Disorders Flashcards
Pre-hepatic: cause, serum bilirubin levels, stool colour, signs & symptoms
- hemolytic anemia or internal hemorrhage; increase in RBC breakdown = increase in unconjugated bilirubin production
- ^^^ unconj, ^ conj.
- brown
- anemia: fatigue, dizzy, pale skin; ? enlarged spleen
Gilbert’s Syndrome: cause, serum bilirubin levels, stool colour, signs & symptoms
- defect in UDPGT so decrease in bilirubin conjugation
- ^ unconj, v conj.
- light clay
- mild jaundice from time to time, no other symptoms
Dubin-Johnson Syndrome: cause, serum bilirubin levels, stool colour, signs & symptoms
- defect in conj bilirubin transportation to canaliculi
- ^ conj (buildup)
- light clay
- lifelong jaundice, no other symptoms
Hepatocellular dmg & necrosis: cause, serum bilirubin levels, stool colour, signs & symptoms
- hepatitis: mostly viral infections, cirrhosis: irrev scarring, leading cause is alcohol
- ^ unconj, ^^ conj. (hepatocytes functional but bilirubin goes to diff pathways)
- light clay
- ? abdominal pain, ? enlarged liver, +/- enlarged spleen
Post-hepatic (OBD): cause, serum bilirubin levels, stool colour, signs & symptoms
- obstruction causes impaired bilirubin excretion e.g. from gallstones, cysts & tumours, pancreatic cancer compressing bile duct
- ^ conj.
- light clay
- gallstones: pain, pancreatic cancer: pain, weight loss
Inflammatory Bowel Disease: causes, pathophysiology, signs & symptoms
Causes:
1. cause is poorly understood
2. seems to have a genetic predispostion -> impaired immune function
Pathophysiology:
genetic predisposition + exogenous factors + host factors -> dysregulated immune system
*typical onset in adolescence and early adulthood
Signs & symptoms:
1. abdominal pain
2. loss of appetite
3. fatigue
4. diarrhea (bloody if ulcers perforate)
5. possibly anemia
6. possibly leukocytosis
Ulcerative Colitis: pathophysiology, signs & symptoms
Pathophysiology:
- “shallow” inflammation = mucosa only
- only affects colon and rectum
Signs & symptoms:
- often bloody diarrhea
- cts area of mucosal inflammation seen in colonoscopy
Crohn’s Disease: pathophysiology, signs & symptoms
Pathophysiology:
- inflammation extends entire thickness of intestinal wall
- affects all of GI tract; commonly in proximal colon & ileum
Signs & symptoms:
1. diarrhea (mostly non-bloody)
2. small intestine villi damaged -> malabsorption
3. endoscopy shows: patches of inflammation, deep ulcers, swelling & scarring = obstruction
Lactose Intolerance: causes, pathophysiology, signs & symptoms
Causes:
decreased lactase production
Pathophysiology:
decreased lactose breakdown, lactose accumulates in GI lumen
Symptoms:
1. diarrhea (water stays in lumen due to presence of disaccharide)
2. gas/bloating/cramps: gut microbiome breaks down lactose and produces methane and hydrogen gas
Malabsorption Syndromes: causes, pathophysiology, signs & symptoms
Causes:
1. Impaired mucosal absorption mechanism or brush boarder (microvilli) enzymes
2. pancreatic disorder: decrease in digestive enzymes
3. liver disorder: low bile output
4. infection causes intestinal damage
Pathophysiology:
involves dmg to intestinal mucosal lining or decreased nutrient digestion (lack of enzymes)
Symptoms:
1. abdominal discomfort
2. diarrhea
3. weight loss
4. Specifics depend on which nutrient is not absorbed e.g. decreased fat absorption can result in steatorrhea
Celiac Disease: causes, pathophysiology, signs & symptoms
Cause:
HSR to gluten
Pathophysiology:
Immune-mediated dmg to small intestinal mucosa leads to malabsorption:
1. dmg to intestinal epithelial cells
2. blunted villi
3. damaged intestinal microvilli
Symptoms:
1. abdominal pain
2. diarrhea
3. weight loss
4. possibly anemia if B12 not absorbed
Tropical Sprue: causes, pathophysiology, signs & symptoms
Cause:
Poorly understood
Pathophysiology:
Observed to be caused by ova, parasites, and bacteria (E. coli, Enterobacter, Klebsiella). Occurs in residents or visitors of tropical and sub-tropical areas
Symptoms:
Same as celiac disease
Pernicious Anemia: causes, pathophysiology, signs & symptoms
Causes:
- autoimmune disease that produces antibodies against parietal cell components and intrinsic factor
- dmg to terminal ileum
Pathophysiology:
1. antibodies againts IF prevent B12 from being absorbed properly
2. decreased in RBC production
Symptoms:
1. anemia: fatigue, shortness of breath, pale skin
2. if parietal cells destroyed, gastric pH > RR
3. esp in elderly: degeneration of nervous system
Zollinger-Ellison Syndrome: causes, pathophysiology, signs & symptoms
Cause:
Gastrinoma - G-cell tumour in dudoenum and pancreas
Pathophysiology:
- G cells produce too much gastrin -> parietal cells make more HCl
- stomach: hyperplasia of parietal cells
- small intestine: villi dmg causes malabsorption
Symptoms:
1. recurring/severe ulcers -> bloody diarrhea
2. tumor
3. ^ HCl, ^ gastrin
4. possibly steatorrhea if fat malabsorption
Peptic ulcers: causes, pathophysiology, signs & symptoms
Cause:
1. H.pylori infection
2. long-term NSAID use (e.g. ibuprofen)
3. physiological stress, severe illness, major surgery
4. genetics
Pathophysiology:
Damaged mucosal lining (HCl, pepsin, inflammation) or impaired mucosal protection (less mucous, bicarbonate)
Symptoms:
1. abdominal pain/discomfort
2. bloating
3. weight loss/loss of appetite
4. nausea & vomiting
5. often bloody diarrhea
6. obstruction due to scarring or swelling
7. ^ HCl, ^ pepsin, ^ gastrin
