Term
Motility Dysphagia is a _____ disorder
Structural Dysphagia is a ______ disorder |
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Definition
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Term
To assess the esophagus to the GE junction
Evaluate: 1) dysphagia 2) strictures |
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Definition
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Term
Measures the pressure of the esophageal walls
Used for assessing G.I. motility and peristaltic movements
Some are combined with a PH monitor as well |
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Definition
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Term
| - burning sensation in the epigastric or substernal region |
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Definition
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Term
| - vomiting of bright red blood |
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Definition
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Term
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Definition
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Term
| presence of blood in the stool (e.g. small or large bowel) |
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Definition
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Term
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Definition
CBC with differential platelets
T & C for PRBC’s
PT/PTT
Hepatitis panel
“Consider endoscopy” |
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Term
| Signs of volume depletion |
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Definition
orthostatic hypotension
pallor
tachyarrhythmias
Start IV access (large site - 16 gauge) & administer fluids |
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Term
| treatment for constipation: |
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Definition
| MOM, Bran powder, osmotic laxative, increase liquids |
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Term
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Definition
* Tachycardia with a elevation of pulse about 15 to 20 from the supine to the standing position
•Decrease in systolic blood pressure of about 15 to 20 mm Hg from the supine to the standing position. |
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Term
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Definition
| RUQ pain, radiates to the right shoulder |
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Term
| epigastric pain referred pain |
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Definition
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Term
| referred pain: RLQ pain, epigastric/umbilicus |
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Definition
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Term
| epigastric or pain radiating to the back referred main |
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Definition
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Term
| Pulmonary & Cardiac causes- may radiate to the |
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Definition
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Term
| indicative of peritoneal irritation |
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Definition
| Rigidity- involuntary spasm of the abdominal muscles |
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Term
| sign of peritoneal irritation and can be elicited by palpating deeply and slowly in an abdominal area away from the suspected area of local inflammation. |
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Definition
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Term
| type of peritonitis is felt in the area of palpation. |
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Definition
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Term
| pain associated with peptic ulcers: |
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Definition
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Term
| pain associated with perforated ulcer |
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Definition
| extremely intense pain of sudden onset |
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Term
| episodic pain with no intervening pain- free intervals |
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Definition
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Term
| constant steady pain with without intervening pain-free intervals |
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Definition
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Term
| on avg you can hear bowel sounds every seconds: |
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Definition
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Term
| "tinkling" bowel sound like water being poured from one cup to another |
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Definition
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Term
| bowel signs absent is a sign of? |
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Definition
| paralytic ileus or peritonitis |
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Term
| pain produced by deep inspiration during palpation of the right subcostal area. (e.g. cholecystitis) |
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Definition
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Term
| Pyelonephritis produces what sign |
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Definition
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Term
| pain produced by passive extension of the leg |
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Definition
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Term
| rotation of the thigh in a flexed position |
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Definition
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Term
| tendernes at Mc Burney's point |
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Definition
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Term
| Bluish discoloration of flank from retroperitoneal hemorrhage (pancreatitis) |
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Definition
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Term
| Bluish discoloration of periumbilical area from retroperitoneal hemorrhage (pancreatitis) |
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Definition
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Term
| Pushing on left lower quadrant produces pain McBurney’s point (appendicitis) |
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Definition
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Term
| KUB shows: Air fluid levels, Air under the diaphragm, contrasting colors |
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Definition
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Term
Diarrhea:
stool wt > ____grams/day
>____ loose or watery stool in 24 hrs
> ______ bloody stool in 24 hrs |
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Definition
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Term
Diarrhea:
Acute:
Persistant
Chronic |
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Definition
< 14days
> 14 days
> 1month |
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Term
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Definition
Infectious
Bacterial (15-20%)
Viral (50-70%)
Parasitic (10-15%)
Inflammatory bowel diseases
Irritable bowel syndrome
Functional diarrhea
Ischemia
Fecal impaction with overflow
Laxative abuse & other drugs |
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Term
Large volume, water stools
afebrile, no significant abdominal pain
No blood or pus in stool
typically self-limited |
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Definition
| Non- Inflammatory Diarreah |
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Term
| Frequent small volume stool, fever, tenesmus, or severe abdominal pain may be present, Often fecal leukocyte, lactoferrin, and occult blood+ |
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Definition
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Term
Name this bug:
Most common cause of bacterial gastroenteritis
Associated with undercooked poultry
watery or hemorrhagic diarrhea
Associated with post-infectious reactive arthritis & Guillain-Barre syndrome |
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Definition
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Term
Name that bug:
Gram negative curved rod
Enterotoxin mediated, “rice water” stools
No fecal leukocytes or blood
Prominent dehydration
Associated with
Foreign travel
Undercooked seafood from Gulf Coast
Decreased gastric acid increases susceptibility |
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Definition
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Term
Name the bug:
Gram negative rod
Common food borne illness
Assoc. with contaminated poultry, eggs, & milk products
Bacteremia occurs in 2-14% of pts |
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Definition
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Term
Name that bug:
10-20% of all diarrheal cases in US
Person-to-person contact
Exudative colonic hemorrhagic diarrhea
May be complicated by HUS, TTP, arthritis |
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Definition
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Term
Name that bug:
Associated with undercooked ground beef
Abdominal pain & bloody diarrhea
Complicated by HUS & thrombocytopenic purpura
Antibiotics early in disease may increase likelihood of HUS |
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Definition
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Term
name the pathogens:
One of most common protozoal pathogens in U.S. causing persistent diarrhea
Associated with:
exposure to contaminated water, e.g. camping trip
IGA deficiency
Day care outbreaks |
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Definition
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Term
| Loperamide is what type of agent and what is it used for |
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Definition
| antimotility agent: decrease stool frequency/volume |
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Term
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Definition
| Stimulates intestinal sodium and water absorption, binds eterotoxin, some direct antibacterial effect. |
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Term
| Potential complications with using antimicrobial therapy for acute diarrhea |
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Definition
not required for most acute diarrhea
prolong duration of shedding in salmonella and c. diff, Increases risk of HUS in shiga toxin producine E.coli |
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Term
| Most common antibiotics used for bacterial GI infection |
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Definition
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Term
A 43 yo WF has a 1 day h/o an acute diarrheal syndrome associated with mid abdominal discomfort and bloating. She denies bloody stool and has not taken antibiotics recently. She calls the office and requests a prescription. Which of the following would you prescribe.
