Patho Exam 4 Flashcards
What effect is a result of inhibiting the parasympathetic nervous system with a drug such as atropine?
Salivation decreases
What does B-Adrenergic stimulation from sympathetic fibers cause?
increased salivation
Which gastric cells secrete hydrochloric acid and intrinsic factor?
Parietal
Which enzyme breaks down protein-forming polypeptides in the stomach?
Pepsin
Which gastric hormone inhibits acid and pepsinogen secretion, as well as decrease the release of gastrin?
Somatostatin
Exposure to which substance protects the mucosal barrier of the stomach?
Prostaglandins
Which statement best describes the gastrointestinal tract?
The gastrointestinal tract is a hollow tube that extends from the mouth to the anus.
Which statement is true regarding the state of the intestinal tract at birth?
The intestinal tract is sterile
What is the role of the normal intestinal bacterial flora?
Metabolizing bile salts, estrogens, and lipids
Which structure synthesizes clotting factors and the vitamin K necessary for hemostasis?
Liver
The process of conjugation of bilirubin in the liver is best described as which transformation?
Unconjugated (fat-soluble) bilirubin into conjugated (water-soluble) bilirubin
What type of diarrhea is a result of lactase deficiency?
Osmotic
A person who has cholera would be expected to have which type of diarrhea?
Secretory
Which statement is false concerning how abdominal pain is produced?
(True:Chemical mediators, such as histamine, bradykinin, and serotonin, produce abdominal pain. Edema and vascular congestion produce abdominal pain by stretching. Ischemia, caused by distention of bowel obstruction or mesenteric vessel thrombosis, produces abdominal pain.)
Low concentrations of anaerobes, such as Streptococci, Lactobacilli, Staphylococci, Enterobacteria, and Bacteroides, produce abdominal pain.
Which statements are true regarding parietal pain? (Select all that apply. 4)
- Parietal pain arises from the parietal peritoneum. 2. It is generally more localized than visceral pain.
- Nerve fibers that travel to the spinal cord are involved in parietal pain.
- Parietal pain corresponds to dermatomes T6 and L1.
How can abdominal pain that is visceral in nature best be described?
Abdominal pain that is visceral in nature is diffused, vague, poorly localized, and dull.
What is the cause of gastroesophageal reflux disease?
Zone of low pressure of the lower esophageal sphincter
What is the cause of reflux esophagitis?
Delayed gastric emptying
By what mechanism does intussusception cause an intestinal obstruction?
Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply
Protrusion of intestine through weakness in abdominal muscles or inguinal ring
Herniation
Twisting of the intestine on its mesenteric pedicle with occlusion of blood supply; associated w/fibrous adhesion & most common in large intestine of older adults
Torsion (volvulus)
Inflamed saccular herniations (diverticula) of mucosa & submucosa through tunica muscularis of colon; most common in obese people over 60.
Diverticulosis
Growth in the intestinal lumen
Tumor
Loss of peristaltic motor activity in the intestine associated with abdominal surgery, peritonitis, hypokalemia, ischemic bowel, spinal trauma, pneumonia, neuropathies, or myopathies.
Paralytic (adynamic) ileus
Peritoneal irritation from surgery or trauma leading to formation of fibrin & adhesions that attach to intestines.
Fibrous adhesions
What is the most immediate result of a small intestinal obstruction?
Distention
What are the cardinal symptoms of small intestinal obstruction?
Colicky pain caused by distention, followed by vomiting
An intestinal obstruction at the pylorus or high in the small intestine causes metabolic alkalosis by causing which outcome?
Excessive loss of hydrogen ions normally absorbed from gastric juices
What is a cause of chronic antral gastritis?
Helicobacter pylori bacteria
Which statements are true regarding chronic gastritis? (Select all that apply.4)
- Chronic gastritis tends to occur in older adults.
- Results in chronic inflammation and mucosal atrophy.
- Mucosal atrophy is a common outcome.
- Epithelial metaplasia is often observed.
Chronic gastritis treatment: (3)
- Smaller meals; soft, bland diet; avoidance of alcohol and NSAIDs
- Administration of combination antibiotics
- Vitamin B: For pernicious anemia correction
After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism?
Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen
Which statement is consistent with dumping syndrome?
Dumping syndrome usually responds well to dietary management.
The most common clinical manifestation of portal hypertension is what type of bleeding?
Esophageal
What is the most common manifestation of portal hypertension–induced splenomegaly?
Thrombocytopenia
Which statement is false concerning the pathophysiologic process of alcoholic cirrhosis? (True:Alcohol is transformed to acetaldehyde, which promotes liver fibrosis, mitochondrial function is impaired decreasing oxidation of fatty acids, & acetaldehyde inhibits export of proteins from the liver.)
