GI Disorders

Question 1

What are causes of vomiting?

Answer 1

• Blood-born drugs & toxins (dirty food, alcohol overdose)
• Vestibular apparatus (motion sickness)

Question 2

What occurs during vomiting?

Answer 2

-Net blood loss of H2O’
(Drop in BP, low tissues blood perfusion, low oxygen and nutrient delivery, low removal of CO2)

-Alkalosis (pH > 7.45)
(Acid loss, blood accumulation of HCO3, decrease in enzyme functions)

Question 3

What are treatments of diarrhoea?

Answer 3

• Fluids replacement (electrolytes)
• Diet: starch & simple proteins
• Opium-like drugs

Question 4

What is GIT motility increased by?

Answer 4

• Abnormal nerve activity (affects rate of water absorption)

- Osmotic effect of luminal contents (e.g. increased water-retaining substances)

Question 5

How is IBS diagnosed?

Answer 5

Symptoms at least once a week in the last in the last 3 months + 2 of below

• Pain (defecation)
• Associated with change in stool frequency
• Associated with change in stool form

Question 6

How is IBS treated?

Answer 6

• Manage stress
• Adequate fibre intake (avoid fat, gas-producing food, alcohol & caffeine)
• Antispasmodic and anticholinergic drugs

Question 7

What is osmotic diarrhoea?

Answer 7

• Ingestion of poorly absorbed substrate e.g. lactose
• Produces gas resulting in pain and flatulence
• Stops when patient stops consuming the poorly absorbed solute

Question 8

What is the mechanism behind constipation?

Answer 8

GIT flow rate decreases, contact time of contents in lumen increases, increased absorption of water and ions

Question 9

What are 2 causes of constipation?

Answer 9

• Insufficient intake of fibre/ water retaining substances

- Weakness of abdominal muscles e.g. inactivity + pregnancy

Question 10

What does the stomach secrete?

Answer 10

• Pepsinogen: inactive form of pepsin
• Hydrochloric acid: antimicrobial and activation / conversion of pepsinogen
• Mucus: protection of the mucosa

Question 11

What is peptic ulcer disease?

Answer 11

-Break/ ulceration in mucosal lining

Question 12

What are the 2 types of peptic ulcers?

Answer 12

• Duodenal

- Gastric

Question 13

What are superficial ulcers called?

Answer 13

Erosions (erode only the mucosa)

Question 14

What are true ulcers?

Answer 14

Erode through the muscularis mucosa or even deeper into submucosa

Question 15

What can true ulcers do?

Answer 15

• Damage blood vessels causing haemorrhage

- Perforate the gastro wall

Question 16

What is the primary defect of duodenal ulcers?

Answer 16

-Hypersecretion of acid and pepsin from the stomach

Question 17

What are causes of duodenal ulcers?

Answer 17

• Long term use of NSAIDs
• Helicobacter pylori infection of gastric / duodenal mucosa
• Irregular meal time
• Alcohol
• Smoking

Question 18

What are symptoms of duodenal ulcers?

Answer 18

• Chronic intermittent pain
• Empty stomach pain (2-3hrs after eating)
• “Pain-food-relief” pattern: ingestion of food + antacids relieves the pain
• Bleeding causing hematemesis + melena

Question 19

What do asymptomatic duodenal ulcers indicate?

Answer 19

First sign may be a haemorrhage / perforation

Question 20

How is duodenal ulcers diagnosed?

Answer 20

endoscopy, urea breath test

Question 21

How is duodenal ulcers has to be treated?

Answer 21

Acid suppressors

Antibiotics

Question 22

What is the primary defect of gastric ulcers?

Answer 22

Abnormality that increases the permeability of the gastric mucosa to hydrogen ions

Question 23

What are symptoms of gastric ulcers?

Answer 23

• Epigastric pain immediately after eating
• Chronic
• Vomiting + weight loss
• Cancerous

Question 24

What is jaundice caused by?

Answer 24

Hyperbilirubinemia

Question 25

What are the 3 stages of hepatitis type A?

Answer 25

• prodromal (abrupt / insidious)
• Jaundice
• Convalescent

Question 26

What does the exocrine pancreas do?

Answer 26

Releases digestive juices through a duct to the duodenum

Question 27

What does the endocrine pancreas do?

Answer 27

Releases hormones into the blood

Question 28

What do acini produce?

Answer 28

Inactive digestive enzymes and bicarbonate

Question 29

What is acute pancreatitis?

Answer 29

Sudden and severe inflammatory reaction to an acute irritant which activates and releases pancreatic enzymes

Question 30

What is the causes of acute pancreatitis?

Answer 30

Gall stone, beer BBQ

Question 31

How is acute pancreatitis diagnosed?

Answer 31

Lab: ELEVATED serum amylase + lipase

CT scan

Question 32

What is the treatment for acute pancreatitis?

Answer 32

Pain relief
Fasting
IV fluids
antibiotics