A. A floroquinolone
B. Metronidazole
C. Tetracycline
D. Fluids and no specific antibiotics; request telephone follow up in 24 to 48 hours. |
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Definition
| D. The patient has been ill for only 24 hours. Most acute diarrheal syndromes are self-limited and do not require antibiotic therapy. It is prudent to arrange follow-up in 24 to 48 hours to reassess her symptoms. If she is not better at that time, evaluation and possible treatment should be considered |
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Term
A 32 yo man has bloody diarrhea of 1 day’s duration associated with abdominal pain, fever, and small, frequent stools. He was previously well. Which of the following pathogens is most likely causing this patient’s acute illness?
A) Giardia lamblia
B) Cryptosporidium
C) Campylobacter jejuni
D) Rotavirus
E) Enterotoxigenic E. Coli |
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Definition
C. Campylobacter Jejuni
The patient has an acute diarrheal syndrome that is most consistent with an inflammatory process with mucosal erosions and ulcerations. C. jejuni is a common cause of inflammatory diarrhea. The other organisms listed usually cause a watery, noninflammatory process with larger stool volumes. |
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Term
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Definition
Osmotic: large amnts of poorly absorb osmotic active solutes: disaccharidase defic. or laxative abuse
Malabsorptive syndromes:also maldigestion. excessive fat excretion
secretory condition: increased intestinal secretion decr absorption |
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Term
| Opioids should not be used in paients with what kind of diarrhea |
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Definition
| bloddy, high fever or systemic toxicity |
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Term
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Definition
| rest bowel, avoid high fiber fats milk caffeine and alcohol |
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Term
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Definition
| antidiarrheal agents like loperamide or lomotil/Diphenoxylate |
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Term
| antiperistalitic agents which may prolong and worsen diarrhea assoc with organsism penetrate the intestinal mucosa |
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Definition
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Term
| do not use this antidiarrheal in paients with high fever or if blood is present in stool |
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Definition
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Term
| when to use antibiotic with diarrhea |
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Definition
empirical treatment with mod to severe fever, tenesmus, or bloody stools or presence of fecal leukocytes while stool bact culture is incubating
cipro, ofloxacin,metronidazole. Penicillins and macrolides are no longer used bc of resistance |
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Term
| Risk for peptic ulcer disease |
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Definition
| Helicobacter pylori, NSAIDs, Smoking, Blood Group O, Alcohol, increased gastrin release, relatives w PUD |
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Term
what am I
gram -, survives in cold water, never penetrates mucosa, produces urease, toxins, can be resistant to antibio, assoc with peptic ulcers and is a carcinoget |
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Definition
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Term
| Hpylori infection can lead to 4 diseases: |
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Definition
| Gastritis, Gastric cancer, peptic ulcer and MALT lymphoma |
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Term
| most sensitive and specific test for H. Pylori detection |
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Definition
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Term
| Treatment of Hpylori in patients with peptic ulcer |
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Definition
PPI (most important)+Clarithromycin+Metronidazol (amoxycillin also can add tetracycline) all for 10 days to 2 wks
F/U urea breath test 1month after stop of treatment |
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Term
| Treatment of Hpylori in patients with peptic ulcer |
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Definition
PPI (most important)+Clarithromycin+Metronidazol (amoxycillin also can add tetracycline) all for 10 days to 2 wks
F/U urea breath test 1month after stop of treatment |
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Term
| High risk patients in GI bleed must go to ICU who are they? |
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Definition
age >60yo
fresh haematemesis with malaena worse than either alone
NSAID or warfarin or steroid use
pts with ccf, copd etc
pulse>100 sysBp < 100
blood transf > 6units
endoscopic stigmata of bleeding |
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Term
| treatment of peptic ulcers after endoscopy |
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Definition
PPI treatment x 8-12 week
H. Pylori eradication
post readication confirm
repeat endoscopy for gastric ulcers |
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Term
| Chronic and recurrent syndrome of abdominal pain and erratic disturbance of defecation (constipation and/or diarrhea). May commonly include “bloating.” |
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Definition
IBS
abdominal pain is relieved by defecation or is assoc with change in fequency or consist of stools |
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Term
| Major factors that are significant in the pathogenesis of IBS |
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Definition
abnormal motility
Nociception
psychosocial |
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Term
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Definition
| Defect in abdominal wall allowing protrusion of intraabdominal or retroperitoneal contents. |
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Term
| Most common hernia, accounting for 75% of hernia repairs. |
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Definition
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Term
| Hernia through the conjoint tendon medial to epigastric vessels |
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Definition
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Term
| Hernia through deep inguinal ring lateral to epigastric vessels |
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Definition
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Term
Bulging and/or pain in groin with activity, coughing, sneezing (anything that increases intraabdominal pressure)
Up to 1/3 asymptomatic bulge |
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Definition
| Inguinal Hernia presentation |
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Term
| when inguinal Hernia contents not able to be reduced into peritoneal cavity, increased pain, possible obstructive symptoms |
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Definition
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Term
| When inguinal hernia contents compromised viability – severe pain, skin discoloration, acidosis, sepsis |
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Definition
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Term
| this type of hernia exits below the inguinal ligament: more medial |
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Definition
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Term
| Type of hernia that is much more likely to present incarcerated or strangulated. more common in women, mass in lower medial groin or upper medial thigh |
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Definition
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Term
| Watchful waiting is not appropriate for_____ hernias due to the much greater risk of incarceration / strangulation |
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Definition
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Term
| 3 Hernias through a defect in anterior abdominal wall |
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Definition
Umbilical-through umbilical stalk
Incisional- through previous incision
Epigastric- above umbilicus/ below xiphoid through linea alba |
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Term
| test for hernias in Obese patients |
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Definition
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Term
| Uncommon hernia seen in thin elderly women: 90% of them present as bowel obstruction. CT required for diagnosis |
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Definition
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Term
| compression of anterior obturator nerve causing hip pain exacerbated by extension and external rotation of the thigh |
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Definition
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Term
| Hernia Defect along between semilunar line and lateral rectus muscle on the anterior abdominal wall |
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Definition
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Term
| name 4 typical symptoms of GERD |
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Definition
| Heartburn, Regurtitation, Dysphagia, Waterbash |
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Term
Intestinal metaplasia: change of esophageal squamous cells to intestinal-type columnar epithelium.
