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Patho Exam 3 > CH 17 & 18: digestive and urinary systems > Flashcards

CH 17 & 18: digestive and urinary systems Flashcards

1
Q

Carbohydrate metabolism generates

A

ATP

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2
Q

lipid metabolism provides

A

energy storage and release

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3
Q

protein metabolism provides

A

amino acids

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4
Q

Adequate nutrition relies on

A

optimal intake
digestion
absorption
transportation of nutrients,
excretion of waste products.

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5
Q

Once the food goes through the process of digestion, the extracted nutrients are made suitable for

A

absorption and transportation.

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6
Q

process of ingesting and utilizing nutrients for energy.

A

Nutrition

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7
Q

Metabolism allows chemical
reactions that do three things

A

(1) produce heat to maintain body temperature
(2) conduct neural impulses
(3) contract muscles.

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8
Q

Nutrition also provides the substances needed for the

A

growth, repair, and
maintenance of cells.

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9
Q

Water functions to:

A
  • Serve as a solvent promoting the availability of solutes to the cell
  • Promote and maintain fluid balance
  • Provide a transport medium for nutrients and wastes
  • Serve as a lubricant
  • Contribute to the regulation of body temperature
  • Provide the foundation for metabolic reactions
  • Contribute to the structure of cells and the circulatory system
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10
Q

The major macronutrients that are converted to usable sources of energy are:

A

proteins, lipids, and
carbohydrates.

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11
Q

proteins are broken down into :

A

amino acids and absorbed into circulation

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12
Q

how many amino acids are essential and required in the diet

A

9

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13
Q

dietary fats:
support -
stimulate -

A

supports digestion by decreasing gastric motility and secretions
stimulates pancreatic enzymes and bile secretion to facilitate digestion, absorption, and transportation of fat-soluble vitamins.

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14
Q

Essential fatty acids influence:

A

plasma membrane fluidity
receptor function
enzyme activity
cytokine production.

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15
Q

considered an essential fatty acid and has been demonstrated to reduce many disease states, including heart disease.

A

Linoleic acid

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16
Q

digested and converted into glucose

A

carbohydrates

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17
Q

what are two actions of glucose after digested

A
  1. where about 50% is used for oxidation or stored as glycogen
  2. exits the liver and is circulated throughout the body to be used by cells for energy.
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18
Q

major role of carbohydrates

A

provide energy

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19
Q

organic substances that the body is unable to manufacture (for the most part) and,
therefore, must be consumed. (

A

Vitamins

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20
Q

fat soluble vitamins

A

ADEK

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21
Q

Vitamin K function

A

coagulation of the blood

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22
Q

Thiamin B1 function

A

regulation of neural function

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23
Q

Folate functions

A

DNA RNA synthesis
red blood cells and white blood cells in bone marrow

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24
Q

Cobalamin functions

A

metabolism of all cells, GI tract, bone marrow, nervous tissue

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25
Q

major roles of vitamins are to help develop

A

genetic materials, red blood cells, hormones, collagen, and nervous
system tissue.

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26
Q

Minerals constitute

A

bone, hemoglobin, enzymes, hormones, and chemical mediators.

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27
Q

macrominerals include

A

sodium, potassium, calcium, phosphorus, magnesium, and sulfur.

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28
Q

microminerals include

A

iron, zinc, fluoride, and copper.

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29
Q

Hunger and satiety are regulated in the brain by the

A

hypothalamus, based on feedback from the gastrointestinal tract on the quantity and quality of food in the stomach and intestines

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30
Q

digestion is essential for what 3 functions

A

(1) digesting and extracting macronutrients
(2) absorbing nutrients
(3) forming a physiologic and chemical barrier against microorganisms and other foreign materials introduced during food ingestion.

