Clinical Manifestations in GI Disorders (Adults Pt 1)

Question 1

Clinical Manifestations of the GI Tract

Answer 1

Anorexia, vomiting, constipation, diarrhea, abdominal pain, and evidence of GI bleeding are clinical manifestations of many disorders of the GI tract.

Question 2

Anorexia

Answer 2

Lack of desire to eat despite physiologic stimuli that would normally produce hunger

Question 3

Cachexia

Answer 3

Associated with an underlying illness (cancer, CHF, COPD) causing ongoing muscle loss (not fat loss) that is not entirely reversed w/ nutritional supplementation. Causes SYSTEMIC inflammation.

Question 4

Vomiting

Answer 4

Emptying the stomach and intestinal contents through the mouth.

Question 5

Vomiting can lead to ____,____,____, and disturbances such as hyponatremia, hypokalemia, hypochloremia, and _____.

Answer 5

Fluid, electrolyte, acid base, metabolic acidosis

Question 6

What happens when someone vomits in the GI system?

Answer 6

GI contraction and reverse peristalsis of the esophagus. Preceded by nausea and retching (dry heaving) with the exception of projectile vomiting.

Question 7

Define Retching (dry heaving)

Answer 7

Reverse movement (retroperistalsis) of the stomach & esophagus without vomiting.

Question 8

Vomiting is associated with direct stimulation of the vomiting center in the Brian called ______ makes up the brain stem structure: midbrain, pons, and medulla.

Answer 8

Medulla oblongata

Question 9

Projectile vomiting

Answer 9

Spontaneous vomiting that does not follow nausea or retching

Question 10

Constipation

Answer 10

Infrequent or difficulty defecation

Question 11

Normal Bowel Elimination

Answer 11

2 - 3 per day / 1 per week

Question 12

What are the 4 classifications for constipation ?

Answer 12

Normal transit (functional), slow transit constipation, pelvic floor dysfunction, secondary

Question 13

Normal Transit (functional) constipation

Answer 13

Normal rate, but difficulty getting stool out (due to low residual, low fluid diet, and sedentary lifestyle

Question 14

Slow Transit Constipation

Answer 14

Impaired colonic motor activity with infrequent bowel movements; straining, abdominal distinction, palpable stool

Question 15

Pelvic Floor Dysfunction

Answer 15

Failure of the pelvic floor muscles and sphincter to relax with defecation (ex pregnancy)

Question 16

Secondary Constipation.

Answer 16

From an actual disease processes, diet, medications. Ex: Neurogenic disease drugs that decrease intestinal motility, endocrine, or metabolic disorders or obstruction

Question 17

What are the clinical manifestations of constipation:

Answer 17

Two of the following for at least 3 months: Straining, lumpy hard stools, incomplete emptying, manual maneuvers to facilitate stool evacuation, fewer than 3 bowel movements per week

Question 18

Fecal impaction is also considered a clinical manifestation of constipation. T or F

Answer 18

True: Fecal impaction is when you have hard dry stool retained in the rectum.

Question 19

5 different types of diarrhea

Answer 19

Osmotic, secretory, exudative, inflammatory, motility

Question 20

Osmotic Diarrhea

Answer 20

Draws water into the lumen by osmosis, causes diarrhea. Osmotic diarrhea stops when the offending agent is stopped. Ex: Osmotic laxatives, too much magnesium or Vitamin C, undigested lactose, fructose malabsorption.

Question 21

Secretory Diarrhea

Answer 21

Cholera toxin; Diarrhea continues even when there is no oral food intake.

Question 22

Exudative Diarrhea

Answer 22

Blood and pus in the stool. Ex: IBD, E.coli, food poisoning

Question 23

Inflammatory Diarrhea

Answer 23

Damage to the mucosal lining, or brush border. Leads to a passive loss of protein - rich fluids & decreased ability to absorb these lost fluids.

Question 24

Motility Diarrhea

Answer 24

Excessive motility decreases transit time, mucosal surface contact, & opportunities for fluid absorption.

Question 25

Manifestations of acute bacterial or viral infection with Diarrhea:

Answer 25

FEVER, with or without vomiting or cramping pain

Question 26

Manifestations of inflammatory bowel disease:

Answer 26

fever, cramping, BLOODY STOOLS

Question 27

Manifestations of malabsorption syndromes:

Answer 27

STEATORRHEA (fat in the stools), bloating, & diarrhea

Question 28

Clinical manifestations of diarrhea:

Answer 28

Dehydration, electrolyte imbalance (HYPOnatremia, HYPOkalemia), metabolic acidosis, & weight loss

Question 29

Abdominal pain is a common symptom for a number of GI disorders. T or F

Answer 29

True

Question 30

Name 4 classifications of abdominal pain:

Answer 30

• Parietal (somatic pain) in the peritoneum
• visceral pain (in the organs)
• referred pain
• biochemical mediators of the inflammatory response (histamine, bradykinin, and serotonin) stimulate pain and nerve endings, producing abdominal pain!

Question 31

Upper GI Bleeding from the esophagus, stomach and duodenum is what color? What is the consistency like?

Answer 31

Frank, bright red in emesis, or DARK grainy digested blood in stool

Question 32

Which organs from the lower GI are involved in bleeding dysfunctions?

Answer 32

jejunum, ileum, colon, or rectum

Question 33

Define Hematemesis

Answer 33

Bloody vomit

Question 34

Define Hematochezia

Answer 34

Bloody stools

Question 35

Define Melena

Answer 35

Black, tarry stools

Question 36

Define Occult bleeding

Answer 36

Not visible