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20 Cards in this Set
- Front
- Back
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Cholelithiasis |
Gallstones- many are silent clinically Cholesterol- contain crystalline cholesterol Pigment- composed of bilirubin Ca salt Female, Fat, Fertile, Forty Risks: Age and Sex- middle aged females Environment- estrogen exposure Acquired- stasis Hereditary- ABC transporter deficiency |
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Cholesterol Gall Stones |
Cholesterol concentration exceeds solubility within bile salts and crystallizes. Brought on by supersaturation, hypomotility, accelerated crystallization, and secretion of mucus in the gallbladder trapping cholesterol accumulations Round, yellow to gray-white |
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Pigmented Stones |
Mixtures of unconjugated bilirubin w/ Ca bile salts. Disorders that raise UC levels of bilirubin (anemias) increase risk of development. As well as infection with Ascaris (worm), E Coli. brown to black |
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Biliary Colic |
symptom of gallstone passing through bile duct. Typically follows a fatty meal as CCK levels rise and the gallbladder is forced to contract against a decreased luminal area. Gallstones can progress to cholecystitis or a gallstone illeus. |
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Acute Cholecystitis |
typically brought on by gallstone obstruction of cystic duct. Chemical irritation and inflammation of gallbladder leads to disruption of protective mucus lining and distension and perforation can occur. Clinical: RUQ, biliary colick, with radiation towards the right shoulder blade |
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Chronic Cholecystitis |
Sequel to repeated bouts of acute disease. Can progress to fibrosis of the mucosa and outpouching diverticulum like (Rokitansky-Aschoff Sinuses) Leads to Porcelain Gallbladder on x-Ray |
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Carcinoma of the Gallbladder |
Biggest risk factor is Gallstone history Overexpression of the ERB2 Gene w/ two types: Exophytic: grows luminally (polypoid) Infiltrating: ulcerates into mucosa Typically Adenocarcinomas, can be resected w/ some chemotherapy used |
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Pancreas Divisum |
most common congenital abnormality improper fusion of the pancreatic and cystic ducts can lead to pancreatitis in some patients |
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Annular Pancreas |
band like ring of tissue that encircles the duodenum, can lead to duodenal obstruction |
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Pancreatitis |
Broken into Acute/Chronic- both initiated by injuries that lead to autodigestion of pancreas. Normal Protection: 1. enzymes are packaged as inactive precursors 2. packaged with vesicles 3. Only activated once in Duodenum (entero) |
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Acute Pancreatitis |
Reversible pancreatic injury w/ inflammation. Results from inapropriate activation of enzymes that destroy tissue. activation of trypsin can lead to increased coagulation pathways as well by activated kinin systems and by damaging Acinar cells Other Risks: Meds, Blunt trauma, ischemia, mumps infections Clinically- abdominal pain referring to back and left shoulder w/ acute abdomen |
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Acute Pancreatitis Duct Obstruction |
commonly caused by gallstones, neoplasms, parasites leads to increased pressure and accumulation of zymogens leading to breakdown of fat in pancreas and assctd inflammation |
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Acute Pancreatitis Primary Acinar Cell Injury |
release of enzymes and self digestion caused by Toxins or Hypercalcemia |
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Acute Pancreatitis Defective Intracellular Transport |
typically enzymes and activating chemicals are carried seperately. However if mixed within pancreas activation will occur and auto-digestion occurs. |
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Alcohol Consumption and Pancreas |
can cause pancreatitis through all 3 paths 1.) contracts sphincter of Oddi and increases plugs 2.) directly toxic for acinar cells via free-radicals and increased risk of mixing enzymes with activators |
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Chronic Pancreatitis |
prolonged inflammation w/ irreversible destruction, fibrosis, and loss of function. Commonly caused by Alcoholism Follows repeated bouts of pancreatitis Clinically- same as acute, can lead to diabetes after destruction of exocrine pancreas |
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Congenital Pancreatic Cysts |
small to medium sized thinly lined and poorly formed pancreatic ducts. Can be caused by VHL and or ADPKD |
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Pseudocysts |
arise during or following bouts of pancreatitis |
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Cystic Neoplasm |
range from benign to potentially lethal 1.) Serous Cystic Neoplasms- occur in tail, can be resected 2.) Mucinous Cystic- precursor to carcinoma, larger and filled with mucin 3.) Intraductal Papillary Neoplasm- head of pancreas |
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Pancreatic Carcinoma |
infiltrating ductal adenocarcinoma. 4th leading cause of death. With terrible prognosis Begins with telomere shortening and KRAS mutation, progresses to CDKN2A inactivation, and finally a loss of TP53, SMAD4, BRCA2. Typically arises in the head of pancreas and are often clinically silent until the growth blocks secretion of pancreas. Clinically: pain, jaundice, weight loss (advanced disease) |
