GI 6 Flashcards
Hypovolemia consequences
Tissue ischemia ➡️ metabolic acidosis ➡️ circulatory collapse/shock
(but ⛔️early protracted vomiting)
Causes of HYPOvolemia
Diarrhea, hemorrhage, vomiting, NaCl & H2O depriv, excessive sweat, renal disease
Mech Diarrhea
SODIM Filt Secretion: ab.Starling F Osm diarrhea Secretory dia Inflammation Ab Motility
Low level Filt Secr
High level
Low: Chronic ISF loss
Protein losing enteropathy
High: diarrhea/ fl seq bowel
Causes of Filt Secr
VHVL
⛔️VR from intestines
Portal Hypertension
⏫volume (IV fluids)
Lymph obstr
Causes of Osm Diarrhea➡️paracell passive mov H2O
➡️Hypovolemia
CHO overload: ⏫VFA
Villi atrophy: mal dig/abs; bypass SI
➡LI: ️Excess fermentation
Secretory Diarrhea ➡️ Hypovolemia
Enterotoxins:✳️cAMP➡️
⛔️electroneutral NaCl abs & ✳️CFTR➡️ Cl & HCO3 secr
*Na-coup Nutri abs still active
Inflammation ➡️ Hypovolemia
Immune response
⏫WBC:⬆️PG➡️✳️cAMP ~Secr Diarr
Villi Damage➡️ Osm Diarr
Filt Secr
Ab.Motility ➡️Hypovolemia
Hypermotility: laxatives & IBM
&Hypomotility (most common)
️Hypovolemia compensation: fl. abs
SNS: ⛔️ENS & PSNS
Enkep interneurons
Aldo ➡️ LI
✳️segmentation: slow passage
⬆️fl abs ⬇️secr
Colonic Salvage
LI = large reserve capacity for electrolytes & fl abs (x3)
Impt colonic flora
Some SI Disease ➡️⛔️diarrhea symp
Pancreas
Endocrine: insulin (B) & glucagon (a)
Exocrine:
ecbolic secr➡️zymogens
hydrolatic secr➡️alk [HCO3]➡️neutralize GA
Neuro control of Pancr Secr
CGI
Cephalic: conditioned reflex➡️
PSNS➡️VIP(hydrolactic):✳️CFTR + Ach(ecbolic):✳️proenz
Gastric: food in stomach➡️
PSNS: ✳️VIP/Ach
(Prime) Intestinal phase:
Acid:⬆️Secretin+VIP➡️✳️cAMP
FA/AA in SI: ⬆️CCK+Ach:⬆️[Ca2+]
Pancreatitis
⛔️pancr duct flow➡️ autodigestion of ducts ➡️ leak proenz to blood & peritoneal cavity
Liver: CHO metab
Prime Fn: euglycemia
- Glycogenolysis (rapid)
- Gluconeogenesis
- Interconv monosacc