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MD 4910 NCP I > 4923 C15 Diseases of the Lower GI > Flashcards

4923 C15 Diseases of the Lower GI Flashcards

1
Q

bacterial overgrowth syndrome

A

Malabsorption & malnutrition that result from cross-contamination of bacteria from the colon to the small intestien.

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2
Q

bilirubin

A

The breakdown product of hemoglobin molecules; it is normally excreted from the body via bile secretions

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3
Q

celiac disease (CD)

A

Inflammation of the small intestine caused by gluten found in various grains, including wheat.

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4
Q

folds of Kerckring

A

The tissue of the small intestine is circularly folded into folds of Kerckring.

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5
Q

What are the spaces between villi called?

A

crypts

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6
Q

How much of the small intestine must be removed before reduction in its capability is observed?

A

More than 50%

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7
Q

migrating motility complex (MMC)

A

Weak contractions of the GI tract that serve to assist in clearing waste.

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8
Q

motilin

A

A hormone secreted by the small intestine, assists in the control of the MMC. Release is stimulated by inter digestive state and it stimulates gastric motility between meals.

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9
Q

Why is gastrin released?

A

Release is stimulated by ingestion of protein, AAs, peptides, coffee, alcohol, Ca; gastric distention, vagal stimulation, HCl in contact with gastric mucosa.

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10
Q

Function on gastrin?

A

Stimulates secretion of: acid, pancreatic HCO3, pancreatic enzymes; gallbladder contraction, gastric motility, intestinal motility, insulin release, gastric oxyntic gland mucosa growth, pancreatic growth. Relaxes ileocecal sphincter. Inhibits gastric emptying.

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11
Q

Stimulatory functions of secretin?

A

Release due to acid in duodenal lumen. Stimulates: pancreatic HCO3 secretion, pancreatic enzymes, gallbladder contraction, insulin release, pancreatic growth.

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12
Q

Inhibitory functions of secretin?

A

Acid secretion, gastric emptying & gastric motility, intestinal motility, mucosal growth.

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13
Q

Cholecystokinin (CCK): stimuli for release

A

Nutrients in duodenal lumen, especially fat and to a lesser extent protein.

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14
Q

Stimulatory functions of CCK

A

Acid secretion, HCO3 and pancreatic enzyme production, gallbladder contraction, intestinal motility, insulin release, mucosal growth, pancreatic growth

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15
Q

Inhibitory functions of CCK

A

Gastric emptying, gastric motility.

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16
Q

resistant starch

A

Indigestible starch that can be found naturally in foods such as beans and peas; produced during food processing or from chemical modification.

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17
Q

synbiotics

A

products that contain both prebiotics and probiotics.

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18
Q

inulin

A

A fructooligosaccharide derived from chicory, stimulates beneficial bacteria in the gut; intravenous inulin is used as a diagnostic test for kidney function since it is not utilized by the body and is excreted in the urine.

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19
Q

Diarrhea

A

An increase in frequency of bowel movements &/or an increase in water content of stools. >200g/day for adults. >20g/kg for children.

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20
Q

Osmotic diarrhea can be caused by?

A

Maldigestion of nutrients, sorbitol, or fructose, laxatives, antacids. Stops when made NPO

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21
Q

sorbitol

A

A sugar alcohol; is used as a sugar substitute

22
Q

fructose

A

A disaccharide absorbed by a facilitated transport mechanism but not against a concentration gradient; when the concentration of fructose in the small intestine is greater than that of glucose, its rate of absorption slows and the unabsorbed fructose is fermented in the colon, causing diarrhea.

23
Q

Secretory diarrhea

A

Results from excessive fluids & electrolyte secretions into the intestine, is caused by disease.

24
Q

What are causes of secretory diarrhea

A

Traveler’s diarrhea. Also, prostaglandins, hormone-producing tumors, excessive bile acids. Antibiotic - C. diff. More fluid loss than osmotic diarrhea. Persistes during NPO

25
Q

Clostridium difficile

A

Gram+ anaerobic bacterium. Common HAI.

26
Q

C. diff infection is associated w/ which antibiotics?

A

Ampicillin, amoxicillin, cephalosporines, clindamycin.