Occurs on 10-30% patients with GERD regardless of symptoms. |
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Definition
Barrett's esophagus
Barrett's itself is asymptomatic |
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Term
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Definition
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Term
| Phases of Gastric Acid Secretion |
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Definition
Cephalic phase: Vagus
Gastric Phase: Gastric Distention, nutrients
Intestinal Phase: MMC |
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Term
Atypical symptoms of GERD
non-cardiac chest pain:
Hoarseness
chronic cough
asthma
bronchitis
pulmonary fibrosis |
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Definition
noncardiac:mcc 50%
hoarseness: typically worst in am
50% pts with GERD-related asthma do not have heartburn |
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Term
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Definition
A-D
A<5mm
B> 5mm
Bridging,75%
briding > 75% |
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Term
Primarily due to ineffective or abdormal LES
Total length should be >2cm (mean 3.6cm)
Intraabdominal length should be >1cm (mean 2cm)
Tone should be >6mm Hg (mean 14mm Hg) |
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Definition
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Term
| 4 factors that contribute to GERD |
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Definition
1. Incompetent LES
2. Irritant effects of refluxate
3. abnormal esophageal clearance
4. Delayed gastric emptying |
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Term
| first evaluation of choice for esophageal dysphagia to differentiate between mechanical lesions and motiligy disorders. incontrast to endoscopy it gives info about motility |
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Definition
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Term
| pH monitoring continuously with probe passed nasally and placed 5 cm above LES: info acid esophageal reflux |
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Definition
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Term
| assesses esophageal motility. small pressure sensing catheter is passed nasally into esophagus: access UES and LES |
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Definition
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Term
| 1.measures electrical conductivity through the esphagus? 2.Indirect measurement of bile reflux used particularly in 3.diabetics or those with sig bloating |
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Definition
| Impedence testing Bilitec monitor Gastric empty study |
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Term
Antacids neutralize acid (carbonate, Al hydroxide, Mg hydroxide)provide symptom relief but no change in acid production.
SE include |
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Definition
| Hypercalcemia, milk-alkali syndrome, diarrhea, renal failure |
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Term
| first line therapy for GERD? |
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Definition
H2Blockers
Can cause cytopenias (particularly thrombocytopenia), gynecomastia, elevated LFTs |
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Term
Most powerful acid suppression
Final common pathway for acid secretion
Can reverse Barrett’s changes in some studies
Second line therapy when H2RB fail.
First line therapy for erosive esophagitis. |
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Definition
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Term
| Cimetiding, Ranitidine, famotidine, nizatidine are |
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Definition
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Term
| most common causes of erosive gastritis? |
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Definition
drugs (NSAIDs), alcohol, stress due to severe med/surg illness, portal hypertension.
Upper endo is most sensitive |
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Term
| 4 agents used to improve mucosal defenses |
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Definition
| Sucralfate, Bismuth, prostaglandin analogs, antacids |
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Term
| caused by gastrin secreting gut neuroendocrine tumors, which results in hypergastremia and acid hypersecretion. over 2/3 gastrinomas are malignant |
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Definition
Zollinger-Ellison Syndrome
use increased fasting serum gastrin concentration |
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Term
| what is the Gold standard for diagnosing GERD |
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Definition
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Term
| Acute dilation of the colon > 6cm due to inflammation or infection. fever, dehydration, abdominal pain, leukocytosis and diarrhea (often bloody) |
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Definition
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Term
70% of polyps are?
Malignant potential correlates with? |
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Definition
adenomatous (benign tumor of glandular origin)3% contain invasive carcinoma
2. polyp size, villous features and degree of dysplasia |
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Term
| It takes how may years for a medium sized adenoma to develop in the colon from normal appearing mucosa and how many years for a gross cancer to arise |
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Definition
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Term
| Adenocarcinoma is a common colorectal cancer: over half develop where in the colon? |
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Definition
| proximal to the splenic flexure: the cecum and ascending colon |
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Term
If tumor is in the proximal colon what are the S/S
If tumor is in distal colon s/s |
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Definition
1. fecal occult blood, anemia
2. change in bowel habits, hematochezia
diagnose with colonoscopy |
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Term
| what is the tx choice for colon cancer? |
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Definition
| resection if resectable, lymph node dissection to stage cancer. |
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Term
prognosis of colon cancer depends on stage; 5 yr survival for
stage 1
stage 2
stage 3
stage 4 |
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Definition
1. 80-100%
2. 50-75
3. 30-50%
4. 5% |
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Term
overall survival rate for colorectal cancer is? if resected
independent risk factors for develop of metastases |
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Definition
35%, 55%
mutaion of the P53 and los of expression of the DCC gene |
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Term
| most common vascular abnormality of the GI tract and most frequesnt cause of recurrent lower intestinal bleeding after age 60 |
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Definition
| Angiodysplasia: Vascular ectasia: associated with aging |
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Term
| Vascular ectasia are usually confined to what parts of colon, usually are multiple rather than single, smaller than 10mm |
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Definition
| cecum and ascending colon: diagnosed by angiography or colonoscopy |
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Term
| CREST stands for? variant of scleroderma and has vascular ectasia as well (angiodysplasia) |
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Definition
| Calcinosis, Raynauds phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia |
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Term
| colon cancer is probably related to? and possibly related to? |
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Definition
High fat diet and low fiber
beer/ale consumption, low diet selenium, fecapentaenes: from colon bacteria
heterocyclic amines from charbroiled and fried meat/fish |
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Term
| on colonoscopy the most common site of colorectal adenomas is? |
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Definition
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Term
Who is at highest lifetime risk of colorectal carcinoma?
42 year old female with a father who was diagnosed with colon cancer at age 70.
28 year old male diagnosed with ulcerative colitis at age 17.
55 year old male with an 8mm tubular adenoma found at colonoscopy.
49 year old female with a mother diagnosed with rectal cancer at age 68 and a sister with a tubular adenoma at age 50. |
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Definition
28 year old male diagnosed with ulcerative colitis at age 17.
Patients with ulcerative colitis beyond 8 years duration may have a colon cancer risk as high as 1% per years duration. |
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Term
In colorectal cancer the best predictor of outcome is:
Size of tumor
Tumor stage at time of presentation
Differentiation of tumor
Presence of K-ras mutations |
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Definition
| Stage of tumor at presentation is the best predictor of prognosis for the patient. |
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Term
| Preferred cancer detection test is anuual |
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Definition
FIT
Fecal Immunohistochemical Test
patients over 50 and a positive test lead to colonoscopy |
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Term
Colonoscopy is an appropriate screening tool at an age < 50 for all of the following groups of patients except:
Patient with multiple first degree relatives with colon cancer
Patient with a second-degree relative with a tubular adenoma
Patients with long-standing left-sided ulcerative colitis
Patients with a large (>1cm) tubular adenoma on prior colonoscopy |
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Definition
| B) A second degree relative with a tubular adenoma history is relatively common with low potential for hereditary colon cancer thus it is not an indication for a colonscopy. |
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Term
| A 53 year old male is found to have an 9mm pedunculated tubular adenoma on screening colonoscopy, and snare polypectomy is utilized for its complete removal. No other lesions are found. What is the next appropriate colonoscopic screening interval? |
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Definition
5 years
This patient has a small adenoma with a low risk of malignant transformation, and no family history of colon cancer, thus repeat colonoscopy in 5 years is appropriate. |
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Term
| FAP is an autosomal ______ inheritance |
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Definition
|
|
Term
| Similar to FAP, however a milder autosomal recessive phenotype involving FAP somatic mutations. |
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Definition
| MAP: multiple adenoma syndrome |
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Term
Inherited disease in which colon cancers arise in discrete adenomas, but polyposis does not occur.
