangeal
-dysphagia

Front 14

What are the signs and symptoms of Zenker's Diverticulum?

Back 14

-dysphagia
-aspiration
-coughing after eating
-halitosis
-feeling of food stuck in throat

Front 15

What is the treatment for Zenker's diverticulum?

Back 15

open or endoscopic surgical repair

Front 16

The lower esophageal sphincter failing to relax during swallowing is known as? This results from the failure of distal esophageal inhibitory neurons.

Back 16

achalasia

Front 17

what are the signs and symptoms of achalasia?

Back 17

-regurgitation
-halitosis
-substernal pain

Front 18

What is the treatment for achalasia?

Back 18

endoscopic dilation of LES and antispasmodic drugs

Front 19

Barrett's Esophagus is the changle in normal lining of the esophagus with intestinal type ____ cells. This is a ______ conditions associated with _____.

Back 19

-goblet cells
-precancerous
-GERD

Front 20

What is the treatment for Barrett's Esophagus?

Back 20

-PPI
-ablation
-surgery
-diet modification

Front 21

Esophageal varices put a pt at risk for iatrogentic and/or spontaneous _____ and they should be treated like a _____ _____.

Back 21

bleeding
full stomach

Front 22

Radiation treatment decreasing tissue compliance, tissue friability, PEG placement and esophagectomy (major surgery) are all characteristics of?

Back 22

esophageal cancer

Front 23

____ is a pediatric congenital defect.

Back 23

atresia

Front 24

Mallory-Weiss syndrome is a tear of the GE junction secondary to _____ and ____.

Back 24

retching and coughing

Front 25

What are the anesthetic considerations for all esophageal diseases?

Back 25

-aspiration prophylaxis
-RSI with cricoid pressure
-awake extubation
-regional anesthesia

Front 26

What is GERD?

Back 26

leakage of stomach contents into the esophagus due to weakened LES tone

Front 27

What are the risk factors for GERD?

Back 27

-hiatal hernia
-pregnancy
-obesity
-diabetes
-alcoholism
-scleroderma
-Zollinger-Ellison syndrome

Front 28

What is the treatment for GERD?

Back 28

-Antacids
-PPI
-H2 Blockers
-vagotomy
-gastric resection

Front 29

A tear in the gastro-esoophagus caused by vomiting, retching or vigorous coughing is known as?

Back 29

Mallory-Weiss Syndrome

Front 30

How do Mallory-Weiss pts typically present and is surgery usually needed?

Back 30

-present with upper GI bleeding
-surgery is rarely needed because the bleeding usually stops spontaneously

Front 31

If a Mallory-Weiss pt has continued bleeding, they usually respond to _____ therapy or _____ _____.

Back 31

-vasopressin therapy
-angiographic embolization

Front 32

Diffue esophageal spasm is seen most often in the _____. And is typically due to ____ dysfunction

Back 32

_elderly
-ANS

Front 33

The pain of diffuse esophageal spasm mimics _____ _____ and may respond to _____.

Back 33

-angina pectoris
-nitroglycerin

Front 34

_____ and _____ (decreasae lower esophageal sphincter pressure) may also relieve the pain of a spasm.

Back 34

nifedipine and isorbide

Front 35

The ____ is the storage pouch for food and is divided into three parts; _____, _____ and _____.

Back 35

-stomach
-fundus, body and antrum

Front 36

_____ of the stomach initiates gastric phase digestion.

Back 36

distension

Front 37

stimulation of the ____ nerve and ________ initiates production of hormones, mucous, enzymes and stomach acid to break down food.

Back 37

vagus nerve and gastric enteric nervous system

Front 38

Don't be confused, there is an area called the ____ of the stomach.

Back 38

cardia

Front 39

The main defect leading to esophagitis in GERD is a decrease in the resting tone of the ___.

Back 39

LES

Front 40

________ drugs decrease the LES tone and increase the risk of silent regurgitation.

Back 40

anticholinergic drugs (atropine and glycopyrrolate)

Front 41

What three drugs increase LES tone?

