Dumping Syndrome Flashcards

1
Q

Patho of dumping syndrome

A

Rapid emptying of stomach -> jejunum-> fluid shift from blood stream into jejunum -> decreased blood volume -> shock-like manifestations

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2
Q

Describe Dumping syndrome

A

Group of vasomotor & GI symptoms caused by rapid emptying of gastric content to jejunum

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3
Q

Initial s/sx

A

Sweating & pallor

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4
Q

Early s/sx occurs

A

5-30 min after eating

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5
Q

Other early s/sx: W(D)TF-DND(P)-A

A

Weakness & dizziness
Tachycardia
Feeling of fullness & discomfort
Diarrhea
Diaphoresis & palpitations
Nausea
Abdominal cramps

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6
Q

Late signs occurs

A

2-3 hours after eating

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7
Q

Late sign

A

Hyperglycemia(initial): insulin secretion then hypoglycemia

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8
Q

Position during eating/meals

A

Lying or recumbent

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9
Q

Position after eating/meals and rationale

A

Left-side lying ( jejunum is on the R)
Recumbent or slightly elevated
- to prevent rapid emptying by gravity for 30 mins

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10
Q

Diet

A

High protein(3-4 hours emptying)
High fats
Limit carbohydrates( no simple sugar): 1-2 hours

  • small frequent meals
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11
Q

Fluid intake to prevent dumping syndrome

A

Take fluid after meals or between meals not with meals.

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12
Q

These should be avoided bec. They are stimulant that causes rapid emptying

A

Ver Hot & cold food and beverages

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13
Q

Give anticholinergics or antispasmodics when?

A

30 min before meals

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14
Q

Example of anticholinergic or antispasmodic meds ( BRAL-NP

A

Bentyl ( dicyclomine)
Robinul (glycopyrrolate)
Atropine sulfate
Levsin
Nulev (hyoscyamine)
Propantheline bromide

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15
Q

Ulcers that occur when gastric acids came in contact with area of anastomosis w/duodenum or jejunum

A

Marginal ulcers

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16
Q

is caused by reflux of duodenal contents

A

Alkaline reflux gastritis

17
Q

Due to partial or total loss of intrinsic factor secreted by parietal cells

A

Vit B12 deficiency

18
Q

What does parietal cells produces

A

hydrochloric acid
Intrinsic factors

19
Q

Result from deficiency of intrinsic factor necessary for intestinal absorption of vit B12

A

Pernicious Anemia

20
Q

Assessment in pernicious anemia: SSS-WPF

A

Smooth beefy red tongue
Severe pallor
Slight jaundice
Weight loss
Paresthesia of hands & feet
Fatigue

21
Q

Tx for pernicious anemia

A

Vit B12 injection IM, Z-track method
- severe: weekly then monthly for 100-200microgram(mcg)
Mild/moderate: 3-4 mos or as maintenance