Accounts for approximately 5% of colon cancers.
Autosomal dominant disorder with high penetration. |
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Definition
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Term
Which of the following is considered to be an oncogene?
p53
APC
K-ras
MSH2 |
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Definition
| K-ras is an oncogene, whereas p53, and APC are tumor suppressor genes, and MSH2 is a mismatch repair gene. |
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Term
Which of the following is a true statement regarding familial adenomatous polyposis?
1. Widespread mutations have been identified on chromosome 2p.
2. Women should be screened with endometrial biopsy and ultrasonography.
3. APC genetic analysis detects fewer than half of patients with known mutation.
4. Upper endoscopy every 1 to 3 years is part of a standard screening protocol. |
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Definition
Upper endoscopy every 1 to 3 years is a part of a standard screening protocol.
Patients with FAP are at high risk for upper gastrointestinal malignancy. |
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|
Term
|
Definition
Gastric fluid analysis: NG tube
Serum Gastrin Level
Stool examination: fecal fat, occult blood, fecal leukocytes, fecal electrolytes, fecal phenolphthalein |
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Term
Lab test Used to:
1) evaluate of patients with hypergastrinemia
2) diagnose Z-E Syndrome
3) determine malignancy
4) monitor efficacy of anti-ulcer treatments. |
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Definition
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|
Term
lab test Used to:
1) evaluate patients with PUD
2) diagnose Z-E syndrome
3) diagnose G-cell hyperplasia |
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Definition
Serum Gastrin Level
Is much easier: from blood vs putting an NG tube down
Gastrin is a hormone that stimlates the gastric acid |
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Term
| lab test Used to: evaluate function and integrity of the bowel in patients with GI bleed, infection, inflammation, malabsorption and diarrhea |
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Definition
Stool Examination
Fecal Fat (could be from cystic fibrosis)
Occult blood
Fecal Leukocytes
fecal electrolytes
fecal phenophthalein |
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|
Term
| for diagnosing invasive colitis vs other diarrheal illness from stool |
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Definition
|
|
Term
| stool test for laxative abuse in patients with suspected anorexia, bulemia, or fictitious disorder. |
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Definition
|
|
Term
| Tests for synthesis function of liver |
|
Definition
Total protein albumin
Prothrombin time (PT) |
|
|
Term
| Test the membrane integrity cellular necrosis: |
|
Definition
Alanine Amino transferase ALT
Aspartate Amino Transferase AST
Alkaline PHosphatase ALP
GGT: people who drink alot
sometimes symptoms dont occur until 80% of liver is bad |
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|
Term
| Test the detoxifying ability of the Liver |
|
Definition
| Billirubin- Total conjugated |
|
|
Term
|
Definition
Albumin + globulins
Albumin (major serum protein) is 2/3 of total serum protein
too much Gobulin means problem (multiple mylenoma |
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|
Term
low albumin concentration:
who will have this what will result |
|
Definition
liver failure
malnourished (alcoholics)
increased catabolism
Loss, dilution
inc of fluid out of the vessels and into the lymphatics causes edema |
|
|
Term
| hapatocellular vs biliary tract |
|
Definition
Hepat: ALT, AST, LD
biliary tract: ALP, GGT( ALP is elevated)
5-NT (ALP is elevated) |
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|
Term
|
Definition
AST/ALT:
>1: suggestive of alcoholic liver dis.
>2: highly suggestive
AST lower than ALT in healthy people, inverted ratio-> high level of suspicion for liver disease |
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|
Term
| Test for pancreatic injury |
|
Definition
Amylase and Lipase
pancreatitis: enzymes autodigest the organ itself that's why it is painful |
|
|
Term
Amylase elevated in many non-pancreatic disorders
Lipase _____specific for pancreatitis than amylase
Lipase: remains elevated longer after acute pancreatitis
Elevated amylase w/ nl lipase: nonpancreatic origin |
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Definition
|
|
Term
| tumor lab marker for hepatocellular carcinoma |
|
Definition
|
|
Term
elevated in cases of severe
liver impairment; correlation
w/ encephalopathy: con-troversial |
|
Definition
|
|
Term
| protrombin time is the most sensitive test for liver function |
|
Definition
|
|
Term
|
Definition
|
|
Term
| hep C antibody test is the best screening test for Hepc |
|
Definition
| sensitive over 99%..positive test suggests viremia until refuted |
|
|
Term
| more specific test for Hepc |
|
Definition
| RIBA: recombinant Immunoblot: patient had it or has it. can rule out false positive other tests |
|
|
Term
|
Definition
6
most common in US is Genotype 1 |
|
|
Term
|
Definition
acute hepc (20% get rid of it)
chronic hep 80% get chronic
cirrhosis 20% of 80% go on to cirrhosis |
|
|
Term
|
Definition
0-4
gradding 0-4inflammation
stage 0-4 fibrosis |
|
|
Term
| single biggest intervention is to get patient to stop drinking if they have Hep C to prevent |
|
Definition
|
|
Term
| to diagnose Hep A look for |
|
Definition
antibody for Hep A
how do youknow acute vs old
acute you have IgM
transmission is fecal oral
old you have IgG |
|
|
Term
| almost everyone with Hep A recovers: |
|
Definition
| used to see more in children. when in adult they get really sick you either die or it goes away |
|
|
Term
|
Definition
sexually, needles
very easy to transmit
usually you recover 90% time
can be chronic
it is a carcinogen |
|
|
Term
|
Definition
Hep B surface antigen: if you have surface antigen you have Hep B very little false+ or -
antibiody
initially IgM then IgG |
|
|
Term
|
Definition
| IFN (interferon) or Lamivudine (protease inhibitor) |
|
|
Term
| child turcotte Pugh: A, B, C |
|
Definition
for grading liver disease
child C more than 50% be dead in one year |
|
|
Term
| MELD model for end stage liver disease |
|
Definition
how to asign donor livers
match by size, and blood type (no tissue matching) MELD higher the score more ill get the liver
good way to predict prognosis in alcoholic cirrohsis |
|
|
Term
what am I:
Incubation period: 5-21 days
Diarrhea before fever, later constipation, pain, anorexia, neuropsychiatric, rose spots
GI bleed, perforation may cause death |
|
Definition
|
|
Term
Abdominal pain, fever with mesenteric adenitis or pseudo-appendicitis
Undercooked meats, or cross contamination
Invasive enterocolitis, abscesses, bacteremia |
|
Definition
|
|
Term
Common problem, especially after clindamycin and ampicillin
Hospital transmission
Host susceptibility
Malaise, diarrhea, fever, leukocytosis
Diagnosis: stool for toxin
Therapy: Metronidazole |
|
Definition
| C. Difficile and antiobiotic associated colitis |
|
|
Term
Rare disease: weight loss, arthralgias, diarrhea, abdominal pain
PAS positive bacteria in lamina propria
Middle aged white men
Diagnosis: bowel biopsy, PCR
Therapy: TMP-SUL for year |
|
Definition
|
|
Term
| ”spontaneous” –seeding of ascites from bacteremia: usually single organism: what type of peritonitis |
|
Definition
|
|
Term
| seeding of peritoneum from abdominal spillage: mixed bacteria. what type of peritonitis |
|
Definition
|
|
Term
Tenderness, rebound, rigidity, fever, nausea, vomiting, prostration, leukocytosis
Tx is broad spectrum antibiotics surgery is secondary
Collection of fluid under diaphragm or in pelvis
Severity of symptoms related to dose, host response, virulence, immunosuppresion |
|
Definition
|
|
Term
Complication of peritonitis, appendicitis.
