The University of Alabama
NUR 529 Exam 3 Blueprint
Unit 11. Disorders of GI Function. Chapters 36-39. There are 10 questions from this unit.
1. Chapter 36. Intestinal flora, roles. Essential vitamins in clotting, what are they and how
are they made? Pg. 1067.
• Functions of the intestinal flora is:
o Metabolic activities that salvage energy & absorbable nutrients
o Trophic effects on intestinal epithelial cells
o Protection of the colonized host against invasion by pathogenic organisms
• Major metabolic function of colonic microflora is the fermentation of undigestible
dietary residue & endogenous mucus produced by the epithelial cells.
• Fermentation of carbohydrates, including resistant starches, cellulose, pectins,
unabsorbed sugars, is a major energy source in the colon
• Colonic microorganisms help with vitamin synthesis and absorption of calcium,
magnesium, and iron
o Colonic flora synthesizes vitamin K (essential for clotting & wound healing),
after first week of life
• Resident gut flora provides resistance to colonization by exogenous
microbes/pathogens
o Antibiotics can disrupt the microbial balance and allow overgrowth of species
with pathogenicity (i.e. C.diff)
• Probiotics (lactobacilli, bifidobacterial, escheria coli) can modify the composition of
enteral microflora & can help maintain remission in ulcerative colitis
,2. Chapter 37. Disorders of Gastrointestinal Function. Alterations in intestinal absorption.
Celiac disease. What are the dietary recommendations for celiac disease? Pg. 1107.
(note: I am not expecting you to learn Table 37.2 but I do recommend printing this table and
putting it in your notebook/clipboard for clinicals).
• Celiac disease (gluten-sensitive enteropathy) – immune-mediated disorder (T-cell)
triggered by ingestion of gluten containing grains (most common genetic diseases
today 1-6%)
o Inflammation reaction that results in the loss of absorptive villi from the
intestine impaired absorption of macronutrients (proteins, carbs, fats) and
micronutrients (vitamins, minerals)
o Exposure to gluten is most prominent in the proximal part of small intestine
o Dx is based on clinical manifestations (S&S), serologic tests, intestinal small
bowel biopsy, IgA antihuman tissue transgluaminase (TTG) and IgA
endomysial antibody immunofluorescence (EMA), common to get iron
deficiency anemia (IDA) if positive
o Dietary recommendations are complete elimination of gluten. Meats,
vegetables, fruits, and dairy are safe options provided they are not
contaminated during processing
3. Chapter 37. Disorders of the Stomach. Gastric mucosal layers. Which medications affect the
mucosal layer? Which ones increase the risk for GI bleeding? Pg. 1083.
• NSAIDS, ASA, and infections with H. Pylori cause gastric irritation
4. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bilirubin
elimination and jaundice. How do we get rid of bilirubin? Pg. 1122.
, • Bilirubin Bis Bthe Bfinal Bproduct Bof Bthe Bbreakdown Bof Bheme Bcontained Bin Baged BRBCs
Band Bit Bgives Bbile Bits Bcolor.
• free Bbilirubin Bis Btransported Bthrough Bblood Battached Bto Bplasma Balbumin Buntil Bit
Breaches Bthe Bliver Bwhere Bit Bis Bmade Binto Bconjugated Bbilirubin Band Bbecomes Bsoluble
Bin Bbile Band Bthus Bsecreted Bas Ba Bconstituent Bof Bbile Bwhich Benables Bit Bto Bbass
Bthrough Bthe Bbile Bducts
into Bthe Bsmall Bintestine. BIn Bthe Binteresting B~50% Bof Bbilirubin Bbecome Burobilinogen
Bby Bthe Bintestinal Bflora Band Bis Bexcreted Bin Bthe Bfeces
• normal B<1.5 Bmg/dL
5. Chapter B38. BDisorders Bof BHepatobiliary Band BExocrine BPancreas BFunction. BBile Bproduction Band
cholestasis. BHow Bdoes Bthe Bbody Bbreak Bdown Band Bdigest Bfat? BPg. B1122.
• The Bsecretion Bof Bbile Bis Bnecessary Bfor Bdigestion B& Babsorption Bof Bdietary Bfats
Band Bfat Bsoluble Bvitamins.
• Bile Bsalts B(formed Bfrom Bcholesterol) Bare Bimportant Bin Bdigestion;
o they Bhelp Bemulsify Bdietary Bfats
o they’re Bnecessary Bfor Bthe Bformation Bof Bthe Bmicelles Bthat Btransport Bfatty
Bacids Band Bfat-soluble Bvitamins Bto Bthe Bsurface Bof Bthe Bintestinal Bmucosa Bfor
Babsorption
6. Chapter B38. BDisorders Bof BHepatobiliary Band BExocrine BPancreas BFunction. BBile Bproduction
Band Bcholestasis. BWhat Bis Bthe Bfunction/role Bof Bbile? BPg. B1122.
