Patho-Pharm Exam 1 - GI Flashcards
(125 cards)
1
Q
What hormone stimulates parietal cell release of HCl?
A
Gastrin
2
Q
What part of the autonomic nervous system is involved in the cephalic phase of digestion?
A
The parasympathetic
3
Q
What phase of digestion is stimulated when you think about food?
A
Cephalic phase
4
Q
The presence of food in the stomach stimulates what hormone release?
A
Gastrin
5
Q
In what part of the stomach is gastrin released from?
A
The antrum of the stomach
6
Q
What happens to the chyme in the stomach when it mixes with gastrin?
A
Becomes very acidic
7
Q
What is the hormone that is released in the duodenum that stimulates the release of buffers?
A
Secretin
8
Q
What two organs does secretin stimulate>
A
Liver and pancreas
9
Q
What do the liver and pancreas release when stimulated by secretin?
A
Bicarb (HCO3) and water
10
Q
What is the end result of secretin excretion by the duodenum?
A
Buffers the acidic chyme
11
Q
What hormone is released in the duodenum that is involved in fat digestion?
A
Cholecystokinin
12
Q
What organ does cholecystokinin stimulate?
A
The gallbladder
13
Q
What does the gall bladder release upon stimulation with cholecystokinin?
A
Bile
14
Q
What is the trigger for the release of cholecystokinin?
A
Presence of fat in the small intestine
15
Q
What GI hormone is released when chyme moves into the small intestine?
A
Gastric inhibitory peptide
16
Q
Where is gastric inhibitory peptide released from?
A
Intestinal mucosa
17
Q
What does gastric inhibitory peptide cause?
A
Stomach shutdown, decrease in acid release and motility
18
Q
What hormone keeps the empty stomach moving?
A
Motilin
19
Q
Motilin is triggered when?
A
When stomach is empty or has food in it that can’t be digested
20
Q
What hormone is released upon the cephalic phase of digestion?
A
Gastrin
21
Q
What hormone stimulate liver and pancreas to release bicarb and water and where is it released from?
A
Secretin
22
Q
What hormone is triggered by fat and where is it released from?
A
Cholecystokinin, from the duodenum
23
Q
What hormone is secreted when chyme moves into the small intestine?
A
Gastric inhibitory peptide
24
Q
What hormone is triggered when the stomach is empty or when you’re sleeping?
A
Motilin
25
Cephalic, gastric and intestinal are three phases of what?
Gastric secretion
26
In what phase of gastric secretion does gastric secretion begin?
Cephalic
27
What type of input stimulates the cephalic phase of digestion?
Sensory input
28
What is the second phase of gastric secretion?
Gastric phase
29
In what phase of digestion does gastric secretion stop?
Intestinal phase
30
What are released in the exocrine function of the pancreas?
Digestive enzymes and bicarb
31
What does the pancreas release through the endocrine function?
Insulin
32
What digestive hormone is considered the "fireman"?
Secretin
33
What hormone cleans the gut for the next meal?
Motilin
34
What is the valve that allows food to move from the stomach to the small intestine?
Pyloric sphincter
35
What are the folds in the stomach that allow it to stretch?
Rugae
36
What parts of the digestive system absorb the following?
- Sugars, proteins
- Water, electrolytes
- Iron, calcium, fats, sugars, protein, electrolytes, vitamins, magnesium, sodium
- Water, alcohol
- Bile sales, B12, chloride
Jejunum - Sugars, proteins
Colon - Water, electrolytes
Duodenum - Iron, calcium, fats, sugars, protein, electrolytes, vitamins, magnesium, sodium
Stomach - Water, alcohol
Ilieum - Bile sales, B12, chloride
37
How long is the small intestine?
20 ft
38
What is the diameter of the small intestine?
1 inch
39
What is the pH of chyme when it arrives in the small intestine?
2.0
40
After the secretion of what hormone is the pH of chyme decreased to 6.3?
Secretin
41
How long is the large intestine?
