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Hepatic, Pancreatic, and Biliary System Disorders
Exam 1
59
Pathology
Graduate
09/08/2011

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Cards

Term
Name some S&S of hepatic diseases
Definition
-GI symptoms
-Right upper ab pain
-Jaundice
-Dark Urine
-Light or clay colored feces
-Edema/ascites
Term
An acute or chronic inflammation of the liver
Definition
Hepatitis
Term
What are 5 causes of hepatitis?
Definition
-Viral
-Alcoholic
-Chemical/drug/toxic
-Autoimmune
-Idiopathic
Term
Name the 5 types of viral hepatitis.
Definition
A, B, C, D, and E
Term
Name 2 ways to prevent viral hepatitis.
Definition
-Perform universal precaution
-Immunization
Term
This viral hepatitis occurs in less than 30,000 cases reported to CDC in 2000; reduced incidence with introduction of the vaccine.
Definition
Hepatitis A
Term
This viral hepatitis results in acute infection only. It does not progress to chronic or cirrhosis. There is a small risk of fulminant hepatitis and there is lifetime immunity.
Definition
Hepatitis A
Term
How can hepatitis A be transferred?
Definition
Fecal-oral route:
Spread by feces, saliva, and contaminated food and water
Term
Name 7 risk factors for contracting hepatitis A.
Definition
1. Household contacts or sexual contacts with infected persons
2. Unprotected homo/bisexual activity
3. Injection/non-injection illegal drug users
4. Living in areas with increased incidence rates (kids at biggest risk)
5. Travel to areas where it is epidemic
6. Tattoo incription or removal; body or ear piercing with unsterile needles
7. Blood cloothing factor disorder
Term
Name 2 treatments for hepatitis A
Definition
-Immune globulin before or within 2 weeks of exposure
- Supportive; most ppl recover within 6 to 10 weeks
Term
How can hepatitis A be diagnosed?
Definition
Blood test to identify antibody; anti-HAV; IgM
Term
Is there a vaccine available for hepatitis A?
Definition
Yes, combined HAV and HBV vaccine available (Twinrix)
Term
This viral hepatitis has a reduced incidence; 150,000 new acute cases in US; 1 million carriers
Definition
Hepatitis B
Term
This is the most common cause of chronic hepatitis and liver cancer; second major cause of cirrhosis in the US after alcohol abuse
Definition
Hepatitis B
Term
Name 4 ways Hepatitis B can be transmitted.
Definition
1. Parenteral
2. Sexual contact
3. Vertical
4. Unidentified exposure
Term
Name 10 risk factors for Hepatitis B.
Definition
1. Injection drug use
2. Unprotected homo/bisexual activity
3. Incarceration in correctional facilities
4. Certain ethnic groups from areas such as asia, south america, mexico, etc
5. Travel to high risk areas
6. Occupational risk (morticians, dental workers, health care workers, etc)
7. Liver transplant recipient
8. Infants born to mothers with HBV
9. Multiple blood product or blood transfusion before July 1992
10. Immunocompromised ppl; recieving/administering chronic kidney dialysis
Term
How can you treat Hepatitis B?
Definition
Alpha interferon and lamivudine for chronic HBV; effective in 40%; HBIG for exposed, unvaccinated persons
Term
How can you diagnose HBV?
Definition
Bloo test to identify antigen and antibodies; HBsAg; HBeAg; HBcAg
Term
Is there a vaccine available for Hepatitis B?
Definition
Yes, combined with HAV and HBV
Term
This viral hepatitis incidence is transfusion-related cases were decreased with blood screening but increased incidence expected related to risk behaviors in 60s and 70s; 4 million infected
Definition
Hepatitis C
Term
This viral hepatitis accounts for 60% to 70% of all chronic hepatitis; 30% of chronic cases progress to cirrhosis; associated with liver cancer.
Definition
Hepatitis C
Term
Name 2 ways in which Hepatitis C can be transmitted
Definition
Parenteral
Unidentified exposure
Term
Name 6 risk factors for Hepatitis C
Definition
1. Current or previously used injected illegal drugs; intranasal cocaine use with shared equipment
2. Received blood transfusion or organ transplant before July 1992 or blood clotting products made before 1987
3. Tattooing/body piercing as a risk factor for HCV has not been completely evaluated in the US but isn't likely
4. Evidence of liver disease; liver transplant recipient
5. Infants born to HCV-infected mothers
6. Long-Term kidney dialysis
Term
What is the treatment for Hepatitis C?
Definition
Combination therapy (interferon, ribaviron) in select cases
Term
How can you diagnose Hepatitis C?
Definition
-Blood test to identify antibody; does not distinguish between current and past infection; anti-HCV
-Limited use of nucleic acid test
Term
Is there a vaccine available for hepatitis C?