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31
Q

stomach acids are a part of which line of defense

A

first
by destroying many types of microorganisms and other
harmful substances on contact

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32
Q

Four major secretory cells are found in the stomach:

A

 Mucous cells, which secrete alkaline mucus and protect the epithelium from stress and acid
contact (protection from stomach acid)
 Parietal cells, secrete both hydrochloric acid, a strong acid needed to activate pepsinogen and
destroy pathogens, and intrinsic factor, a glycoprotein needed for intestinal absorption of
vitamin B12 -INTRINSIC FACTOR
 Chief cells, which secrete pepsin, a proteolytic enzyme critical to protein digestion
 G cells, which secrete gastrin, a hormone responsible for controlling acid secretion and
stimulating gastric motility

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33
Q

complex process of taking in nutrients and moving these to the circulation to be used by cells.

A

Absorption

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34
Q

Small intestine contains:

A

 duodenum contains the
openings for the bile and
pancreatic ducts
 Jejunum is 8 ft long
 Ileum is 12 ft long
 Ends in the cecum

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35
Q

Large Intestine includes:

A

 5 feet long
 Absorbs water and eliminate
waste
 Intestinal bacteria vital role in
the synthesis of some B and K
vitamins
 Colon includes the ascending,
transverse, descending
sigmoid and rectum

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36
Q

altered nutrition possible causes

A

 Genetic defects that impact metabolism or absorption of nutrients
 Malformation or damage to the gastrointestinal mucosa
 Inadequate or excessive dietary intake of required nutrients
 Excessive nutrient losses, such as through vomiting, diarrhea, or laxative use
 Hypermetabolic states that exert excessive demands, such as with hyperthyroidism, cancer,
burns, fever, or severe infection
 Malabsorptive syndromes
 Ingestion of unsafe food and water

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37
Q

lack of nutrient intake most often related to inadequate calorie consumption, inadequate intake of essential vitamins and minerals, or problems with digestion, absorption, or
distribution of nutrients in the body.

A

Undernutrition

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38
Q

most common nutrients that are
inadequately consumed or in great demand in those presenting with undernutrition.

A

Protein, iron, and vitamins

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39
Q

Protein malnutrition related to:

A

Marasmus deprivation of all food, a condition of starvation
Kwashiorkor persons consuming adequate carbohydrates

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40
Q

dietary glucose is unavailable for
glucose-dependent tissues, such as the brain and muscle tissue

A

in marasmus

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41
Q

lack of movement of specific nutrients across the gastrointestinal mucosa.

A

Malabsorption

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42
Q

Carbohydrate malabsorption is often the result of

A

pancreatic enzyme deficiencies
absence or reduction of brush border disaccharidases
congenital deficiency of the glucose–galactose transporter
bacterial flora overgrowth in the intestine.

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43
Q

clinical manifestations of altered immunity

A

weight loss
muscle weakness
muscle wasting
dehydration
fatigue
vitamin and mineral deficiencies

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44
Q

digestive system labs

A

a complete blood count with red blood cell indices
peripheral smear
sedimentation rate (to detect inflammation)
serum electrolytes
urinalysis
urine culture.
protein status, including serum albumin, transferrin, creatinine, and blood urea nitrogen (BUN) levels.

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45
Q

reduction in the number of circulating blood cells and subsequently reduced hemoglobin levels

A

anemia

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46
Q

represents a problem of iron demand on red blood cell development that cannot be met with current iron stores.

A

Iron-deficiency anemia

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47
Q

clinical manifestations of IDA

A

manifestations include pallor of the skin and mucous membranes
fatigue
weakness
lightheadedness
breathlessness
palpitations
headache
tachycardia
syncope
brittle hair
nails and mouth sores.

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48
Q

craving to chew or eat substances of non-nutritive value, such as chalk, soil, clay, or paper

A

Pica.

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49
Q

form of pica in which the person chews ice.

A

Pagophagia

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50
Q

Excessive body fat
Major contributor to morbidity and mortality
Health crisis

A

Obesity

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51
Q

the primary cell involved in obesity, are highly active metabolic, endocrine, and inflammatory cells.

A

Adipocytes

52
Q

clinical manifestations of obesity

A

excess weight and body fat

53
Q

comorbidities of obesity

A

diabetes
heart disease
hypertension
hyperlipidemia
stroke
osteoarthritis
liver disease
gallstones
poor wound healing
sleep apnea
certain cancers

54
Q

functional units of the kidneys, forming urine through filtration, reabsorption, and secretion.