Polymicrobial, Bacteroides fragilis
Subacute pain, fever, leukocytosis
Dx: expert exam, CT, tagged WBC scan
Therapy: drainage, antibiotics |
|
Definition
|
|
Term
Affects 20% of people with diverticulosis
“Left sided appendicitis”, may be masked in immunosuppressed or aged
Diagnosis: suspicion, pain, fever, CT |
|
Definition
|
|
Term
Inflammed cecum in face of immunosuppression (neutropenia, neonate) or vascular compromise (shock)
Fever, RLQ pain, distension, shock
Dx: CT dilated cecum, gas in wall
Rx: Cipro/Metronidazole, support, surgery
Prognosis: poor |
|
Definition
|
|
Term
Inflammed gall bladder after obstruction of cystic duct, usually from stones or worms
Epigastric or RUQ pain, “cholic” waves, right shoulder radiation
Diagnosis: ultrasound
Complications: perforation, gangrene, cholangitis
Therapy: antibiotics and surgery |
|
Definition
|
|
Term
Inflammation of hepatic and common bile ducts
Acute high fever, chills, jaundice (Charcot’s Triad), RUQ pain, bacteremia
Dx: ultrasound, HIDA scan
Complications: shock, hepatic abscess
Therapy: surgical drainage plus imipenem |
|
Definition
|
|
Term
| - washing out of the stomach with sterile water or a saltwater solution |
|
Definition
|
|
Term
| the removal of pressure caused by gas or fluid in a body cavity (e.g. stomach, intestinal tract) |
|
Definition
|
|
Term
| “A nasogastric tube is inserted through one of the nostrils, down the nasopharynx, and into the alimentary tract.” |
|
Definition
|
|
Term
| NG tube contraindications |
|
Definition
Choanal atresia-
as a congenital d/o where the back of the nasal passage is blocked,
Can be unilateral or bilateral; associated with ht or mental retardation
Massive facial trauma or basilar skull fracture
Esophageal stricture or atresia
Ingestion of caustic substance, unless performed under direct visualization |
|
|
Term
| chronic disease of GI tract from mouth to anus:fever, abdominal pain, liquid bowel movements, RLQ pain, RLQ mass and tenderness, perianal dsease with abscess and or fistulas |
|
Definition
| signs and symp of Crohn's disease |
|
|
Term
| chronic, recurrent dz characterized by diffuse mucosal inflammation involving only the colon. |
|
Definition
|
|
Term
| true intestinal diverticulum that results from failure of the vitelline duct to obliterate during the 5th week of fetal development: most prevalent congenital abnomality of the GI tract: 2% population |
|
Definition
|
|
Term
| what is an acute organic intestinal obstruction and where does it occur most frequently |
|
Definition
| mechanical obstruction of the small intestine is a common surgical disorder: common causes are adhesions, hernias, volvulus, chrons |
|
|
Term
| abdominal distention is minimal in proximal obstruction but pronounced in _____obstruction |
|
Definition
|
|
Term
What is a functional obstruction?
what is another name for this? |
|
Definition
obstruction with no known or detectable organic basis
pseudo-obstruction or ileus |
|
|
Term
| what imaging technique is most accurate in dx acute appendicitis |
|
Definition
abdominal or transvaginal US
CT is good for suspect appy perf or periappendic abscess |
|
|
Term
| indications: bowel obstruction, pneumoperitoneum, screening for renal calculi, not for gallstones. |
|
Definition
|
|
Term
indications: internal organs differentiate between cystic and solid lesions of liver and kidneys, gallbladder, and pancreas.
no contraindications |
|
Definition
|
|
Term
indications: abdominal and pelvic organs, abscess, splenic infarction, aortic aneurysm, pancreatitis or carcinoma.
Contraindications: Pregnancy, IV dye allergic. |
|
Definition
|
|
Term
indications: complementary to CT in evaluation of liver lesions, retroperitoneal lymphadenopathy from blood vessels.
Contraindications: cardiac pacemakers, intraocular metallic foreign bodies, intracranial aneurysm clips, cochlear implants, some artificial heart valves. |
|
Definition
|
|
Term
indications: GERD, hiatal hernia, esophageal cancer and varices.
contraindicated in pregnancy |
|
Definition
|
|
Term
indications: Inflammatory bowel disease or neoplasm, fistula, bowel obstruction, diverticulitits.
