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34 Cards in this Set

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What is negative feed back?
(page 450) The most common feedback system, negative feedback, occurs because the rising hormone level negates the initiating change that triggered the release of the hormone.
What are target organs?
(page 451??) Although a hormone is distributed throughout the body, only those cells with appropriate receptros for that hormone are affected. Hormone receptors of the target cell have two main functions: (1) to recognize and bind specifically and with high affinity to their particular hormones and (2) to initiate a signal to appropriate intracellular effectors.
What is cushings syndrome?
Excessive levels of circulating cortisol. Cushing like syndrome: result of exogenous administration of cortisone. Common signs and symptoms: redistribution of adipose tissue: truncal obesity, moon face and buffalo hump. Osteoporosis, muscle wasting, hyperglycemia, striae, HTN, increased susceptibility to infections, depression.
What is addisons disease?
(page 500) Hypocortisolism (low levels of cortisol secretion) develops because of either inadequate stimulation of the adrenal glands by ACTH or a primary inability of the adrenals to produce and secrete the adrenocortical hormones. Sometimes there is partial dysfunction of the adrenal cortex, so only synthesis of aldosterone or the adrenal androgens is affected. Hypofunction of the adrenal cortex may affect glucocorticoid or mineralocorticoid secretion or both. Primary adrenal insufficiency is termed Addison disease. It is relatively rare, occurring most often in adults ages 30 to 60 years, although it may appear at any time. Addison disease is caused by autoimmune mechanisms that destroy adrenal corical cells and is more common in women...Addison disease is characterized by elevated serum ACTH levels with inadequate corticosteroid and mineralocorticoid synthesis. Before clinical manifestations of hypocortisolism are evident, more than 90% of total adrenocortical tissue must be destroyed.
Explain the chief role of the pancreas in digestion of food
(page 979) The exocrine pancreas secretes an alkaline solution and the enzymes (trypsin, chymotrypsin, carboxypeptidase, beta-amylase, lipase) that digest proteins, carbohydrates, and fats.
Explain what bilirubin is and differentiate between conjugated and unconjugated
(pages 971-972) Bilirubin is a by-product of the destruction of aged red blood cells. It gives bile a greenish black color and produces the yellow tinge of jaundice. Unconjugated= lipid soluble. Conjugated= water soluble.
Where does bile come from and what is it used for
(page 970) The liver assists intestinal digestion by secreting 700 to 1200 ml of bile per day. Bile is an alkaline, bitter-tasting, yellowish green fluid that contains bile salts (conjugated bile acids), cholesterol, bilirubin (a pigment), electrolytes, and water. It is formed by hepatocytes and secreted into the analiculi. Bile salts, which are conjugated bile acids, are required for the intestinal emulsification and absorption of fats. Having facilitated fat emulsification and absorption, most bile salts are actively absorbed in the terminal ileum and returend to the liver through the portal circulation for resecretion.
Compare duodenal, gastric and stress ulcers
Describe the complications of liver dysfunction
What is anorexia?
(page 982) Anorexia is lack of a desire to eat despite physiologic stimuli that would normally produce hunger.
What is vomiting?
(page 982) Vomiting is the forceful emptying of stomach and intestinal contents (chyme) through the mouth. Stimuli initiating the vomiting reflex include the presence of ipecac or copper slats in the duodenum; severe pain; distention fo the stomach or duodenum; torsion or trauma affecting the ovaries, testes, uterus, bladder, or kidney; motion; and activation of the chemoreceptor trigger zone in the medulla.
What is nausea?
(page 982) Nausea is a subjective experience associated with various conditions. Specific neural pathways have not been identified, but hypersalivation and tachycardia are common associated symptoms.
What is retching?
(page 982) Retching begins with deep inspiration. The glottis closes, intrathoracic pressure falls, and the esophagus becomes distended. Simultaneously the abdominal muscles contract, creating a pressure gradient from abdomen to thorax. The lower esophageal sphincter and body of the stomach relax, but the duodenum and antrum of the stomach go into spasm. The reverse peristalsis and pressure gradient force chyme from the stomach and duodenum up nto the esophagus. Because the upper esophageal sphincter is closed, chyme does not enter the mouth. AS the abdominal muscles relax, the contents of the esophagus drop back into the stomach. This process be repeated several times before vomiting occurs.
What is projectile vomiting?
(page 982) Spontaneous vomiting not preceded by nausea or retching is called projectile vomiting. It is caused by direct stimulation of the vomiting center by neurologic lesions (e.g. tumors or aneurysms) involving the brain stem or can be a symptom of gastrointestinal obstruction (pyloric stenosis). The metabolic consequences of vomiting are fluid, electrolyte, and acid-base disturbances.
