Term
| cholestasis disorder definition / cause / result / pathogenesis / manifestations |
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Definition
definition: a dec in bile flow through intrahepatic canaliculi & reduction in secretion of water, bilirubin, and bile acids by the hepatocytes
result: bilirubin, cholesterol, and bile acids, accumulate in the blood
caused: by intrinsic liver disease
pathogenesis: cholelithiasis, common duct structures, or obstructing neoplasms
manifestation: Pruritus (inc plasma bile acids), Skin
xanthomas (focal accumulations of cholesterol) , impaired
excretion of cholesterol,inc serum alkaline phosphatase , dec
absorption of Vitamin A, D, K |
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Term
| jaundice definition / causes / |
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Definition
cause: jaundice or a yellowish discolouration of the skin and deep tissue results from abnormally high levels of bilirubin in the blood (becomes evident when the serum bilirubin level rises above (2 to 2.5mg/dl)
causes:
-Excessive destruction of red blood cells
-Impaired uptake of bilirubin by the liver cells
-Decreased conjugation of bilirubin Obstruction of bile flow in the canaliculi of the hepatic lobules or in the intrahepatic or extrahepatic bile ducts |
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Term
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Definition
1. Prehepatic
-Major cause is excessive hemolysis of red blood cells
-Unconjugated bilirubin
2. Intrahepatic
-Caused by disorders that directly affect the ability of the liver
to remove bilirubin from the blood or conjugate it so it can be
eliminated in the bile
-Conjugated bilirubin
3. Posthepatic
-Occurs when bile flow is obstructed between the liver and the
intestine
-Conjugated bilirubin |
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Term
| assessments of liver function |
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Definition
-Serum aminotransferase levels: assess injury to liver
cells
-Serum bilirubin, GGT, and alkaline phosphatase:
measure hepatic excretory function
-Ultrasonography, CT scans, and MRI: evaluate liver
structures
-Angiography: visualizes the hepatic or portal circulation
-Liver biopsy: used to obtain tissue specimens for
microscopic examination |
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Term
| factors contributing to susceptibility to drug induced liver disease |
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Definition
- Genetic predisposition
- Age
- Underlying chronic liver disease
- Diet and alcohol consumption
- Use of multiple interacting drugs |
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Term
| what are the four types of drug induced liver diseases |
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Definition
- Direct hepatoxic injury : acetaminophen, isoniazid,
and phenytoin
- Idosyncratic reactions: unpredictable, not related to
dose
- Cholestatic reactions: decreased secretion of bile or
obstruction of the biliary tree. Acute intrahepatic
cholestasis
- Chronic hepatitis: resembles autoimmune hepatitis |
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Term
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Definition
1. Hepatitis is inflammation of liver
2. Autoimmune disorders
3. Reactions to drugs and toxins
4. Infectious disorders
- Malaria, infectious mononucleosis, salmonellosis, and
amoebiasis
5. Hepatotropic viruses that primarily affect liver cells or
hepatocytes
-Direct cellular injury and induction of immune responses
against the viral antigens |
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Term
| know hepatotropic viruses |
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Definition
- HAV: hepatitis A virus
- HBV: hepatits b virus
- HDV: hepatitis b - associated delta virus
- HCV: hepatitis c virus
- HEV: hepatitis e virus |
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Term
| chronic viral hepatitis definition / cause / symptoms |
|
Definition
- definition: defined as a chronic inflammatory reaction of the liver of more than 3-6 months duration
-cause: hbv, hcv, hdv
-symptoms: fatigue, malaise, loss of appetite, and occasional bouts of jaundice |
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Term
| alcohol induced liver disease |
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Definition
1. fatty liver disease: accumulation of fat in hepatocytes, a condition, called steatosis, pathogenesis is not completely understood
2. alcoholic hepatitis: inflammation and necrosis of liver cells
3. cirrhosis
4. metabolism: Directly absorbed in stomach, ADH system, NAD/H and increased, lactic acid, MEOS (microsomal ethanol oxidizing system), Acetaldehyde and free radicals, Peroxisomes |
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Term
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Definition
| fibrosis replacement of hepatic tissue & loss of liver function |
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Term
| manifestations of cirrhosis |
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Definition
- Weight loss (sometimes masked by ascites)
- Weakness
- Anorexia
-Diarrhea or constipation
-Hepatomegaly
-Jaundice
-Abdominal pain
-Portal hypertension : Venous blood from the gastrointestinal tract empties into the portal vein and travels through the liver before moving into the general venous circulation.
Ascites :
Esophageal varices
Splenomegaly |
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Term
| what is liver failure and its manifestations |
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Definition
- definition: the most severe clinical consequence of liver disease is hepatic failure
-manifestations: hematologic disorders / endocrine disorders / skin disorders / hepatorenal syndrome / hepatic encephalopathy |
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Term
| components of the hepatobiliary system |
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Definition
1. gallbladder
2. left and right hepatic ducts: come together to form the common hepatic duct
3. the cystic duct: extends to the gall bladder
4. the common bile duct: formed by the union of the common hepatic and the cystic duct |
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Term
| common disorders of the biliary system |
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Definition
1. cholelithiasis (gallstones): caused by precipitation of the substances contained in bile, mainly cholesterol and bilirubin
2. choledocholithiasis: stones in common duct
3. inflammation of the gallbladder (cholecystits)
- acute cholecystits is a diffuse inflammation of the gallbladder
- chronic cholecystitis results from repeated episodes of acute cholecystitis or chronic irritation of the gallbladder by stones.