Contraindications: toxic megacolon and immediately after full-thickness colonscopic biopsy. |
|
Definition
|
|
Term
| indications: metastatic tumor, alcoholic liver disease. Contraindications: Pregnancy |
|
Definition
|
|
Term
| indication: locating the cause and extent of extra-hepatic biliary obstruction, primary sclerosing cholangitis, and chronic pancreatitis. |
|
Definition
|
|
Term
| Acute Cholecystitis:(99mTc-labeled imidodiacetic Acid) to investigate obstruction to the biliary tract. Administered IV and removed by the liver from the blood and concentrated in bile. It can be detected in the gallbladder in 10 to 60 minutes. Excreted through the common bile duct into the duodenum within 45 minutes. Any obstruction of the cystic duct will prevent the agent from entering the gallbladder. |
|
Definition
|
|
Term
| Inject isotope labeled red cells, IV and the abdomen is scanned to find concentrated areas of activity that would represent the bleeding site. |
|
Definition
| Lower GI Bleed Labeled Red Cell study |
|
|
Term
| What is the most accurate method for diagnosing early gastric carcinoma? |
|
Definition
| Upper endoscopy, with cytologic brushings and biopsies of suspicious lesions. |
|
|
Term
| signs and symptoms of gastric carcinoma. |
|
Definition
generally asymptomatic until disease is advanced
Dyspepsia, vague epigastric pain, anorexia, early satiety, and weight loss are the most common presenting symptoms. Patients may initially get relief from OTC medications, further delaying diagnosis. |
|
|
Term
| IBS treatment: reserved for 1/3 patients who do not respond to education and diet change |
|
Definition
antispasmodic agents-anticholinergic: dicyclomine, hyscyamine, propantheline-get rid of postprandial pain.
antidiarrheal agents: Loperamid diphenoxylate w atropine
anticonstipation: fiber, Cisapride
Psychotropic agents: SSRI
behavior modification
avoid antianxiety meds |
|
|
Term
| Twisting of colon is referred to as? |
|
Definition
|
|
Term
| What is the rules of 2 for Meckel's diverticulum |
|
Definition
2% of population
2ft aove the distal ileum
2 inches long |
|
|
Term
| Intussusception: what is it and what test would you order |
|
Definition
telescoping of the intestine
Barium enemal: both diagnostic and treatment |
|
|
Term
| What study is used to look for cholecystitis |
|
Definition
|
|
Term
| diffuse fibrosing and nodular condition of the liver associated with certain clinical findings including portal vein HTN and hepatic failure |
|
Definition
|
|
Term
| What criteria is used to show the prognosis and morbidity for pancreatitis |
|
Definition
|
|
Term
| If the urine is tea colored that is a sign of |
|
Definition
|
|
Term
| This is elevated in some bone diseases and is produced in the bone and blood |
|
Definition
|
|
Term
| This lab is increased when liver damage is caused by alcholism |
|
Definition
| Gamma-Glutamyltranspeptidase GGT |
|
|
Term
| Elevated bulirubin can result from what blockage |
|
Definition
|
|
Term
| increase accumulation of iron as hemosiderin in the liver, pancreas, heart, adrenals, testes, pituitary and kidney |
|
Definition
|
|
Term
| Hep A is transmitted by what |
|
Definition
|
|
Term
| Hep B is transmitted by what? |
|
Definition
| infected blood, blood products, sexual contacts, saliva, semen and vaginal secretions |
|
|
Term
|
Definition
| fissure, hypertrophied anal papillae, sentinel pile |
|
|
Term
| Anal Cancer is usually caused by what? |
|
Definition
|
|
Term
| The pancreas secretes this as an exocrine gland to neutralize stomach acid in the duodenum? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| stomach is divided into 2 pouches for wt loss |
|
Definition
|
|
Term
| distal ileum anastomosed to remnant stomach |
|
Definition
|
|
Term
| food moves too fast through GI, precipitated by ingestion of high sugar foods/drinks |
|
Definition
|
|
Term
| vomiting with pyloric stenosis is usually described as being this? |
|
Definition
|
|
Term
| What type of Hepatitis usually runs with Hep B? |
|
Definition
|
|
Term
| what is a physical finding on a child with pyloric stenosis? |
|
Definition
|
|
Term
|
Definition
Permanent vs. Temporary
Elective vs. Emergency
Flecal vs. Urinary |
|
|
Term
| Surgically created opening between the GI or GU tract and the skin. |
|
Definition
|
|
Term
| List four disease/conditions that can lead to as ostomy |
|
Definition
Congenital Conditions
Inflammatory Bowel Disease
Cancer
Diverticulitis
Trauma
Diverting Colostomy |
|
|
Term
| imperforated anus, and necrotizing enterocolitis. |
|
Definition
Hirschsrung's disease: Congenital condition
down's syndrome more likely to have this. |
|
|
Term
| ) is a serious gastronintestinal disease of unknown etiology in neonates. is characterized by necrosis of part of the intestine. Premature infants are the most susceptible to this dz |
|
Definition
| NEC: necrotizing Enterocolitis |
|
|
Term
| disease always involves the rectum and is limited to the colon. Therefore, proctocolectomy with ileostomy is curative for these patients. |
|
Definition
|
|
Term
Mechanical or Functional
due to blockage of bowel lumen?
failure of peristalsis? |
|
Definition
|
|
Term
Common 5 days after abdominal operation?
After 7 days consider this? |
|
Definition
Adynamic (paralytic ileus)
Mechanical etiology: |
|
|
Term
| This type of blockage is more serious and usually needs an operation. caused by adhesions, malignancy, hernias, malrotation, |
|
Definition
|
|
Term
| GI system begins to develop during what week of gestation? |
|
Definition
|
|
Term
Tight frenulum (tongue-tie)
Surgical release if frenulum is so tight infant can’t nurse adequately
May be clipped later if child experience speech problems |
|
Definition
|
|
Term
Triad of micrognathia (small mandible), cleft palate, and glossoptosis (tongue malpositioned downward
never place supine
assess babies with cleft palate |
|
Definition
|
|
Term
Esophagus may end in blind pouch before it connects with stomach or may have fistula with trachea (unnatural connection)
Five types |
|
Definition
| Tracheoesophageal Atresia or fistula (TEF) |
|
|
Term
S&S: 3 C’s - coughing, choking, and cyanosis; excessive oral mucous, bubbles, drooling
diagnose before feeding bc aspiration can happen |
|
Definition
TEF
Tracheoesophageal Fistula |
|
|
Term
| Treatment and prognosis of Pyloric Stenosis |
|
Definition
Pyloromyotomy and prognosis is excellent
Emesis immediately after feeding beginning about 2 to 4 wks of age and grows increasingly forceful until projectile, usually smells sour sinc3 digestion has begun |
|
|
Term
Protrusion of abdominal contents thru abd wall at junction of abd and umbilicus
Failure of abdominal contents to return to abdomen when abdominal walls begins to close about 10 weeks gestation |
|
Definition
|
|
Term
Similar to omphalocele but abdominal wall defect is not at umbilicus & is not covered by peritoneal sac, so contents spill freely
Harder to repair |
|
Definition
|
|
Term
Protrusion of abdominal contents (one or more organs) into the chest cavity through a defect in the diaphragm
Most common on left side |
|
Definition
|
|
Term
Progressive inflammatory process that causes bile duct fibrosis
Cause is unknown, but is prenatal: viruses, toxins, or chemicals are suspected
Obstruction of bile ducts doesn’t allow flow of bile out of liver and into small intestine and gall bladder; |
|
Definition
|
|
Term
| Without bile in the intestines, fat and fat-soluble vitamins cannot be absorbed, leading to malnutrition and growth failure. without treatment this is fatal, Jaundice occurs within 2wks to 2 months. |
|
Definition
|
|
Term
Congenital anomaly resulting from an absence of ganglion cells in the colon
Also known as megacolon or congenital aganglionosis
newborns fail to pass meconium
absence of innervation means that peristolisis cant occur leading to obstruction |
|
Definition
|
|
Term
Chronic malabsorption syndrome d/t a sensitivity to protein, particularly the gluten protein found in grains (wheat, barley, rye, oats)
Patients usually can eat corn, and sometimes rice |
|
Definition
|
|
Term
| Refers to nonforceful expulsion of food and secretions through the mouth |
|
Definition
|
|
Term
Major cause of infant mortality in developing countries
Primarily viral or bacterial
Most commonly viral, usually rotaviruses or adenoviruses |
|
Definition
|
|
Term
Most common cause of abdominal surgery in children
Seen most frequently in adolescent boys (10 to 30 year-olds) |
|
Definition
|
|
Term
Fever is a late sign
Difficult to differentiate from gastroenteritis (symptoms are often identical), but rebound tenderness is specific for this
WBC elevated
Sonogram is usually diagnostic
Absent BS may indicate rupture and peritonitis |
|
Definition
|
|
Term
Protein deficiency
Symptoms are most common in toddlers (1 to 3 year-olds require a high protein intake for rapid growth)
Found almost exclusively in developing countries
Tends to occur after weaning, when protein intake drops as milk feedings stop |
|
Definition
|
|
Term
what is going on?
