Physiology Of GI Disorders Flashcards
1
Q
Clinical Presentation of Coeliac Disease
A
- indigestion
- constipation
- diarrhoea
- bloating
- stomach pain
- anaemia
- weight loss
- fatigue
- thinning bones
- reproductive problems
- problems that affect growth/puberty
- Dermatitis Herpetiformis - red raised patches often with blisters causing severe itching and often stinging.
2
Q
Management of Coeliac Disease
A
- Gluten-free diet - cannot eat food which contains wheat, barley, rye, and similar grains. Oats do not contain gluten but avenin which is similar so may have to avoid it too.
- if they have Dermatitis Herpetiformis, they can be given Dapsone as well as gluten-free diet.
3
Q
Clinical Presentation of Acute Pancreatitis
A
- Grey Turner’s Sign - bruising on side/back - caused by haemorrhagic fluid spreading from the posterior pararenal space ro the lateral edge of the quadratus lumborum muscle and thereafter to the subcutaneous tissues by means of defect in fascia.
- Cullen’s Sign - Periumbilical ecchymosis - due to tracking of blood from retroperitoneum to umbilicus along the gastrohepatic and falciform ligaments.
4
Q
Clinical Presentation of Hirschsprung Disease
A
- short segment of colonic aganglionosis
- typically first presents with failure to pass meconium in first 2 days after birth. Approx 75% present in first 6 weeks.
- definitive diagnosis requires full thickness rectal biopsy.
5
Q
Management of Hirschsprung Disease
A
Surgical removal of affected portion of colon.
6
Q
Causes of Vomiting in Newborns
A
- May have swallowed material during delivery.
- Overfeeding.
- Swallowed air.
- Gastrointestinal Atresia.
- Increased Intercranial Pressure.
- Duodenal Atresia.
- Hypertrophic Pyloric Stenosis.
- Non-obstructive causes include cows milk protein allergy, congenital adrenal hyperplasia, galactosaemia, hyperammonaemias, organic acidaemias, septicaemia, meningitis and UTIs.
7
Q
Side effects of Anticholinergic Drugs
A
- Urinary retention (cant pee)
- Blurred vision (cant see)
- Dry Mouth (cant spit)
- Constipation (cant shit)
- Drowsiness or sedation
- Dizziness
- Confusion or delirium
- Hallucinations
- Reduced sweating and elevated body temperature.
8
Q
Effect of Complex Neurodisability on GIT Problems
A
- Sialorrhea/drooling
- Affect peristalsis and emptying
9
Q
Ways to Combat GIT Problems Caused by Complex Neurodisability
A
- Anticholinergics
- Transdermal Scopolamine Patches
- Botulinum Toxin A Injections into glands
- Gastronomy
- Jejunal Tube Feeding
10
Q
Toilet Training
A
- try to make it a positive experience - have to try make it as fun as possible, praise, routine, take it in steps (potty > step + seat > toilet).
- if they have a bad experience, they hold it in, become constipated and then it is sore so it becomes a cycle. Laxatives can help in this situation.
11
Q
Malrotational Intestinal Obstruction
A
- 1- obstruction of the duodenum may result from congenital peritoneal bands (Ladds bands) which run over the duodenum from the caecum in the right upper quadrant.
- 2- a midgut volvulus.
- 3- internal hernia in the mesentry.
12
Q
Paralytic Ileus
A
- Functional obstruction caused by malfunction in the nerves in the intestine and subsequent impairment of peristalsis.
- Caused by 5P’s- Postoperative, Peritonitis, Potassium low, Pelvic and spinal fractures, Parturition.
- Symptoms include nausea, vomiting, distension, reduced/absent bowel movements and sounds.
- Generalised, uniform, gaseous distension of the large and small bowel is evident on radiographs.
13
Q
Large Bowel Obstruction
A
- Most common cause is colonic cancer, typically in sigmoid.
- Second most common cause is acute diverticulitis.
14
Q
Small Bowel Obstruction
A
-Most common cause is adhesions in developed countries and incarcerated hernias in developing countries..
15
Q
Hypertrophic Pyloric Stenosis
A
- Causes projectile vomiting
- Can begin anytime after birth (but do not assume its characteristic pattern before week 2/3).
- Occurs in every 3/1000 babies.
- Treated by pyloromyotomy.
