Nausea and Vomiting Overview
33 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the most common type of hiatal hernia?

  • Sliding hiatal hernia (correct)
  • Rolling hiatal hernia

    • What is the medical term for heartburn?

    Pyrosis

    Which of the following is NOT a risk factor for GERD?

  • Exercise (correct)
  • Obesity
  • Alcohol consumption
  • Smoking

    • What is the primary function of the Lower Esophageal Sphincter (LES)?

    <p>Preventing the reflux of gastric contents into the esophagus.</p> Signup and view all the answers

    Achalasia is a common and easily treatable disorder.

    <p>False</p> Signup and view all the answers

    What is the primary cause of gastritis?

    <p>Breakdown of the gastric mucosal barrier</p> Signup and view all the answers

    Which of the following is NOT a common complication of Peptic Ulcer Disease (PUD)?

    <p>Appendicitis</p> Signup and view all the answers

    What is the name of the surgical procedure used to treat PUD that involves a partial gastroectomy?

    <p>Billroth I and II</p> Signup and view all the answers

    The medical term for bad breath is ______.

    <p>Halitosis</p> Signup and view all the answers

    Eosinophilic esophagitis is primarily caused by a bacterial infection.

    <p>False</p> Signup and view all the answers

    Which of the following is a common environmental trigger for eosinophilic esophagitis?

    <p>Pollens</p> Signup and view all the answers

    What is the primary characteristic of achalasia?

    <p>Absence of peristalsis in the lower two thirds of the esophagus.</p> Signup and view all the answers

    Which of the following is NOT a typical clinical manifestation of achalasia?

    <p>Diarrhea</p> Signup and view all the answers

    Botulinum toxin injection is a primary treatment option for achalasia, indicated for all patients.

    <p>False</p> Signup and view all the answers

    What is the medical term for the breakdown of the gastric mucosal barrier?

    <p>Gastritis</p> Signup and view all the answers

    Which of the following is a common risk factor for gastritis?

    <p>Alcohol abuse</p> Signup and view all the answers

    Chronic gastritis can lead to a deficiency in ______, which can cause pernicious anemia.

    <p>intrinsic factor</p> Signup and view all the answers

    Peptic Ulcer Disease is only found in the stomach and duodenum.

    <p>False</p> Signup and view all the answers

    Which of the following is a common risk factor for Peptic Ulcer Disease?

    <p>Regular consumption of NSAIDs</p> Signup and view all the answers

    What is the medical term for a condition where food moves too quickly from the stomach to the small intestine?

    <p>Dumping syndrome</p> Signup and view all the answers

    Which of the following is NOT a typical clinical manifestation of Peptic Ulcer Disease?

    <p>Severe constipation</p> Signup and view all the answers

    What is the name of the medical procedure that involves a surgical removal of the herniated sac?

    <p>Herniotomy</p> Signup and view all the answers

    Nissen and Toupet Fundoplication is a surgical procedure used to treat hiatal hernia.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a risk factor for hiatal hernia?

    <p>Regular exercise</p> Signup and view all the answers

    What is the primary treatment for eosinophilic esophagitis?

    <p>Allergy testing and avoidance of food triggers.</p> Signup and view all the answers

    Achalasia can lead to weight loss in patients due to difficulty swallowing.

    <p>True</p> Signup and view all the answers

    What is the primary mechanism of action of H2 receptor blockers in treating GERD?

    <p>Decreasing acid production</p> Signup and view all the answers

    The medical term for the condition where the lining of the stomach produces intrinsic factor, which is impaired with gastritis, is ______ anemia.

    <p>pernicious</p> Signup and view all the answers

    Dumping syndrome is a common complication after a Billroth I or II procedure.

    <p>True</p> Signup and view all the answers

    Which of the following drugs is commonly used to treat Peptic Ulcer Disease?

    <p>Omeprazole</p> Signup and view all the answers

    What is the primary characteristic that determines the severity of upper GI bleeding?

    <p>The origin of the bleeding.</p> Signup and view all the answers

    Which of the following is NOT a typical clinical manifestation of GERD?

    <p>Severe constipation</p> Signup and view all the answers

    Patients who abuse alcohol are at increased risk of developing gastritis with hemorrhage.

