nausea, emesis and IBS

Question 1

what centre causes sickness due to anxiety and memories?

Answer 1

cerebral cortex

Question 2

what centre causes motion sickness and morning sickness?

Answer 2

vestibular centre

Question 3

what centre causes sickness due to GI issues, chemotherapy and radiotherapy?

Answer 3

vagus centre

Question 4

what centre causes sickness due to drugs, toxins and metabolic disorders?

Answer 4

chemoreceptor trigger zone

Question 5

what is motion sickness?

Answer 5

a disagreement between the vestibular centres perception of movement and the eyes perception of movement

Question 6

what type of drug is used to treat chemotherapy induced sickness? give a example of that drug?

Answer 6

dopamine receptor antagonist e.g metoclopramide

Question 7

what is an important thing to remember about dopamine receptor antagonist drugs duration?

Answer 7

should only be used for up to 5 days or may cause tremors and neurological adverse effects

Question 8

give 2 drug types that can be used to treat motion sickness and post op nausea?

Answer 8

antihistamines, anticholinergics

Question 9

give a side effect of motion sickness tablets?

Answer 9

drowsiness (if driving should use non drowsy tablets)

Question 10

describe the difference between chronic and acute inflammation?

Answer 10

acute is short lasting and associated with mostly leukocytes and is characterised by fluid retention and plasma proteins whereas chronic is longer and associated with lymphocytes and macrophages, characterised by blood vessel proliferation and tissue disruption

Question 11

what transcription factor controls inflammation?

Answer 11

NF-kB

Question 12

what are the 5 stages of acute inflammation?

Answer 12

• vasodilation
• increased vascular permeability
• leukocyte migration
• stasis
• phagocytosis

Question 13

what are the 2 types of inflammation mediation?

Answer 13

cell derived mediation: produced locally at the site of inflammation, pre accumulated in intracellular granules
plasma protein derived mediation: produced in the liver and circulate in the plasma

Question 14

name a drug which has powerful anti inflammatory properties?

Answer 14

glucocorticoids e.g prednisolone

Question 15

describe the cellular process of coeliac disease?

Answer 15

in coeliac patients, gluten activates transglutamase enzymes which trigger a series of cascades, ending in the activation of CD4 T cells which cause inflammation of the upper region of the small intestine

Question 16

what is crohns disease?

Answer 16

inflammatory lesions over the entire GI tract with the whole thickness of the GI wall inflamed, crohns comes in flare ups

Question 17

give 3 symptoms of crohns disease?

Answer 17

diarrhoea, weight loss and abdominal pain

Question 18

what is the first line treatment of crohns disease (include dose, direction and counselling point)?

Answer 18

corticosteroid: prednisolone
dose: 20-49mg once daily
directions: taken at night
counselling point: never stop taking it suddenly

Question 19

what is ulcerative colitis?

Answer 19

inflammation of the intestinal mucosa

Question 20

give 3 symptoms of UC?

Answer 20

over 5 stools a day
blood in stools
lack of energy (anaemia)

Question 21

what is the first line treatment for UC?

Answer 21

aminosalycyte

Question 22

what causes gout?

Answer 22

an excess of uric acid which forms crystals which deposit in joints

Question 23

what level of uric acid is considered gout?

Answer 23

above 6.8mg/100ml

Question 24

name 3 drug types that can be used to treat sickness?

Answer 24

dopamine receptor antagonists
h1 receptor antagonists
anticholinergics

Question 25

give 3 general side effects of anti sickness tablets?

Answer 25

blurred vision, urinary retention, dry mouth

Question 26

what drug is most commonly used to treat drug induced sickness?

Answer 26

dopamine receptor antagonists e.g metoclopramide

Question 27

what two drug types can be used to treat motion sickness?

Answer 27

anticholinergics and antihistamines