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What are the 2 types of nausea and what causes them?
Central Nausea: Major trigger inside of the brain outside of the blood-brain-barrier (BBB) the CTZ zone is detected and senses things that are inside of our body that are not supposed to be, and will cause the body to want to eliminate that thing
Local Nausea: Other nausea is related to distention in the stomach
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What is the process of vomiting and what is it coordinated by?
Coordinated by the somatic nervous system
- 1) Diaphragm descends
- 2) Abdominal muscles contract
- 3) Gastric cardia open
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Vomiting Center (VC) vs. Chemoreceptor Trigger Zone (CTZ)
VC: located in the medulla; coordinate the respiratory, GI, and abdominal muscles; the common pathway that mediates comiting from all causes
CTZ: accessible to blood and cerebrospinal fluid (CSF); helps to induce vomiting
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What neurotransmitters are involved in the CTZ associated with N & W
- Dopamine,
- Opiate
- Serotonin
- Acetylcholine
- Histamine
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Signs associated with N & V that are serious and require more intervention
- Blood in vomitus
- Abdominal pain/distension
- Fever
- Severe headable
- Recent trauma
- Diabetes
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What is the function of CCK?
stimulates the gall bladder
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What is function of gastrin?
Stimulates secretion of gastric acid adn pepsinogen, increases GI blood flow
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What is function of Ghrelin?
Stimulates hunger
(may be useful in weight loss/obesity treatment by helping people to stop feeling hungry)
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What is the function of GLP-1?
Supresses glucagon, slows gastric emptying
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What is the function of GIP?
augments insulin release
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What is the function of secretin?
Stimulates the production of bicarbonate in the stomach
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What do parietal cells secrete?
HCL and intrinsic factor
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What is the function of intrinsic factor?
To absorb vitamin B12 in the GI tract and prevent anemia
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What do the chief cells secrete?
Gastrin
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What are the 3 types of parietal cell receptors?
Histamine
Gastrin
ACH
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Large volume vs. small volume diarrhea
Large volume: viral or bacterial infection; can cause K+ loss and acidosis
Small volume: frequent loss of small amounts of stool; characteristic of ulcerative colitis and Crohn's disease
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What is the total amount of fluid secreted from the GI tract in a day?
7,100 mL
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What is the best indicator of fluid status?
Body weight
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What are the major risk factors for geting constipation?
- Age
- Menopause
- Enlarged prostate
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What is GERD, what are the major symptoms, and what are the causes?
GERD= backflow of GI contents into the esophagus because of a weakened cardiac spincter
Symptoms= heartburn, regurgitation
Causes= high-fat diet, pregnancy, obesity, congenital defects
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What is gastritis, what causes it, and what do you use to treat it
Gastritis- the inflammation of the stomach that happens when anything disrupts the stomach's protective mucus lining
- Causes by:
- H. pylori (acute)
- Degeneration of the stomach wall, pernicious anemia (chronic)
You use flagle to treat acute gastritis
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What is a peptic ulcer, what is it caused by, and how is it diagnosed?
Peptic ulcer= erosion of the mucosal layer in the GI tract
Caused by H. pylori, decreased mucus production (from excessive use of NSAIDs/aspirin), increased acid production (caffiene, alchohol, and nicotine)
Diagnosed by gastroscopy, endoscopy, blood test, occult blood
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What are the symptoms of peptic ulcers?
Pain in stomach
Pain immediately after eating
Weight loss/gain
Hematemesis
Melana (blood in the stool)
Dyspepsia (heart burn)
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Signs of GI bleeding
hematemesis
hematochezia (blood in rectum)
melena
occult bleeding
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What is peritonitis, what causes it, and what are the symptoms/treatments?
Peritonitis= inflammation of the peritineum
Causes= perforation of the gut of orgon into perineal space
Symptoms: pain, n/v, rigid abdomen, tachycardia, fever, increased WBC
Treatment: antibiotics, shock prevention (fluids, dopamine, etc)
*high risk for septicimia and septic shock*
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Intestinal obstruction: causes, signs/symptoms, what will happen if left untreated
Causes= tumors, adhesions, volvulus (where bowel is tied in a knot), intussuception (bowel tunnels into another), severe constipation
Signs: pain, distention, n/v, anorexia, diarrhea, reduced/abscent BS, abdom tenderness, fever
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What is an ileus, what causes it, and what are the symptoms?
Ileus: paralysis of the bowel; usually happens post-op
Causes: abdom surgery, reduction of blood supply to abdomen, kidney/heart disease, medications
Symptoms: abdom cramping/distention, N/V, failure to pass gas/stool
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Crohn's disease vs. ulcerative colitis
Crohn's has patchy inflammation over all of the GI tract, diarrhea w/o blood, malabsorption, LRQ pain
Colitis: bloody diarrhea mixed with mucus, fever, weight loss, LLQ pain, n/v
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Gallbladder disease: symptoms
Symptoms= jaundice, visceral pain, clay colored stool, steatorrhea (fatty stool)
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Pancreatitis: symptoms, treatment
Symptoms= RUQ pain, vomiting, tender abdomen, high amylase/lipase
Treatment= supportive care only
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Portal hypertenion: definition, complications, symptoms
Portak hypertension: increase in portal vein pressure due to obstructed blood flow
Leads to development of collateral veins, substances that are normally filtered by the liver may bypass and circulate in the blood
manifestations: eopshageal varicies, hemorrhoids, enlarged veins, ascites
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