A

Nephrons.

55
Q

2 primary roles of the kidneys

A

Regulation of body fluid and the balance between acids and bases

56
Q

waste product produced by the kidneys, stored in the bladder, and excreted via the urethra through a complex interplay between neural, motor, and hormonal mechanisms

A

urine

57
Q

basic processes of the renal system

A
  • Regulation of body fluid volume and composition
  • Elimination of metabolic wastes
  • Synthesis, release, or activation of hormones
  • Erythropoietin
  • Renin
  • Vitamin D
  • Regulation of blood pressure
58
Q

functions of nephrons

A

 Filter water-soluble substances from the blood
 Reabsorb filtered nutrients, water, and electrolytes
 Secrete waste

59
Q

functions of the kidneys

A

 Maintain acid-base
 Excrete the end products of body metabolism
 Control fluid and electrolytes
 Excrete bacterial toxins, water-soluble medications, and the metabolites of medications
 Secrete renin to regulate blood pressure RAAS
 Synthesize Vitamin D so calcium can be absorbed
 Secrete erythropoietin to stimulate the bone marrow to make RBCs

60
Q

homeostasis of water

A

 ADH reabsorption of water stimulated by dehydration, sodium concentration, or decrease in
blood volume
 Lack of ADH = Diabetes insipidus

61
Q

homeostasis of sodium

A

 When sodium increases extra water is retained
 This increases blood volume and increases BP
 BP increases gfr increases
 RAAS controls the reabsorption of sodium and stimulates the release of aldosterone
 Aldosterone also increases the amoung of K in the blood

62
Q

ureters composed of:
Bladder composed of:

A

 Ureters composed of smooth muscle
 Bladder composed of detrusor muscle and sphincters

63
Q

urinalysis components

A

 pH
 Specific gravity
 Protein
 Glucose
 Ketones
 Nitrite
 Leukocyte esterase
 Microscopic analysis includes crystals, casts squamous cells, WBCs and RBCs

64
Q

should not be found in urine:

A

o Glucose
o Ketones
o Nitrite
o Bacteria
o Leukocyte esterase
o Crystals
o Stones
o protein

65
Q

possible motility issues of urine

A

 Results in stasis of urine in the bladder and the kidney
 Can cause precipitation (solid substances to form from fluid
 Blockage
 Pyelonephritis and acute tubular necrosis

66
Q

Inadequate arterial blood supply

A

ischemia or infarction

67
Q

The consequences of obstruction are influenced by the:

A

o Degree of the obstruction (complete or partial)
o Duration of the obstruction
o Acuity or chronicity of the condition

68
Q

possible complication of a patency issues

A

 Can lead to structural damage impaired function
 Can lead to ischemia and necrosis
 Can lead to obstruction of urine flow
 Can lead to dilation injuries – hydronephrosis – decreased GFR and decreased function
 Can developed within 24 hours
 Can also lead to infection, sepsis and loss of function

69
Q

stasis of urine behind the obstruction of renal structures, ureters, or urethra

A

urinary obstruction

70
Q

collection of gas and fluid behind the obstruction

A

intestinal obstruction

71
Q

signs and symptoms of obstructive disease

A

 Altered volume of urine
 Altered urine characteristics
 Bleeding
 Pain
 Distension
 Anorexia
 Nausea
 Vomiting
 Fever

72
Q

patho indications for altered urinary elimination

A

proteinuria
glucosuria
ketonuria
hematuria
pyuria
bacteriuria

73
Q

Laboratory analysis of stool
may include:.

A

microscopic examination or chemical evaluation.
Color, consistency, volume, shape, and odor should be consistent with characteristics described previously.

74
Q

Increased motility may impair:

A

nutrition
may enhance loss of water and electrolytes.

75
Q

Decreased motility prolongs storage time in the large intestine, increasing:

A

fluid loss from fecal matter, forming hard stools, and potentially promoting the return of waste products to circulation.

