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PHRM2101 > WEEK 10: Gastrointestinal Health > Flashcards

WEEK 10: Gastrointestinal Health Flashcards

1
Q

What does “motility” refer to?

A

Motility refers to contraction and relaxation of walls and sphincters of gastrointestinal tract to move (propel) content.

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2
Q

Gastric motility is regulated by what types of contractions?

A

gastric motility is regulated by a combination of tonic and phasic (also called rhythmic) contractions.

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3
Q

What is the purpose of gastrointestinal motility?

A

Gastrointestinal motility serves to fragment and mix food boluses for digestion and absorption along with propelling contents along the tract.

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4
Q

In what way are phasic contractions physiologically different from tonic contractions?

A

phasic contractions are characterised by periods of relaxation and contraction, rather than being sustained.

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5
Q

T or F
Tonic contractions are sustained contractions that are maintained for several minutes to hours.

A

T

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6
Q

Where anatomically are tonic contractions typically observed?

A

These are usually observed at the sphincters separating the different parts of the gastrointestinal tract.

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7
Q

All tonic contractions happen subconsciously except for…

A

the sphincters that control defecation

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8
Q

Defecation centres in the …. allow for conscious input when defecating.

A

lumbro-sacral spinal cord

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9
Q

Phasic contractions occur through … signaling generated by interstitial cells of Cajal in the enteric nervous system.

A

autonomic

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10
Q

Phasic contractions occur through autonomic signaling generated by …. in the enteric nervous system.

A

interstitial cells of Cajal

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11
Q

Phasic contractions occur through autonomic signaling generated by interstitial cells of Cajal in the …. system.

A

enteric nervous

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12
Q

Constipation is clinically defined as…

A

small/infrequent/difficult bowel movements

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13
Q

T or F
Constipation can have a variety of causes.

A

T

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14
Q

Occasional bouts of constipation can be caused by…

A

dehydration, a lack of fibre or a particular drug regimen.

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15
Q

Chronic constipation is defined as having fewer than … bowel movements per week.

A

3

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16
Q

T or F
Neurological problems can cause chronic constipation.

A

T
Specifically, neurological problems that affect the nerves that control the colon and rectum.

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17
Q

What type of patients could you expect to have chronic constipation caused by neurological problems?

A

Patients with a spinal cord injury, a previous stroke, diabetes, multiple sclerosis, Parkinson’s disease, and dementia are at higher risk of chronic constipation.

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18
Q

What is anismus?

A

A type of pelvic floor dysfunction where patients are unable to relax their pelvic muscles.

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19
Q

What is dyssynergic defecation?

A

A disorder caused by physical problems with the muscles involved in defecation such as defects in the coordination of relaxation and contraction.

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20
Q

What type of patients could you expect to have chronic constipation caused by physical problems?

A

Patients with blockages in the colon or rectum such as bowel obstructions, rectal cancer or another abdominal cancer that puts pressure on the colon.

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21
Q

T or F
Conditions leading to dehydration such as chronic hyperglycaemia as a result of diabetes and thyroid imbalances, can cause chronic constipation.

A

T

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22
Q

What are the four different types of interventions that are frequently used to try and provide symptomatic relief of chronic constipation? (that don’t involve drugs passing into circulation)

A

Stool softeners,
osmotics,
stimulants, and
bulk-forming agents.

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23
Q

Chronic diarrhoea is defined as having at least …/… of stools being loose or watery for a period of … months or more.

A

one quarter
3

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24
Q

Acute diarrhoea is typically associated with ….

A

viral or bacterial infections or the effects of a course of antibiotics.

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25
Q

How can diarrhoea kill someone?

A

Through dehydration

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26
Q

What are the indications of serious dehydration in adults?

A

No urination or low urination with dark-colour, dry skin & mouth, excessive thirst, fatigue, weakness, confusion and/or disorientation

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27
Q

What are the indications of serious dehydration in young children and infants?

A

No or low urination (in infants not having a wet nappy for 3 or more hours), dry skin, mouth and tongue. Fever above 39*, no tears when crying, drowsiness, lack of response, or grumpiness, Sunken eyes, cheeks, or abdomen

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28
Q

T or F
Chronic diarrhoea is almost always a symptom of another underlying condition.

A

T

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29
Q

What conditions could chronic diarrhoea be a sign of?

A

IBS or IBD condition, such as Crohn’s or Ulcerative Colitis.

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30
Q

In children and infants, … species are the most common cause of acute diarrhoea.

A

Rotavirus

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31
Q

In the general Australian population, … is the most common cause of acute diarrhoea with an estimated 1.8 million infections per year.

A

norovirus

32
Q

What viruses may produce acute diarrhoea?

A

Rotavirus, norovirus, enteric adenovirus, astrovirus, viral hepatitis and cytomegalovirus

33
Q

What two bacteria are most commonly the cause of travellers diarrhoea?

A

E. coli and C. coli

34
Q

What is dysbiosis?

A

An imbalance between the types of organism present in a person’s natural microflora, especially that of the gut.

35
Q

Antibiotics can lead to … resulting in diarrhoea.

A

dysbiosis

36
Q

Why can artificial sweeteners cause diarrhoea?