27
Q

C. diff is treated w/ which antibiotics

A

Metronidazole, or vancomycin

28
Q

Metabolic consequences of diarrhea?

A

Fluid loss as high as 15L/day. Dehydration. Hyponatremia. Hypokalemia. Acidosis.

29
Q

Sighs of dehydration

A

wt. loss, skin turgor, dry conjunctiva, multi furrowed tongue, cracked lips, orthostatic BP, Tachycardia, flattened neck veins, capillary refill, decreased diaper changes, depressed fontanel.

30
Q

Frank blood in stool

A

Contamination with blood from the rectum or anus.

31
Q

Occult blood

A

Detected in testing. Bleeding from the lower GI tract.

32
Q

Melena

A

A dark stool, caused by blood fro =m the upper GI>

33
Q

lactoferrin

A

A protein in plasma and secretions (milk, mucus bile), secreted by leukocytes, that can bind iron; it helps prevent infection by depriving bacteria of the iron necessary for their growth.

34
Q

Medications used to treat diarrhea

A

LoMotil. Immodium, Tincture of Opium, paregoric, Kaopectate, or bismuth subsalicylate.

35
Q

Fecal microbiota transplantation

A

Stool is obtained from a health donor and is infused into the patient, usually via colonoscopy - restores normal colonic microflora.

36
Q

low-residue diet

A

a diet low in fiber, and other food constituents that may contribute to bulk in the large intestine. Begin with starches and slowly add one food at a time as tolerated.

37
Q

Nutriton implications of diarrhea

A

Is dependent on volume, length of time. Metabolic consequences. Transit time. Appetite. The elderly and infants are at most risk for complications.

38
Q

Goals for nutrition therapy for diarrhea

A

Restore normal fluid, electrolyte, acid/base balance. Decrease GI motility. Thicken consistency of stool. Repopulate the GI tract. Gradually introduce solid foods.

39
Q

WHO formula for rehydration

A

1/3-2/3 tsp. NaCl; 3/4 tsp. sodium bicarbonate; 1/3 tsp. KCl; 1/3 tsp. sugar or rice powder in 1 L of sterile water.

40
Q

Intervention to decrease motility

A

Avoid sugar sweetened beverages. Avoid caffeine. Avoid high fiber & gas producing foods. Codeine, paregoric, lomotil.

41
Q

Intervention it thicken consistency of stool

A

Infant: use formula or age appropriate foods w/ apple powder, banana flakes, or pectin added. BRAT diet.

42
Q

BRAT

A

Bananas, rice, applesauce, toast. Anti-secretory agents, but not nutritionally sufficient. AAP does not recommend use of.

43
Q

Constipation

A

A decrease in frequency of bowl movements w/ straining w/ defecation and/or hard stools

44
Q

Diagnostic criteria for constipation

A

Rome III Consensus Criteria define constipation as a condition where at least 2 of the following symptoms have occurred in the previous year for at least 12 non-consecutive weeks. Also, loose stools are rarely present w/out the use of laxatives

45
Q

Etiology of constipation

A

IBS, inadequate fiber/fluid intake, laxative abuse, anatomical abnormalities, medications, iron supplements, neurologic disorders: MS, Parkinson’s.

46
Q

Medications for constipation

A

Bulking agents: soluble fiber forms gel in the colon; retains water & increases peristalsis. Laxatives

47
Q

Bulking agents?

A

Psyllium, Calcium polycarbophil, Methylcellulose, Guar gum.

48
Q

Nutrition therapy for constipation

A

Adults 25-35g of dietary fiber. Children their age + 5g fiber/day. Increase fiber gradually, add one food, wait several days, add another. FLUID!!

49
Q

Caution w/ extreme high fiber

A

Malabsorption of minerals. Increased satiety for young children and therefore, risk of inadequate intake.

50
Q

pelvic floor dysfunction

A

Weakening of the pelvic floor that can cause the organs to shift, bulge, & push outwards against each other, resulting in urinary of fecal incontinence or obstruction, vaginal prolapse or pain, sexual dysfunction, etc.

MD 4910 NCP I (15 decks)

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