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Patho-Pharm > Patho-Pharm Exam 1 - GI > Flashcards

Patho-Pharm Exam 1 - GI Flashcards

1
Q

What hormone stimulates parietal cell release of HCl?

A

Gastrin

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2
Q

What part of the autonomic nervous system is involved in the cephalic phase of digestion?

A

The parasympathetic

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3
Q

What phase of digestion is stimulated when you think about food?

A

Cephalic phase

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4
Q

The presence of food in the stomach stimulates what hormone release?

A

Gastrin

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5
Q

In what part of the stomach is gastrin released from?

A

The antrum of the stomach

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6
Q

What happens to the chyme in the stomach when it mixes with gastrin?

A

Becomes very acidic

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7
Q

What is the hormone that is released in the duodenum that stimulates the release of buffers?

A

Secretin

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8
Q

What two organs does secretin stimulate>

A

Liver and pancreas

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9
Q

What do the liver and pancreas release when stimulated by secretin?

A

Bicarb (HCO3) and water

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10
Q

What is the end result of secretin excretion by the duodenum?

A

Buffers the acidic chyme

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11
Q

What hormone is released in the duodenum that is involved in fat digestion?

A

Cholecystokinin

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12
Q

What organ does cholecystokinin stimulate?

A

The gallbladder

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13
Q

What does the gall bladder release upon stimulation with cholecystokinin?

A

Bile

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14
Q

What is the trigger for the release of cholecystokinin?

A

Presence of fat in the small intestine

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15
Q

What GI hormone is released when chyme moves into the small intestine?

A

Gastric inhibitory peptide

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16
Q

Where is gastric inhibitory peptide released from?

A

Intestinal mucosa

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17
Q

What does gastric inhibitory peptide cause?

A

Stomach shutdown, decrease in acid release and motility

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18
Q

What hormone keeps the empty stomach moving?

A

Motilin

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19
Q

Motilin is triggered when?

A

When stomach is empty or has food in it that can’t be digested

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20
Q

What hormone is released upon the cephalic phase of digestion?

A

Gastrin

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21
Q

What hormone stimulate liver and pancreas to release bicarb and water and where is it released from?

A

Secretin

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22
Q

What hormone is triggered by fat and where is it released from?

A

Cholecystokinin, from the duodenum

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23
Q

What hormone is secreted when chyme moves into the small intestine?

A

Gastric inhibitory peptide

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24
Q

What hormone is triggered when the stomach is empty or when you’re sleeping?

A

Motilin

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25
Q

Cephalic, gastric and intestinal are three phases of what?

A

Gastric secretion

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26
Q

In what phase of gastric secretion does gastric secretion begin?

A

Cephalic

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27
Q

What type of input stimulates the cephalic phase of digestion?

A

Sensory input

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28
Q

What is the second phase of gastric secretion?

A

Gastric phase

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29
Q

In what phase of digestion does gastric secretion stop?

A

Intestinal phase

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30
Q

What are released in the exocrine function of the pancreas?

A

Digestive enzymes and bicarb

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31
Q

What does the pancreas release through the endocrine function?

A

Insulin

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32
Q

What digestive hormone is considered the “fireman”?

A

Secretin

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33
Q

What hormone cleans the gut for the next meal?

A

Motilin

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34
Q

What is the valve that allows food to move from the stomach to the small intestine?

A

Pyloric sphincter

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35
Q

What are the folds in the stomach that allow it to stretch?

A

Rugae

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36
Q

What parts of the digestive system absorb the following?

  • Sugars, proteins
  • Water, electrolytes
  • Iron, calcium, fats, sugars, protein, electrolytes, vitamins, magnesium, sodium
  • Water, alcohol
  • Bile sales, B12, chloride
A

Jejunum - Sugars, proteins
Colon - Water, electrolytes
Duodenum - Iron, calcium, fats, sugars, protein, electrolytes, vitamins, magnesium, sodium
Stomach - Water, alcohol
Ilieum - Bile sales, B12, chloride

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37
Q

How long is the small intestine?

A

20 ft

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38
Q

What is the diameter of the small intestine?

A

1 inch

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39
Q

What is the pH of chyme when it arrives in the small intestine?

A

2.0

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40
Q

After the secretion of what hormone is the pH of chyme decreased to 6.3?

A

Secretin

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41
Q

How long is the large intestine?

A

5 feet

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42
Q

What part of the digestive system absorbs water from solid waste and eliminates wastes by evacuating bowels?

A

The large intestine

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43
Q

How much water does the large intestine absorb?

A

1.5 - 6 L

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44
Q

How many liters of fluid move through the intestines daily?

A

9 L

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45
Q

Of the 9 liters of water that moves through the intestines daily, how much is from intake?

A

2 L

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46
Q

What does PPN stand for?

A

Partial parenteral nutrition

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47
Q

Is PPN a short term or long term solution to intake?

A

Short term

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48
Q

What is PPN administered through?

A

A peripheral vein

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49
Q

What does TPN stand for?

A

Total parenteral nutrition

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50
Q

Through what is TPN administered?

A

Central line

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51
Q

Why is TPN nutrition caustic?

A

Because of the sugars

52
Q

In what type of nutritional administration is there a high risk of infection and why?

A

TPN, the sugars

53
Q

Is and NG tube short or long-term solution to nutritional adminstration?

A

Short

54
Q

Radiographic placement confirmation is required of what feeding methods?

A

Nasojejunal and nasoduodenal

55
Q

What is a delay or difficulty with defecation present for two or more weeks?

A

Constipation

56
Q

What is the failure to completely evacuate the bowles called?

A

Constipation

57
Q

What can the following cause?

Dehydration, lack of fiber, lack of exercise, obstruction, medicines, change in diet, certain foods, anesthesia

A

Constipation

58
Q

What are non-pharmaceutical interventions to constipation?

A

Moving patient, fluids, fiber, massage, if on bedrest, reposition frequently

59
Q

What type of constipation is associated with physical abnormalities?

A

Acute

60
Q

What type of constipation is associated with lifelong bowel and dietary habits and laxative use?

A

Chronic

61
Q

What is the indication for laxatives?

A

Relief of constipation or prep bowel for procedure

62
Q

What is the most overused and incorrectly used OTV medication?

A

Laxatives

63
Q

Should laxatives by used for abdominal pain?

A

No

64
Q

What bulk-forming laxative is the safest, OTC recommended for long-term use?

A

Psyllium (Metamucil) - natural
Methylcellulose (Citrucel) - synthetic

65
Q

What is the MOA of psyllium?

A

Draw water into the colon and increase bulk

66
Q

If not take with liberal water, what can psyllium case?

A

Esphageal or intestinal obstruction

67
Q

When’s the best time to take psyllium?

A

At bedtime

68
Q

What should be monitored with all laxatives?

A

Fluid and electrolyte levels

69
Q

Is psyllium immediate acting?

A

No

70
Q

What laxative is an emollient?

A

Docusate sodium

71
Q

Is docusate sodium a stimulant?

A

No

72
Q

How long does it take docusate sodium to work?

A

6-12 hours

73
Q

Docusate sodium and what are 2 emollients?

A

Mineral oil

74
Q

What is the MOA of emollients?

A

Lubricates stool & GI tract
Softens stool by lowering surface tension
Allows water and fat to be absorbed into stool

75
Q

Is an electrolyte balance an adverse effect of emollients?

A

Yes, as with all laxatives

76
Q

Magnesium hydroxide, magnesium sulfate, magnesium citrate sodium are what type of laxatives?

A

Saline laxatives

77
Q

What is the mode of action of saline laxatives?

A

Increase osmotic pressure and draw water into colon

78
Q

What laxatives increase osmotic pressure and which are hyperosmotic?

A

The salines (magnesiums) increase osmotic pressure and the hyperosmotics are sugar based: polyethylene glycol, lactulose, sorbitol, glycerin.

79
Q

What’s the difference in adverse effects of hyperosmotics vs. salines?

A

Hyperosmotics can cause bloating as well as electrolyte imbalance. Salines only cause electrolyte imbalance.

80
Q

How quickly will saline laxatives work?

A

3 hours

81
Q

What type of laxatives are senna and bisacodyl?

A

Stimulants

82
Q

Wha tis the MOA of stimulant laxatives?

A

Induce intestinal peristalsis, increase water retention

83
Q

What is the site of action of plant extract stimulants?

A

The entire GI tract

84
Q

What adverse effects can occur with stimulant laxatives?

A

Skin rash, malabsorption of nutrient, electrolyte imbalances

85
Q

At what speed do the different pharmacologic classes of laxatives work? (list from fastest to slowest)

A

Stimulant (bisacodyl) - suppository - hold for 10-15 minutes to melt before movement, pill 10-45 minutes
Hyperosmotics (sugar-based) - 30-60 minutes
Salines (Magnesiums) - 3 hrs
Stimulants (senna) - take at nite - 8 hours
Emolliants (Docusate sodium, mineral oil) 6-12 hrs
Bulk-forming (psyllium) - 12-72 hrs

86
Q

Electrolyte imbalance, cramps, diarrhea, dehydration gas, nausea are all adverse effects of what?

A

Laxatives

87
Q

Chronic diarrhea last how long?

A

More than 2 weeks

88
Q

Acute diarrhea last how long?

A

Up to one week

89
Q

Acute diarrhea is usually attributed to what?

A

Most common-virus. Also bacterial or parasitic.

90
Q

What is the BRAT diet used for?

A

Diarrhea

91
Q

What should be administered IV or oral to support a patient with diarrhea?

A

Fluids

92
Q

Accessing skin turgor and mucous membranes should be monitored for what condition?

A

Diarrhea

93
Q

Ginger ale and flat Coke assist with what condition?

A

Diarrhea

94
Q

What does the BRAT diet stand for?

A

Bananas
Rice
Applesauce
Tea

95
Q

Do you want to stop diarrhea or not?

A

Don’t want to stop it. Want that stuff out.

96
Q

Spicy foods, smoking, hiatal hernia, fatty foods, chocolate, pregnancy, obesity and nasogastric tube can cause what condition?

A

GERD

97
Q

What is GERD?

A

Gastrointestinal reflux disease

98
Q

What are the two types of cells at the distal end of the esophagus?

A

Smooth squamous followed by columnar at end.

99
Q

What happens to cause GERD that involves the columnar epithelium in the esophagus?

A

When HCl acid moves above the columnar epithelium, damage occurs

100
Q

How do anti-cholinergics cause GERD?

A

By slowing down peristaltic action

101
Q

Fowl taste, epigastric pain, dry cough and laryngitis are symptoms of what?

A

GERD

102
Q

If GERD is not managed, it can lead to a cascade of conditions? Put them in sequential order.

Barret esophagus
Erosive esophagitis
Esophageal adenocarcinoma

A

Erosive esophagitis
Barret esophagus
Esophageal adenocarcinoma

103
Q

What is Barrett’s esophagus?

A

When the flat, pink lining of the esophagus becomes thickened and red due to acid reflux.

104
Q

The following are non-pharmacological interventions for what condition?

Eat smaller, more frequent meals
Avoid eating before bedtime
Avoid alcohol, aspirin, ibuprofen and caffeine
Stop smoking
Elevate head of bed

A

GERD

105
Q

What is the MOA of antacids?

A

Neutralizes present gastric acid following dissolution in gastric contents

106
Q

Do antacids stop acid production?

A

No

107
Q

What helps promote secretion of mucous and prostaglandins to stop HCl and increase bicarb?

A

Antacids

108
Q

An increase or decrease in cardiac sphincter tone occurs with antacids?

A

Increase

109
Q

A dose of antacid can do what to gastric pH

A

Raise gastric pH from 1.3 to 1.6

110
Q

Raising gastric pH from 1.3 to 1.6 is a what % decrease in gastric acidity?

A

50%

111
Q

What is the adverse effect of magnesium antacids?

A

Constipation

112
Q

What is the adverse effect of aluminum and calcium antacids?

A

Constipation

113
Q

What is the adverse effect of calcium antacids?

A

Kidney stones, rebound acidity afer discontinuing, CV rhythm disturbances

114
Q

Sustained use of sodium bicarb as an antacid can lead to what?

A

Metabolic alkalosis

115
Q

Most antacids are secreted by what organ?

A

The kidney

116
Q

What type of antacid products are contraindicated for patients with renal problems?

A

Magnesium products

117
Q

What medication should you avoid if you are on a sodium bicarb?

A

Aspirin

118
Q

When should antacids be taken?

A

After meals or before bed.

119
Q

Sodium bicarb may negate protective effects of which type of products?

A

Enteric coated products

120
Q

Calcium carbonate as an antacid can contribute to what condition?

A

Constipation

121
Q

Magnesium hydroxide as an antacid can contribute to what condition?

A

Diarrhea

122
Q

What is considered the onset of antacids?

A

Immediate

123
Q

Are antacids intended for long or short term use?

A

Short term

124
Q

If BUN is increased, that’s an indication of what?

A

Dehydration

125
Q

If creatinine is increased only, what organ is affected?

A

Kidney function

Patho-Pharm (8 decks)

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