76
Q

factors altering bowel elimination

A

analgesics
emotional stress
reduced activity

77
Q

possible causes of bowel obstruction

A

 tumors, polyps, and impacted feces
 fluid and gas accumulation, bowel obstruction is manifested by abdominal distension and pain
 if obstruction impairs venous return,
o edema develops in the large intestine, leading to reduced absorption.
o Edema promotes continued fluid and gas accumulation because water and gas move
into the bowel lumen.
o Hydrostatic forces may increase so that fluid is forced through the bowel wall into the
peritoneum. Further, bacteria may gain access to the circulation, promoting the
development of sepsis.
o Perforation may result from the pressure that exceeds the ability of the tissue to retain
its structure.

78
Q

assessment for bowel obstruction

A

 Inspection
 Auscultation
 Palpation
 Characteristics of stool color consistency presence of fat or blood
 Watery, hard, stringy, fatty, foul odor
 Hemorrhoids
 Blood
 Pain

79
Q

alterations in texture of stool that can give cause

A

watery
hard
stringy
fatty
foul odor

80
Q

Watery diarrhea can mean:

A

o Acute onset caused by gastroenteritis or anxiety
o Chronic pattern linked to inflammatory conditions or a high-fiber diet. Also caused by
intolerance to particular foods or the effects of certain medications

81
Q

hard diarrhea can mean

A

o Water content low, resulting in a dry stool that is difficult to pass
o May contribute to the development of hemorrhoids. Linked to low-fiber diet, side
effects of certain medications, or voluntary avoidance of stool evacuation

82
Q

stringy diarrhea can mean

A

o May be caused by parasitic infections

83
Q

fatty diarrhea can mean

A

o Caused by malabsorption of fat
o Likely to float

84
Q

foul odor in diarrhea can mean

A

o May be caused by steatorrhea, parasitic infection, or malabsorption syndromes

85
Q

 Characterized as diffuse, radiating and generalized; difficult to determine precise location
 Caused by stretching, distension, or inflammation, inducing edema and vascular congestion

A

Visercal

86
Q

 Described as sharp, intense, and localized to a specific site
 Caused by injury to the abdominal wall or parietal peritoneum

A

Somatic (also known as parietal)

87
Q

 Felt at a location different from origin of pain
 Caused by the sharing of a common afferent pathway between origin of pain and referred location

A

Referred

88
Q

Individuals at risk for development of kidney stones include those with:

A
  • Obstructive renal calculi (kidney stones) is an emergecy
  • Genetic predisposition
  • Urinary tract infection
  • Cystic kidney disease
  • Diabetes
  • Obesity
  • Gout
  • Hyperparathyroidism
  • Gastric bypass
89
Q

fluid-filled cysts in kidney tissue bilaterally, leading to progressive loss of nephrons
may be inherited or acquired.

A

polycystic kidney disease

90
Q

Progressive decline in GFR is characteristic of decline in kidney function as follows:

A

Mild disease, GFR 60 to 89 mL per minute
Moderate disease, GFR 30 to 59 mL per minute
Severe disease, GFR 15 to 29 mL per minute
Renal failure, GFR < 15 mL per minute

91
Q

 rapid loss of kidney function
 leads to cell hypoperfusion, cell death, decreased renal function
 normal function can return if the cause removed
 prerenal, intrarenal and postrenal causes

A

Acute Kidney Injury AKI

92
Q

AKI: blood loss, dehydration, shock, infection (outside the kidney)

A

prerenal

93
Q

AKI: tubular necrosis, prolonged ischemia, obstruction or nephrotoxicity

A

intrarenal

94
Q

AKI: between the kidney and the outside: bladder neck obstruction or infection

A

postrenal

95
Q

kidney disease that has Slow progressive and irreversible - Occurs in stages

A

chronic kidney disease

96
Q

% loss of function nephrons before patient becomes symptomatic

A

75%

97
Q

characteristic of GFR for CKD

A

GFR <60 ml per min for 3 months or longer

98
Q

causes of CKD

A

o Can follow AKI
o DM or other metabolic disorders
o Hypertension
o Urinary obstruction
o Recurrent infections
o Renal artery occlusion
o Autoimmune disorders

