Viewing All Flashcards for HUN4446 Exam 1
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The study of a set of instructions (potentially
heritable and reversible) that affects gene expression independent of changes
in nucleotide sequence. Twins can have the same genotype, different
epigenotype, and a different phenotype.
Methylated= gene turned off; RNA POL II unable to reach DNA strand to transcribe
Single Nucleotide Polymorphism; a subset of nutrigenetics.
MTHFR677 C-->T impaired function increases homocysteine level, causing an increase in vascular disease riskhowever,having this SNP has a protective effect for colorectal cancer, unless you have impaired folate status
Snp that commonly occur together at multiple locations along a gene Jonas brothers
Nutrigenetics is when a persons genetic makeup alters the way they metabolize dietary componentsex. SNP, inborn error of metabolismnutrigenomics is how dietary components affect the expression of genesex.epigenetics
Difficulty swallowing
Oral (prepatory, transit): mouth--> pharynxpharyngeal: pharynx--> esophagusesophageal: esophagus--> stomach
Inability to move bolus from front of mouth to back of throat weakness of lips and tongue, pocketing of food in mouth, drooling liquidsnueromuscular disordersneurodegenerative disorders (MS, ALS, parkinsons, CNS)CVA (stroke)Surgery/medications/chem/radiationpainful oral lesions (hiv/aids).
Symptoms: coughing choking food stuck in throat, nasal regurgitation, pneumoniacauses: CVA strokeneurodegenerative disorders
Coughingaspiration pneumoniacauses: structural/mechanical abnormalities such as benign tumor, esophageal cancer, esophageal web, extrinsic compression, achalasia, diabetic nueropathy
Simple swallowing tests (bedside tests)endoscopy esophageal manometry: pressure catheterbarium swallow : x-ray and bariumvideofluoroscopy: GOLD STANDARD
Change texture of food to form cohesive bolustemperature of foodadjust for painTF/PN as indicated
Pureed diet (forms its own bolus). Poor oral phase abilitycant protect airway
Mechanically altered diet. mild to moderate oral and pharyngeal dysphagia
Transition to regular diet. oral phase intact. exclusion of just a few foods
Neurodegenerative disorders
Dysphagia, regurgitation/vomiting, heartburn, chest pain, sitophobia, weight loss, nutrient deficiencies
Manometry, endoscopy, barium swallow
Semisolid liquid foods, small frequent meals, slow eating, avoid temp extremes, avoid acidic/ spiced foods. Decrease fiber, increase fat
Nitrates, botox, pneumatic dilation, calcium channel blockers, laparascopic esophageal mytomy and partial fundoplication
GERD or reflux esophagitis
23)
Stomach contents reenter the esophagus through the LES
Altered LES function, abnormal esophageal contractions, slow gastric emptying, dilations/ surgical treatment for achalasia, scleroderma, diabetes, increased intra abdominal pressure, hiatal hernia
Pyrosis, increased salivation, dysphagia, belching, regurgitation, nausea, dental erosion
Most common: symptomsendoscopy, barium swallow, esophageal manometrygold standard: 24 h pH esophageal monitoring
Reduce dietary fat, increase fiber, avoid peppermint, spearmint, caffeine, coffee, alcohol, chocolate
H2Receptors blockers, proton pump inhibitors, antacids, LES changing agent, protective barrier (foaming agent).
Yes, the stomach can be sewn around the LES
30)
Proton pump inhibitors
31)
Histamine 2 receptor blockers
Foaming agent
Barretts esophagus, esophagitis, esophageal bleeding, ulcers, hematemesis, melena, anemia, dysphagia, cough, asthma, aspiraiton pneumonia
Daily heartburn for over 5 years
Endoscopy, tissue biopsy,
Waking at night due to pain, vomiting, hematemesis, melena, difficulty swallowing
When the stomach bulges out past the diaphragm. this causes gerd.
Congenital ( born with it)traumamore likley to occur with age, pregnancy
Endoscopy, barium swallow
As gerd would be treated. also, lose weight to decrease abdomen pressure
Esophagus (rare), stomach, and duodenum
Erosion of mucosal lining that can occur all the way through the mucosa, submucosa, and to the muscle layer. Circumsbribed erosion
Mucus production, bicarbonate production, removal of excess acid by blood flow, and renewel and repair of epithelial cells
Gastrinacetylcholinehistamine
Prostaglandins
Decrease in mucosal integrity ( mucosal damage, reduced blood flow) and an increase in acid and pepsin secretion.
H.pylori, NSAID/aspirin, steroids, excessive alcohol, smoking, trauma/burn injury (takes blood to site of trauma, reduces acid removal) and zollinger-ellison syndrome. (ZE)
Tumor in pancreas or duodenum that causes the secretion of gastrin. causes PUD
H.pylori bacteria
Abdominal pain, ingestion of food/acids may relieve or worsen symptoms, weight gain or weight loss coffee ground hematemsis and melena
Barium swallow or endoscopy or you can look at gastrin levels to diagnose ZE
Endoscopy, tissue biopsy, blood antibody test, breath labeled carbon test or stool antigen test.
Treatment of h. pylori
1. proton pump inhibitor2. clarithromycin3. amoxicilin or metronidazole1. proton pump inhibitor or H2RB2. bismuth salicylate3. tetracycline or metronidazole
Resection of the vagus nerve
Removal of the pylorus (bottom section of the stomach that connects stomach to small intestines).
Bilroth 1 cuts out pyloris and connects the remaining portion of the stomach to the duodenum
Bilroth 2 connects the stomach to the side of the small intestines
Makes a small stomach pouch and connects the jejunum to that stomach pouch
Occurs 10-15 minutes after eating. the symptoms are early satiety, explosive diarrhea, dizziness, flushing, sweating, weakness, tachycardia
2 hours after eating
Alimentary hypoglycemia
Simple carbs
67)
Hunger, weakness, nausea, perspiration, eat small meals, high in protein, every two hours.
Inability to metabolize gluten correctly. Celiacs is a autoimmune disease
Non-tropical strue, gluten sensitive enteropathy, and celicias sprue.
Pregnancy, viral infection, high dose gluten challenge, gi surgery
Genetic predisposition and environmental trigger. Celiacs is an autoimmune diseaese
Gluten--> prolamins--> zonulin released--> gluten enters cell--> IEL causes cell damage--> damaged cells release tissue transglutaminase--> deaminates gluten--> cytokines and chemokines and fighter t cells were released--> antibodies were released ( Anti human tissue transglutaminase and endomysial
Small intestines
Intestinal damage, flattening of villi, disturbed nutrient absorption, extraintestinal effects
Depression, irritabilty, peripheral neuropathy, muscle weakness, bone loss, dental erosion, anemia, skin rashes (dh) canker sores.
Clinical response to gluten free diet, symptoms, tests, intestinal biopsy
Seriological tests: igA anti-human tissue transglutaminase, and antiendomysial HLA DQ2; HLADQ8--> high negative predictive value
Chronic ill health, stunted growth, infertility, skeletal disorders, intestinal lymphoma