Medical Conditions: Anorexia and Vomiting

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Questions and Answers

What is a primary cause of acute gastritis?

Excessive consumption of fiber

Dehydration

Overeating spicy food

Infection by Helicobacter pylori (correct)

Which of the following is a potential complication of chronic gastritis?

Mucosal atrophy (correct)

Acute pain relief

Hemorrhage

Improved digestion

What distinguishes true ulcers from superficial ulcerations?

True ulcers heal more quickly

True ulcers extend through the muscularis mucosae (correct)

True ulcers are typically less painful

True ulcers are caused exclusively by stress

Which of the following medications is known to contribute to gastritis?

Nonsteroidal anti-inflammatory drugs (NSAIDs) Signup and view all the answers

What are common clinical manifestations of acute gastritis?

Vague abdominal discomfort and epigastric tenderness Signup and view all the answers

What is the most common type of peptic ulcer?

Duodenal ulcer Signup and view all the answers

Which factor is NOT associated with the development of duodenal ulcers?

Increased mucosal permeability Signup and view all the answers

What characterizes a stress-related mucosal disease?

Multiple sites of ulceration Signup and view all the answers

Which type of stress ulcer is associated with brain trauma?

Cushing ulcer Signup and view all the answers

What is the primary defect in gastric ulcers?

Increased mucosal permeability to hydrogen ions Signup and view all the answers

What causes osmotic diarrhea?

A nonabsorbable substance in the intestine draws excess water Signup and view all the answers

What is the primary cause of projectile vomiting?

Increased intracranial pressure Signup and view all the answers

Which condition is most likely to cause motility diarrhea?

Irritable bowel syndrome Signup and view all the answers

Which of the following conditions is commonly associated with nausea?

Abnormal pain Signup and view all the answers

What is the primary result of increased cAMP in the gastrointestinal tract?

Secretion of chloride and water by the crypt cells Signup and view all the answers

What characterizes slow-transit constipation?

Impaired colonic motor activity Signup and view all the answers

What generally causes small-volume diarrhea?

Inflammatory disorders of the intestine Signup and view all the answers

Which metabolic disturbance is commonly associated with vomiting?

Hyponatremia Signup and view all the answers

Which of the following conditions does NOT contribute to secretory diarrhea?

Pancreatic enzyme deficiency Signup and view all the answers

Which of the following factors can lead to secondary constipation?

Neurological disorders Signup and view all the answers

Which symptom is NOT typically associated with nausea?

Abdominal cramps Signup and view all the answers

Which of these medications is known to inhibit bowel motility?

Antacids with aluminum hydroxide Signup and view all the answers

What commonly accompanies the vomiting process?

Nausea Signup and view all the answers

What is the primary characteristic of acute intestinal obstructions?

They usually have mechanical causes. Signup and view all the answers

Which condition is primarily characterized by the telescoping of one part of the intestine into another?

Intussusception Signup and view all the answers

What is a common risk factor for diverticulosis?

Individuals older than 60 years Signup and view all the answers

Which of the following best describes extrinsic obstruction?

Results from growths originating outside the intestine. Signup and view all the answers

What type of intestinal obstruction involves loss of blood supply?

Strangulated obstruction Signup and view all the answers

Which of the following factors can cause functional (paralytic) ileus?

Electrolyte imbalances and peritonitis Signup and view all the answers

What is a common cause of chronic intestinal obstructions?

Tumors or chronic inflammation, especially in the large intestine Signup and view all the answers

What term describes the protrusion of intestine through a weakness in abdominal muscles?

Hernia Signup and view all the answers

Study Notes

Anorexia

Side effects of drugs and disorders of other organ systems, including cancer, heart disease, and renal disease, can lead to anorexia.

Vomiting

Is the forceful emptying of stomach and intestinal contents (chyme) through the mouth.
The vomiting center lies in the medulla oblongata.
Nausea is a subjective experience associated with various conditions, including abnormal pain and labyrinthine stimulation.
Hypersalivation and tachycardia are common associated symptoms.
Retching is the muscular event of vomiting without the expulsion of vomitus.
Spontaneous vomiting not preceded by nausea or retching is called projectile vomiting.
Projectile vomiting can be caused by direct stimulation of the vomiting center by neurologic lesions, such as increased intracranial pressure, tumors, or aneurysms, involving the brainstem.
It can also be a symptom of gastrointestinal obstruction (pyloric stenosis).
The metabolic consequences of vomiting include fluid, electrolyte, and acid-base disturbances, such as hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis.

Constipation

Normal transit (functional) constipation involves a normal rate of stool passage but there is difficulty with stool evacuation.
Normal transit constipation is associated with a sedentary lifestyle, low-residue diet, or low fluid intake.
Slow-transit constipation involves impaired colonic motor activity with infrequent bowel movements, straining to defecate, mild abdominal distention, and palpable stool in the sigmoid colon.
Secondary constipation can be caused by diet, medications, or neurogenic disorders (e.g., stroke, Parkinson disease, spinal cord lesions) in which neural pathways or neurotransmitters are altered and colon transit time delayed.
Aging may result in decreased mobility, changes in neuromuscular function, use of medications, and comorbid medical conditions causing constipation.
Constipation as a notable change in bowel habits can be an indication of colorectal cancer.
Medications that can cause constipation include Opiates (particularly codeine), Antacids containing calcium carbonate or aluminum hydroxide, Iron, and Bismuth.
Other causes of constipation include Pelvic hiatal hernia and Pregnancy.

