Aneurysms, Liver , Pancreas

Question 1

Pancreatitis

Answer 1

Inflammation of the pancreas
(chronic or acute)

enzymes (trypsin) are activated in pancreas instead of Small I. leads to inflammation and auto digestion

Question 2

Symptoms of pancreatitis

Answer 2

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

Question 3

Cystic fibrosis: Pancreatic insufficiency

Answer 3

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

Question 4

How to measure liver

Answer 4

percussion dullness

Question 5

Functions of the liver

Answer 5

Synthetic
metabolism
excretory
detoxification

Question 6

Synthetic function of liver

Answer 6

produces plasma proteins : albumen and coagulation factors
synthesizes triglycerides, cholesterol, carbohydrates

Question 7

Metabolism of liver

Answer 7

protein catabolism and synthesis of urea
breaks down RBC and removes bilirubin

Question 8

Excretory of liver

Answer 8

produces bile for the digestion of fats

Question 9

Detoxification of liver

Answer 9

detoxifies noxious chemicals (first pass effect)

Question 10

Jaundice, Varices, and Ascites are both a sign of what

Answer 10

liver dysfunction

Question 11

Jaundice

Answer 11

Excess bilirubinemia
Hyperbilirubinemia

Question 12

Ascites

Answer 12

Abdominal swelling : fluid in peritoneum

can cause pulmonary complications due to implication on diaphragm and lung volumes
rapid shallow breathing
resembles restrictive lung pathology

Question 13

Cause of ascites

Answer 13

altered starling forces in portal vessels (low oncotic pressure due to hypoalbuminemia) AND increase portal venous pressure

Question 14

Interventions of ascites

Answer 14

Diuresis and NA+ restriction
paracenteses : fluid removal

Question 15

Hapatopulmonary syndrome

Answer 15

desaturation of SPO2 when sitting upright

Question 16

Varices

Answer 16

Portal hypertension causes enlarged veins and may burst causing upper GI bleeds and hematemesis

Question 17

Hepatic encephalopathy

Answer 17

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

Question 18

Asterixis “liver flap”

Answer 18

a sign of hepatic encephalopathy

hand flex and extension tremor

Question 19

Which is more dangerous an aneurysm or a dissection

Answer 19

Dissection is more dangerous

aneurism: ballooning /weakening of vessel wall

dissection : tear in the intimal layer

Question 20

Presentation of ruptured dissecting AAA

Answer 20

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

Question 21

risk factors of AAA and how do you fix one

Answer 21

age, family history, male, smoking, high cholesterol
, CAD, atherosclerosis

stent graft placed in abdominal aorta