Disorders Of The Gallbladder,liver & Pancreas

Front 1

Chloelithiasis

Back 1

-The presence of gallstones within the gallbladder or in the biliary tract

-More likely to occur in people with a sedentary lifestyle, a familial tendency , diabetes mellitus, and obesity.

-Cholesterol secretion can increase risk of gallstones.

Native & Hispanic Americans more prone to developing gallstones

Front 2

Choledocholithiasis

Back 2

When gallstones lodge in the common bile duct, the patient has?

Front 3

Chloecystitis

Back 3

-An inflammation of the gallbladder

-Caused by gallstones 90-95% of time

Other causes:obstructive tumors of the biliary tract, stressful situations such as cardiac surgery, severe burns,or multiple trauma

-Infections can occur from E-COLI organisms

Front 4

When balance between cholesterol, bile salts, and calcium in the bile is altered to the point that these substances precipitate

Back 4

When does chloelithaiasis (gallstones) develop?

Front 5

Clay colored stools that float as a result of undigested fat content

Back 5

What does the absence of bile result in?

Front 6

A fatty meal

Back 6

Severe pain may be triggered by?

Front 7

The right clavicle,scapula,or shoulder

Back 7

Where may pain be referred to in a patient with chloecystitis?

Front 8

Jaundice

Back 8

What occurs as bile backs up into the liver and blood, (yellow tint to skin and sclera)

Front 9

Liver Damage

Back 9

If obstruction to the gallbladder is unrelieved what can occur?

Front 10

Unbearable upper right quad pain (biliary colic)

Back 10

The symptom most often present in acute flare-up of chronic chloecystitis is?

Front 11

peritonitis

Back 11

Rupture spills gallbladder contents into the abdominal cavity and causes?

Front 12

Chronic Chloecystits MILDER s/s

Back 12

-NAUSEA after eating fatty foods

-Flatulence

-nausea after eating , discomfort in the right upper quad

Front 13

Low grade fever, rather than pain

Back 13

What are the common s/s in the ELDERLY that may have Chloecystitis?

Front 14

Chloelithiasis(gallstones)

Back 14

What must be considered in an elderly patient with abdominal pain when other causes cannot be found?

Front 15

Diagnosis of Chloelithiasis and Chloecystits

Back 15

-Ultrasonography

-CT scan

-ERCP

-HIDA SCAN

-Liver function test ( ALT, AST)

-Elevated WBC (INFECTION)

Front 16

-Low-fat diet

-Restriction of alcohol intake

-Spaced out meals

-Antibiotics IF peritonitis is present

-Fluids administered and Electrolytes are rebalanced

Back 16

What is the treatment of Chloelithasis and Chloecystitis?

Front 17

POSTCHLOECYSTECTOMY DIET

Back 17

-Foods to be avoided: whole milk,creame,butter,cheese made from whole milk,ice creme, nuts,fried foods,rich pastries,and gravies

-Keep a record of foods eaten and symptom occurrence will indicate other foods that may be a problem for a particular pt.

Front 18

ERCP

Back 18

What may be done to detect common bile duct stones?

Front 19

Chloecytectomy (gallbladder removal)

Back 19

What is the surgical procedure of choice for a patient with Chloelithasis?

Front 20

-Increasing abdominal rigidity and pain

-Changes in vital signs

-"free air pain" (retained CO2 gas used during procedure)

Back 20

What are signs of internal bleeding in a patient who underwent a laparoscopic chloeccytectomy procedure?

Front 21

contact dissolution therapy

Back 21

involves injecting a drug, methyl tert-butyl ether, into the gallbladder to dissolve stones in 1-3 days is called?