Diarrhea

Diarrhea is generally caused by excessive amounts of water or secretions or both in the intestines.
The three major mechanisms of diarrhea are osmotic, secretory, and motility.
Osmotic diarrhea occurs when a nonabsorbable substance in the intestine draws excess water into the intestine, increasing stool weight and volume, producing large-volume diarrhea.
Causes of osmotic diarrhea include lactase and pancreatic enzyme deficiency; excessive ingestion of synthetic nonabsorbable sugars; and full-strength tube-feeding formulas.
Secretory diarrhea is caused by excessive mucosal secretion of fluid and electrolytes, producing large-volume diarrhea.
Infectious causes of secretory diarrhea include viruses (e.g., rotavirus), bacterial enterotoxins (e.g., Escherichia coli and Vibrio cholerae), and exotoxins from overgrowth of Clostridium difficile following antibiotic therapy or small bowel bacterial overgrowth.
Motility diarrhea occurs when excessive motility decreases transit time and opportunity for fluid absorption, resulting in diarrhea.
Motility diarrhea can be caused by resection of the small intestine (short bowel syndrome), surgical bypass of an area of the intestine, irritable bowel syndrome, hyperthyroidism, and laxative abuse.
Small-volume diarrhea is usually caused by an inflammatory disorder of the intestine, such as ulcerative colitis, Crohn disease, or microscopic colitis, but also can result from colon cancer or fecal impaction.

Abdominal Pain

Abdominal pain is a common symptom of various diseases.
The causal mechanisms of abdominal pain are mechanical, inflammatory, or ischemic.
Generally, the abdominal organs are not sensitive to mechanical stimuli, such as cutting, tearing, or crushing.
These organs are, however, sensitive to stretching and distention, which activate nerve endings in both hollow and solid structures.
Abdominal pain may be generalized to the abdomen or localized to a particular abdominal quadrant.
The nature of the pain is often described as sharp, dull, or colicky.
Fibrosis and thickening may develop.

Gastritis

Gastritis is an inflammatory disorder of the gastric mucosa.
It can be acute or chronic and affect the superficial mucosa of the fundus or antrum, or both.
Acute gastritis is caused by injury of the protective mucosal barrier caused by drugs, chemicals, or Helicobacter pylori infection.
Nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen, indomethacin, and aspirin) can cause gastritis because they inhibit prostaglandin synthesis, which normally stimulates the secretion of mucus.
Alcohol, histamine, digitalis, and metabolic disorders, such as uremia, are contributing factors.
The clinical manifestations of acute gastritis can include vague abdominal discomfort, epigastric tenderness, and bleeding.
Healing usually occurs spontaneously within a few days.
Chronic gastritis tends to occur in older adults and causes chronic inflammation, mucosal atrophy, and epithelial metaplasia.

Peptic Ulcer

A peptic ulcer is a break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum.
Ulcers develop when mucosal protective factors are overcome by erosive factors commonly caused by NSAIDs and H.pylori infection.
Peptic ulcers can be single or multiple, acute or chronic, and superficial or deep.
Superficial ulcerations are called erosions because they erode the mucosa but do not penetrate the muscularis mucosae.
True ulcers extend through the muscularis mucosae and damage blood vessels, causing hemorrhage, or perforate the gastrointestinal wall.

Peptic Ulcer Disease

Duodenal ulcers are the most common type of peptic ulcers.
Developmental factors of duodenal ulcers include Helicobacter pylori infection, hypersecretion of stomach acid and pepsin, use of NSAIDs, high gastrin levels, and acid production by cigarette smoking.
Gastric ulcers tend to develop in the antral region of the stomach, adjacent to the acid-secreting mucosa of the body.
The primary defect in gastric ulcers is an increased mucosal permeability to hydrogen ions.
Gastric secretion tends to be normal or less than normal.

Stress Ulcer

A stress-related mucosal disease is an acute form of peptic ulcer that tends to accompany the physiologic stress of severe illness or major trauma.
Usually multiple sites of ulceration are distributed within the stomach or duodenum.
Stress ulcers are classified as ischemic and Cushing ulcers.
Ischemic ulcers develop within hours of an event such as hemorrhage, multisystem trauma, severe burns, heart failure, or sepsis.
Shock, anoxia, inflammation, and sympathetic responses cause ischemia of the stomach and duodenal mucosa, disrupting the mucosal barrier.
Stress ulcers that develop as a result of burn injury are often called Curling ulcers.
Cushing ulcer is associated with severe brain trauma or brain surgery.
Decreased mucosal blood flow and hypersecretion of acid caused by overstimulation of the vagal nuclei damage the mucosal barrier, causing erosions and ulceration.

Intestinal Obstruction

Acute obstructions usually have mechanical causes, such as adhesions or hernias.
Chronic or partial obstructions are more often associated with tumors or inflammatory disorders, particularly of the large intestine.
The extent of intestinal obstruction can be partial or complete.
The location of the obstructing lesion can be intrinsic or extrinsic.
Intrinsic obstruction develops within the intestinal lumen; examples: gut wall edema or hemorrhage, foreign bodies (gallstones), tumors, or gut wall fibrosis.
Extrinsic obstruction originates outside the intestine; examples: tumors, torsion, fibrosis, hernia, intussusception.
Effects of intestinal obstruction on the intestinal wall include simple luminal obstruction without impairment of blood supply, strangulated luminal obstruction with occlusion of blood supply, and closed loop obstruction at each end of a segment of intestine.
Causal factors of intestinal obstruction include mechanical blockage of the intestinal lumen by intrinsic or extrinsic lesions and functional (paralytic ileus) caused by paralysis of the intestinal musculature.

Inflammatory Bowel Disease

Ulcerative colitis (UC) and Crohn disease (CD) are chronic relapsing inflammatory bowel diseases (IBDs).

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Description

This quiz covers essential topics on anorexia and vomiting, focusing on their causes, symptoms, and related complications. Explore various scenarios where these conditions may arise, including metabolic consequences and underlying disorders. Test your knowledge on the physiological mechanisms involved in these medical conditions.