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A lack of desire to eat despite physiologic stimuli that would normally produce
Associated with nausea, abdominal pain, diarrhea, psychological stress, cancer, heart
disease and renal disease
The forceful emptying of the stomach and intestinal contents through the mouth
Area of the brain that detects stimulants such as toxins or certain neurtransmtters in the blood, and acts as a vomit-inducing center.
What reflex can be triggered by the
vestibular system (cranial nerve VIII)
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?
What neurotransmitters and receptor are indicated in vomiting?
dopamine, serotonin, opioid, acetylcholine and substance P receptors
A subjective experience associated
with a number of conditions including visceral pain, motion, opiates
What are common symptoms of nausea?
hypersalivation and tachycardia
What is retching?
Non productive vomiting
Spontaneous vomiting that does not
follow nausea or retching
What type of vomiting is due to direct stimulation of vomiting
centers by neurologic lesions like increased intracranial pressure, tumors, or
What are causes of infrequent defecation?
- Muscle weakness or pain caused by
- abdominal surgery
What are causes of difficult (painful) defecation?
- Lesions of the anus, inflamed
- hemorrhoids, fissures, or fistulae make defecation painful
What drugs are implicated in infrequent or difficult defecation?
- excessive use of antacids, opiates,
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
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
Lactose, magnesium sulfate, phosphate, sulfate, sorbitol are all examples of non-absorbable substances in which form of diarrhea?
What are causes of malabsorption in osmotic diarrhea?
- lactate deficiency, pancreatic enzymes or bile salt deficiency,
- bacterial over growth
Introduction of full strength tube
feeding and dumping syndrome are causes of which type of diarrhea?
substance draws water into the intestine causing whch type of diarrhea?
Excessive mucosal secretion of chloride or bicarbonate rich fluid or
inhibition of sodium absorption causes which type of diarrhea?
What are some causes of secretory diarrhea?
bacterial enterotoxins, neoplasms
Type of diarrhea caused by resection of the small intestine (decreased transit time)
What are some causes of motility diarrhea?
- diabetic neuropathy, resection of the small intestine, surgical bypass
- or fistula formation between loops of the intestine
causes cramping, pain, urgency and frequency in which disease states related to diarrhea?
- Ulcerative colitis or Crohn
What are some treatments for diarrhea?
antibiotics, diuretics, antihypertensives, laxatives
What is the treatment for diarrhea?
- of fluid and electolyte balance
- nutritional deficiencies in chronic conditions or malabsorption
- that solidify stools or decease frequency and water content
What medications solidify stool or decease frequency and its water content?
- Natural bran, psyllium, loperamide
- (opiate), diphenoxylate,and atropine
What malabsorption syndrome is associated with fat in the stool?
Dehydration, electrolyte imbalance,
metabolic acidosis, weight loss, inflammatory bowel disease and malabsorption describe the clinical manifestation of which dysfunction?
Abdominal pain caused by stretching and distention
Abdominal pain caused by obstruction of blood flow (thrombosis or distention)
mediators of the inflammatory response stimulate nerve endings producing abdominal pain
histamine, bradykinin, andserotonin
Types of abdominal pain
- Parietal peritoneum,Visceral,
Type of abdominal pain where a stimulus is acting on the organ
Type of abdominal pain where pain is felt at a distance from the source
Location of bleeding originating from esophagus, stomach, or duodenum
Upper GI bleeding
Location of bleeding originating from the jejunum, ileum, colon, or rectum
Blood in vomit
red or burgundy blood from the rectum
present in macroscopic amounts due to slow, chronic blood loss
What are some mechanical obstructions associated with dysphagia?
tumors, strictures, diverticular herniations
What are some functional obstructions associated with dysphagia?
neuro or muscular disorders (cerebrovascular accidents, and parkinson's disease)
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
Achalasia is caused by the autoimmune destruction of _____ and the atrophy of _____.
myenteric ganglion; smooth muscle
and discomfort while swallowing, retrosternal pain, regurgitation, unpleasant
taste, vomiting, aspirations are clinical manifestations of which condition?
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
Condition characterized by the reflux of acid
(and pepsin) from the stomach to the esophagus
Gastroesophageal reflux disease (GERD)
If GERD causes inflammation of the esophagus, it is called
A normal functioning lower esophageal sphincter maintains a zone of _____ to prevent chyme reflux.
that increase abdominal pressure can contribute to GERD?
- obesity and Helicobacter pylori infections
- Delayed gastric emptying from gastric or duodenal ulcers
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)
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)
What is the treatment for Gastroesophageal reflux disease (GERD)?
- pump inhibitors, histamine type 2 antagonists, antacids, treatment for H.
- pylori, weight reduction, smoking cessation
protrusion of stomach through the diaphragm, in to the thorax
Type of hiatal hernia that represents 90% of all cases; which type (ie. type I, II, II)
Sliding Hiatal Hernia; Type I
What causes Sliding hiatal hernia?
- Coughing, bending, tight clothing,
- ascites, pregnancy accentuates the hernia
Which form of hiatal hernia is characterized by GERD and esophagitis?
Sliding hiatal hernia, Type I
Sliding hiatal hernia is characterized by
GERD and esophagitis
Type of hiatal hernia described as "rolling"?
Paraesophageal; Type II
Which hiatal hernia is uncommon for presenting with GERD?
What are some complications with paraeosphageal hiatal hernia?
gastritis, ulcer formation, strangulation of tissue
Reflux, peptic ulcer, cholecystitis, cholelithiasis, chronic pancreatitis, diverticulosis are all comorbidites (presented as secondary illnesses) to which condition?
epigastric pain, heartburn, vomiting, regurgitation and substernal pain are clinical manisfestations to which condition?
What is the treatment for hiatal hernia?
eating small, frequent meals, don’t lie down after eating, weight control, treatment of reflux
Blocking or narrowing of the
opening between the stomach and the duodenum