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CHI 335 > Lecture 8 GI System Part 1 > Flashcards

Lecture 8 GI System Part 1 Flashcards

1
Q

What is the regulator of nutrition intake?

A

Hypothalamus

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2
Q

What is the factor of nutrition intake?

A
  1. Hunger
  2. Thirst
  3. Satiety
  4. Food availability
  5. Emotional and physical health
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3
Q

Describe altered nutrition.

A

Inadequate or excessive digestion, absorption, transportation or metabolism of nutrients.

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4
Q

What is the cause of altered nutrition?

A
  1. Genetic defects
  2. Ineffective mucosa
  3. Inadequate or excessive intake
  4. Excessive nutrient losses
  5. Hyper-metabolic syndromes
  6. Ingestion of unsafe food and water.
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5
Q

What is inherited metabolic disorder?

A
  1. Error in amino acid and lipid metabolism
  2. Commonly a problem of a genetically based defect in enzyme activity.
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6
Q

Give me 2 examples of inherited metabolic disorders.

A
  1. Phenylketonuria (PKU)
  2. Tay-sachs disease
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7
Q

Patient has error in amino acid and lipid metabolism and genetically based defect in enzyme activity.
What is the disease?

A

Inherited metabolic disorder

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8
Q
  1. Inadequate calorie consumption
  2. inadequate intake of vitamins mineral
  3. Problems with digestion, absorption or distribution of nutrition in body

What is the disease?

A

undernutrition

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9
Q

What is the results of experiencing undernutrition?

A
  1. Weight loss
  2. muscle wasting
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10
Q

The patient experiencing weight loss and muscle wasting. What is the disease?

A

Undertake nutrition.

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11
Q

What is overnutrition?

A
  1. Excessive consumption of nutrient.
  2. Excessive caloric intake
  3. Vitamin or mineral toxicity
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12
Q

What is malaborption (吸收不良)?

A

Lack of movement of one or more nutrients across the gastrointestinal mucosa

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13
Q

What problems causes the malabsorption?

A
  1. problems with processing or digesting nutrients
  2. with intestinal mucosa
  3. lymphatic obstruction
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14
Q

What is food allergy?

A

Immune system - mediated adverse reaction to foods.

E.g.
Eggs, peanuts, milk, soy, fish and shellfish, tree nuts, wheat

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15
Q

Give me five sign of altered nutrition.

A
  1. Weight loss or gain
  2. Muscle wasting and weakness
  3. Changes in skin and mucous membrane
  4. Problems with wound healing, infection
  5. Dehydration, diarrhea, abdominal pain
  6. Fatigue
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16
Q

What is the diagnostic strategies related to Altered Nutrition?

A
  1. Nutritional assessment
    e.g. Multiple day dietary intake recall, measure of height, weight –> BMI
  2. Laboratory tests
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17
Q

Give me 5 treatment strategies for altered nutrition.

A
  1. Dietary interventions
    1.1 Increase intake of particular macronutrient
    1.2 Taking vitamin and mineral supplements
    1.3 Reducing overall caloric intake
    1.4 Avoiding specific foods

2 Pharmacologic intervention
2.1 exogenous digestive enzyme

18
Q

Give me 4 examples of abdominal pain — GI in gastroduodenal.

A
  1. PUD
  2. Gastritis
  3. Malignancy
  4. Gastric volvulus
19
Q

Give me 10 examples of abdominal pain — GI in intestinal.

A
  1. Appendicitis ⭐️
  2. Obstruction ⭐️
  3. Diverticulitis
  4. Gastroenteritis
  5. Mesenteric adenitis
  6. Strangulated hernia
  7. IDB ⭐️
  8. Intussusception
  9. Volvulus
  10. TB ⭐️
20
Q

Give me 4 example of abdominal pain — GI in hepatobiliary.

A
  1. Acute cholecystitis
  2. Chronic cholecystitis
  3. Cholangitis
  4. hepatitis
21
Q

Give me 3 examples of abdominal pain — GI in pancreatic.

A
  1. Acute pancreatitis
  2. Chronic pancreatitis
  3. Malignancy
22
Q

Give me 3 examples of abdominal pain — GI in Splenic.

A
  1. Traumatic Rupture
  2. Spontaneous Rupture
  3. Infarction
23
Q

Give me 7 examples of abdominal pain — GI in urinary tract.

A
  1. Cystitis ⭐️
  2. Acute retention of urine
  3. Acute pyelonephritis
  4. ureteric colic ⭐️
  5. Hydronephrosis
  6. Tumour ⭐️
  7. Polycystic kidney ⭐️
24
Q

Give me 7 examples of abdominal pain — GI in Gynaecological (婦科).

A
  1. Ruptured ectopic pregnancy ⭐️
  2. Ruptured/ Torsion of ovarian cyst
  3. Salpingitis ⭐️
  4. Severe dysmenorrhoea
  5. Mittelschmerz
  6. Endometriosis ⭐️
  7. Degeneration of fibroid ⭐️
25
Q

Give me 6 examples of abdominal pain — GI in Vascular.

A
  1. Aortic aneurysm
  2. Mesenteric embolus ⭐️
  3. Mesenteric angina ⭐️
  4. Mesenteric venous thrombosis ⭐️
  5. Ischaemic colitus
  6. Acute aortic dissection ⭐️
26
Q

Give me 8 examples of abdominal pain — GI in Medical causes

A
  1. Hypercalcaemia
  2. Uraemia ⭐️
  3. Diabetic ketoacidosis
  4. Sickle cell disease ⭐️
  5. Addison’s disease ⭐️
  6. Acute intermittent porphyria
  7. Henoch - schonlein purpura
  8. Tabes dorsalis ⭐️
27
Q

Give me 7 abdominal pain — referred pain?

