3 types of diarrhea Correct Answers 1. osmotic: non-
absorbable substances draws excess water into intestine (large
volume diarrhea)
2. secretory: excess mucosal secretions (large volume) -
bacterial problem!!
3. motility: increase in motility leaves less transit time for fluid
reabsorption
abdominal parietal (somatic) pain Correct Answers more
localized and intense
abdominal reffered pain Correct Answers visceral pain felt
away from the organ involved
ex. gallbladder pain is felt in the back by the scapulae
abdominal visceral pain Correct Answers arises from a
stimulus; difficult to localize (cramping, fullness)
abnormalities with cortisol can occur where? Correct Answers
at the hypothalmic-pituitary level (ACTH-depedent) or in
adrenal glands (ACTH-independent)
acromegaly Correct Answers hypersecretion of GH from
anterior pituitary
-most common cause is an adenoma
-occur due to high GH and IGF-1 secretion in adults
acute complication in DM: dawn effect Correct Answers early
AM rise in BS with no hypoglycemia at night
,-related to increase in GH during the night
-managed through altering blood glucose time
acute complication in DM: somoygi effect Correct Answers
more common in IDDM (insulin dependent - Type 1)
-hypoglyceia can stimulate the release of counterregulatory
hormones (epi, GH, cortisol, glucagon) which causes rebound
effect and causes hyperglycemia
-managed with bed time snack, so pt does not wake up with
hypoglycemia
adaptation for marasmus Correct Answers depends on the
suppression of insulin (no insulin...increase in BS...inhibits use
of fat storages)
-anti-insulin secretions (glucagon, cortisone, epi, GH) stimulate
use of FFA (free fatty acids)
FFA - liver - stimulates ketones - NRG; brain prefers glucose
but can use ketones for NRG
-liver fxn continues, but caloric intake too low to support protein
synthesis
addison's disease Correct Answers decrease in cortisol levels
1. primary: destruction of adrenal cortex
2. secondary: usually autoimmune
infection, cancer, abrupt cessation of glucocorticoid therapy
,adrenal crisis and tx Correct Answers abrupt severe adrenal
insufficiency
tx: cortisol replacement for life, glucose/fluid replacement
aldosterone/Na+ replacement if aldosterone deficiency
adrenal gland Correct Answers 1. adrenal cortex (stimulated by
ACTH - adrenocorticotropic hormone)
ACTH is made in the pituitary
-zona glomerulosa: mineralocorticoids (aldosterone - Na/H2O
reabsorption)
-zona fasciculata: glucocorticoids (cortisol - carb metabolism,
anti-inflammatory/growth-suppressant)
-zona reticularis: sex hormones (minimal estrogen, weak
androgens)
2. adrenal medulla (innervated by SNS)
adrenal medulla secretes: Correct Answers chromaffin cells
secrete catecholamines: epi and norepi (majority epi)
-fight or flight, hyperglycemia
aging and the digestive system Correct Answers -tooth enamel
worn down
-loss of teeth
-peridontal disease and gum recession
-osteoporosis
-decline in # of taste buds, sense of smell, and salivary secretion
-decrease in esophageal and gastric motility
Allostatic load Correct Answers individualized amounts of
stressors in an individual's life -influences their physiologic
responses
appendicitis Correct Answers inflammation of the vermiform
appendix
-epigastric and RLQ pain
-McBurney's point: rebound tenderness
-fever, leukocytosis
most severe symptom: peritonitis
ascites Correct Answers accumulation of fluid in the peritoneal
cavity
-most commonly caused by liver cirrhosis
-evident by abdominal distention, abdominal girth, weight gain
-evaluate with a SAAG
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