Alterations of Digestive Function

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Alterations of Digestive Function
2014-11-23 13:34:04
Digestive Function Gastrointestinal
Pharmacy Pathophysiology
Alterations of Digestive Function
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  1. A lack of desire to eat despite physiologic stimuli that would normally produce
  2. Associated with nausea, abdominal pain, diarrhea, psychological stress, cancer, heart
    disease and renal disease
  3. The forceful emptying of the stomach and intestinal contents through the mouth
  4. Area of the brain that detects stimulants such as toxins or certain neurtransmtters in the blood, and acts as a vomit-inducing center.
  5. What reflex can be triggered by the
    vestibular system (cranial nerve VIII)
  6. Syrup of ipecac or copper salts in the duodenum, severe pain, distention of the
    stomach, or duodenum, torsion or trauma affecting the ovaries, testes, bladder,
    uterus or kidney are all triggers of what reaction?
  7. What neurotransmitters and receptor are indicated in vomiting?
    dopamine, serotonin, opioid, acetylcholine and substance P receptors
  8. A subjective experience associated
    with a number of conditions including visceral pain, motion, opiates
  9. What are common symptoms of nausea?
    hypersalivation and tachycardia
  10. What is retching?
    Non productive vomiting
  11. Spontaneous vomiting that does not
    follow nausea or retching
    ˜Projectile vomiting
  12. What type of vomiting is due to direct stimulation of vomiting
    centers by neurologic lesions like increased intracranial pressure, tumors, or
    Projectile vomiting
  13. What are causes of infrequent defecation?
    • Muscle weakness or pain caused by
    • abdominal surgery
  14. What are causes of difficult (painful) defecation?
    • Lesions of the anus, inflamed
    • hemorrhoids, fissures, or fistulae make defecation painful
  15. What drugs are implicated in infrequent or difficult defecation?
    • excessive use of antacids, opiates,
    • anticholinergics
  16. What disease states or illnesses are associated with infrequent or difficult defecation?
    • Hypothyroidism, diabetic
    • neuropathy, multiple sclerosis, spinal cord trauma, cancer, cerebrovascular
    • disease, irritable bowel syndrome
  17. Establishing a routine, exercise, increased fluid and fiber intake, bulk
    supplements, stool softeners, laxatives are all treatment options for what indication?
    Infrequent or difficult defecation
  18. Lactose, magnesium sulfate, phosphate, sulfate, sorbitol are all examples of non-absorbable substances in which form of diarrhea?
    Osmotic diarrhea
  19. What are causes of malabsorption in osmotic diarrhea?
    • lactate deficiency, pancreatic enzymes or bile salt deficiency,
    • bacterial over growth
  20. †Introduction of full strength tube
    feeding and dumping syndrome are causes of which type of diarrhea?
    Osmotic diarrhea
  21. A non-absorbable
    substance draws water into the intestine causing whch type of diarrhea?
    Osmotic diarrhea
  22. Excessive mucosal secretion of chloride or bicarbonate rich fluid or
    inhibition of sodium absorption causes which type of diarrhea?
    Secretory diarrhea
  23. What are some causes of secretory diarrhea?
    bacterial enterotoxins, neoplasms
  24. Type of diarrhea caused by resection of the small intestine (decreased transit time)
    Motility diarrhea
  25. What are some causes of motility diarrhea?
    • diabetic neuropathy, resection of the small intestine, surgical bypass
    • or fistula formation between loops of the intestine
  26. Inflammation
    causes cramping, pain, urgency and frequency in which disease states related to diarrhea?
    • †Ulcerative colitis or Crohn
    • disease
  27. What are some treatments for diarrhea?
    antibiotics, diuretics, antihypertensives, laxatives
  28. What is the treatment for diarrhea?
    • •Restoration
    • of fluid and electolyte balance

