Pathophysiology Exam 3

What are potential triggers of nausea and vomiting? (3)

• increased intracranial pressure

• inflammation of GI tract

• vestibular apparatus (motion sickness)

What is the chemoreceptor trigger zone (CTZ) and how does it relate to nausea and vomiting?

area in the medulla oblongata that is stimulated in response to percieved toxic chemicals

Hematemesis is a sign of bleeding in

the upper GI tract due to tear (esophagus, gastric ulcer); yellow-green if from duodenum

Recurrent vomiting increases risk of

• aspiration

• esophagus inflammation

• dental decay

• loss of HCl

secretory/osmotic diarrhea

• excessive release of solutes

• water follows via osmosis, resulting in watery diarrhea (Ex. cholera)

dysentary diarrhea

• blood and epithelial cells present in stool

• defecation is diffcult w/ cramps

steatorrhea diarrhea

• oily, foul-smelling stool

• floats on top of water as a result of fat malabsorption

hematochezia GI bleeding

bleeding brisk, close to anal end

melena GI bleeding

• black, tarry stool (partially-digested blood)

• bleeding slow or higher in GI tract

What are the two common drugs that cause constipation

opiates and anticholinergics

What is a useful radiopaque contrast agent for diagnostic imaging of the GI system?

barium

What liver functions are tested for GI issues (4)

• AST/ALT - higher in hepatocytes, possible rupture of hepatocytes

• total protein/albumin - decreased with liver malfunction

• coagulation - clotting factors synthesized by liver

• GGT/alkaline phosphatase - elevated with biliary system disease

What enzymes are checked in the pancreas for GI issues?

amylase and lipase - elevated with damage

dysphagia

difficulty swallowing causes anywhere from oral cavity to stomach

abnormal outpouching in GI tract causes dysphagia

diverticulum

condition where lower esophageal sphincter fails to dilate and allow food into the stomach

achalasia

stomach content flow back up esophagus lining

GERD

bile salts (in gallbladder) form stones that migrate elsewhere in billary system

cholelithiasis

treatment for cholelithiasis

laporscopic cholecystectomy or urdodiol (dissolve stones, takes 6 mnths)

R upper abd. pain, nausea, vomitting

symptoms of cholelithiasis

digestive enzymes from the pancreas leak into abd. as a result of excess alcohol or gallstone blocking duct

pancretitis

fever/chills, shock, upper abd. pain radiating to back

symptoms of pancreatitis

treatment for pancreatitis

• stop oral intake

• IV fluid

• opiates for pain

liver inflammation caused by virus, toxicity, replicated hepatocytes

hepatitis

fever/chills, nausea, anorexia, jaudice (due to bilirubin)

symptoms of hepatitis

treatment for hepatitis

• interferon drugs

• antiviral drugs

• vaccine

bilirubin metabolism fails and liver can no longer regenerate caused by alcholism

cirrhosis

treatment for cirrhosis

• paracentesis - removal of fluid in abd

• liver transplant

ammonia and other toxins damage neurons caused by ongoing worsening of cirrhosis

hepatic encephalopathy

transmitted via fecal/oral route

hepatitis A and E

transmitted via needles, sexual contact

hepatitis HBC, HCV

require presence of HBV

hepatitis D