Definition
No
Term
Liver diseases produced by excessive consumption of ethanol
Definition
Alcoholic Liver Disease
Term
Name 3 things included under alcoholic liver disease
Definition
Fatty liver, alcoholic hepatitis, and cirrhosis
Term
About 15% of alcoholics develop ___
Definition
Cirrhosis
Term
Alcoholism causes __% of cases of cirrhsis
Definition
70%
Term
A pint of whiskey (approx 80 gams of ethanol) per day or 10-15 years is considered a threshold for development of cirrhosis
Definition
Ethyl Alcohol
Term
What can occur fatty liver disease
Definition
Hepatic enlargement
Term
What can occur with alcoholic hepatitis?
Definition
Anorexia, malaise, fever, right upper ab pain, jaundice
Term
What can occur with cirrhosis?
Definition
GI symptoms, ascites, GI bleeding, liver failure, palmar erythema, spider angiomas
Term
What complications can come from fatty acid liver disease?
Definition
Reversible with abstinence, associated with sudden death
Term
What complications can occur with alcoholic hepatitis?
Definition
Hepatic failure
Term
What complications can occur with cirrhosis liver disease?
Definition
Portal hypertension, ascites, and esophageal varices, progressive liver failure
Term
Prognosis of alcoholic liver disease depends on abstinence.
Definition
Fatty liver and alcoholic hepatiis may recover fully; prognois is poor for cirrhosis
Term
What is the treatment for Alcoholic Liver Disease?
Definition
Abstinence; treatments of complications of cirrhosis; liver transplantation.
Term
End stage liver disease in which the normal hepatic architecture is destroyed and replaced by scar tissue encircling nodule of regenerating hepatocytes.
Definition
Cirrhosis
Term
What is the most common cause of cirrhosis in the US?
Definition
Alcohol
Term
How is the prognosis for cirrhosis?
Definition
Poor
Term
Inflammation of the pancreas; most commonly caused by gallstone or alcoholism
Definition
Acute Pancreatitis
Term
Leakage of pancreatic enzymes digest the pancreas and surrounding tissues
Definition
Acute Pancreatitis
Term
Name the clinical manifestations of acute pancreatitis.
Definition
-Acute epigastric pain radiating to the back
-N&V
-Serum amylase and lipase increase
Term
What is the treatment for acute pancreatitis?
Definition
Supportive and symptomatic treatment
NPO (nothing by mouth)-to reduce pancreatic stimulaton and allow it to recover
Term
Long term pancreatic inflammation usually due to chronic alcoholism
Definition
Chronic Pancreatitis
Term
What are the clinical manifestations for chronic pancreatitis?
Definition
Chronic or recurrent epigastric pain
The pt may have signs of pancreatic insufficiency, with malabsorption and diabetes mellitus
Term
Primary malignant tumor of pancreas, usually adenocarcinoma arising from pancreatic ducts
Definition
Carcinoma of Pancreas
Term
The 4th most common cause of cancer death; highest in men, blacks, Native Americans, Polynesians
Definition
Carcinoma of Pancreas
Term
Carcinoma of the pancreas has the highest incidence in what ages?
Definition
60+
Term
6 risk factors for carcinoma of pancreas
Definition
-Chronic gallbladder disease
-Diabetes mellitus
-Chronic hereditary pancreatitis
-Cigarette smoking
-Diets high in meat and fat
-Occupational exposure of carcinogns
Term
Name 5 clinical manifestations of carcinoma of pancreas
Definition
-Systematic signs of cancer such as anorexia, weight loss
-Epigastric pain radiating to back
-Back pain
-Jaundice with acute painless dilation of gallbladder
-Carcinomas of the head are detected early due to jaundice
Term
Name 5 complications from carcinoma of the pancreas
Definition
1. Obstructive jaundice especially with tumors of the head
2. Widespread metastatis, commonly to liver, lung, and peritoneum
3. Intestinal obstruction
4. Migratory thrombophlebitis (Trousseau's sign)
5. Cachexia
Term
Stone in the gallbladder. A common disorder. Incidence increases with age.
Definition
Cholelithiasis
Term
What are the risk factors for cholelithiasis?
Definition
Age
Female
Multiparity
Obesity
Remember as 4Fs "Female, Fertile, Forty, Fat"
Term
What are the clinical manifestations of cholelithiasis?
Definition
Usually asymptomatic, episodic pain in the right upper quadrant, N&V, usually precipitated by fatty meals. Biliary colic (severe pain) occurs when stones transiently block the cystic duct.
Term
Inflammation of the gallbladder usually associated with gallstones
Definition
Cholecystitis
Term
What are the clinical manifestations of Cholecystitis?
Definition
Episodic biliary colic starts suddenly and often occurs postprandially. Severe right upper quadrant pain referred to the right scapula, low fever. Pain is steady and abates slowly.
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