A
  1. Myocardial infarction ⭐️
  2. Pericarditis ⭐️
  3. Pleurisy ⭐️
  4. Thoracic spine disease e.g. disc, tumor ⭐️
  5. Testicular torsion
  6. Herpes zoster
  7. Lobar pneumonia
28
Q

Give me 7 other symptoms of abdominal pain.

A
  1. Heartburn and regurgitation
  2. Dysphagia
  3. Diarrhoea ⭐️
  4. Constipation ⭐️
  5. Bleeding ⭐️
  6. Jaundice ⭐️
  7. Pruritus
29
Q

Give me 7 signs of disease that present with both skin and gut involvement.

A
  1. Dermatitis herpetiformis (Coeliac disease)
  2. Acantosis nigricans (Malignancy, DM)
  3. Porphyria cutanea tarda (Alcoholic liver disease)
  4. Generalized pigmentations (Hemochromatosis)
  5. Brown-black lesion of the lips (Peutz - jeghers syndrome)
  6. Pallor (IDA)
  7. Ecchymoses (Liver failure)
30
Q

Give me 5 GI disease sign is related to weight change.

A
  1. Malabsorption
  2. Malignancies
  3. Anorexia nervosa
  4. Obesity
  5. Other metabolic / endocrine condition
31
Q

Give me 5 GI diseases sign is related to hands.

A
  1. Terry’s nail (Chronic liver disease)
  2. Clubbing (Cirrhosis, IBD, Coeliac disease)
  3. Palmar erythema (Chronic liver disease) 手掌紅斑
  4. Pallor on palmar creases (IDA)
    手掌皺紋蒼白 (IDA pallor appear on skin as well)
  5. Dupuytren’s contracture (Alcoholism)
32
Q

Give me 7 GI disease signs are related to eyes.

A
  1. Jaundice (Hyperbilirubinaemia)
  2. Anaemia
  3. Kayser - fleischer rings (Wilson disease)
  4. Iritis (IBD) IBD is a intestinal disease
  5. Xanthelasmata (elevated serum cholesterol, cholestasis)
  6. Periorbital purpura (Amyloidosis)
33
Q

Give me 7 other organ signs are relate to GI disease

A
  1. Glossitis & angular stomatitis
    舌炎和口角炎 (Iron, folate and vitamin B12 deficiencies)
  2. Gynecomastia 男性乳房發育症 (Chronic liver disease)
  3. Generalised abdominal distension (fat, fluid, fetus, flatus, faeces, big tumor, ovian tumour or hydrate cyst)
  4. Prominent abdominal veins and caput medusae (severe portal HTN)
  5. Pulsation (could be normal or indicate AAA)
  6. Skin discolouration or lesions
  7. Hepatomegaly (infection, infiltrative, neoplastic, metabolic, vascular)
34
Q

Give me 4 possible signs of skin discolouration or lesions in GI disease.

A
  1. Herpres zoster
  2. Cullen’s sign (Acute pancreatitis)
  3. Grey - Tuner’s sign (Acute pancreatitis)
  4. Spider naevus (Alcoholic liver disease, Hepatitis B and C, pregnancy)
35
Q

What can chronic liver disease lead to?

A

Skin:
Terry’s nail
Palmar erythema

Other:
Gynecomastia

36
Q

What can IDA lead to?

A

Skin:
Pallor

Hand:
Pallor on palmar creases

37
Q

Give me 3 sign and symptom of Acute Liver Disease.

A
  1. Asymptomatic (無症狀) and anicteric (無黃疸)
  2. Generalised symptoms of malaise (全身乏力), anorexia (厭食) and fever
  3. Jaundice appears as the illness progresses
38
Q

Give me 8 sign and symptom of Chronic liver disease

A
  1. Asymptomatic or complain of non specific symptom. (fatigue)
  2. Right hypochondria pain (Liver distension)
  3. Abdominal distension (Ascites)
  4. Ankle swelling (Oedema)
  5. haematemesis and melaene (Gl bleeding — variceal)
  6. Pruritus (Cholestasis)
  7. Gynaecmastia, loss if libido and amenorrhoea (endocrine dysfunction)
  8. Confusion and drowsiness, neuropsychiatric complications (hepatic encephalopathy)
39
Q

What is the S&S key different between Acute Liver Disease and Chronic Liver Disease?

A

Symptom:
1. liver distension
2. Ascites
3. Oedema
4. GI bleeding — visceral
5. Cholestasis
6. Endocrine dysfunction
7. Hepatic encephalopathy

40
Q

What is the pertinent investigations of GI disease?

A
  1. blood tests
  2. imaging
  3. Breath test
  4. Endoscopy
  5. Other
41
Q

Give me 7 liver function test.

A
  1. ALT : Specific for liver and has liver disease will raise
  2. AST: Hepatic Necrosis, MI, muscle injury and CHF will raise
  3. GGT: Obstruction (cholestasis), Meds and Alcohol will raise
  4. ALP: Non-specific, Liver,
  5. Serum Bilirubin
  6. PT
  7. Protein
42
Q

What are the 3 patterns of hyperbilirubinaemia (jaundice)

A
  1. Pre-hepatic: increased bilirubin production (UP unconjugated)
  2. Hepatic: Liver dysfunction (NO conjugation)
  3. Post-hepatic (Cholestatic) (UP conjugated)

CHI 335 (8 decks)

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