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Alim 1 > consequences of fluid loss from the GI tract > Flashcards

consequences of fluid loss from the GI tract Flashcards

1
Q

what is osmotic diarrhoea

A

decreased electrolyte/nutrient absorption due increase in osmotic particles in the gut

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2
Q

what is deranged motility diarrhoea

A

increased rate of flow of intestinal contents

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3
Q

what is secretory diarrhoea

A

abnormal increase in GIT secretions - ach, substance P, 5-HT, neurotensin act to increase rate of intestinal secretion via inc. [Ca2+]

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4
Q

what causes osmotic diarrhoea

A

disaccharide deficiency - can be drug induced - malabsorption of galactose

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5
Q

what causes secretory diarrhoea

A

excessive laxative use, digestion/absorption defects, infection

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6
Q

how does cholera cause diarrhoea

A

survives acidity of GIT

enterotoxin stimulates adneylate cyclase - inc cAMP - more Na, Cl, H2O loss

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7
Q

how is secretory diarrhoea treated

A

water, electrolyte, glucose replacement

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8
Q

causes of bloody diarrhoea

A

chronic disease
ulcerative colitis
neoplasm

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9
Q

consequences of severe diarrhoea

A

hypovolaemia

metabolic acidosis due to loss of HCO3

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10
Q

what is vomiting

A

retrograde giant contraction - oral expulsion of gastric contents and bile

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11
Q

causes of vomiting

A 
symptom of illness in children
pregnancy
alcohol dependency
metabolic disorders
removal of ingested toxic substances
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12
Q

physiological changes associated with vomiting

A

inc: salivation, HR, sweating
pallor
nausea

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13
Q

how is vomiting stimulated

A

neuronal inputs from the body to the vomiting centre in the medulla oblongata

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14
Q

inputs that can initiate vomiting

A 
SI/stomach distension
substances that act on chemoreceptors in brain/intestine
increased ICP
motion sickness
intense pain
gag reflex
sight/smell/emotional circumstances
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15
Q

how does vomiting occur

A 
nausea 
deep inspiration, closure of epiglottis
inc abd. pressure
retrograde giant contraction
breath held, chest fixes
dec. oeso pressure - relaxation of UOS & LOS
inc abd pressure
forceful explosion
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16
Q

consequences of excessive vomiting

A

inc salt/water loss
sever dehydration
circulatory problems
metabolic alkalosis due to loss of gastric acid

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17
Q

what is lost in vomit

A 
food
mucus (& na, k, cl, hco3)
gastric acif
upper intestinal contents, incl bile
blood
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18
Q

consequences of fluid loss from GIT

A 
hypovolaemia
haemoconcentration
dehydration
ionic imbalances
malnutrition, inc mortality
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19
Q

consequences of hypovolaemia

A

dec. venous return
arterial hypotension
inc myocardial O2 demand w/ dec perfusion leads to dysfunction
inc anaerobic metabolism > acidosis

20
Q

what does a combo of acidosis and myocardial dysfunction lead to

A

multi organ failure :D

21
Q

consequences of dehydration

A

heat shock, fainting
higher blood viscosity; higher BP; clotting more likely
kidneys get overloaded - toxins accumulate
digestive problems

22
Q

how does the body respond to water loss

A

CV adaptation
Renal adaptation
behavioural adaptation - stimulates fluid intake when possible

23
Q

consequences of na and h2o loss

A

decreased plasma volume and venous pressure

24
Q

cv result of decreased venous pressure

A 
dec: venous return, atrial pressure
ventricular EDV
SV
CO
arterial BP
25
Q

Renal consequences of decreased venous pressure

A

increased activity of renal sympathetic nerves
inc constriction of renal arterioles
dec GFR
dec na, h20 secretion

26
Q

consequence of severe sweating

A

loss of hypo osmotic salt soln

27
Q

result of loss of hypo-osmotic salt soln

A

dec plasma vol

inc plasma osmolarity

28
Q

consequences of dec plasma volume

A

dec GFR
inc plama aldosterone
increased plasma vasopressin

29
Q

consquence of dec GFR w/ inc plasma aldosterone

A

dec na secretion

30
Q

result of inc plasma vasopressin

A

dec h2o secretion

31
Q

systemic response of the body to dec arterial pressure due to dec plasma vol

A

inc renin secretion by renal juxtaglomerular cells
inc plasma renin
inc plasma ang2
inc aldosterone secretion by adrenal cortex
inc plasma aldosterone
inc na reabsorption in collecting ducts
dec na excretion

32
Q

response of the body to dec GFR/flow to macula densa

A

dec NaCl concentration in macula densa

inc renin secretion

33
Q

physiologic response to consequences of hypovolaemia

A 
dec venous/atrial/arterial pressure
detected by CV baroreceptors
inc ADH secretion by post pit.
inc. plasma vasopressin
inc h2o permeability in collecting ducts
inc h2o reabsorption
dec h2o excretion
34
Q

what stimulates the sensation of thirst

A

inc ang2
inc plasma osmolarity
dry mouth/throat
monitoring of h2o intake by GIT

35
Q

effect of dehydration on calcium levels

A

dec nacl, k, INC [Ca2+] > hypercalcaemia

36
Q

clinical consequences of hypercalcaemia

A

inc risk of kidney stones, kidney failure, arrhythmia, dementia

37
Q

symptoms of hypercalcaemia

A 
nausea/vomiting
loss of appetite
constipation
abdominal pain
excessive thirst
fatigue, lethargy, paresis, joint pain, confusion
38
Q

how does ADH work

A

inserts aquaporin 2 channels into renal collecting ducts

increases h2o permeability of ducts - results in concentred urine

39
Q

effect of h2o on adh secretion

A

dec in osmolarity of blood and interstitial fluid

dec in ADH secretion - water channels removed

40
Q

what happens if there are no water channels in the collecting ducts

A

decreased permeability - increased water loss

41
Q

factors that regulate release of ADH

A 
large decrease in blood vol
severe dehydration - causing gfr decrease - less h2o in urine
hyperventilation - inc fluid loss
vomiting/diarrhoea 
fever, heavy sweating
42
Q

how does the thirst centre in the hypothalamus work

A

stimulates desire to drink - water gain if thirst is quenched

43
Q

how does ANG2 work

A

stimulates aldosterone secretion - dec volume of h2o lost in urine

44
Q

how does aldosterone work

A

promotes water/na/cl reabsorption - dec water loss in urinw

45
Q

how does ANP work

A

stimulates natriuresis - inc excretion of na/cl/h2o - increased water loss in urine

46
Q

how does ADH/vasopressin work

A

increase collecting duct permeability and hence water reabsorption - decreased loss of water in urine

Alim 1 (11 decks)

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