Back 41

-succs
-reglan
-neostigmine

Front 42

Which prophylactic agents decrease gastric acid secretion and increase gastric pH?

Back 42

-cimetidine (tagament)
-ranitidine (zantac)

Front 43

_____ is a nonparticulate antacid that increases gastric pH.

Back 43

sodium citrate (bicitra)
*lasts about 30 mins

Front 44

Bicitra should be given along with IV ______ primarily to pts with high risk for aspiration (diabetics, morbidly obese, pregnant)

Back 44

metocolpramide (reglan)

Front 45

_____ pressure in ____ is used to minimize the risk of silent aspiration in GERD.

Back 45

cricoid pressure in RSI

Front 46

What is a hiatal hernia?

Back 46

herniation of part of the stomach into the thoracic cavity

Front 47

A hiatal hernia predisposes the development of _____ _____.

Back 47

gastric esophagitis.

Hint 47

Hourglass stmach

Front 48

With a sliding hiatal hernia, you will develop esophagitis because the hernia is connected to the esophagus. However, with a paraesophageal hernia, the hernia creates a separate pouching and there will be no ____.

Back 48

esophagitis

Front 49

The typical symptom of peptic ulcer dieases (PUD) is burning epigastric pain exacerbated by ____ and improved with _____.

Back 49

-exacerbated by fasting
-improved with meals

Front 50

PUD is caused by increased _____ production, bacterial infection _______, or ingestion of irritant substances.

Back 50

-acid
-H. pylori

Front 51

There are 15,000 deaths per year due to complications of PUD which include?

Back 51

-bleeding*
-peritonitis
-sepsis
-dehydration
-perforation*
-gastric outlet obstruction*

Front 52

Zollinger-Ellison syndrome is most common between ages 30-50 and it is a gastric _____ with an ____ production of gastrin hormone.

Back 52

tumor with an increased production
*tumor usually in the pancreas or small intestine

Front 53

Zollinger-Ellison syndrome is characterized by increased gastric acid production that leads to _____, erosive _____ and _____.

Back 53

PUD, erosive esophagitis and diarrhea

Front 54

_____ is seen in 50% of Zollinger-Ellison pts.

Back 54

GERD
*90% report abdominal pain and peptic ulcerations

Front 55

Zollinger-Ellison syndrome is part of a condition called ____?

Back 55

Multiple endocrine neoplasia type I (MEN I)
*inherited disorder that endocrine glands are overactive or form a tumor. most commonly involves pancreas, parathyroid and pituitary.

Front 56

What are the anesthesia considerations for Zollinger-Ellison Syndrome?

Back 56

-large amount of gastric volume
-electrolyte imbalances-hypokalemia
-metabolic alkalosis

Front 57

What are the general treatments for gastric diseases?

Back 57

1. medication
-H2 blockers, PPI, carafate, H. Pylori treatment
2. Surgery
-vagotomy, gastrectomy, tumor removal
3. lifestyle modification
-discontine ETOH, stress management, diet changes

Front 58

What is the most common syndromes after a gastrectomy?

Back 58

-dumping: rapid dumping of food into the small intestine, no treatment, need diet adj.
-Alkaline reflux gastritis: cause mucosal injurt due to bile content in pts with disrupted pylorus sphincter. may need surgery for the diversion of the intestine.

Front 59

What are the three parts of the small intestine?

Back 59

-duodenum
-jejunum
-ileum

Front 60

The _______ is regulated by local enteric reflexes initiated by tactile or irritative stimuli from chyme in the intestines.

Back 60

intestinal phase

Front 61

The _____ secretes alkaline mucous, bicarb ions, hormones and enzymes protect mucosa.

Back 61

small intestines

Front 62

the _____ is the primary site of gastrointestinal absorption.

Back 62

small intestines

Front 63

What are the three parts of the large intestine?

Back 63

-ascending
-transverse
-descending

Front 64

What does the proximal large intestine absorb?

Back 64

-electrolytes
-water

Front 65

The distal large intestine stores ?