A

because they are neither absorbed nor digested and are osmotically active, drawing water into the gastrointestinal tract, particularly the colon resulting in loose stools.

37
Q

Why can lactose cause diarrhoea in those without lactase in their gut microbiota?

A

Undigested lactose is osmotically active, causing osmotic diarrhoea and can also be used by certain types of gut flora which have a propensity to promote diarrhoea

38
Q

Surgery involving partial resection of the intestine can sometimes cause diarrhoea due to changes in …

A

nutrient absorption

39
Q

Why can gallbladder removal cause diarrhoea?

A

gallbladder removal, which results in a large decrease in bile acid delivery to the gastrointestinal tract reduces fat absorption, which can result in diarrhoea.

40
Q

T or F
Irritable bowel syndrome and irritable bowel disease are interchangeable terms.

A

F
IBS is functional gastrointestinal disorder and is thus defined by a series of symptoms (rather than a specific cause)
IBD is a category of gastrointestinal disorders such as Crohn’s disease and ulcerative colitis

41
Q

IBS is defined as recurrent … pain on average at least …day/week in the last … months, associated with … or more of the following Rome IV criteria:
…
…
…

A

abdominal, 1, 3, 2

Related to defecation
Associated with a change in frequency of stool
Associated with a change in form (appearance) of stool

42
Q

IBS classified into at least … different types.

A

4

43
Q

How many types of stool are recognised in the bristol stool scale?

A

7

44
Q

What stool types in the bristol stool scale are considered abnormal?

A

1, 2, 6 and 7

45
Q

What is IBS subtype C?

A

IBS with predominant constipation

46
Q

In order to be classified as having IBS subtype C patients must have greater than …% of bowel movements with Bristol stool types … or … and less than …% of bowel movements with Bristol stool types … or …

A

25%, 1 or 2, 25%, 6 or 7

47
Q

What is IBS subtype D?

A

IBS with predominant diarrhea.

48
Q

What is IBS subtype M?

A

IBS with mixed bowel habits

49
Q

What is IBS subtype U?

A

Unclassified

50
Q

In order to be classified as having IBS subtype D patients must have … than 25% of bowel movements with Bristol stool types … or … and … than 25% of bowel movements with Bristol stool types … or …

A

greater, 6 or 7, less, 1 or 2

51
Q

In order to be classified as having IBS subtype M patients must have … than 25% of bowel movements with Bristol stool types 1 or 2 and … than 25%% of bowel movements with Bristol stool types 6 or 7.

A

greater, greater

52
Q

T or F
Since the cause(s) of IBS are unknown, all treatment is focussed on symptomatic relief.

A

T

53
Q

The first line of treatment for IBS is…

A

lifestyle modification.

54
Q

T or F
Triggers for IBS are generally thought to be causative.

A

F!

55
Q

T or F
There is some evidence that people with IBS-D who are not coeliac may benefit from reducing gluten.

A

T

56
Q

T or F
All current treatments for Crohn’s Disease are targeted at altering immune system function.

A

T

57
Q

T or F
IBS has a strong autoimmune component

A

F
The causes of IBS are unknown. IBD has a strong autoimmune component.

58
Q

What does NAFLD stand for?

A

Non-alcoholic Fatty Liver Disease

59
Q

What does NASH stand for?

A

Non-alcoholic Steatohepatitis

60
Q

Non-alcoholic fatty liver disease (NAFLD) can progress to what?

A

Non-alcoholic steatohepatitis (NASH)

61
Q

…. is the most common alcoholic liver disease or alcoholic hepatitis.

A

Drug induced liver disease

62
Q

T or F
The outcomes for Drug induced liver disease are the same as for NASH.

A

T

63
Q

The consumption of which drug is most commonly associated with drug induced liver disease?

A

paracetamol

64
Q

…. is the most frequent cause of acute liver failure in Western countries.

A

Drug-induced liver disease

65
Q

The most common symptom of drug induced liver injury is…

A

jaundice

66
Q

T or F
Most cases of drug-induced liver injury are accompanied by debilitating symptoms.

A

F
Most cases of DILI are asymptomatic.

67
Q

T or F
Dili is more common in men than women.

A

F
DILI is more common in women

68
Q

T or F
A liver biopsy is required for the diagnosis of DILI

A

F

69
Q

Do clinical presentations of hepatocellular (cytotoxic) injury have a predictable or idiosyncratic mechanism of hepatotoxicity?

A

Predictable

70
Q

Do clinical presentations of cholestatic injury have a predictable or idiosyncratic mechanism of hepatotoxicity?

A

idiosyncratic

71
Q

If a patient has Hepatocellular (cytotoxic) injury, their histologic findings will show…

A

hepatitis

72
Q

If a patient has Cholestatic injury, their histologic findings will show…

A

Cholestasis

73
Q

If a patient has mixed DILI, their histologic findings will show…

A

Steatosis

74
Q

What is Steatosis?

A

Fatty liver.

75
Q

What is Cholestasis?

A

the slowing or stalling of bile flow from your liver.

76
Q

What is Hepatitis?

A

Inflammation of the liver tissue.

PHRM2101 (12 decks)

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