99
Q

labs for kidney disease

A

GFR best estimate for kidney function
CMP contains electrolytes BUN Creatinine
BUN elevated
Creatinine elevated
Urinalysis abnormal: RBCs, WBCs, casts, proteinuria, bacteria, nitrite, leukocyte esterase if infection
CBC: anemia, leukocyutosis, thrombocytopenia
Renal ultrasound

100
Q

prevents reflux of gastric contents into the esophagus

A

lower esophageal sphincter

101
Q

are critical in producing and secreting digestive enzymes and bile into the gastrointestinal tract.
Ex:

A

Enyzmes
salivary glands, pancreas, and liver,

102
Q

secrete alkaline mucus and protect the epithelium from stress and acid contact

A

mucous cells

103
Q

secrete both hydrochloric acid, a strong acid needed to activate pepsinogen and destroy pathogens, and intrinsic factor, a glycoprotein needed for intestinal absorption of vitamin B12 -INTRINSIC FACTOR

A

parietal cells

104
Q

secrete pepsin, a proteolytic enzyme critical to protein digestion

A

chief cells

105
Q

secrete gastrin, a hormone responsible for controlling acid secretion and stimulating gastric motility

A

G cells

106
Q

deprivation of all food, a condition of starvation

A

Marasmus

107
Q

persons consuming inadequate proteins

A

Kwashiorkor

108
Q

Problems with processing or digesting nutrients:

A

pancreatic dysfunction
enzyme deficiencies
inadequate bile secretion

109
Q

Problems with moving substances across the mucosa:

A

inflammatory conditions
gastrointestinal atrophy
excessive ingestion of a nutrient
use of certain medications
protein deficiencies

110
Q

inhibits transport of nutrients once they have been absorbed across the mucosa and may occur with neoplasms or infectious processes

A

Lymphatic obstruction

111
Q

how many exposures to food for allergy to occur

A

at least two

112
Q

classes of BMI

A

*Class 1: BMI of 30 to less than 35
*Class 2: BMI of 35 to less than 40
*Class 3 (extreme or severe obesity): BMI of 40 or higher

113
Q

diagnosis of obesity

A

comprehensive evaluation for comorbidities, such as hypertension, hypercholesterolemia, diabetes, hypothyroidism, venous varicosities, osteoarthritis, sleep apnea, depression, reproductive alterations, and infection

114
Q

kidneys processing of cardiac out

A

20-25%
1000mL of blood per minute

115
Q

neuromuscular function alterations of urine

A

*may involve the neurons of the peripheral and central nervous systems, neurotransmitter production, and availability or coordination of neural impulses from initiation to action
*Result in retention or incontinence

116
Q

perfusion issues of urine

A

*Inadequate arterial blood supply – ischemia or infarction
*Damage to the renal structures
*Decrease perfusion due to excessive constriction of arterioles, inadequate vascular volume, or obstructed patency of the arterial supply, as occurs with an embolism

117
Q

infection causing bowel patentcy issues and patho

A

appendicitis
– inflammatory response – if not treated and ruptures – infection of the peritonial cavity – septic shock – reduced perfusion to all organs

118
Q

diagnostics of bowel obstruction

A
  • Guaiac Test occult blood
  • Xray
  • Barium enema
  • Sigmoidoscopy
  • colonoscopy
119
Q

types of urinary incontinence

A

*involving muscular contraction, neural transmission, hormonal stimulation, or mechanical factors
*stress,
*urge,
*nocturia
*overflow,
*functional – inabilit to get to the toilet

120
Q

GFR < 60 indicates:

A

CKD

121
Q

proteinuria possible etiologies

A

renal failure
nephrotic syndrome
preeclampsia
renal artery/vein thrombosis
glomerular disease
tubulopathy

122
Q

glucosuria possible etiologies

A

diabetes mellitus

123
Q

ketonuria possible etiologies

A

DM
ketoacidosis
starvation

124
Q

hematuria possible etiologies

A

glomerular damage
tumors
kidney trauma
UTI
acute tubular infection
urinary tract obstruction

125
Q

pyuria possible etiologies

A

upper and lower UTI
acute glomerulonephritis
renal calculi

Patho Exam 3 (3 decks)

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