Back 65

fecal matter

Front 66

In the large intestine, mucous secretion protects _____ and colonic bacteria produces vitamins _____ and ___.

Back 66

-mucosa
-vitamins K and B12

Front 67

Name Two types of Inflammatory bowel disease and their location

Back 67

Ulcerative Colitis – lower colon
Crohn’s Disease – entire GI tract

Front 68

S/S of Intestinal Dz (5)

Back 68

Diarrhea, rectal bleeding, tenesmus, mucous stools, cramping

Front 69

Medical Tx for Intestinal Dz (3)

Back 69

antibiotics, steroids, immunosuppressant

Front 70

Surgical Tx may be indicated when ___ (5) is/are present

Back 70

strictures, fissures, obstruction, abscess, cancer

Front 71

Anesthesia for Intestinal Dz: Alfenta ___mg & Propofol ___ amt; Pt is very senstitive to ___

Back 71

1mg; large amt; pain

Front 72

Irritable Bowel Syndrome Patients complain of generalized bowel discomfort usually confined to the ___

Back 72

left lower quadrant (descending portion of colon)

Front 73

IBS: pt's have associated vasomotor instability like ___ (sympathetic issues)

Back 73

tachycardia, fatigue hyperventilation, diaphoresis, and headaches

Front 74

Splenic flexure syndrome is ____ in the splenic flexure and can produce pain in the ___, radiating down the ___

Back 74

left shoulder, left arm

Front 75

IBS: anesthesia use ____ because its ___ acting

Back 75

Alfenta, short acting

Front 76

Inflammatory Bowel Dz is the ___ most common chronic inflammatory disorder after rheumatoid arthritis

Back 76

second

Front 77

Ulcerative Colitis affects the lining of the ___ and ___.
Cause is unknown
About 50% are limited to the rectum
40% beyond the sigmoid but not the whole colon
20% involves the entire colon

Back 77

large intestine & rectum

Front 78

S/S of Ulcerative Colitis ___.

Back 78

diarrhea, rectal bleeding, crampy abdominal pain, anorexia, nausea, vomiting, fever, and weight loss

Front 79

Catastrophic illness is seen in up to 15% of the UC patients. 1% may have a severe attack that leads to a massive hemorrhage. If bleeding is significant, a ___ is the treatment of choice.

Back 79

cholectomy

Front 80

Crohn's Dz presents as acute or chronic ___

Back 80

inflammation

Front 81

Complications of Crohn's Dz ___ & ___
A high spiking fever implies an ___

Back 81

Penetrating-fistula
Bowel obstructions
Intra-abdominal abscess

Front 82

Types of Crohn's Dz:
___is the most common site of inflammation in the terminal ileum

Back 82

Ileocolitis

Front 83

Ileocolitis's usuall presentation is a chronic hx of recurrent ___ and diarrhea

Back 83

Right lower quad pain

Front 84

Ulcer is ___ white tissue

Back 84

flattened

Front 85

Types of Crohn's Dz:
___ is an extensive inflammatory process associated with a loss of digestive and absorptive surfaces

Back 85

Jejunoileitis

Front 86

Jejunoileitis results in ___ and steatorrhea

Back 86

Malabsorption

Front 87

In Jejunoileitis, Nutritional deficiencies can be caused by poor and enteric losses of protein and other nutrients leading to hypoalbuminemia, ___, ___, and coagulopathy. Vertebral fractures are caused by vitamin D deficiency, hypocalcemia and prolonged glucocorticoid use.

Back 87

hypocalcemia, hypomagnesemia

Front 88

Crohn's Dz Type:
Colitis and Perianal Dz present with low/high grade fever, malaise, diarrhea, and abdominal pain

Back 88

Low

Front 89

Colonic disease may fistulize into the stomach or duodenum causing ___. It may cause malabsorption by limiting normal bacterial overgrowth.

Back 89

feculent vomiting

Front 90

Types of Crohn's Dz:
____ symptoms include: Nausea, vomiting, and epigastric pain. Patients usually have a H. pylori-negative gastritis.

