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102 Cards in this Set
- Front
- Back
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Hepatic Encephalopathy |
Accumulation of toxins related to liver failure, causing a disruption of neurotransmission. ammonia toxic to the brian |
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clinical manifestations of hepatic encephalopathy |
personality changes, confusion, memory loss, flapping tremor (asterixis), stupor, coma, death |
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Treatment of hepatic encephalopathy |
correct fluid and electrolyte imbalances withdraw depressant drugs metabolized by the liver restrict dietary protein intake eliminate intestinal bacteria |
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Jaundice |
called icterus yellowish or greenish pigmentation of the skin caused by hyperbilirubienmia (>2.5-3mg/dl) |
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Causes of Jaundice |
Extrahepatic obstruction to bile flow (gallstones) Intrahepatic obstruction (hepatocellular disease sex: cirrhosis, heptitis) Prehepatic obsturction: excessive production of bilirubin
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Clinical manifestations of jaundice |
dark urine clay-colored stools yellow discoloration occurring first in sclera of the eye skin xanthomas ( cholesterol deposits)
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Treatment of jaundice |
correct cause, jaundice is only a sign of underlying disorder |
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Autoimmune Hepatitis |
rare, chronic and progressive T-cell mediated inflammatory liver disease |
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Viral Hepatitis |
systemic viral disease that primarily affects the liver |
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Viral hepatitis |
can cause hepatic cell necrosis, kupffer cell hyperplasia and infiltration of liver tissue by mononuclear phagocytes
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Viral Hepatitis Treatment |
Restrict physical acitivy maintain low-fat high carbo diet if bile flow is obstructed avoid direct contact with blood or body fluids of individuals with hepatitis B or hepatitis C |
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Hepatitis A |
found in the feces, bile and sera of infected individuals. transmitted by fecal-oral route. |
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Hepatitis B |
transmitted through contact with infected blood, body fluids and contaminated needles. maternal transmission occurs if mother is infected during the 3rd trimester |
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Hepatitis C |
responsible for most cases of posttransfusion hepatitis. also implicated in infections related to IV drug use and HIV infection 80% develop liver disease No vaccine is avaiable |
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Hepatitis D |
dependent on hepatitis B. Treatment: Pegylated interfrom alpha |
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Hepatitis E |
Fecal-oral transmission contaminated water or uncooked meat most common in asian and african countries.
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The clinical course of hepatitis |
incubation, prodromal, icteric and recovery |
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The sequence for the development of alcoholic liver disease |
Steatosis, steatohepatitis and fibrosis |
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Cholecystitis |
inflammation of the gallbladder |
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Pancreatitis |
inflammation of the pancreas |
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pancreatitis is associated with: |
alcohol intake and cholelithiasis |
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Causes of Pancreatitis |
caused by injury or damage to pancreatic cells and ducts, causing leakage of pancreatic enzymes into the pancreatic tissue
these enzymes causes autodigestion of pancreatic tissue and leak into bloodstream to cause injury to blood vessels and other organs |
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The most common cause of chronic pancreatitis |
Alcohol abuse can go away if stop drinking |
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Anorexia |
loss of appetite , lack of desire to eat, despite physiologic stimuli that would normally produce hunger |
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Vomiting |
Forceful emptying of the stomach and intestinal contents through the mouth |
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Vomiting center |
medella oblongata |
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vomiting |
can lead to fluid, electrolyte and acid-base disturbances, hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis |
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Projectile vomiting |
spontaneous vomiting that does not follow nausea or retching |
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retching |
vomiting w/o expulsion of vomitus |
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Nausea |
hypersalivation and tachycardia |
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Constipation |
infrequent or difficulty defection
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Normal transit constipation |
normal rate of stool passage but difficulty with stool evacuation from low residue low-fluid diet |
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Slow-transit constipation |
impaired colonic motor activity with infrequent bowel movements and straining |
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Pelviv floor dysfunction(anismus) |
failure of pelvic floor muscles or anal sphincter to relax with defecation |
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Secondary constipation |
from an actual disease process or condition |
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Fecal impaction |
hard, dry stool retained in rectum |
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Diarrhea |
increased frequency bowel movements (3 or more per day). increased volume, fluidity, weight of feces
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osmotic diarrhea |
nonabsorbable substance in the intestine draws water into the lumen by osmosis, causing large-volume diarrhea |
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Secretory diarrhea |
form of large-volume diarrhea caused by excessive mucosal secretion of chloride or bicarbonate rich fluid or the inhibition of net sodium absorption |
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motility diarrhea |
excessive motility decreases transit time, mucosal surface contact and opportunities for fluid absorption |
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Clinical manifestations of diarrhea |
dehydration, electrolyte imbalance (hyponatremia, hypokalemia) metabolic acidosis and weight loss |
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Systemic manifestations of diarrhea |
manifestations acute bacterial or viral infections manifestations of inflammatory bowel disease manifestations of malabsorption syndrome |
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Hematemesis |
bloody vomit |
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Hematochezia |
bloody stool |
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Melena |
black, tarry stools |
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Occult bleeding |
not visible |
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Dysphagia |
difficulty swallowing. mechanical obstructions of esophagus (instrinsic vs. extrinsic)
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Achalasia |
denervation of smooth muscle in the esophagus and lack of lower esophageal sphincter relaxation
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clinical manifestations of dysphagia |
upper esophageal obstruction: discomfort occurring 2-4 seconds after swallowing
lower esophageal obstructions: discomfort occurring 10-15 seconds after swallowing |
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Gastroesophageal reflux disease (GERD) |
