Trauma and Nuitrition (GI pathology)

Question 1

What is Shock?

Answer 1

• Interruption to the supply of substrates to the cell (oxygen, glucose, water ect.)
• Interruption to the removal of metabolites from the cell.

Question 2

What happens in Phase 1 of Shock?

Answer 2

• Develops 2-6hrs after injury.
• Cytokines, catecholamines and cortisol secreted.
• tachycardia
• increased respiratory rate.
• peripheral vasoconstriction (to preserve organs)
• Hypovolaemia (decreased blood volume)

Question 3

What happens in Phase 2 of shock (catabolic state)

Answer 3

• develops 2days post injury
• increased O2 consumption
• increased metabolic rate
• increased glycolysis
• lipolysis (breakdown adipose for energy)

Question 4

What happens in Phase 3 of shock (anabolic state)

Answer 4

Restoration of:

• protein synthesis
• nitrogen balance
• fat stores
• muscle strength

Question 5

What is happens during the inflammatory response at the trauma site?

Answer 5

1) Pathogens enter wound,
2) Platelets release clotting factors
3) Mast cells cause vasodilation, to increase blood flow to area.
4) Neutrophils/Macrophages phagocytose pathogens.

Question 6

What are the 5 signs of inflammation?

Answer 6

1) Heat
2) Redness
3) Swelling
4) Pain
5) loss of function

Question 7

What are the endocrine effects of cytokines?

Answer 7

Cytokines mediate the secretion of catabolic hormones such as glucagon,

They also inhibit anabolic hormones such as growth hormone.

Question 8

What happens when glucose and oxygen supplies stop?

Answer 8

1) Glycgenolysis (glycogen to glucose convertion)
2) Gluconeogenesis (breakdown of amino acids to from glucose)
3) Lipolysis and Ketogenesis

ANAEROBIC RESPIRATION in absence of Oxygen. Produces Lactate. So cannot occur when lactate becomes toxic.

Question 9

What is Primary Malnuitrition?

Answer 9

• Protein-calorie undernuitrition

- deficiency of specific nutrients

Question 10

What is Secondary Malnuitrition?

Answer 10

• appetite suppressed
• Not absorbed
• increased demand of specific nutrients to meet body needs

Question 11

Why is Cystic Fibrosis commonly associated with Malnutrition?

Answer 11

Thick, sticky mucus prevents secretion of digestive enzymes.

Question 12

How is Cystic Fibrosis treated as a respiratory disease?

Answer 12

• Physio
• Exercise
• Bronchodilators
• Mucolytics

Question 13

How is Cystic fibrosis treated as a GI disease?

Answer 13

• Pancreatic enzyme replacement,
• Nuitritional supplements
• high cal diet

*helps to maintain body weight.