Back 90

Gastroduodenal Crohn's Dz

Front 91

___ is the mainstay of treatment for mild to moderate disease. It delivers antibacterial and anti-inflammatory actions.

Back 91

Sulfasalazine

Front 92

___ agents to induce remission of UC and CD. Up to 30% of patients have allergic reaction. (headaches, anorexia, nausea)

Back 92

5 Acetylsalacylic acid agents to induce remission of UC and CD. Up to 30% of patients have allergic reaction. (headaches, anorexia, nausea)
-Hypersensitivity reactions include rash, fever, hepatitis, pancreatitis, impaired folate absorption, and worsening of the disease.

Front 93

A majority of patients with moderate to severe UC benefit from ___. ___ 40 to 60 mg/day

Back 93

glucocorticoids.
Prednisone 40 to 60 mg/day

Front 94

Surgical indications for ___ include massive hemorrhage, perforation, toxic megacolon, intractable disease and cancer.

Back 94

UC

Front 95

Surgical indications for ___ include strictures, hemorrhage, abscess, fistulas, intractable disease, and cancer.

Back 95

CD

Front 96

Pseudomembranous Enterocoitis is often associated with ___, ___, ___ & ___

Back 96

antibiotic therapy (mostly clindamycin and lincomycin) bowel obstruction, CHF, and intestinal ischemia. (wiping out normal flora)

Front 97

S/s of Pseudomembranous Enterocoitis ___

Back 97

fever, watery diarrhea, dehydration, skeletal muscle weakness, intestinal ileus, and metabolic acidosis

Front 98

Carcinoid Tumors
70% originate in ___, ___, or the ___/___

Back 98

bronchus, jejuno-ileum, or the colon/rectum.
-Typically found incidentally during surgery for suspected appendicitis.
-Tumors can occur in almost any GI tissue (w/ cardiac effects)

Front 99

Carcinoid Tumors can secrete numerous ____.

Back 99

GI peptides including: Gastrin, insulin, somatostatin, motilin, neurotensin, tachykinins, glucagon, gastrin releasing peptide, serotonin, growth hormone, calcatonin, pancreatic peptide, and prostaglandins.

Front 100

Carcinoid Syndrome occurs in 20% of pts. The two most common symptoms are ___ & ___

Back 100

flusing and diarrhea

Front 101

In 90-100% of Carcinoid Syndrome pt's, ___ is overproduced a produces diarrhea by increasing gut motility

Back 101

Serotonin
-Serotonin receptor antagonist (5-HT3 antagonists) relieve symptoms in most cases

Front 102

S/s of Carcinoid crisis include ___. and if not treated, it can be fatal.
-The crisis may be provoked by ___, ___, or a ___

Back 102

intense flushing, diarrhea, abdominal pain, tachycardia, hypertension, or hypotension. If not treated, this can be fatal.
-by stress, chemotherapy, or a biopsy.
*Avoid histamine response

Front 103

Carcinoid Syndrome diagnosis relies on measurement of ___ or ___ ____

Back 103

urine or plasma serotonin

Front 104

False positive results are possible if eating ___rich foods-bananas, pineapples, walnuts, pecans, hickory nuts, cough syrup with guaifenesin, acetaminophen, salicilates or L-dopa.

Back 104

serotonin

Front 105

Carcinoid Syndrome management of Anesthesia: Administration of ___ prior to manipulation of the tumor will attenuate most hemodynamic responses.

Back 105

octreotide
-Use of epidural anesthesia is safe if treated with octreotide and careful hemodynamic monitoring is done. (sympathetic blockade from epidural or spinal may worsen hypotension

Front 106

Increased/Decreased serotonin associated with delayed emergence

Back 106

Increased

Front 107

Carcinoid Syndrome management of Anesthesia:
___, a serotonin antagonist, is a helpful antiemetic.