Paroxysmal abdominal pain/vomiting
Sausage-shaped mass
“Current-jelly” rectal bleeding
Barium enema findings
Most frequent cause of intestinal obstruction under age 2 |
|
Definition
|
|
Term
| It is now well recognized that this organ is an immunologic organ that actively participates in the secretion of immunoglobulins, particularly immunoglobulin A (IgA). |
|
Definition
|
|
Term
| The appendix can be up to _______ long |
|
Definition
20cm
lined with lympoid follicles |
|
|
Term
| the most commonly performed emergency operation in the world. |
|
Definition
|
|
Term
|
Definition
Pancreatic duct obstruction
Pancreatic ischemia
Premature activation of zymogens (proenzymes) within the pancreatic acinar cells |
|
|
Term
It occurs when the proteolytic enzymes are activated in the pancreas rather than the intestinal lumen
The active enzymes then digest membranes within the pancreas, leading to:
Edema
Vascular damage
Cellular injury
Death |
|
Definition
|
|
Term
| The pancreas has these two properties? |
|
Definition
| Gland with both endocrine and exocrine properties |
|
|
Term
1. comprised of alpha, beta, and delta cells part of the Pancrease that is an Endocrine gland
2. alpha cells secrete?
3. beta cells secrete?
4. delta cells secrete? |
|
Definition
1. Islet of Langerhans
2. Glucagon
3. Insulin
4. Somatostatin (inhibitor of GH secretion |
|
|
Term
| cells that make up the Exocrine Pancreas: form the bulk of the gland, produce an enzyme rich juice that is secreted into the small intestine during food digestion |
|
Definition
Acinar Cells
The exocrine tissue also secretes bicarbonate to neutralize stomach acid in the duodenum |
|
|
Term
| A disorder characterized by inflammation of the pancreas due to inappropriate activation of pancreatic enzymes within the pancreas, or in the extrapancreatic tissue with consequent local or systemic complications |
|
Definition
Acute Pancreatitis:
Most cases of mild acute pancreatitis is self-limited |
|
|
Term
| Most common causes of Pancreatitis in the US are: |
|
Definition
Alcohol and cholethiasis
attacks usually follow a large heavy meal or alcohol binge |
|
|
Term
| a couple of etiologies of Acute pancreatitis? |
|
Definition
blunt abdominal truama or traum during surgery (ERCP)
Hypertriglyceridemia (above 1000 mg/dl)
drugs: thiazide diuretics, lasix, ACE
opportunistic infections: CMV, Candida, or TB
Penetrating peptic ulcer
Sphincter of Oddi dysfunction |
|
|
Term
| It is a sphincter muscle located at the surface of the duodenum. It appears slightly distal to the joining of the common bile duct and pancreatic duct as they enter the descending duodenum and forms from the ampulla of Vater. |
|
Definition
| Sphincter of Oddi Dysfunction |
|
|
Term
| Symptoms of Acute Pancreatitis? |
|
Definition
Often severe, constant, boring epigastric abdominal pain radiating to the back
Pain exacerbated by p.o. intake
Nausea and vomiting |
|
|
Term
| Physical Exam of Acute Pancreatitis? |
|
Definition
Pyrexia
Can’t tolerate lying supine, lean forward with both knees to the chest
Rigidity, guarding, and distention
Cullen’s sign or Grey Turner’s sign
May have hypoactive bowel sounds secondary to a paralytic ileus
Rarely, palpable upper abdominal mass due to a pseudocyst |
|
|
Term
|
Definition
Serum:
CBC with differential
Amylase- peak 24 hrs.
Lipase-slightly more sensitive and specific than amylase-peak 24 hrs.
LFT’s (to look at the liver)
Metabolic Panel |
|
|
Term
| Gold Standard imaging for acute pancreatits |
|
Definition
CT Abdomen with contrast:
Necessary to r/o pancreatic necrosis (area showing hypoperfusion of contrast)
May cause renal failure with creatinine > 1.5 mg/dL.