• Bile Bis Ba Bfluid Bmade Bby Bthe Bliver, Bstored Bin Bthe Bgallbladder Band Bhelps Bwith
Bdigestion Bby Bbreaking Bdown Bfats Binto Bfatty Bacids Bso Bthey Bcan Bbe Babsorbed Bby Bthe
Bbody Bthrough Bthe Bdigestive Btract
• Bile Bcontains Bwater, Bbile Bsalts, Bbilirubin, Bcholesterol, Band Bcertain Bby-products
Bof Bmetabolism
7. Chapter B38. BDisorders Bof BHepatobiliary Band BExocrine BPancreas BFunction. BPage B1127-
1130. BCompare Band Bcontrast Bthe Btransmission Bof Bhepatitis BA, BB, Band BC.
• Hepatitis BA B(HAV) B- Bfecal-oral Broute, Bdrinking Bcontaminated Bmilk Bor Bwater
Bor Bshellfish Bfrom Bdirty Bwater Bcan Balso Bbe Bcommon
o 14-28 Bdays Bincubation, BHAV Breplicates Bin Bthe Bliver, Bexcreted Bin Bbild,
Bshed Bin Bfeces
o young Bkids Bare Basymptomatic B(epidemics Bhappen Bwith Bkids; Bpoor
Bpotty Btraining)
• Hep BB B(HBV) B– Binfected Bblood B(needle-stick) Bor Bserum B(sexual), Bmore Bserious,
Blonger Bincubation
• Hep BC B(HCV) B– Bcontaminated Bblood Btransfusions/products B(rare Bin Bthe BUS)
8. Chapter B39. BAlterations Bin BNutritional BStatus. BMalnutrition Band BStarvation. BWhat
Bdiagnostic Blabs Bsupport Ba Bmalnutrition Bdiagnosis? BPg. B1167.
• Albumin B(20 Bday Bhalf-life), BPrealbumin B(shorter Bhalf-life), Bevaluation Bof Bintake,
anthropometric Bmeasurements B(BMI)
9. Chapter B39. BAlterations Bin BNutritional BStatus. B Energy Bstorage. BAdipose Btissue Bis Ban
Bendocrine Borgan Band Bcontrols Bappetite, Bhow Bdoes Bit Bdo Bthis? BPg. B1155.
NUR 529 Exam 3 Blueprint
Unit 11. Disorders of GI Function. Chapters 36-39. There are 10 questions from this unit.
1. Chapter 36. Intestinal flora, roles. Essential vitamins in clotting, what are they and how
are they made? Pg. 1067.
• Functions of the intestinal flora is:
o Metabolic activities that salvage energy & absorbable nutrients
o Trophic effects on intestinal epithelial cells
o Protection of the colonized host against invasion by pathogenic organisms
• Major metabolic function of colonic microflora is the fermentation of undigestible
dietary residue & endogenous mucus produced by the epithelial cells.
• Fermentation of carbohydrates, including resistant starches, cellulose, pectins,
unabsorbed sugars, is a major energy source in the colon
• Colonic microorganisms help with vitamin synthesis and absorption of calcium,
magnesium, and iron
o Colonic flora synthesizes vitamin K (essential for clotting & wound healing),
after first week of life
• Resident gut flora provides resistance to colonization by exogenous
microbes/pathogens
o Antibiotics can disrupt the microbial balance and allow overgrowth of species
with pathogenicity (i.e. C.diff)
• Probiotics (lactobacilli, bifidobacterial, escheria coli) can modify the composition of
enteral microflora & can help maintain remission in ulcerative colitis
,2. Chapter 37. Disorders of Gastrointestinal Function. Alterations in intestinal absorption.
Celiac disease. What are the dietary recommendations for celiac disease? Pg. 1107.
(note: I am not expecting you to learn Table 37.2 but I do recommend printing this table and
putting it in your notebook/clipboard for clinicals).
• Celiac disease (gluten-sensitive enteropathy) – immune-mediated disorder (T-cell)
triggered by ingestion of gluten containing grains (most common genetic diseases
today 1-6%)
o Inflammation reaction that results in the loss of absorptive villi from the
intestine impaired absorption of macronutrients (proteins, carbs, fats) and
micronutrients (vitamins, minerals)
o Exposure to gluten is most prominent in the proximal part of small intestine
o Dx is based on clinical manifestations (S&S), serologic tests, intestinal small
bowel biopsy, IgA antihuman tissue transgluaminase (TTG) and IgA
endomysial antibody immunofluorescence (EMA), common to get iron
deficiency anemia (IDA) if positive
o Dietary recommendations are complete elimination of gluten. Meats,
vegetables, fruits, and dairy are safe options provided they are not
contaminated during processing
3. Chapter 37. Disorders of the Stomach. Gastric mucosal layers. Which medications affect the
mucosal layer? Which ones increase the risk for GI bleeding? Pg. 1083.
