Question

A 60 year old male truck driver was taken to the nearest hospital because of vomiting and mild abdominal A pain that caused him to shake vigorously and lose consciousnes. Upon arrival, his vital signs were taken: Vital Functions Blood pressure 90/50 mm Hg Resting heart rate Resting respiration rate 110 beats per minute 18 breaths per minute Body temperature 98°F RBC count normal WBC Platelets Erythropoietin PaCO PaO normal normal elevated 50 mm Hşg 60 mm Hg Because heart attack was initially suspected, the patient was given four 80mg aspirin tablets while an EKG was ordered. His EKG recording seemed to indicate the occurrence of a heart attack so he was asked to stay overnight for close monitoring. While resting, the patient requested for some water / food in which he took a couple of spoonfuls of a clear chicken soup. After a little while, the patient said he needed to defecate in which he was then helped to sit up. While in this position, the patient started to vomit again - he ejected vomitus and stool of ground coffee color. Upon further questioning, it was revealed that he has been a chronic alcohol drinker without food during those drinking bouts. Also, he confessed he would drink those 5-hour energy drinks that are high in caffeine content in order to keep him awake while on long distance driving. Endoscopy was immediately ordered which confirmed that his stomach lining has bleeding ulcers. 1. Assess his GI functions. A. (0.5) Based on GI wall histology, how far into the layers are the gastric ulcers capable of causing a blood-laden (ground coffee color) vomitus? Why do you think so?

Need help with these human physiology questions about the GI system! Thank you!

Answer 1

1. A. Ground coffee color vomitus is due to the presence of blood in the gastrointestinal tract that appears on the vomitus gives dark color. The main cause is GI ulcer that occurs due to the erosion present on the lining of the stomach. The innermost layer of mucosa is involved where the gastric juice is secreted become inflamed and lead to bleeding.

B. Lifestyle habits, spicy foods, alcohol, stress, NSAIDs are the causative factors for gastric ulcers. The causative factors affect the digestive enzyme that protects the lining of the stomach that leads to excessive production of stomach acid. This results in erosion on the protective layer of the stomach and causes ulcers.

C. The patient has a habit of chronic alcohol and use of caffeine during long driving. Moreover, he didn't have the food properly. This may worsen the symptoms and continuous alcohol drinking irritates the gastric mucosa and causes bleeding in the stomach. Prolonged gastritis leads to blood vomiting which appears ground coffee color.

D. Proton pump inhibitor is a type of drug that minimizes the stomach acid secretion by blocking the secretion of acid production. It inhibits the ATPase that presents on the parietal cell membrane thereby reducing the acid secretion.

E. H2 receptor blocker inhibits the H2 receptor in the parietals cells and decreases the stomach acid secretion stimulated by the factors such as alcohol, caffeine, food etc.

F. The patient was given with three foods and three snacks in a periodic interval to avoid hunger and overeating. Because both hunger and overeating stimulate excessive secretion of stomach acid which further worsen the ulcer.

G. He was advised to cut down the caffeine, spicy and acidic foods. Caffeine, spicy foods are increases the secretion of stomach acid. So avoiding such things helps for fast healing of ulcers.