Back 107

ondansetron

Front 108

Drugs that may provoke a carcinoid crisis: ___

Back 108

succinlycholine, mivacurium, atracurium, epinephrine, norepinepherine, dopamine, thiopental

Front 109

Drugs that are considered safe in avoiding a carcinoid crisis: ___

Back 109

Propofol, etomidate, cisatracurium, rocuronium, fentanyl, all inhalational agent

Front 110

___ is an acute or chronic inflammation of the pancreas caused by duct blockage or excess alcohol intake

Back 110

Pancreatitis

Front 111

S/s of Pancreatitis ___

Back 111

fever & shock, *increased serum amylase level
-Excruciating, unrelenting mid-epigastric abdominal pain that radiates to the back is universally seen.
Sitting forward decreases the pain.
Nausea and vomiting occur at the peak of the pain.
Abdominal distention with ileus develops.
Dyspnea reflects pleural effusions or ascites.
Obtundation and psychosis reflect DTs related to ETOH withdrawal (72hrs). Development of tetany is due to hypocalcemia.

Front 112

Pancreatitis Tx; ___

Back 112

NPO, IV fluids, management of pain, nutritional, diabetes coverage, placement of surgical drain or stent
Endoscopic removal of gallstones within the first 24 to 72 hours from the onset of symptoms

Front 113

Most likely cause of Acute pancreatitis?

Back 113

pancreatic autodigestion
-Gallstones and ETOH abuse lead to up to 80% of cases.

Front 114

Pancreatitis is diagnosed based on (2)

Back 114

increased serum amylase level
Contrast enhanced CT

Front 115

Pancreatitis complications: (2)
Also, What 4 things can lead to a 50% mortality rate?

Back 115

Shock (develops early & frequent cause of death), & hypotension (Sequestration of large volumes of fluid in the peripancreatic space, hemorrhage and decreased SVR)
-Hypoxia, ARDS, renal failure and pancreatic infection can lead to a 50% rate of mortality

Front 116

____ & ___ are Impaired absorption of fat, iron, calcuim, bile salts, amino acids, and saccharides.

Back 116

malabsorption and maldigestion

Front 117

impaired fat absorption, ___, is most likely due to small bowel disease, liver, biliary tract disease, or pancreatic exocrine insufficiency.

Back 117

streatorrhea

Front 118

Hypoalbuminemia, fat-soluble vitamin deficiencies (A, D, E, K), hypocalcemia, and hypomagnesemia may be present in patients with __ and ___ disease

Back 118

liver & biliary tract

Front 119

Maldigestion occurs in ___-sensitivity enteropathy

Back 119

Gluten
-previously termed celiac Dz

Front 120

Gluten-Sensitivity Eneropahty is a dz of the ___ that produces streatorrhea. It leads to ___, ___, and ___

Back 120

small intestine that produces steatorrhea (malabsorption of fat). It leads to weight loss, abdominal pain, and fatigue

Front 121

Gluten-Sensitivity Eneropahty treatment involves ___ from the diet

Back 121

removal of gluten (wheat, rye, barley)

Front 122

Malabsorption is seen in significant small/large bowel resections?

Back 122

small
-TPN is needed if small, frequent feedings are not effective.

Front 123

___ syndrome is characterized by:
diarrhea, steatorrhea, trace element deficiencies, and electrolyte imbalances (hyponatremia, hypokalemia)

Back 123

Short bowel syndrome

Front 124

GI bleeding most commonly occurs from the upper/lower GI tract?

Back 124

upper (ulcer)

Front 125

Bleeding from the lower GI tract from ___ accounts for up to 20% of all cases of GI Bleeding and primarily affects elderly patients.

Back 125

diverticulosis

Front 126

Hypotension and tachycardia are seen if blood loss approaches ___% of the blood volume.

Back 126

25%

Front 127

Lower GI bleeding (colonic) usually occurs in elderly patients and typically presents as the passage of bright/dark red blood.

Back 127

bright

Front 128

-A ___ is done to exclude anorectal lesions.
-For persistant bleeding, angiography and embolic therapy may be attempted.
-Up to 15% of patients will require surgery.

