LESSON 1: Gastrointestinal System and Disorders of the Gastrointestinal, Hepatobiliary, and Pancreatic Systems

DISCUSSION: Disorders of Hepatobiliary and Exocrine Pancreas Function

Introduction
Answer the following questions
Forty-nine-year-old Frank has been a heavy drinker for the past 25 years. He also has a history of hypertension, hyperlipidemia, and recent upper respiratory viral infection. Frank’s only current medication is Lasix (furosemide) 40 mg od. He presents with severe epigastric pain that radiates to his back and worsens when lying down. His abdomen is distended, and bowel sounds are hypoactive. Frank has a fever and is diaphoretic and hypotensive, and his serum calcium is very low.
Discussion Guidelines
Initial Post
In your initial post, answer the following questions:
1. Frank is being transferred to the ICU. If you were the ICU nurse, what would you have to consider in Frank’s case?
2. What would you expect in the way of treatment modalities for Frank?

NOTE TO WRITER: PLEASE DO NOT USE QUOTED MATERIAL BECAUSE IT IS CONSIDERED PLAGIARISM.

NOTE TO WRITER: Linked is a PDF copy of the book being used in the class. The book has to be one of the references. The chapters being used this lesson is Chapter 36 “Structure and Function of the Gastrointestinal System” Chapter 37 “Disorders of Gastrointestinal Function”, Chapter 38 “Disorders of Hepatobiliary and Exocrine Pancreas Function”, Chapter 39 “Alterations in Nutritional Status”.

Norris, T. L., & Lalchandani, R. (2019). Porth’s pathophysiology: Concepts of altered health states (10th ed.). Wolters Kluwer.

file:///Users/jowusu/Downloads/Porth%E2%80%99s%20Pathophysiology_%20Concepts%20of%20Altered%20Health%20States.pdf

ALSO TO WRITER: This is a pathophysiology class so use more background information on the cellular level of the topic being discussed. Avoid cryptic information and use more of the course content and the chapter of the book which apply to the topic to complete the discussion.

FOR EXAMPLE THIS IS A QUOTE FROM THE INSTRUCTER THAT I WANT THE WRITER TO PAY ATTENTION TO WHEN COMPLETING THE DISCUSSION “As was described in the previous course announcement, there is an expectation of graduate level work in BIO PATHO. Simply using your textbook in forum and case study answers IS NOT adequate (that effort will not earn you an A in this class; and the syllabus clearly says that is inappropriate). A minimum of four sources need to be cited. Background information should ALWAYS be provided. For example, suppose the question leads you to diagnose that a person has hypertension, and you tell me all the evil consequences of hypertension and what the patient better do to reverse the many adverse effects of hypertension. Great. What is blood pressure to begin with? What is it normally? What regulates blood pressure? What can predispose someone to hypertension? What are modifiable and non-modifiable risk factors for hypertension? What will hypertension do in the short-term? Long-term? This is appropriate background information. Students putting in the effort to do this by providing background content in exceptional forum post or case study answers will be rewarded during grading.”

I WILL ASLO ATTACH THE POWERPOINTS FOR THIS LESSON TO SERVES AS A GUIDE.

file:///Users/jowusu/Downloads/Porth%E2%80%99s%20Pathophysiology_%20Concepts%20of%20Altered%20Health%20States.pdf

ALSO NOTE TO WRITER: BELOW IS THE LEARNING OUTCOMES FOR THIS LESSON. LET THIS BE A GUIDE WHEN COMPLETING THIS ASSIGNMENT

At the end of this lesson, you will be able to:
Structure and Function of the Gastrointestinal System
• Structure and Organization of the Gastrointestinal Tract
o Describe the anatomic structures of the upper, middle, and lower gastrointestinal tract
o Describe the four layers of the gastrointestinal tract wall
o Describe the structure and function of the peritoneum and how it attaches to the abdominal wall
• Motility
o Describe the properties of the interstitial smooth muscle cells that act as pacemakers for the GI tract
o Compare the actions of the enteric and autonomic nervous systems (ANSs) as they relate to motility of the GI tract
o Differentiate tonic and peristaltic movements in the GI tract
• Hormonal, Secretory, and Digestive Functions
o Explain the protective function of saliva
o Describe the function of the gastric mucosal barrier
o Discuss the function of gut flora in terms of metabolic activities, trophic effects, and protection against invasion by pathogenic microorganisms
• Digestion and Absorption
o Differentiate digestion from absorption and relate the characteristics of the small intestine to its absorptive function
o Compare the digestion and absorption of carbohydrates, fats, and proteins
Disorders of Gastrointestinal Function
• Common Manifestations of GI Disorders Anorexia, Nausea, and Vomiting
o Characterize the relationship among anorexia, nausea, retching, and vomiting
o Describe the neural structures involved in vomiting and their mediators
• Disorders of the Esophagus
o Define and cite the causes of dysphagia, odynophagia, and achalasia
o Relate the pathophysiology of gastroesophageal reflux to measures used in the diagnosis and treatment of the disorder in adults and children
o State the reason for the poor prognosis associated with esophageal cancer
• Disorders of the Stomach
o Differentiate between the causes and manifestations of acute and chronic gastritis
o Characterize the proposed role of Helicobacter pylori in the development of chronic gastritis and peptic ulcer and cite methods for diagnosis and treatment of the infection
Disorders of Hepatobiliary and Exocrine Pancreas Function
• The Liver and Hepatobiliary System
o Describe the lobular structures of the liver
o Describe the function of the liver in terms of carbohydrate, protein, and fat metabolism
o Relate the mechanism of bile formation and elimination to the development of cholestasis
• Disorders of Hepatic and Biliary System
o State the three ways by which drugs and other substances are metabolized or inactivated in the liver and provide examples of liver disease related to the toxic effects of drugs and chemical agents
o Compare hepatitis A, B, C, D, and E in terms of source of infection, incubation period, acute disease manifestations, development of chronic disease, and the carrier state
o Describe the physiologic basis for portal hypertension and relate it to the development of ascites, esophageal varices, and splenomegaly
• Disorders of the Gallbladder and Exocrine Pancreas
o Explain the function of the gallbladder in regulating the flow of bile into the duodenum and relate to the formation of cholelithiasis (gallstones)
o Describe the clinical manifestations of acute and chronic cholecystitis
o Cite the possible causes and describe the manifestations and treatment of acute and chronic pancreatitis
Alteration in Nutritional Status
• Nutritional Status
o Define calorie and state the number of calories derived from the oxidation of 1 g of protein, fat, or carbohydrate
o Describe four types of energy expenditure
• Nutritional Needs
o Discuss the different dietary standards that are utilized to formulate uniform diet guidelines for calories, proteins, fats, carbohydrates, fiber, vitamins, and minerals
o Differentiate between hunger, appetite, and satiety
o State the interactions between neurohormones in both short-term and long-term mechanisms to control food intake
• Overweight and Obesity
o Explain the use of body mass index (BMI) in evaluating body weight
o Define and discuss the causes and types of obesity and health risks associated with obesity
• Undernutrition and Eating Disorders
o State the difference between protein–calorie starvation (that is, marasmus) and protein malnutrition (that is, kwashiorkor)
o Compare the eating disorders of anorexia and bulimia nervosa (BN) and the complications associated with each


 

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