    <p>True</p> Signup and view all the answers

    Study Notes

    Nausea and Vomiting

    • Etiology and Pathophysiology: Nausea, vomiting, and the chemoreceptor trigger zone (CTZ) are involved.
    • Clinical Manifestations: Nausea/vomiting, anorexia, dehydration, electrolyte imbalance (metabolic alkalosis), and weight loss. Fluid loss is a key concern.
    • Metabolic Alkalosis in Vomiting: Vomiting expels stomach acid, leading to alkalosis. Symptoms may include irritability, muscle twitching, cramps, and tingling.
    • Associated Imbalance: Hypocalcemia can be seen with metabolic alkalosis.
    • Diagnostic Tests: None specifically mentioned.
    • Treatment: NPO status, IV fluids, clear liquid diet, NG tube, Zofran, Reglan, and promethazine.
    • NPO discontinuation: The patient's nausea and vomiting levels must improve and a PO challenge is attempted.
    • PO challenge: Offering water after NPO discontinuation to see how the patient tolerates oral fluids. Continued n/v = still NPO.
    • NG tube use: Used for small bowel obstruction, compressing the stomach and removing contents.
    • Vomiting Center Location: Medulla oblongata.
    • Direct Activation: Signals from the brain (cerebral cortex) like fear, anxiety, unpleasant smells, sights, or pain directly activate the vomiting center.
    • Indirect Activation: Chemoreceptor trigger zone (CTZ) is first activated by signals from the stomach/small intestine, via vagal nerves, or medicine (e.g., morphine, chemo); subsequently, activating the vomiting center .
    • Vomiting Center Actions: Coordinates stomach, diaphragm, and abdominal muscles to expel contents.
    • Involved Receptors: Serotonin, dopamine, histamine, and acetylcholine.
    • Chemoreceptor Trigger Zone (CTZ): Part of the brain that triggers nausea and vomiting, responding to chemical stimuli (drugs, etc.), and activating the autonomic nervous system.

    Gastroesophageal Reflux Disease (GERD)

    • Etiology/Pathophysiology: Incompetent lower esophageal sphincter (LES).
    • Risk Factors: Alcohol, chocolate, peppermint, tea, coffee, drugs, obesity, smoking, some medications.
    • Clinical Manifestations: Heartburn (pyrosis), dysphagia, dyspepsia, regurgitation, wheezing, coughing, shortness of breath (dyspnea), and globus sensation (lump in throat).
    • Complications: Esophagitis, Barrett's esophagus, and pneumonia (PNA).
    • Barrett's Esophagus: Esophageal metaplasia (reversible cell change from flat to columnar cells). Stimulated by reflux.
    • Pneumonia (PNA): Aspiration of gastric secretions.
    • Diagnostic Tests: Endoscopy with biopsy (visualization and tissue sample for analysis), and esophagram (Barium swallow).
    • Treatment - Drugs: Proton pump inhibitors (PPIs - Protonix), H2 receptor blockers (Pepsid), antiulcer (Sucralfate), antacids (Tums, Mylanta).
    • Treatment - Lifestyle/Diet: Avoid certain foods (chocolate, peppermint, fatty foods, coffee, tea, etc.), late-night meals/snacks, milk, and large meals. Small, frequent meals. Elevate head of bed.
    • Treatment - Surgery: Nissen and Toupet fundoplication (wrapping stomach around the esophagus to strengthen LES).
    • Lower Esophageal Sphincter (LES): Prevents reflux of gastric contents.
    • GERD Causes: Weakened LES, supine position, increased intra-abdominal pressure.
    • Hiatal Hernia Association: GERD can be associated with a hiatal hernia.

    Hiatal Hernia

    • Etiology/Pathophysiology: Weakening of diaphragm muscles. Two types: sliding and rolling.
    • Risk Factors: Ascites, obesity, pregnancy, heavy lifting, tumors.
    • Clinical Manifestations: Similar to GERD (pyrosis, dysphagia, dyspepsia, regurgitation, wheezing, coughing, dyspnea, globus sensation).
    • Complications: GERD, esophagitis, hemorrhage, stenosis, ulceration, strangulation, and regurgitation with tracheal aspiration.
    • Diagnostic Tests: Esophagram, endoscopy.
    • Treatment - Lifestyle: Avoid constricting garments, heavy lifting.
    • Treatment - Surgery: Herniotomy (removal of herniated sac), herniorrhaphy (closure of hiatal defect), gastropexy (fixing stomach below diaphragm), Nissen/Toupet fundoplication.
    • Treatment - Drugs: Similar to GERD treatment.
    • Sliding Hiatal Hernia: Stomach slides into the esophagus, often resolved when upright.
    • Rolling (Paraesophageal) Hiatal Hernia: Stomach forms a pocket alongside esophagus; more serious.
    • Esophageal Hiatus: Opening in diaphragm for esophagus.
    • Diaphragm Role: Separates chest from abdomen and helps prevent acid reflux .

