Disturbances in Digestion

Question 1

unpleasant sensation often localised to the abdomen that is typically interpreted as an urge to vomit.

Answer 1

NAUSEA

Question 2

forceful oral expulsion of gastric contents.

Answer 2

VOMITING

Question 2

Rythmatic synchronized contractions of the diaphragm, abdominal and intercostal muscles against a closed glottis causing the intra abdominal and decrease the intra thoracic pressure causing the gastric contents to go up through the esophagus

Answer 2

RETCHING

Question 3

Explain the process of vomiting

Question 4

Neurotransmitters involved in coordinating vomiting

Answer 4

How “SHAD”

1. Serotonin
2. Histamine
3. Acetylcholine
4. Dopamine

Question 4

What are the 3 phases of vomiting?

[What’s up “PRE”]

Answer 4

What’s up “PRE”

1. Pre-ejection
2. Retching
3. Expulsion

Question 5

prodromal nausea, salivation, and retrograde peristalsis to force intestinal contents into the stomach and lower oesophagus

Answer 5

PRE-EJECTION

Question 6

relaxation of oesophageal sphincters, pyloric contraction, violent contraction of diaphragm and abdominal muscles to expel gastric contents

Answer 6

EXPULSION

Question 6

closure of epiglottis and elevation of soft palate

Answer 6

RETCHING

Question 7

Red flags to suggest a serious cause of vomiting:

Answer 7

1. shock and volume depletion
2. severe abdominal pain
3. abnormal vomit – haematemesis,
4. coffee-ground appearance, bilious
   acute or focal neurological symptoms

Question 8

Common antiemetic drugs

[MOPDA]

Answer 8

1. Metoclopramide
2. Ondansetron
3. Promethazine
4. Domperidone
5. Aprepitant

Question 9

Transient inflammation of the gastric mucosa due to local irritants such as alcohol, aspirin, bacterial endotoxins

Answer 9

ACUTE GASTRITIS

Question 10

Most common cause of chronic gastritis

Answer 10

HELICOBACTER PYLORI

Question 10

can occur from hematologic disorders that decrease platelet levels or function such as dengue hemorrhagic fever & thrombocytopenia.

Answer 10

GI BLEEDING

Question 11

A type of bacteria that infects your stomach. It can cause sores and inflammation in the lining of your stomach or the upper part of your small intestine (the duodenum).

Answer 11

H. PYLORI

Question 12

Lower GI bleeding is most often caused by ______ & ______

Answer 12

Hemorrhoids & Colon polyps

Question 13

3 major causes of GI bleeding

Answer 13

1. Peptic Ulcer Disease (PUD)
2. Gastritis
3. Esophageal varices

Question 14

Symptoms of GI bleeding

Answer 14

1. Blood in vomit/stool
2. Black tarry stools (melena-LGIB)
3. Abdominal pain
4. Blood loss

Question 14

What is the best diagnostic test to rule out upper gastrointestinal bleeding?

Answer 14

ENDOSCOPY

Question 14

Lab test that shows if the rbc level, hgb, & hct are decreased (indicatives if the pt. is losing blood)

Answer 14

CBC

Question 15

What is the best diagnostic test to rule out lower gastrointestinal bleeding?

Answer 15

COLONOSCOPY

Question 16

S/sx of hemorrhagic shock

Answer 16

• Decreased BP
• Increased PR
• Weak & thready pulse
• Hypothermia

Question 17

shows if the rbc level, hgb, & hct are decreased (indicatives if the pt. is losing blood)

Answer 17

Partial thromboplastin time (PT) and Activated Partial Thromboplastin Time (APTT)

Question 18

What fluids do you administer if the patient is bleeding?

Answer 18

• Isotonic solutions (PNSS bolus or PLR)

Question 19

An ulceration in the mucosal wall of the stomach, pylorus, duodenum, or esophagus in portions accessible to gastric secretions

Answer 19

PEPTIC ULCER DISEASE (PUD)

Question 19

Areas where PUD can occur

Answer 19

1. Stomach mucosal wall 2. Pylorus 3. Duodenum 4. Esophagus

Question 20

What are the top 2 most common peptic ulcers?

Answer 20

1. Duodenal ulcers 2. Gastric ulcers

Question 21

Ulcer that occur commonly in the antrum, but also in the body/fundus

Answer 21

GASTRIC ULCER

Question 21

Ulcer that occur in the upper portion of the duodenum

Answer 21

DUODENAL ULCER

Question 22

Ulcer that occur as a result of the backward flow of HCl from the stomach into the esophagus.

Answer 22

ESOPHAGEAL ULCER

Question 23

Classification of ulcer that is short duration, superficial erosion, and minimal inflammation. It resolves quickly when the cause is identified and removed

Answer 23

ACUTE ULCER

Question 23

Classification of ulcer based on location

Answer 23

1. Gastric ulcer 2. Duodenal ulcer 3. Esophageal ulcer

Question 23

Classification of ulcer based on degree & duration of mucosal involvement

Answer 23

1. Acute ulcer 2. Chronic ulcer

Question 24

Classification of ulcer that is long duration, eroding through the muscular wall with the formation of fibrous tissue.

Answer 24

CHRONIC ULCER

Question 24

Medications to treat PUD

Answer 24

1. Antacids 2. PPI 3. H2-receptor antagonists 4. Cytotec

Question 25

Rare digestive disorder that results in too much gastric acid

Answer 25

ZOLLINGER-ELLISON SYNDROME

Question 25

Common causes of PUD

Answer 25

1. H. pylori infection 2. Chronic NSAIDs use 3. Zollinger-Ellison Syndrome 4. Lifestyle

Question 25

used for H. pylori infections by covering the site of the ulcer and keeps the stomach acid away.

Answer 25

BISMUTH SUBSALICYLATES "Pepto-Bismol"