What is constipation?
(page 982) Constipation is difficult or infrequent defecation. It is a common complaint caused by personal habits and various disorders and drugs. It usually means a decrease in the number of bowel movements per week, hard stools, and difficult evacuation, but the definition must be individually determined. Normal bowel habits range from two or three evacuations per day to one per week.
What is diarrhea?
(page 983) Diarrhea is an increase in the frequency of defecation and the fluditiy and volume of feces. Many factors determine stool volume and consistency, including water content of the colon and the presence of unabsorbedable material, and intestinal secretions...Normally approximately 150mil of water is excreted daily in the stool.
What is hematemesis?
(page 984) Bloody vomitus; either fresh, bright red blood or dark grainy digest blood with "coffee grounds" appearance.
What is hematochezia?
(page 984) Fresh, bright red blood passed from the rectum
What is melena?
(page 984) Black, sticky, tarry, foul-smelling stools caused by digestion of blood in the gastrointestinal tract.
What is occult blood?
(page 984) Trace amounts of blood in normal-appearing stools or gastric secretions; detectable only with a guaiac test.
What is icteric ?
(page 1007) The color of jaundice. (there is an icteric phase in hepatitis.)
What is bulimia ?
(page 1001) Bulimia nervosa is characterized by binging-the consumption of normal to large amounts of food, often several thousand calories at a time-followed by self-induced vomiting or purging of the intestines with laxatives.
What is portal hypertension?
(page 1002) Portal hypertension is abnormally high blood pressure in the portal venous system. Pressure in this system is normally 3mmHg; portal hypertension is an increast to at least 10mmHg.
What is dysphagia?
(page 984) Dysphagia is difficulty swallowing. It can result from mechanical obstruction of the esophagus or a disorder that impairs eophageal motility. Intrinsic obstructions originate in the wall of the esophageal lumen and include tumors, strictures, and diverticular herniations (outpouchings).
What is GERD?
(page 986) Gastroesophageal reflux (GER) is the reflux of the chyme (acid and pepsin) from the stomach through the lower esophageal sphincter to the esophagus.
What is Hiatal hernia?
(page 987) Hiatal hernia is the protrusion (herniation) of the upper part of the stomach through the diaphragm and into the thorax. There are two types of hiatal hernai: Sliding hiatal hernia, paraesophageal hiatal hernia.
What is pyloric obstruction?
(page 987) Pyloric obstruction is the narrowing or blocking of the opening between the stomach and the duodenum.
What does PUD stand for?
peptic ulcer disease
What is diverticular disease, diverticuoliss, diverticulits?
(page 989) Diverticula are herniations or saclike outpouchings of mucosa through the muscle layers, usually in the wall of the sigmoid colon. Diverticulosis is asymptomatic diverticular disease. Diverticulitis represents inflammation. Diverticular disease is most common in elderly persons, but the incidence is increasing in younger individuals, particularly when much of the diet consists of refined foods.
What is appendicitis? S/S?
(page 999) Appendicitis is an inflammation of the vermiform appendix, which is a projection from the apex of the cecum. It is the most common surgical emergency of the abdomen and affects 7% to 12% of the population. It generally occurs between 20 and 30 years of age, although it may develop at any age. S/S Gastric or periumbilical pain is the typical symptom of an inflammed appendix. The pain may be vague at first, increasing in intensity over 3 to 4 hours. It may subside and then recur in the RLQ, indicating extension of the inflammation to the surrounding tissues. Nausea, vomiting and anorexia follow the onset of pain, and low grade fever is common. Diarrhea occurs in some individuals, particularly children; others have a sensation of constipation. Perforation, peritonits, and abscess formation are the most serious complications of appendicits.
What is ulcerative colitis?
(page 996) Ulcerative colitis is a chronic inflammatory disease that causes ulceration of the coloni mucosa, usually in the rectum and sigmoid colon. The lesions appear in susceptible individuals between 20 and 40 years of age.
What is crohn disease?
(page 997) Crohn disease (granulomatous colitis, regional enteritis) is an inflammatory disorder that affects both the large and small intestine…There also may be deficiencies in folic acid and vitamin D absorption.
What is cirrhosis of the liver?
(page 1008) Cirrhosis is an irreversible inflamatory disease that dirupts liver structure and function and is leading cause of death in the United States.
List some complications of liver disease.
Portal hypertension, ascities, encephalopathy, jaundice,