    • •Correct
    • nutritional deficiencies in chronic conditions or malabsorption

    • •Medications
    • that solidify stools or decease frequency and water content
  29. What medications solidify stool or decease frequency and its water content?
    • †Natural bran, psyllium, loperamide
    • (opiate), diphenoxylate,and atropine
  30. What malabsorption syndrome is associated with fat in the stool?
  31. Dehydration, electrolyte imbalance,
    metabolic acidosis, weight loss, inflammatory bowel disease and malabsorption describe the clinical manifestation of which dysfunction?
  32. Abdominal pain caused by stretching and distention
  33. Abdominal pain caused by obstruction of blood flow (thrombosis or distention)
  34. Biochemical
    mediators of the inflammatory response stimulate nerve endings producing abdominal pain
    histamine, bradykinin, andserotonin
  35. Types of abdominal pain
    • Parietal peritoneum,Visceral, 
    • Referred
  36. Type of abdominal pain where a stimulus is acting on the organ
  37. Type of abdominal pain where pain is felt at a distance from the source
  38. Location of bleeding originating from esophagus, stomach, or duodenum
    Upper GI bleeding
  39. Location of bleeding originating from the jejunum, ileum, colon, or rectum
  40. Blood in vomit
  41. Bright
    red or burgundy blood from the rectum
  42. Dark,
    tarry stools
  43. Blood not
    present in macroscopic amounts due to slow, chronic blood loss
    Occult bleeding
  44. Difficulty
  45. What are some mechanical obstructions associated with dysphagia?
    tumors, strictures, diverticular herniations
  46. What are some functional obstructions associated with dysphagia?
    neuro or muscular disorders (cerebrovascular accidents, and parkinson's disease)
  47. †Type of dysphagia characterized by the denervation
    of smooth muscle in the esophagus and lower esophageal sphincter; also the failure
    of lower esophageal sphincter to relax
  48. Achalasia is caused by the autoimmune destruction of _____ and the atrophy of _____.
    myenteric ganglion; smooth muscle
  49. pain
    and discomfort while swallowing, retrosternal pain, regurgitation, unpleasant
    taste, vomiting, aspirations are clinical manifestations of which condition?
  50. What is the treatment for dysphagia?
    • eating slowly, eating small meals, drinking fluid with meals, sleeping
    • with the head elevated to prevent regurgitation and aspirations,
    • anticholinergics, mechanical dilation, surgery
  51. Condition characterized by the reflux of acid
    (and pepsin) from the stomach to the esophagus
    ˜Gastroesophageal reflux disease (GERD)
  52. If GERD causes inflammation of the esophagus, it is called
    reflux esophagitis
  53. A normal functioning lower esophageal sphincter maintains a zone of _____ to prevent chyme reflux.
    high pressure
  54. What conditions
    that increase abdominal pressure can contribute to GERD?
    • obesity and Helicobacter pylori infections
    • Delayed gastric emptying from gastric or duodenal ulcers
  55. Heartburn, regurgitation of chyme,
    and upper abdominal pain within 1 hour of eating; asthma or chronic cough are the clinical manifestations of which condition?
    ˜Gastroesophageal reflux disease (GERD)
  56. Esophagitis, hyperemia, increased
    capillary permeability, edema, tissue fragility, erosion, ulcerations,
    fibrosis, basal cell hyperplasia, precancerous lesions (Barrett esophagus),
    esophageal carcinoma are all attributed to which condition?
    ˜Gastroesophageal reflux disease (GERD)
  57. What is the treatment for ˜Gastroesophageal reflux disease (GERD)?
    • proton
    • pump inhibitors, histamine type 2 antagonists, antacids, treatment for H.
    • pylori, weight reduction, smoking cessation
  58. protrusion of stomach through the diaphragm, in to the thorax
    Hiatal hernia
  59. Type of hiatal hernia that represents 90% of all cases; which type (ie. type I, II, II)
    Sliding Hiatal Hernia; Type I
  60. What causes Sliding hiatal hernia?
    • Coughing, bending, tight clothing,
    • ascites, pregnancy accentuates the hernia
  61. Which form of hiatal hernia is characterized by GERD and esophagitis?
    Sliding hiatal hernia, Type I
  62. Sliding hiatal hernia is characterized by
    GERD and esophagitis
  63. Type of hiatal hernia described as "rolling"?
    Paraesophageal; Type II
  64. Which hiatal hernia is uncommon for presenting with GERD?
  65. What are some complications with paraeosphageal hiatal hernia?
    gastritis, ulcer formation, strangulation of tissue
  66. Reflux, peptic ulcer, cholecystitis, cholelithiasis, chronic pancreatitis, diverticulosis are all comorbidites (presented as secondary illnesses) to which condition?
    Hiatal Hernia
  67. Dysphagia,
    epigastric pain, heartburn, vomiting, regurgitation and substernal pain are clinical manisfestations to which condition?
    Hiatal Henria
  68. What is the treatment for hiatal hernia?
    eating small, frequent meals, don’t lie down after eating, weight control, treatment of reflux
  69. Blocking or narrowing of the
    opening between the stomach and the duodenum
    ˜Pyloric obstruction