Aneurysms, Liver , Pancreas Flashcards
Pancreatitis
Inflammation of the pancreas
(chronic or acute)
enzymes (trypsin) are activated in pancreas instead of Small I. leads to inflammation and auto digestion
Symptoms of pancreatitis
severe abdominal pain , radiates to the back
nausea, vom
symptoms worsen with eating esp. fatty foods
relived with forward leaning
severe pain leads to hypertension and tachycardia
dehydration: hypotension
Cystic fibrosis: Pancreatic insufficiency
Inability to secrete bicarbonate and water limits the about of enzymes released in lumen of small I.
if enzymes reach lumen , often inactive as not enough alkaline to neutralize gastric acid
How to measure liver
percussion dullness
Functions of the liver
Synthetic
metabolism
excretory
detoxification
Synthetic function of liver
produces plasma proteins : albumen and coagulation factors
synthesizes triglycerides, cholesterol, carbohydrates
Metabolism of liver
protein catabolism and synthesis of urea
breaks down RBC and removes bilirubin
Excretory of liver
produces bile for the digestion of fats
Detoxification of liver
detoxifies noxious chemicals (first pass effect)
Jaundice, Varices, and Ascites are both a sign of what
liver dysfunction
Jaundice
Excess bilirubinemia
Hyperbilirubinemia
Ascites
Abdominal swelling : fluid in peritoneum
can cause pulmonary complications due to implication on diaphragm and lung volumes
rapid shallow breathing
resembles restrictive lung pathology
Cause of ascites
altered starling forces in portal vessels (low oncotic pressure due to hypoalbuminemia) AND increase portal venous pressure
Interventions of ascites
Diuresis and NA+ restriction
paracenteses : fluid removal
Hapatopulmonary syndrome
desaturation of SPO2 when sitting upright
Varices
Portal hypertension causes enlarged veins and may burst causing upper GI bleeds and hematemesis
Hepatic encephalopathy
reversible decrease in neurologic brain function due to shunting blood away from portal circulation
The loss of brain function when a damaged liver doesn’t remove toxins from the blood.
hepatic failure
associated with increased serum ammonia
Asterixis “liver flap”
a sign of hepatic encephalopathy
hand flex and extension tremor
Which is more dangerous an aneurysm or a dissection
Dissection is more dangerous
aneurism: ballooning /weakening of vessel wall
dissection : tear in the intimal layer
Presentation of ruptured dissecting AAA
sudden abdominal pain : tearing sensation
hypotension
tachycardia
sweating
clamminess
pulsatile mass in abdomen
< 5 cm cannot detect in physical exam
size of abdominal aortic aneurism increases risk
risk factors of AAA and how do you fix one
age, family history, male, smoking, high cholesterol
, CAD, atherosclerosis
stent graft placed in abdominal aorta