4. inflammation of the common bile duct (cholangitis) |
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Term
| disorders of the exocrine pancreas |
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Definition
1. pancreatic secretions
2. contains proteolytic enzymes that break down dietary proteins
3. secretions include pancreatic amylase
-break down starch and lipase, which hydrolyze neutral fats into glycerol and fatty acids
4. pancreatic enzymes are secreted in the inactive form and become activated in the intestine |
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Term
| common causes of acute pancreatitis |
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Definition
- Gallstones (stones in the common duct)
- Alcohol abuse
- Hyperlipidemia
-Hyperparathyroidism
-Infections (particularly viral)
-Abdominal and surgical trauma
-Drugs such as steroids and thiazide diuretics |
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Term
| acute pancreatitis manifestations and pathogenesis |
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Definition
- manifestation: abdominal pain, may radiate to the back,
chest, fever, tachycardia, hypotension, severe abdominal
tenderness, respiratory distress, and abdominal distention
- pathogenesis: autodigestion of pancreatic tissue by
inappropriately activated pancreatic enzymes |
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Term
| chronic pancreatitis definition / cause / manifestations |
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Definition
- definitions: progressive destruction of the exocrine pancreas, fibrosis, and destruction of the endocrine pancreas
-cause: irreversibility of pancreatic function , long term
alcohol abuse
-manifestations: similar to acute, persistent, recurring
episodes of epigastric and upper left quadrant pain;
Anorexia, nausea, vomiting, constipation, and flatulence |
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Term
| diabetes mellitus definition / reoresentation |
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Definition
-prediabetes: impaired fasting plasma glucose and impaired glucose tolerance, disorder of carbs, proteins, fats metabolism
-can represent: An absolute insulin deficiency / Impaired release of insulin by the pancreatic beta cells / Inadequate or defective insulin receptors / Production of inactive insulin or insulin that is destroyed before it can carry out its action |
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Term
| what are the 2 types of diabetes and what it results from |
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Definition
type1: loss of beta cell function / an absolute insulin deficiency
type2: impaired ability of the tissues to use insulin / a relative lack of insulin or impaired release of insulin in relation to blood glucose levels |
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Term
| what are the 2 types of subdivisions of type one diabetes and factors involved of each |
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Definition
1. types 1A: immune-mediated diabetes
-Genetic predisposition (diabetogenic genes)
-A hypothetical triggering event involving an environmental agent that incites an immune response
-Immunologically mediated beta cell destruction
2. types1B: idiopathic diabetes
- Those cases of beta cell destruction in which no evidence
of autoimmunity is present
- Only a small number of people with type 1 diabetes fall
into this category; most are of African or Asian descent.
- Type 1B diabetes is strongly inherited.
- People with the disorder have episodic ketoacidosis due to
varying degrees of insulin deficiency with periods of absolute insulin deficiency that may come and go. |
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Term
| hyperglycaemia in type 2 diabetes |
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Definition
- Impaired beta cell function and insulin secretion
- Peripheral insulin resistance
- Increased hepatic glucose production |
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Term
| causes of beta cell dysfunction |
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Definition
- An initial decrease in the beta cell mass
- Increased beta cell apoptosis/decreased regeneration
- Long-standing insulin resistance, leading to beta cell
exhaustion
- Chronic hyperglycemia can induce beta cell desensitization
(“glucotoxicity”).
- Chronic elevation of free fatty acids can cause toxicity to beta cells (“lipotoxicity”).
- Amyloid deposition in the beta cell can cause dysfunction. |
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Term
| metabolic sundrome and type 2 diabetes |
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Definition
1. metabolic syndromes
- Triglycerides
- HDL
-Hypertension
-Systemic inflammation
-Fibrinolysis
-Abnormal function of the vascular endothelium
-Macrovascular disease
2. obesity and insulin resistance
3. Increased resistance to the action of insulin
4. Impaired suppression of glucose production by the liver
5. Hyperglycemia and hyperinsulinemia |
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Term
| treatment plans for diabetes |
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Definition
1. Nutrition therapy
2. Exercise: cardiovascular fitness and psychological well-being
-Type 2: decrease in body fat, better weight control,
and improvement in insulin sensitivity
3. Anti-diabetic agents |
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Term
| 3 principle types of insulin |
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Definition
-short acting (5-8 hrs)
-intermediate acting (10-24 hrs)
-long acting (6-23 / 20-24 hrs) |
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Term
| acute complications of diabetes |
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Definition
1. Diabetic ketoacidosis
-Hyperglycemia
-Ketosis
-Metabolic acidosis
2. Hyperosmolar hyperglycemic state
3. Hypoglycemia |
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Term
| definitive diagnoses of diabetic ketoacidosis |
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Definition
- Hyperglycemia (blood glucose levels >250 mg/dL)
- Low bicarbonate (<15 mEq/L)
- Low pH (<7.3)
- Ketonemia (positive at 1:2 dilution)
Moderate ketonuria |
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Term
| chronic complications of diabetes |
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Definition
1. Disorders of the microvasculature
- Neuropathies, nephropathies, and retinopathies
- Distal symmetric neuropathy and foot ulceration
2. microvascular complications
- coronary heart disease, stroke, and peripheral vascular disease reflect the combined effects of unregulated blood glucose levels, elevated blood pressure, and hyperlipidemia. |
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