5 feet
42
What part of the digestive system absorbs water from solid waste and eliminates wastes by evacuating bowels?
The large intestine
43
How much water does the large intestine absorb?
1.5 - 6 L
44
How many liters of fluid move through the intestines daily?
9 L
45
Of the 9 liters of water that moves through the intestines daily, how much is from intake?
2 L
46
What does PPN stand for?
Partial parenteral nutrition
47
Is PPN a short term or long term solution to intake?
Short term
48
What is PPN administered through?
A peripheral vein
49
What does TPN stand for?
Total parenteral nutrition
50
Through what is TPN administered?
Central line
51
Why is TPN nutrition caustic?
Because of the sugars
52
In what type of nutritional administration is there a high risk of infection and why?
TPN, the sugars
53
Is and NG tube short or long-term solution to nutritional adminstration?
Short
54
Radiographic placement confirmation is required of what feeding methods?
Nasojejunal and nasoduodenal
55
What is a delay or difficulty with defecation present for two or more weeks?
Constipation
56
What is the failure to completely evacuate the bowles called?
Constipation
57
What can the following cause?
Dehydration, lack of fiber, lack of exercise, obstruction, medicines, change in diet, certain foods, anesthesia
Constipation
58
What are non-pharmaceutical interventions to constipation?
Moving patient, fluids, fiber, massage, if on bedrest, reposition frequently
59
What type of constipation is associated with physical abnormalities?
Acute
60
What type of constipation is associated with lifelong bowel and dietary habits and laxative use?
Chronic
61
What is the indication for laxatives?
Relief of constipation or prep bowel for procedure
62
What is the most overused and incorrectly used OTV medication?
Laxatives
63
Should laxatives by used for abdominal pain?
No
64
What bulk-forming laxative is the safest, OTC recommended for long-term use?
Psyllium (Metamucil) - natural
Methylcellulose (Citrucel) - synthetic
65
What is the MOA of psyllium?
Draw water into the colon and increase bulk
66
If not take with liberal water, what can psyllium case?
Esphageal or intestinal obstruction
67
When's the best time to take psyllium?
At bedtime
68
What should be monitored with all laxatives?
Fluid and electrolyte levels
69
Is psyllium immediate acting?
No
70
What laxative is an emollient?
Docusate sodium
71
Is docusate sodium a stimulant?
No
72
How long does it take docusate sodium to work?
6-12 hours
73
Docusate sodium and what are 2 emollients?
Mineral oil
74
What is the MOA of emollients?
Lubricates stool & GI tract
Softens stool by lowering surface tension
Allows water and fat to be absorbed into stool
75
Is an electrolyte balance an adverse effect of emollients?
Yes, as with all laxatives
76
Magnesium hydroxide, magnesium sulfate, magnesium citrate sodium are what type of laxatives?
Saline laxatives
77
What is the mode of action of saline laxatives?
Increase osmotic pressure and draw water into colon
78
What laxatives increase osmotic pressure and which are hyperosmotic?
The salines (magnesiums) increase osmotic pressure and the hyperosmotics are sugar based: polyethylene glycol, lactulose, sorbitol, glycerin.
79
What's the difference in adverse effects of hyperosmotics vs. salines?
Hyperosmotics can cause bloating as well as electrolyte imbalance. Salines only cause electrolyte imbalance.
80
How quickly will saline laxatives work?
3 hours
81
What type of laxatives are senna and bisacodyl?
Stimulants
82
Wha tis the MOA of stimulant laxatives?
Induce intestinal peristalsis, increase water retention
83
What is the site of action of plant extract stimulants?
The entire GI tract
84
What adverse effects can occur with stimulant laxatives?
