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126 Cards in this Set
- Front
- Back
lack or loss of appetite or hunger
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Anorexia
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Difference between appetite & hunger
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Appetite is psychological, depending on memory and associations.
Hunger is the physiological need for food. |
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The N/V mechanism is part of what nervous system
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involuntary autonomic nervous system
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Ice pica
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Pagophagia
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Flaking paint, clay, or hair pica
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Trichophagia
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Laundry starch pica
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Amylophagia
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compulsive eating of nunnutritive substances.
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Pica
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Pica occurence common with:
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- PG women
- some patients with iron or zinc deficiencies - Children (beginning at age 2 leave by adolescence) |
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Dirt pica
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Geophagia
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S&S of ______
- Intense fear of becoming obese that does not diminish as weight loss increases. - Disturbance of body image - claim to feel fat. - 25% weight loss or -> Protein, calorie malnutrition - Refusal to maintain body weight - NO known physical illness. - Amenorrhea |
Anorexia Nervosa
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Refusal to eat, grossly distorted eating patterns
- loss of 25% of TBW - Protein/calorie malnutrition |
Anorexia Nervosa
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Causes of ______
1) Psychological - rejecting behavior/reinforced by the attention it receives. 20 Endocrine disorder |
Anorexia Nervosa
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- Binge eating
- followed by self-induced vomiting or - abuse of laxatives and/or diuretics |
Bulimarexia
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Binge eating without purging
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Bulimia
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S&S of ______
- Dental problems - inflammation of the esophagus & fluid&electrolyte imbalances. |
Bulimarexia & Bulimia
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- Most prevalent childhood nutritional disorder
- Predictive of adult obesity - Dieting is dangerous in children |
Childhood Obesity
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These are types of ______
1. Hematemesis - Bright red - Coffee ground 2. Melena - Bright Red - Tarry black |
G.I. Bleeding
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Causes of ______
- Disease, trauma, clotting disorders. |
G.I. Bleeding
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Difficulty in swallowing
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Dysphagia
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Causes of ______
- Stroke, CA(cancer), stenosis(narrowing), or scarring. |
Dysphagia
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Inability of the lower esophageal sphincter (cardiac sphincter) to relax -> foot setting in the esophagus until it slowly passes into the stomach -> potential for aspiration.
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Achalasia
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inflammation of the esophagus
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esophagitis
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causes of ______
- reflux of gastric contents - chemical injuries, infection - irritations from hot/spicy foods |
esophagitis
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S&S of _______
- heartburn and pain (similar to cardiac pain) |
Esophagitis
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Backward movement of gastric contents into the esophagus -> heartburn
(most common GI disorder) |
Gastroesophageal Reflux
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Causes of ______
- Hietal hernia - Weak or incompetent cardiac sphincter |
Gastroesophageal Reflux
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Predisposing factors of ______
- weakness of hiatal muscle - increased intrabdominal pressure (obesity, PG, ascites) |
Gastroesophageal Reflux
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S&S of ______
- Gastric reflux -> heartburn, pain occurring 1/2 - 1 hour following a meal. Heartburn worsens with lying. |
Gastroesophageal Reflux
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(Not required)
Tx for Gastroesophageal Reflux |
1. Conservative - lose weight, avoid lying flat, increase HOB(head of bed), frequent small feedings, antacids
2. surgery |
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Outpouching of the esophageal wall caused by a weakness of the muscle layers
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Esophageal Diverticulum
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Major complication w/ Esophageal Diverticulum
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Food can get trapped in pouch
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S&S of ______
- food gets "stuck" - gurgling - coughing - belching - bad breath |
Esophageal Diverticulum
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(not required)
TX of Esophageal Diverticulum |
Surgery
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- Accounts for about 6% of all GI cancers
- Occurs most often in men > 50 - Predisposing factors = alcohol and tobacco, injury to esophagus |
Cancer of the Esophagus
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S&S of ______
- dysphagia - weight loss - anorexia - fatigue - pain or swelling |
Cancer of the Esophagus
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A transient irritation of the gastric mucosa.