Back 128

Sigmoidoscopy

Front 129

___ is inflammation of the appendix

Back 129

Appendicitis

Front 130

S/s of Appendicitis:

Back 130

RLQ pain, anorexia, nausea, vomiting, fever if perforation;
-mild abdominal pain, cramping poorly localized to the epigastric or periumbilical. As the inflammation spreads to the peritoneal surfaces pain becomes steady and severe aggravated by motion and coughing. Nausea and vomiting occur in up to 60% of cases.
WBC count of 10,000 to 18,000 is often seen.
WBC count of greater than 20,000 suggests a perforation.
In the elderly, pain and tenderness are often blunted (diagnosis delayed)
It occurs in 1 of 1000 pregnancies (the most common extrauterine condition requiring abdominal surgery)

Front 131

Tx for Appendicitis:

Back 131

emergent/urgent laparoscopic versus open appendectomy
Antibiotic therapy, hydration, RSI should be considered
-Treatment is early surgery. If there is a palpable mass 3 to 5 days after the onset of symptoms the patient is treated with antibiotics, rest, IV fluids until the mass size decreases (carcinoid). An appendectomy can be done 3 months later

Front 132

Appendicitis peak incidence is age __-___

Back 132

20-30

Front 133

Peritonitis is inflammation of the ___. It may be localized or diffuse, acute or chronic, infectious or aseptic.

Back 133

Peritoneum

Front 134

Acute/Chronic peritonitis is most often infectious and associated with a perforated viscous

Back 134

Acute
-Peritonitits: most common causes include: Bowel perforation, other organ leak, peritoneal disruption (peritoneal dialysis, foreign body-surgical sponge, instrument, powder for surgical gloves).

Front 135

S/s of Peritonitis:

Back 135

acute abdominal pain, tenderness and fever, absent bowel sounds, tachycardia, hypotension, and dehydration.
In elderly and immunosuppresed patients signs of peritoneal irritation may be more difficult to detect.

Front 136

Tx of Peritonitits:

Back 136

rehydration, correction of electrolytes, antibiotics and surgical correction of the underlying defect. (colloids & vasopressors support for open bowel sx)

Front 137

Acute Colonic Pseudo-Obstruction is a clinical syndrome characterized by massive dilatation of the ___ in the absence of mechanical obstruction. It relates to loss of effective peristalsis which produces gradual distention.

Back 137

colon

Front 138

Acute Colonic Pseudo-Obstruction develops in ill patients, hospitalized for other medical problems. If left untreated, massive colonic dilatation can lead to ___ of the colon with associated perforation.

Back 138

ischemia

Front 139

Abdominal Compartment Syndrome can be caused from Bowel Obstruction, Mesenteric Arterial Thrombosis, Ruptured AAA, Trauma, Ascites, Pregnancy, Tumors. S/s ___ (preload, CO, HR, lung compliance, renal/liver flows)

Back 139

↓ preload, ↓CO, reflex tachycardia
↓thoracic compliance, decreased lung volumes
↓hepatic and renal arterial flow

Front 140

Tx of Abdominal compartment syndrome ___

Back 140

Decompressive laparotomy

Front 141

Anesthesia for ACS: ____ stabilization, need for invasive monitoring

Back 141

hemodynamic
-Opening abdomen releases tamponade
-Reperfusion washes out anaerobic metabolites

Front 142

FYI: Other considerations for Intestinal Surgery: Dehydration from bowel prep
Gastric tube for stomach decompression
Fluid maintenance
Body temperature regulation

Back 142

Dehydration from bowel prep
Gastric tube for stomach decompression
Fluid maintenance
Body temperature regulation

Front 143

Carcinoid Syndrome:
Cardiac changes ___
Bronchoconstriction ___
hyperglycemia
Cutaneous flushing ___

Back 143

Cardiac changes (hypotension/hypertension, tachycardia)
Bronchoconstriction (serotonin, bradykinin, substance P)
Hyperglycemia
Cutaneous flushing (histamine, kinins)

Front 144

In ulcerative colitis

Back 144

Asa preparations sulfasalazibe