acid and pepsin refluxes from the stomach into the esophagus causing esophaitis. conditions that increase abdominal pressure (vomiting,coughing,lifting, bending or obesity |
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Hiatal hernia |
protrusion (herniation) of the upper part of the stomach through the diaphragm and into the thorax |
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Peptic Ucler disease |
break of ulceration in the protective mucosal lining of the lower esophagus, stomach or duodenum |
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Peptic ulcer disease risk factors |
genetic predisposition H. pylori infection habitual use of NSAIDs excessive use of alcohol, smoking, acute pancreatitis, chronic obstructive pulmonary disease, obesity, cirrhosis,and over 65 years of age |
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Duodenal uclers |
most common of the peptic ulcers pain begins 30mins to 2hrs after eating when the stomach is empty pain is relieved by food
risk may be reduced with a diet high in Vitamin A & fiber |
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Gastric Ulcer |
Tends to develop in the antral region of the stomach, adjacent to the acid-secreting mucosa of the body |
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clinical manifestations of gastric ucler |
pain occurs immediately after eating tend to be chronic anorexia, vomiting and weight loss |
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Stress Ucler |
peptic ulcer related to a serve illness, multisystem organ failure, or major trauma |
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ischemic ulcer |
develops within hours of an event |
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curling ulcer |
develops after a burn from ischemia |
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cushing ulcer |
develops as a result of head trauma or brain surgery from hypersecretion of hydrochloric acid from the vagal nuclei
bleeding most common |
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Malasboprtion syndromes |
interfere with nutrient absorption |
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Maldigestion |
failure of the chemical processes of digestion |
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malaabsoprtion |
failure of the intestinal mucosa absorb (transport) the digested nutrients |
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Pancreatic insufficiency |
insufficient pancreatic enzyme production ( Lipase, amylase, trypsin, or chymotrypsin) |
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Lactase deficiency |
inability to break down lactose into monosaccharides and thus prevent lactose digestion and monosaccharide absorption. |
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Fat soluble vitamin deficiencies: vitamin A |
night blindness |
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Fat- soluble vitamin deficiencies: Vitamin D |
decreased calcium absorption, bone pain, osteoporosis, fractures |
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Fat- soluble vitamin deficiencies: Vitamin K |
prolonged prothrombin time, purpura and petechiae |
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Fat- soluble vitamin deficiencies: Vitamin E |
testicular atrophy Neurologic defects in children |
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Dumping syndrome |
rapid emptying of hypertonic chyme from the stomach into the small intestine
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clinical manifestations of dumping syndrome |
diarrhea, cramping, nausea and vomiting |
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Late dumping syndrome |
1-3 hrs after eating clinical weakness,diaphoresis and confusion |
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Inflammatory bowel disease |
Uclerative colitis Crohn disease |
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Ulcerative Colitis |
chronic inflammatory disease that causes ulceration of the colonic muscosa
common in 20-40yrs or jewish descent |
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clinical manifestation of ulcerative colitis |
diarrhea (10-20 bowl movement per day), bloody stools, cramps
increased risk for colon cancer is demonstrated |
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Crohn disease |
Granulomatous colitis, ileocolitis or regional enteritis affects any part of the digestive tract from mouth to anus
SKIP lesion ARE common cobblestone appearance |
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Fistulas |
common in Crohn disease BUT NOT in ulcerative colitis
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Fistual |
occurs between skin & intestines occurs between intestine and intestine occurs into bladder & vagina |
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Diverticula |
Hernination of mucosa through the muscle layers of the colon wall |
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Diverticulosis |
asymptomatic diverticular disease |
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Diverticulitis |
inflammatory stage of diverticulosis |
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Appendicitis |
inflammation of the vermiform appendix. causes: obstruction, ischemia, increased intraluminal pressure, infection, ulceration |
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Irritable bowel syndrom |
functional gastrointestional disorder with no specific structure or biochemical alterations |
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common complications of liver disorders |
acute liver failure portal HTN ascites hepatic encephalopathy jaundice hepatorenal syndrome |
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Acute liver failure |
severe impairment of necrosis of liver cells w/o preexisting liver disease or cirrhosis |
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Leading cause of acute liver failure |
Acetaminophen overdose |
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clinical manifestations of acute liver failure |
anorexia, vomiting, abdominal pain and progressive jaundice |
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Cirrhosis |
irreversible inflammatory fibrotic disease that disrupts liver function and even liver structure
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Most common causes of Cirrhosis |
alcohol abuse and viral hepatits |
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cirrhosis (alcoholic liver disease) |
Oxidation of alcohol causing damage to hepatocytes |
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Steatosis |
(alcoholic fatty liver) mildest form, reversible id drinking is stopped |
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Alcoholic hepatits (steatohepatitis) |
inflammation, degeneration and necrosis of the hepatocytes occur |
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Alcoholic cirrhosis (fibrosis) |
toxic effects of alocohol metabolism on the liver |
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Nonalcoholic fatty liver disease |
inflitration of hepatocytes with fat that occurs in the absence of alcohol intake. associated with obesity |
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Portal HTN |
Abnormally high BP in the portal venous system primarily caused by resistance in blood flow (increase to at least 10mm Hg) |
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clinical manifestation of portal HTN |
vomiting blood; ascites |
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Ascites |
high resistance to blood flow through liver that diverts blood flow to the mesenteric vessel
HIGH PRESSURE IN THE LIVER (portal venous system)
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Most common cause of Ascites |
Cirrhosis |
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Treatment of Ascites |
dietary salt restriction Potassium-sparing diuretics monitor serum electrolytes,especially sodium and potassium |
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Best treatment option for Ascites |
Liver transplant |
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Cholelithasis |
inflammation of gallbladder |
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Icetrus |
Jaundice |