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Acute Gastritis
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Causes of ______
- bacterial endotoxins - caffeine - alcohol - ASA (aspirin) |
Acute Gastritis
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Patho of ______
irritant -> inhibit production of prostoglandins (prostoglandins stimulate contraction of uterine and other smooth muscles, decrease B/P, regulate acid secretion of stomach) -> loss of protection of gastric mucosa from normal stomach acids -> disruption of mucosal barrier -> irritation |
Acute Gastritis
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S&S of ______
- ASA - asymptomatic of heartburn or sour stomach - Alcohol - vomiting, GI bleeding, hematemesis(blood vomit) - Endotoxins - abrupt onset, N/V. |
Acute Gastritis
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(not required)
TX of Acute Gastritis |
Usually gone in a few days
aka "bite the bullet" |
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Progressive and irreversible atrophy of part of the epithelium of the stomach which contains glands (pepsin-producing and acid producing cells) -> lack of hydrochloric acid and vitamin B12 absorption (pernicious anemia)
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Chronic Gastritis
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lack of intrinsic factor commonly found in gastric mucosa -> failure to absorb B12
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Pernicious Anemia
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S&S of ______
- Pernicious anemia - impaired O2 transport - Alterations in RBC structure |
Chronic Gastritis
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An ulcer that develops in the upper GI tract which is exposed to acid-pepsin secretions.
- chronic illness with remissions and exacerbations |
Peptic Ulcers
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enzyme that breaks down proteins
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pepsin
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Causes of ______
- H. pylori infections - NSAIDs, esp ASA |
Peptic Ulcers
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S&S of ______
> Pain - burning, gnawing or cramping > Pain - between meals (when stomach is empty) or at 1-2 a.m. > Pain - located near xiphoid, may rotate toward ribs, the back and the right shoulder > Pain - recurs at intervals of weeks or months > Pain - is relieved by food or antacids |
Peptic Ulcers
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Complications from Peptic Ulcers can include: (3 things)
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- Hemorrhage
- Obstruction - due to edema - Perforation - eats through layers of the GI tract -> peritonitis |
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DX for Peptic Ulcers (not required)
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Endoscopy with biopsy to test for H. Pylori or blood test for titers (measures antibodies to H. Pylori)
History of NSAID use |
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TX for Peptic Ulcers (not required)
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Kill H. Pylori infection with anitbiotics
Surgery |
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- Rare
- Caused by gastrin-secreting tumor located in pancreas - Ulcers form from elevated gastrin levels - Usually malignant |
Zollinger-Ellison Syndrome
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- Related to severe stress, trauma, sepsis, head injuries
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Stress ulcers or Curling's ulcer
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Patho of ______
Head injuries -> hypersecretion of HCL Others -> ischemia of the gastric mucosa -> disruption of mucosal barrier -> ulcer from normal acid secretions |
Stress ulcers or Curling's ulcer
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Complications of Stress ulcers or Curling's ulcer include: (2)
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- Hemorrhage
- High mortality |
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TX of Stress ulcers or Curling's ulcer (not required)
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- antacids, tagamet (acid secretion)
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Causes of ______ & ______
- unknown - hereditary (esp. Jewish) - aggravated by psychological stress |
Chron's Disease/ Ulcerative Colitis
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DX of Chron's Disease/Ulcerative Colitis
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- symptoms, x-rays, procto-sigmoidoscopy
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Recurrent granulomatous type of inflammatory response that affect any area of the GI tract
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Chron's Disease
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S&S of ______
- intermittent diarrhea - colicky pain - wt. loss & malaise - low grade fever - perianal abscesses/fistula |
Chron's Disease
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A nonspecific inflammatory condition of the colon
- ulcerative & exudative - affects colon |
Ulcerative colitis
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S&S of ______
- Bloody diarrhea w/ mucous - Colicky pain - Anemia - Hypoproteinemia |
Ulcerative colitis
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Bacteria infections of the colon
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Infectious Colitis
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Common nosocomial infection resulting from antibiotic tx which leads to disruption of the normal bacterial flora of the colon - difficult to treat - must stop antibiotic therapy.
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Clostridium difficile Colitis
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Bacteria found in feces of cattle and milk - contaminated or poorly cooked meat/milk leads to food-borne transmission. Sever infection leads to production of toxins and hemolytic anemia and renal failure. Most common cause of acute renal failure in children.
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Escherichia coli 0157:H7 Colitis
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A pouch or sac formed by herniation of intestinal mucous membrane through the muscle layer of the intestine.
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Diverticular Disease
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S&S of ______
- Change in bowel habits - Diarrhea - Constipation - Bloating - Gas |
Diverticular Disease
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Causes of ______
- Idiopathic - lack of dietary fiber - Aging - Lack of exercise |
Diverticular Disease
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Complications of ______
- Perforation - Peritonitis - Hemorrhage - Bowel obstruction |
Diverticular Disease
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- Kills ~ 57,000 each year
- 2nd most common site of fatal CA - By the time you have symptoms, disease is too far - Asymptomatic until progressed disease |
Colorectal Cancer
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DX for Colorectal Cancer
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- Hemocult - stool (occult blood)
- Digital rectal exam - Proto - sigmoidoscopy |
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Inflammation of the peritoneum is a serious complication which commonly results from spread of infection from abdominal organs (appendicitis), rupture in GI tract, or from penetrating wounds to the abdomen
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Peritonitis
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Pathophysiology of ______
Initial assault (bacteria/chemical) -> exudate (sticky, substance) Adhesions -> seals off area -> pockets of puss form and glue the surfaces together -> localizes the infection (however may become generalized) -> adhesions usually disappear when infection disappears but may persist which later -> intestinal obstruction |
Peritonitis
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S&S of ______
- N/V - Pain & abdominal tenderness w/ movement - Shallow resp. (due to pain) - Rigid, distended abdomen - Fever, increase WBC's |
Peritonitis
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TX of Peritonitis (not required)
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- Antibiotics
- NGT - NPO - Surgery |
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The interference (from whatever cause) with the normal flow of intestinal contents then the intestinal tract
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Intestinal Obstruction
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Types of intestinal obstruction (four)
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- acute
- chronic - partial - complete |
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peristalsis halts -> no movement (i.e. obstruction)
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Paralytic Ileus
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Causes of ______
- Abdominal surgery - Trauma - Peritonitis - Chemical irritation - Ischemia - Electrolyte imbalances |
Paralytic Ileus
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Causes of ______
- Adhesions - Hernias - Volvulus - twisting of bowel - Intussusception - telescoping of bowel - Fecal impaction - Strictures - Tumors |
Mechanical Ileus
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Effects of Intestinal Obstruction
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Fluid and electrolyte imbalance
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S&S of ______
- No bowel sounds or hypoactive - Continuous pain - N/V - Distended abdomen - lack of BMs |
Paralytic ileus
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S&S of ______
- Hyperactive bowel sounds at beginning which later diminish and become absent - N/V - Distended abdomen - lack of BMs |
Mechanical ileus
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TX of Intestinal Obstruction
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- Fluid and electrolytes
- NGT/NPO - Surgery |
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Inflammation of the liver
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Hepatitis
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Causes of ______
- virus - infections - drug toxicity (alcohol) |
Hepatitis
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Acute inflammatory disease caused by hepatitis virus or other virus (CMV, herpes and measles)
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Viral hepatitis
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Fecal, oral route liver inflammation
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Hepatitis A (HVA)
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Blood borne liver inflammation
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Hepatitis B (HVB)
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Other (Non-A, Non-B) liver inflammation
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Hepatitis C (HVC)
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TX of Hepatitis (prevention)
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- Gamma globulin - HVA
- HVB vaccine/ may prevent HVD - No vaccine for HBC or HBE |
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S&S of ______
- Prodromal stage - malaise - Icteric stage - increased bilirubin lvls (jaundice) - dark urine, pale stools - increased liver size - convalescent stage - presents quickly |
Hepatitis A
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S&S of Hepatitis B
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- carry virus w/out symptoms for long time
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Fibrosis and "hardening" of the liver
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Cirrhosis
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Causes of _____
- Viral hepatitis - Alcoholism - Drug toxicity - Chemical exposures - Biliary obstructions - Cardiac disease - Metabolic disorders - Others |
Cirrhosis
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Types of cirrhosis
1. nodules (fibrous) develop 2. Dmg. to the bile ducts 3. 4th leading cause of death in US adults, most common cause of cirrhosis = alcoholism |
1. Postnecrotic
2. Biliary 3. Portal of alcoholic |
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Stages of Cirrhosis
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1. Fatty changes (asymptomatic)
2. liver tenderness, pain, anorexia, fever, jaundice, ascites and liver failure 3. Cirrhosis |
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S&S of _______
- Portal hypertension - fibrous tissue increase portal venous pressure -> dilation of connecting veins (to handle increase pressure) -> venous shunting and congestion -> splenomegaly, Hemorrhoids, esophageal varices, caput medusae (dilated surface veins around the umbilicus), ascites and peripheral edema |
Portal Cirrhosis
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Causes of ______ with Cirrhosis
- Impaired protein synthesis in liver -> colloid osmotic pressure - Obstruction of venous flow through liver -> increase production of lymph -> oozing of serous fluid from liver surface - increase aldosterone -> NA and H2O retention and K loss |
Ascites and edema
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A condition in which acute renal failure occurs with disease of the liver or biliary tract, the cause of which is believed to be either a decrease in renal blood flow or damage to both the liver and the kidneys as from carbon tetrachloride poisoning or leptospirosis.
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Hepatorenal syndrome
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Effects of _______
- decreased sex hormones - decreased synthesis of plasma proteins -> ascites, edema - synthesis of blood-clotting factors -> bleeding - failure to remove and conjugate bilirubin -> jaundice - impaired bile synthesis - impaired gluconeogenesis - decreased ability to convert ammonia to urea -> increased blood ammonia levels |
Hepatocellular dysfunction
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- common problem esp. for women
- cholesterol and bilirubin "rocks" - caused by increase in cholesterol in bile |
Cholelithiasis (gallstones)
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S&S of _______
- many asymptomatic until obstruction of bile flow - jaundice (when bile flow obstructed) - biliary colic = sudden onset of pain which increases in intensity to reach climax in 30-60 minutes - pain located = upper right quadrant, episgastric area, often radiates to the back, right shoulder and right scapula - pain rare on left side but possible - N/V may occur |
Cholelithiasis (gallstones)
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DX of gallstones (not required)
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- oral cholecystogram (x-ray of gb with contrast), ultrasound, gb scan
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TX of gallstones (not required)
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- surgery or lithotripsy
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Inflammation of gallbladder, can be acute or chronic
- associated with gallstones and bile obstruction. |
Cholecystitis
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S&S of ______
1. acute - symptoms like in gallstones 2. chronic - intolerance to fatty foods - vague - belching - possible colicky pain 3. DX/TX same as gallstones |
Cholecystitis
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Severe life threatening disorder due to loss of pancreatic enzymes into surrounding tissues and abdominal cavity. Enzymes begin to autodigest tissues -> necrosis -> hemorrhage
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Acute hemorrhagic pancreatitis
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Causes of ______
- Gallbladder disease - Alcohol abuse |
Acute hemorrhagic pancreatitis
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S&S of ______
- abrupt and dramatic - may follow heavy metal or alcoholic binge - severe epigastric pain and abdominal pain radiating to back - pain is worse when person lies flat - abdominal distension - hypoactive bowel sounds - hypovolemia from loss of large volumes of fluid in retroperitoneal and abdominal cavity - hypovolemic shock - fever - elevated serum amylase/lipase after 24 hrs. |
Acute hemorrhagic pancreatitis
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Prognosis: Acute hemorrhagic pancreatitis
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5% die, life-threatening disease
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TX for Acute hemorrhagic pancreatitis
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- pain relief
- resting pancreas - restoring lost plasma volume |
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Progressive destruction of pancreas, two types
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Chronic Pancreatitis
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stones form in pancrease, seen most often in alcoholics
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Chronic calcifying pancreatitis
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Stenosis of the sphincter of Oddi
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Chronic obstructive pancreatitis
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S&S of ______ & ______
- recurring episodes of epigastric and upper left quadrant pain, precipitated by alcohol abuse and overeating - anorexia - constipation - N/V - flatulence - finally diabetes mellitus and malabsorption syndrome |
Chronic calcifying pancreatitis
and Chronic obstructive pancreatitis |
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TX of Chronic calcifying and obstructive pancreatitis
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low fat diet, alcohol withdrawal, TX biliary disease
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- 5th leading cause of cancer deaths in US
- occurs mostly after age 50, usually between ages 65 and 79 - prognosis poor and usually not dx until advanced, survival <3% |
Cancer of Pancreas
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Cause of ______
- idiopathic, but smoking is major risk factor |
Cancer of Pancreas
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S&S of Cancer of Pancreas
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- pain and jaundice
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DX for Cancer of Pancreas
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ulrasound and CT
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TX for Cancer of Pancreas
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surgery, radiation, and chemo
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Hepatitis:
- source is feces - fecal-oral route of transmission - no chronic infection - pre/post-exposure immunization to prevent |
Hepatitis A
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Hepatitis:
- source is blood/blood-derived body fluids - percutaneous/permucosal route of transmission - chronic infection occurs - pre/post-exposure immunization to prevent |
Hepatitis B
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Hepatitis:
- source is blood/blood-derived body fluids - percutaneous/permucosal route of transmission - chronic infection occurs - blood donor screening; risk behavior modification to prevent |
Hepatitis C
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Hepatitis:
- source is blood/blood-derived body fluids - percutaneous/permucosal route of transmission - chronic infection occurs - pre/post-exposure immunization; risk behavior modification to prevent |
Hepatitis D
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Hepatitis:
- source is feces - fecal-oral route of transmission - no chronic infection - ensure safe drinking water to prevent |
Hepatitis E
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