Skin rash, malabsorption of nutrient, electrolyte imbalances
85
At what speed do the different pharmacologic classes of laxatives work? (list from fastest to slowest)
Stimulant (bisacodyl) - suppository - hold for 10-15 minutes to melt before movement, pill 10-45 minutes
Hyperosmotics (sugar-based) - 30-60 minutes
Salines (Magnesiums) - 3 hrs
Stimulants (senna) - take at nite - 8 hours
Emolliants (Docusate sodium, mineral oil) 6-12 hrs
Bulk-forming (psyllium) - 12-72 hrs
86
Electrolyte imbalance, cramps, diarrhea, dehydration gas, nausea are all adverse effects of what?
Laxatives
87
Chronic diarrhea last how long?
More than 2 weeks
88
Acute diarrhea last how long?
Up to one week
89
Acute diarrhea is usually attributed to what?
Most common-virus. Also bacterial or parasitic.
90
What is the BRAT diet used for?
Diarrhea
91
What should be administered IV or oral to support a patient with diarrhea?
Fluids
92
Accessing skin turgor and mucous membranes should be monitored for what condition?
Diarrhea
93
Ginger ale and flat Coke assist with what condition?
Diarrhea
94
What does the BRAT diet stand for?
Bananas
Rice
Applesauce
Tea
95
Do you want to stop diarrhea or not?
Don't want to stop it. Want that stuff out.
96
Spicy foods, smoking, hiatal hernia, fatty foods, chocolate, pregnancy, obesity and nasogastric tube can cause what condition?
GERD
97
What is GERD?
Gastrointestinal reflux disease
98
What are the two types of cells at the distal end of the esophagus?
Smooth squamous followed by columnar at end.
99
What happens to cause GERD that involves the columnar epithelium in the esophagus?
When HCl acid moves above the columnar epithelium, damage occurs
100
How do anti-cholinergics cause GERD?
By slowing down peristaltic action
101
Fowl taste, epigastric pain, dry cough and laryngitis are symptoms of what?
GERD
102
If GERD is not managed, it can lead to a cascade of conditions? Put them in sequential order.
Barret esophagus
Erosive esophagitis
Esophageal adenocarcinoma
Erosive esophagitis
Barret esophagus
Esophageal adenocarcinoma
103
What is Barrett's esophagus?
When the flat, pink lining of the esophagus becomes thickened and red due to acid reflux.
104
The following are non-pharmacological interventions for what condition?
Eat smaller, more frequent meals
Avoid eating before bedtime
Avoid alcohol, aspirin, ibuprofen and caffeine
Stop smoking
Elevate head of bed
GERD
105
What is the MOA of antacids?
Neutralizes present gastric acid following dissolution in gastric contents
106
Do antacids stop acid production?
No
107
What helps promote secretion of mucous and prostaglandins to stop HCl and increase bicarb?
Antacids
108
An increase or decrease in cardiac sphincter tone occurs with antacids?
Increase
109
A dose of antacid can do what to gastric pH
Raise gastric pH from 1.3 to 1.6
110
Raising gastric pH from 1.3 to 1.6 is a what % decrease in gastric acidity?
50%
111
What is the adverse effect of magnesium antacids?
Constipation
112
What is the adverse effect of aluminum and calcium antacids?
Constipation
113
What is the adverse effect of calcium antacids?
Kidney stones, rebound acidity afer discontinuing, CV rhythm disturbances
114
Sustained use of sodium bicarb as an antacid can lead to what?
Metabolic alkalosis
115
Most antacids are secreted by what organ?
The kidney
116
What type of antacid products are contraindicated for patients with renal problems?
Magnesium products
117
What medication should you avoid if you are on a sodium bicarb?
Aspirin
118
When should antacids be taken?
After meals or before bed.
119
Sodium bicarb may negate protective effects of which type of products?
Enteric coated products
120
Calcium carbonate as an antacid can contribute to what condition?
Constipation
121
Magnesium hydroxide as an antacid can contribute to what condition?
Diarrhea
122
What is considered the onset of antacids?
Immediate
123
Are antacids intended for long or short term use?
Short term
124
If BUN is increased, that's an indication of what?
Dehydration
125
If creatinine is increased only, what organ is affected?
Kidney function