Inflammation and damage leading to cirrhosis begin in the bile canaliculi.
Hepatic fat accumulation is observed in which form of cirrhosis?
Alcoholic
Which statement is false regarding the pathophysiologic process of acute pancreatitis? (True: Bile duct or pancreatic duct obstruction blocks the outflow of pancreatic digestive enzymes. Acute pancreatitis can also result from direct cellular injury from drugs or viral infection. Acute pancreatitis is usually mild and spontaneously resolves.)
Acute pancreatitis is an autoimmune disease in which immunoglobulin G (IgG) coats the pancreatic acinar cells; consequently, the pancreatic enzymes destroy the cells.
Common systemic disease effecting the liver causing hepatic cell necrosis, scarring, Kupffer cell hyperplasia, and hepatocyte apoptosis
Viral Hepatitis
Phases of Hepatitis:
Prodromal (preicteric), Icteric (jaundice), and Recovery phase (regulation of jaundice or beginning of chronic hepatitis).
Which are the early (prodromal) clinical manifestations of hepatitis? (Select all that apply. 3)
Fatigue, Vomiting, & Hyperalgia.
Increased gastrin secretion by the mother in the last trimester of pregnancy may cause which condition in the infant?
Pyloric stenosis
At 2 or 3 weeks of age, an infant who has been well fed and has gained weight begins to vomit for no apparent reason. The vomiting gradually becomes more forceful. These symptoms may be indicative of which disorder?
Pyloric stenosis
Which situations have been associated with possible causes of the failure to thrive (FTT) in infants? (Select all that apply. 4)
GERD, Pyloric stenosis, Intestinal parasites & Psychosocial isolation.
Meconium Plug Syndrome:
benign bowel obstruction
Meconium Aspiration Syndrome:
gasping respirations that cause meconium aspiration
Meconium Ileus:
abnormally sticky meconium causes intestinal obstruction due to lack of digestive enzymes during fetal life
Which term is used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine?
Meconium ileus
With which medical diagnosis is meconium ileus often associated?
Cystic fibrosis
Congenital aganglionic megacolon (Hirschsprung disease) involves inadequate motility of the colon caused by neural malformation of which nervous system?
Parasympathetic
What causes a person with cystic fibrosis to experience an exocrine pancreatic insufficiency?
Pancreatic ducts are obstructed with mucus.
What is the cause of faulty digestion of fats in those diagnosed with cystic fibrosis?
Deficiency of pancreatic enzymes
Cystic fibrosis is characterized by which symptom?
Excessive mucus production
Cystic fibrosis is directly responsible for complications to which structures? (Select all that apply. 2)
Cervix & Liver
Which medication compensates for the deficiency that occurs as a result of cystic fibrosis?
Pancreatic enzymes
What factor associated with gluten-sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily?
Vitamin K deficiency from fat malabsorption
Which foods should be eliminated from the diet for children who have gluten-sensitive enteropathy (celiac sprue)? (Select all that apply.2)
Red meat & Dairy
Clinical manifestations of Celiac Disease:
: diarrhea, meconium ileus; pale, bulky, greasy, foul smelling stool; FTT; Malabsorption syndromes: Rickets bleeding, anemia, fat-soluble vitamin deficiency; Mag & Cal malabsorption: irritability, tremor, convulsions, tetany, bone pain, dental abnormalities, osteomalacia.
Blood vessels of the kidneys are innervated by the:
Sympathetic nervous system
What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?
Juxtaglomerular apparatus (JGA)
What effects do exercise and body position have on renal blood flow?
They activate renal sympathetic neurons and cause mild vasoconstriction.
What is the functional unit of the kidney called?
Nephron
The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland?
Posterior pituitary
What effect do natriuretic peptides have during heart failure when the heart dilates?
Inhibits renin and aldosterone.
What is the direct action of atrial natriuretic hormone?
Sodium excretion
What is the action of urodilatin (a natriuretic peptide)? It inhibits salt and water reabsorption
It inhibits salt and water reabsorption
Which statement is true regarding urodilatin?
Urodilatin is stimulated by a rise in blood pressure and an increase in extracellular volume.
Which renal change is found in older adults?
Decrease in the number of nephrons
Compared with a younger individual, how is the specific gravity of urine in older adults affected?
Specific gravity of urine in older adults is considered low normal.
Regarding the formation of renal calculi, what function does pyrophosphate, potassium citrate, and magnesium perform?
They inhibit crystal growth.