    Eosinophilic Esophagitis (EoE)

    • Etiology/Pathophysiology: Eosinophils in the esophagus, often with family history of allergies.
    • Food Triggers: Milk, eggs, wheat, rye, beef.
    • Environmental Triggers: Pollens, molds, cats, dogs, dust mites.
    • Clinical Manifestations: Similar to GERD and includes pyrosis, dysphagia, dyspepsia, regurgitation, food impaction, nausea/vomiting, and weight loss.
    • Diagnostic Tests: Endoscopy with biopsy, esophagram, allergy skin testing.
    • Treatment: Avoiding trigger foods; proton pump inhibitors (PPIs); corticosteroids (prednisone, Flovent).

    Achalasia

    • Etiology/Pathophysiology: Unknown cause; absent peristalsis in lower esophagus, dilation from fluid accumulation, unopposed contraction of LES (increased LES pressure).
    • Clinical Manifestations: Dysphagia, globus sensation, substernal chest pain, halitosis, inability to belch, GERD symptoms and weight loss .
    • Diagnostic Tests: Endoscopy, esophagram (Barium swallow).
    • Treatment: Endoscopic pneumatic dilation, botulinum toxin injection, smooth muscle relaxants (nitrates, calcium channel blockers).

    Gastritis

    • Etiology/Pathophysiology: Breakdown of gastric mucosal barrier, with acid and pepsin diffusing into mucosa, causing erosion and GI bleeding.
    • Types: Acute and chronic.
    • Mucosal Barrier Role: Protects stomach from acid erosion.
    • Risk Factors: NSAIDs, aspirin, corticosteroids, alcohol, H. Pylori infection.
    • Clinical Manifestations: Anorexia, nausea/vomiting, epigastric tenderness, fullness, self-limiting symptoms, and hemorrhage.
    • Diagnostic Tests: Endoscopy with biopsy, urinalysis (UA), complete blood count (CBC), stool sample.
    • Treatment - Lifestyle/Diet: NPO, NG tube (to reduce acid production)
    • **Treatment - Drugs:**H2 receptor blockers, PPIs, IV fluids, antiemetics, analgesics, or blood transfusions.

    Peptic Ulcer Disease

    • Etiology/Pathophysiology: Erosion of GI mucosa by hydrochloric acid and pepsin; cellular destruction and inflammation, histamine is produced, and goes further than gastritis.
    • Risk Factors: NSAIDs, bile salts, aspirin, ischemia, alcohol, H. Pylori, stress-related mucosal disease (SRMD).
    • Stress-Related Mucosal Disease (SRMD): Increased cortisol and acid production.
    • Clinical Manifestations: Epigastric/abdominal pain, back pain, bloating, nausea/vomiting, fullness.
    • Susceptible Areas: Anywhere in the GI tract exposed to gastric secretions.
    • Complications: Hemorrhage, perforation, gastric outlet obstruction.
    • Diagnostic Tests: Endoscopy w/ biopsy, Barium swallow, CBC, stool sample.
    • Treatment Interventions: NG tube, blood transfusion, IV fluids.
    • Surgery: Billroth I & II (partial gastrectomies).
    • Complication - Dumping Syndrome: Rapid movement of food from stomach to small intestine; symptoms include bloating, nausea/vomiting, abdominal pain, cramping.
    • Treatment - Drugs: H2 blockers, PPIs, antacids, antibiotics (for H. Pylori), cytoprotective drugs, and tricyclic antidepressants.

    Upper GI Bleeding

    • Etiology/Pathophysiology: Bleeding can originate from veins, capillaries, or arteries. Difficult to pinpoint the source.
    • Severity Determination: Determined by the location of origin.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz covers the etiology, clinical manifestations, and treatment of nausea and vomiting. Key concepts include the role of the chemoreceptor trigger zone, metabolic alkalosis, and associated imbalances. Test your knowledge on the management strategies and diagnostic considerations related to these conditions.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser