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Section 9 GI
GI Absorption
Stomach
Alcohol
Duodenum
Iron
Jejunum
Folate
Terminal Ileum
Vitamin B12
Bile Resorption
1 min
Bilirubin Lab Value
0.2-1.2 mg/dL
Increased Bilirubin Causes Jaundice
54 secs
Hyperbilirubinemia
Cause/Mechanism
Increased Unconjugated Bilirubin
Assessment
Jaundice
Kernicterus
Interventions
Early Feedings
Heme Oxygenase Inhibitors
Phototherapy
Protect Eyes
Monitor for Dehydration
Considerations
Monitor Bilirubin Levels
3 mins
Stomach Digestion
Characteristics
Chief Cells Secrete Pepsinogen
Pepsinogen Turned to Pepsin By H+
Protein Breakdown Begins
Mucous Cells Secrete Mucus and Bicarbonate
G Cells Secrete Gastrin
Gastrin Stimulates Parietal Cell HCl Release
Parietal Cells Secrete Intrinsic Factor
2 mins
Small Intestine Absorption
Characteristics
Carbohydrates Undergo Active Transport
Amino Acids Undergo Active Transport
Small Lipids Undergo Passive Diffusion
Epithelial Cells
Intestinal Capillaries
Hepatic Portal Transports Nutrients
Liver
Large Lipids Transported as Chylomicrons
Lacteals Transport Chylomicrons
2 mins
Small Intestine Digestion
Brush border enzymes
Pancreatic Enzymes are secreted via a Duct
Pancreas secretes bicarbonate
Brush Border activates Pancreatic Trypsin
Trypsin activates Chymotrypsin
Trypsin and Chymotrypsin digest Proteins
Gallbladder Releases Bile
Pancreatic Lipase breaks down Lipids
Goblet cells secrete mucus
Pancreatic Amylase breaks down Carbohydrates
Pancreatic Nucleases breakdown DNA/RNA
Digestion occurs in the Duodenum
2 mins
Large Intestine
Characteristics
Colon
Electrolyte Reabsorption
Water Reabsorption
Microflora Produce Vitamins
Rectum Stores Feces
1 min
Liver Biopsy Procedure
Indications
Diagnosis of Liver Disease
Types of Liver Biopsy
Incisional (Open Method)
Needle Biopsy (Closed Method)
Considerations
Coagulation Status
Type and Crossmatch Blood
Right-Side Lying
Post-Biopsy Monitoring
2 mins
Anorexia Nervosa Assessment
Adolescent Girls
Fear of Gaining Weight
Assessment
Excessive Dieting
Distorted Body Image
Decreased Bone Density
Stress Fractures
Lanugo
Amenorrhea
Anemia
Diagnostic Criteria
BMI < 18.5
3 mins
Bulimia Nervosa Assessment
Assessment
Normal Body Weight
Binge and Purge
Electrolyte Disturbances
Alkalosis
Hypokalemia
Parotitis
Enamel Erosion
Russell's Sign
Diagnosis
Once Weekly For 3 Months
2 mins
Anorexia Nervosa and Bulimia Nervosa Interventions
Interventions
Build Trust
Plan Caloric Intake
Supervise Meals
Supervise Elimination
Encourage Liquids
Daily Weights
Use Matter-of-Fact Statements
Give Feelings of Control
Considerations
Tube Feedings If Further Weight Loss
2 mins
Total Parenteral Nutrition (TPN)
Mechanism
Nutrition Given Outside GI
Side Effects
Hyperglycemia
Hyperlipidemia
Refeeding Syndrome
Nausea and Vomiting
Considerations
Slow IV Infusion
Use Large Central Vein
No Added Meds to TPN Line
2 mins
Barrett's Esophagus
Histological findings
Metaplasia in Lower Esophagus
Columnar Epithelium
Associated Pathologies
Gastroesophageal Reflux Disease (GERD)
Esophagitis
Esophageal Ulcers
Increased Risk of Esophageal Adenocarcinoma
1 min
Acute Gastritis
Erosive
Disruption of Mucosal Barrier
Caused by Stress
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Alcohol
Uremia
Burns
Curling's Ulcer
Brain Injury
Cushing Ulcer
Increase H+ Production
1 min
Chronic Gastritis
Type A
Type A
Fundus and Body
Autoimmune
Autoantibodies to Parietal Cells
Pernicious Anemia
Achlorhydria
Type B
Type B
Most Common Type
Helicobacter pylori
Antrum
Increased Risk of MALT Lymphoma
Associations
HIV/AIDS
Crohn's Disease
3 mins
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
1 min
Mallory-Weiss
Characteristics
Bleeding From Tears in Mucosa
Forceful Vomiting
Alcoholism
Eating Disorders (Bulimia)
Painful Hematemesis
Diagnosis
Endoscopy
Management
Observation
2 mins
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
NSAIDs
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
2 mins
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