Pathophysiology of the GIT

Question 1

features of a bulbar palsy

Answer 1

LMN  lesion 
reduced palatal sensation 
reduced gag 
choking 
dysphasia 
flaccid tongue

Question 2

features of a psuedobulbar palsy

Answer 2

UMN lesion
Spastic tongue
jaw jerk increase

Question 3

What can cause dysphagia

Answer 3

Benign obstruction
oesophageal carcinoma
achalasia - peristalsis failure

Question 4

What is Gastro oesophageal reflux disease (GORD)

Answer 4

Transient relaxation of lower oesophageal sphincter between meals
loss of valve effect of an intra-abdominal oesophagus/diaphragmatic constriction
fialure of mucosal defence mechanisms

Question 5

What are some consequences of GORD

Answer 5

Oesphagitis and heartburn

increase in ?

Question 6

Treatment for GORD

Answer 6

Weight loss
Aliginates to heal mucosa
antacids
reducing acid production

Question 7

Side effects of a large amount of vomiting

Answer 7

large fluid loss - dehydration

HCl loss- risk of hyperchloremic alkalosis

Question 8

Features of bowel obstruction

Answer 8

Pain 
Nausea/vomiting/constpiraion 
sounds 
dehdration 
abdominal distension 
X-ray signs

Question 9

Causes of bowel obstruction

Answer 9

Lumen blocked
Wall tumour
Adhesions
ileus

Question 10

Causes of diarrhoea

Answer 10

Increase in intestinal activity
Malabsorption
increase in intestinal secretion
Intestinal inflammation

Question 11

2 Common microorganisms associated with

Answer 11

e. coli

c difficile

Question 12

What can diarrhoea lead to

Answer 12

Dehydration
K+ and HCO-3 loss
hypokaelamia metabolic acidosis

Question 13

Common bowel defects

Answer 13

IBD
infective dysentry - cause of dehydration
not reabsorb water in a large bowel

Question 14

features of constipation

Answer 14

< 3 stools a week 
straining more than 25% of the time 
hard stools ( grading )
incomplete evacuation 
anrectal blockage

Question 15

What is meant by transit time

Answer 15

Time taken from mouth to anus

Question 16

What are defactory disorders

Answer 16

Contraction of EAS
anterior rectocele
rectak prolapse during straining

Question 17

What is meant by a megacolon

Answer 17

Dilated colon
Prolonged constipation
Hirschprungs disease- non- functioning rectum

Question 18

Management for megacolon

Answer 18

May need to be surgical perforation

Dietary fibre and fluid
Laxatives- acute releif

Question 19

Neuro/psychological causes of faecel incontinence

Answer 19

Spinal trauma - transection 
Stroke 
Nerve damage
Dementia 
Spina bifida 
MS

Question 20

Causes of anal sphincter dysfunction

Answer 20

AR nerve damage

Perineal descent

Question 21

Problems with the slaivary glands

Answer 21

Dry mouth 
- Sjug rens syndrome 
- drugs 
- dehydration/shock 
Salivary duct obstruction

Question 22

Gastric acid secretion 3 phases

Answer 22

Cephalic phases
gastric phase
intestinal phase

Question 23

What is malabsorption

Answer 23

Failure of digestion and absorption

Question 24

Why would there be failure of digestion

Answer 24

pancreatic failure
specific failure
bile salt failure

Question 25

Why would there be failure of absorption

Answer 25

decrease in SA for absorption
coeliac disease
intestinal resection

Question 26

consequences of malabsorption

Answer 26

Diarrhoea
wieght loss
abdominal pain
ADEK deficiency

Question 27

management required for malabsorption

Answer 27

Treat disorder
supplement enzyme
treat deficiencies
bypass digestion