Front 22

LITHOTRIPSY OR "SHOCK WAVE" THERAPY

Back 22

occasionally used for gallstones.

procedure involves using sound waves directed through the body to break up the stones. procedure takes 1- 1 &1/2 hrs

-to be a candidate for this procedure there must be no more than three cholesterol gallstones, each smaller than 1 1/2 inches and the patient must NOT BE OBESE

Front 23

Hepatitis

Back 23

Virus that causes extensive inflammation to the liver, scar tissue may form. This may obstruct normal blood flow and bile flow and further damage the liver

Front 24

Hepatitis A

Back 24

- Oral-fecal route; often from contaminatied food
- Responsible for epidemic forms of hepatitis
- Vaccine available
- Most infectious 2 weeks before symptoms
- Acute onset( fever, nausea, no appetite upper abdominal pain, may develop jaundice)
- Treated by rest and avoidance of substances damaging to the liver
- 4-6 small meals per day
- Sucking on hard candy may help
- Prevention/transmission: Both feces and blood during the prodromal stage: Standard precaution for family members. Immune globulin provides temporary passive immunity.- Do not share toothbrush or towels

Front 25

Hepatitis B

Back 25

-Transmitted blood and body fluids, sexual contact, perinatal from mother to infant

- Slower onset

- May be a carrier

- May be asymptomatic. May have fatigue, nausea, vomiting, RUQ pain, dark urine, clay colored stools

- Treat-drug therapy to decrease viral load

- Vaccine

- Immune globulin for those exposed

- Standard Precautions..avoid sexual contact. Do not share tooth brush or razors

Front 26

Hepatitis C

Back 26

- Transmitted blood and saliva, sexual contact, contaminated needles etc.
- May become a chronic carrier
- Slow onset
- No vaccine
- May be asymptomatic or have same signs as hep B
- Treat by reducing viral load…hydration, rest and nutrition
- Most likely hepatitis to lead to cirrhosis
- Avoid sharing toothbrush or razors

Front 27

Hepatitis D

Back 27

- Blood and body fluid. Coexists with hep B or C
- May become a carrier

Front 28

Hepatitis E

Back 28

oral route, contaminated water, underdeveloped countries

Front 29

S/S of Cirrhosis

Back 29

Signs and symptoms
- Subjective: Weakness, fatigue, anorexia, nausea, abd pain, vomiting, fluid retention, itching(due to inc bilirubin)
- Objective: gas, rashes, palmar erythema, caput medusa(varicose veins arising around umbilicus), bleeding and bruising, jaundice, itching, spider angiomas, dark urine, clay stools ,asterixis,encephalopathy

Front 30

Diagnosis of Cirrhosis

Back 30

- Liver biopsy
- Low albumin, elevated PT, elevated AST, ALT,ammonia

Front 31

Treatment of Cirrhosis

Back 31

-paracentesis for ascites
- TIPS shunt to decrease portal pressure and decompress varices
- Neomycin enema: decrease the colonic bacteria that break down protein
-Lactulose
- Binds and removes ammomia
- no alcohol
-Sedatives or opiates are omitted or given with great caution

Front 32

Complications of Cirrhosis

Back 32

- Esophageal varices due to portal hypertension (may rupture..pt may vomit bright red blood)
a. Treat with Blakemore-Stenstaken tube
b. Vasopressors, vasoconstrictors, Nitrogylcerin, beta blockers, vitamin K to decrease PT,

Front 33

Encephalopathy

Back 33

- Due to increased ammonia levels
- Sypmptoms include confusion, convulsions, asterixis, fector hepaticus

Front 34

Liver Transplant

Back 34

-non-alcoholic cirrhosis, biliary atresia, chronic active hepatitis
-will take immune suppressants for life
- Strict infection control, watch for signs of hemorrhage or hypovolemia, monitor labs, jaundice,r quad pain, fever, changes in stool and urine may indicate rejection

Front 35

Liver Cancer

Back 35

-hepatoma or cholangiocarcinoma
-hemachromatosis ( causes deposits of iron in liver….leads to hepatoma)
S&S- RUQ pain, weight loss, fever.. all signs of decreased liver function

Front 36

Amelyse & Lipase

Back 36

Two diagnostic test associated with the pancreas are?

Front 37

Alcoholism

Back 37

What is the most common cause of acute pancreatitis in men?

Front 38

Gallstones

Back 38

What is the most common cause of acute pancreatitis in women?

Front 39

EATING

Back 39

What makes the pain WORST in patients with acute pancreatitis?

Front 40

Leaning Forward

Back 40

What can elieviate discomfort in patients with acute pancreatitis?