• NSAIDS, ASA, and infections with H. Pylori cause gastric irritation
4. Chapter 38. Disorders of Hepatobiliary and Exocrine Pancreas Function. Bilirubin
elimination and jaundice. How do we get rid of bilirubin? Pg. 1122.
, • Bilirubin Bis Bthe Bfinal Bproduct Bof Bthe Bbreakdown Bof Bheme Bcontained Bin Baged BRBCs
Band Bit Bgives Bbile Bits Bcolor.
• free Bbilirubin Bis Btransported Bthrough Bblood Battached Bto Bplasma Balbumin Buntil Bit
Breaches Bthe Bliver Bwhere Bit Bis Bmade Binto Bconjugated Bbilirubin Band Bbecomes Bsoluble
Bin Bbile Band Bthus Bsecreted Bas Ba Bconstituent Bof Bbile Bwhich Benables Bit Bto Bbass
Bthrough Bthe Bbile Bducts
into Bthe Bsmall Bintestine. BIn Bthe Binteresting B~50% Bof Bbilirubin Bbecome Burobilinogen
Bby Bthe Bintestinal Bflora Band Bis Bexcreted Bin Bthe Bfeces
• normal B<1.5 Bmg/dL
5. Chapter B38. BDisorders Bof BHepatobiliary Band BExocrine BPancreas BFunction. BBile Bproduction Band
cholestasis. BHow Bdoes Bthe Bbody Bbreak Bdown Band Bdigest Bfat? BPg. B1122.
• The Bsecretion Bof Bbile Bis Bnecessary Bfor Bdigestion B& Babsorption Bof Bdietary Bfats
Band Bfat Bsoluble Bvitamins.
• Bile Bsalts B(formed Bfrom Bcholesterol) Bare Bimportant Bin Bdigestion;
o they Bhelp Bemulsify Bdietary Bfats
o they’re Bnecessary Bfor Bthe Bformation Bof Bthe Bmicelles Bthat Btransport Bfatty
Bacids Band Bfat-soluble Bvitamins Bto Bthe Bsurface Bof Bthe Bintestinal Bmucosa Bfor
Babsorption
6. Chapter B38. BDisorders Bof BHepatobiliary Band BExocrine BPancreas BFunction. BBile Bproduction
Band Bcholestasis. BWhat Bis Bthe Bfunction/role Bof Bbile? BPg. B1122.
• Bile Bis Ba Bfluid Bmade Bby Bthe Bliver, Bstored Bin Bthe Bgallbladder Band Bhelps Bwith
Bdigestion Bby Bbreaking Bdown Bfats Binto Bfatty Bacids Bso Bthey Bcan Bbe Babsorbed Bby Bthe
Bbody Bthrough Bthe Bdigestive Btract
• Bile Bcontains Bwater, Bbile Bsalts, Bbilirubin, Bcholesterol, Band Bcertain Bby-products
Bof Bmetabolism
7. Chapter B38. BDisorders Bof BHepatobiliary Band BExocrine BPancreas BFunction. BPage B1127-
1130. BCompare Band Bcontrast Bthe Btransmission Bof Bhepatitis BA, BB, Band BC.
• Hepatitis BA B(HAV) B- Bfecal-oral Broute, Bdrinking Bcontaminated Bmilk Bor Bwater
Bor Bshellfish Bfrom Bdirty Bwater Bcan Balso Bbe Bcommon
o 14-28 Bdays Bincubation, BHAV Breplicates Bin Bthe Bliver, Bexcreted Bin Bbild,
Bshed Bin Bfeces
o young Bkids Bare Basymptomatic B(epidemics Bhappen Bwith Bkids; Bpoor
Bpotty Btraining)
• Hep BB B(HBV) B– Binfected Bblood B(needle-stick) Bor Bserum B(sexual), Bmore Bserious,
Blonger Bincubation
• Hep BC B(HCV) B– Bcontaminated Bblood Btransfusions/products B(rare Bin Bthe BUS)
8. Chapter B39. BAlterations Bin BNutritional BStatus. BMalnutrition Band BStarvation. BWhat
Bdiagnostic Blabs Bsupport Ba Bmalnutrition Bdiagnosis? BPg. B1167.
• Albumin B(20 Bday Bhalf-life), BPrealbumin B(shorter Bhalf-life), Bevaluation Bof Bintake,
anthropometric Bmeasurements B(BMI)
9. Chapter B39. BAlterations Bin BNutritional BStatus. B Energy Bstorage. BAdipose Btissue Bis Ban
Bendocrine Borgan Band Bcontrols Bappetite, Bhow Bdoes Bit Bdo Bthis? BPg. B1155.