May show calcification (indicative of chronic disease |
|
|
Term
|
Definition
Strict NPO
IV hydration
NG tube for emesis
Blood glucose control
Demerol
Phenegan
IV PPI
Antibiotics if necrosis is suspected
NG tube low intermittent suction
ERCP with sphincterotomy, stone extraction and stent placement
strict avoidance of alcohol |
|
|
Term
Persistent pain, with presence of pancreatic calcifications
Usually an inflammatory disease – characterized by irreversible damage of the pancreatic architecture
Incidence is about 4/100,000 per year
Alcohol and malnutrition |
|
Definition
|
|
Term
| TX for Chronic Pancreatitis |
|
Definition
avoid alcohol
analgesics
Enzyme therapy: inhibit pancreatic enzyme secretion
Octreotide- Somatostatin: inhibit pancreatic secretion: regulates glucagon and insulin
Endoscopy |
|
|
Term
| Etiology of Chronic Pancreatitis |
|
Definition
Alcohol
Hyperparathyroidism
Obstruction
Idiopathic |
|
|
Term
| Symptoms of Chronic Pancreatitis |
|
Definition
Episodic or persistent pain lasting from days to years
Recurrent episodes will mimic acute attacks
Steatorrhea:
Calcifications on radiographs or ERCP |
|
|
Term
|
Definition
Strict avoidance of alcohol
analgesics
PPI or H2
oral pancreatic enzymes if steatorrhea present |
|
|
Term
| External Hemorrhoids lie where? |
|
Definition
outside anal verge, below dentate line
drainage to internal iliac to caval system
they rarely bleed |
|
|
Term
| Internal hemorrhoids are located here? |
|
Definition
proximal to dentate line
drain to portal system
painless bleeding
4 stages |
|
|
Term
| Rubber band ligation for hemorrhoids causes |
|
Definition
ischemic necrosis
used to treat 1st through 3rd degree hemorrhoids |
|
|
Term
| Surgical Excision is used for hemorroids who failed to respond to conservative treament. what degrees |
|
Definition
|
|
Term
| most common cause of anorectal abscess |
|
Definition
infection of anal crypt into para rectal space
Other causes – infection of hair follicle, hematoma, or after anorectal surgery |
|
|
Term
Two openings connected by hollow tract
Most originate at anal crypts |
|
Definition
|
|
Term
Chronic, recurrent rectal pain or aching
Last 20 minutes or more
Absence of organic cause |
|
Definition
|
|
Term
| area that extends from the internal anal sphincter to the anal verge |
|
Definition
|
|
Term
| The rectum behaves like the____________ with adenocarcinoma common. |
|
Definition
|
|
Term
| predominant indirect-acting bilirubin- may result from overproduction of bilirubin because of lysis; impaired hepatic uptake of bilirubin by certain drugs; |
|
Definition
| unconjugated hyperbilirubinemia |
|
|
Term
| may result from impaired excretion of bilirubin from the liver due to hepatocellular disease, drugs, sepsis, hereditary disorders such as Dubin Johnson syndrome, or extrahepatic biliary obstruction |
|
Definition
| conjugated hyperbilirubinemia |
|
|
Term
| Retention of bile in the liver. |
|
Definition
|
|
Term
| Results from the accumulation of bilirubin- a reddish pigment product of heme metabolism in the body tissues: the cause may be hepatic or nonhepatic. |
|
Definition
|
|
Term
enzyme produced in hepatocytes, the major cell type in the liver. is increased in conditions in which hepatocytes are damaged or die.
All types of hepatitis (viral, alcoholic, drug-induced, etc.) cause hepatocyte damage that can lead to elevations |
|
Definition
| ALT Alanine Aminotransferase |
|
|
Term
| is an enzyme similar to ALT (see above) but less specific for liver disease as it is also produced in muscle and can be elevated in other condition. In some conditions, such as alcoholic hepatitis or shock liver, the elevation in the serum level may higher than the elevation in the serum ALT level. |
|
Definition
| AST: Aspartate Aminotransferase |
|
|
Term
| an enzyme, or more precisely a family of related enzymes, produced in the bile ducts, intestine, kidney, placenta and bone. An elevation in the level of serum of this (actually enzyme activity is measured in the clinical laboratory), especially in the setting of normal or only modestly elevated ALT and AST. activities, suggests disease of the bile ducts |
|
Definition
|
|
Term
| enzyme produced in the bile ducts that, like alkaline phosphatase, may be elevated in the serum of patients with bile duct diseases. Elevations in this, especially along with elevations in alkaline phosphatase, suggest bile duct disease |
|
Definition
| GGT Gama-Glutamyltranspeptidase |
|
|
Term
| major breakdown product that results from the destruction of old red blood cells (as well as some other sources). It is removed from the blood by the liver, chemically modified by a process call conjugation, secreted into the bile, passed into the intestine and to some extent reabsorbed from the intestine. |
|
Definition
|
|
Term
| smallest of the blood cells (actually fragments of larger cells known as megakaryocytes) that are involved in clotting. In some individuals with liver disease, the spleen becomes enlarged as blood flow through the liver is impeded. |
|
Definition
|
|
Term
| enzyme found primarily in bones and the liver. Expected values are higher for those who are growing (children and pregnant women) or when damage to bones or liver has occurred or with gallstones. Low values are probably not significant. |
|
Definition
|
|
Term
| major protein that circulates in the bloodstream. it is synthesized by the liver and secreted into the blood. Low serum concentrations indicate poor liver function. The serum concentration is usually normal in chronic liver diseases until cirrhosis and significant liver damage is present. |
|
Definition
|
|
Term
| When liver function is severely abnormal, their synthesis and secretion into the blood is decreased. it is a type of blood clotting test performed in the laboratory and it is prolonged when the blood concentrations of some of the clotting factors made by the liver are low. |
|
Definition
|
|
Term
| Name the most common cause of cirrhosis in the USA. |
|
Definition
| Alcoholic Liver disease, others are Hep B,C,D, wilson's disease, CHF or Drug toxins |
|
|
Term
| What is the most common cause of acute hepatic failure? |
|
Definition
|
|
Term
| What is ascites and what are some of the causes of ascites? |
|
Definition
| Accumulation of fluid (ascites): marked by a buildup of fluid in the peritoneal cavity. Ascites also may develop from conditions unrelated to the liver, such as congestive heart failure, thyroid disorders, pancreatic and kidney diseases, or cancer that has started in or spread to the peritoneum (the thin layer of tissue covering the intestines). |
|
|
Term
| three classifications of cirrhosis. |
|
Definition
micronodular (typical alcoholic)
macronodular
mixed form |
|
|
Term
| characterized by increased accumulation of iron as hemosiderin in the liver, pancreas, heart, adrenals, testes, pituitary, and kidneys. The patient may develop hepatic, pancreatic, and cardiac insufficiency and hypogonadism. Rarely diagnosed before the fifth decade. |
|
Definition
|
|
Term
| Discuss diseases that are associated with hepatocellular carcinoma. |
|
Definition
|
|
Term
| Which two predisposing conditions are responsible for the majority of cases of acute pancreatitis? |
|
Definition
|
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Term
| Plain films of the abdomen may show gallstones, a "sentinel loop" (a segment of air-filled small intestine most commonly in the LUQ), the "colon cutoff sign" -- a gas filled segment of transverse colon abruptly ending at the area of pancreatic inflammation |
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Definition
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Term
| 5 F's: fat, female, forty, fertile, flatulent. The incidence is high in individuals with Crohn's disease. May also be seen in sickle cell anemia. More frequent in females than males. |
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Definition
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Term
| defined: calculi in the common bile duct |
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Definition
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